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SilverPrime
2023 SilverPrime*
* These charts are brief descriptions of benefits for the plan.
** Prescription Drug: Generic / Formulary Brand / Non-Formulary Brand
◊ Deductible must be met first before cost sharing begins. Family cost is multiplied by (2).
2023 SilverPrime*
* These charts are brief descriptions of benefits for the plans.
** Prescription Drug: Generic / Formulary Brand / Non-Formulary Brand
◊ Deductible must be met first before cost sharing begins. Family cost is multiplied by (2)
□ FPL = Federal Poverty Level
Cost Sharing Reductions (CSR) Plans are available to people who have incomes between 100% and 250% of the Federal Poverty Level (FPL).
2022 Poverty Guidelines for 48 States and the District of Columbia (Excludes Alaska and Hawaii)
They’re very helpful and took care of me when I had an emergency 👍🏾👌🏾💯
Plan Materials
Certificate of Coverage
(includes Contract, Schedule of Benefits, Summary of Benefits and Coverages)
"Off Exchange"
"Exchange"
Summary of Benefits
"Off Exchange"
"Exchange"
Contracts
"Off Exchange"
"Exchange"
* Coming Soon
Important Update
Pharmacy Network Change
MetroPlusHealth Virtual Visit
Access to your doctor—whenever and wherever you need it!
MetroPlusHealth Virtual Visit is the fast, easy way for our members to see a provider for common physical, mental, emotional, and behavioral health issues that are not emergencies. MetroPlusHealth Virtual Visit is available anytime, from anywhere in New York State, 24/7 – and in your language.
GREAT NEWS: STARTING JANUARY 1, 2023, METROPLUSHEALTH MEMBERS WILL RECEIVE THEIR DENTAL BENEFITS FROM DENTAQUEST.
Know your rights and protections against surprise medical bills!
When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible.
Are you receiving care at an NYC Health + Hospitals facility?
Manage Your Health Online With MyChart. Members who receive care at NYC Health + Hospital facilities now have access to MyChart. MyChart is a free secure portal you can use to manage your health information. MyChart allows you to:
- Message your primary care provider’s office
- Request refills of your prescription drugs
- Access your test results
- Schedule appointments
Preventive Services Resources
Health Risk Assessment
Explore all MetroPlusHealth Plans
last updated: January 4, 2023
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