Person holding a cell phone waiting for the subway train doors to open

Medicaid Managed Care

No premiums. No copays. Just quality health care.

Pedestrians cross intersection in crosswalk

MetroPlusHealth Medicaid Managed Care is our plan for people eligible for Medicaid, a government assistance program. You may qualify for Medicaid if you have high medical bills, receive Supplemental Security Income (SSI), or meet certain income, resource, age or disability requirements.

MetroPlusHealth Medicaid Managed Care offers low- or no-cost health coverage to New Yorkers who live anywhere in New York City. You can choose your own primary care physician (PCP). When it comes to other doctors, you can pick from a comprehensive list of providers in all five boroughs.

Covered services range from emergency visits to prenatal care. Best of all, MetroPlusHealth Medicaid Managed Care comes with no monthly premiums or copays.

Plan features

  • 24-hour emergency hotline

  • Dental care

  • Family planning

  • Hospital care

  • Lab tests and x-rays

  • Live customer service representatives who speak your language

  • Personal Care / Home Attendant Services

  • Specialist Care

  • Regular check-ups and office visits with your own Primary Care Provider (PCP)

  • Transportation for eligible members*

  • Vision and hearing examinations

  • Well-baby and well-child care visits

Medicaid Managed Care Benefits

There is no copay for covered benefits!

No-Stress Transportation

Whether you have a medical appointment near your home or across town, MetroPlusHealth wants to ensure you get the care you need when you need it without the stress of getting there. We also want to ensure you arrive at your appointment timely without having to rely on family or friends for your transportation. So…MetroPlusHealth is happy to announce that effective immediately, Medical Answering Services, LLC (MAS) will be responsible for providing you with non-emergency medical transportation services for eligible Medicaid beneficiaries living in the five boroughs of New York City. We encourage our member to take advantage of this benefit in order to ensure that services are provided. If you need to schedule or inquire about receiving transportation benefits please contact MetroPlusHealth Customer Service Department at 1-800-303-9626 (TTY: 711) if you need assistance. Please also provide ample time for your appointment to be scheduled.

Please note in order to be eligible for Medicaid transportation benefits your provider must complete Form 2015 which is verification of Medicaid Transportation Abilities.

Mental Health and Substance Use Services for Children

Effective January 1, 2019, new mental health and substance use services are available with NYS Children’s Medicaid. These services give children/youth (under age 21) and their families the power to improve their health, well-being and quality of life, strengthening families and helping them make informed decisions about their care. Services are provided at home or in the community. Learn more on our Children and Family Support Services page here.

Enroll Anytime

Medicaid Managed Care has a year-round open enrollment period. Learn more about Medicaid and how to enroll with MetroPlusHealth below:

A woman bends down to smell flowers at a storefront

I have been with them for many years and have only good things to say about MetroPlusHealth. They are always helpful, understanding, and working with me.

Ireen S.
Google Review

IMPORTANT NOTICE FOR OUR MEDICAID MEMBERS AGED 18 YEARS AND OLDER

MetroPlusHeath is proud to offer benefits and services that help you live a healthy life. Starting July 1, 2022, you can join a no-cost Medically Tailored Meals program that provides healthy meals straight to your home.

Through this program, you and other members who qualify can get:

  • Help from a registered dietitian and nutritionist. This person is a food and nutrition expert and will help give guidance and support in choosing healthy foods.

Up to three meals per day delivered to your home for six months at a time. You may be able to continue receiving meals as long as you are eligible for this program. These meals are tailored for your specific health needs and can help you gain access to healthy, nutritious foods.

Important Message to Our Members: Earn $100 in reward points for getting your COVID-19 vaccine!

Members age 12+ who are in our MedicaidSNP-HIV, or HARP plans who get all required doses on or after 11/01/2021 earn 1,000 reward points ($100 value)!

Visit MetroPlusHealth Rewards to let us know you have completed your vaccinations, or call us at 1-800-510-3944 (TTY: 1-844-488-9723) Monday-Friday 8 a.m. to 8 p.m. ET and you will earn your reward points instantly. Then, shop hundreds of items in the MetroPlusHealth Rewards Catalog!

Get a COVID-19 vaccine now and earn rewards!

Ready to learn more—or to apply?

Call us at 1-855-809-4073 or visit us at our Virtual Office. Just click here to find a representative in your neighborhood who speaks your language and is ready to help. We can even enroll you over the phone. You can also contact us here. One of our representatives will reach out to you ASAP to review your plan options.

Our Member Handbook explains the details of your MetroPlusHealth Medicaid coverage, including your benefits, the rules of the plan, and information about how to receive care.

Important Notice: Effective October 1, 2021, our members now access their behavioral health services through MetroPlusHealth. Learn more here.

Important Notice for Our Medicaid Members:

You may have recently received a notice telling you that effective October 1, 2021, MetroPlusHealth will begin to cover Applied Behavior Analysis for eligible members under the age of 21.  New York State has decided that this benefit will be covered by Medicaid Fee-For-Service not by MetroPlusHealth.  On October 1, 2021, if eligible, you will still be able to receive these services, but you will have to use your Medicaid card.

If you would like a hard copy of this handbook, you can submit a request online here or call us at 1-800-303-9626 (TTY: 711). Please be sure to tell us which plan handbook – for example, Medicaid – you need.

Speak to MetroPlusHealth

Questions? Ready to sign-up?

Our Member Services team is always here to help. We are here Monday through Saturday from 8:00AM to 8:00PM. Just call 1-800-303-9626 (TTY:711).

Our 24/7 Customer Service Hotline will answer your call at other times and on holidays.

Medicare members can call us 24/7 at 1-866-986-0356 (TTY: 711).

If you are experiencing a mental health crisis, our Behavioral Health Crisis after hours partner — Vibrant Emotional Health — can be reached 24/7 at 1-866-728-1885 (SMS capable for the hearing impaired).

IMPORTANT NOTICE TO OUR MEDICAID MEMBERS

Announcing a New Foster Care Transition to Medicaid Managed Care- Special Population

Starting July 1, 2021, MetroPlusHealth will cover Article 29-I Voluntary Foster Care Agency (VFCA) Health Facility services for children and youths under age 21 in foster care and other special populations, as indicated.

Also starting July 1, 2021, some children and youth must join a Medicaid managed care plan, including:

  • children and youth placed in foster care in New York City, and
  • children and youth placed in foster care and a 29-I VFCA Health Facility

Some children and youth placed in foster care cannot join a Medicaid managed care plan. They will keep getting services through regular Medicaid.

Did you know?

If you are turning 65 within the next 3 months or you are 65 years of age or older, you may be entitled to additional medical benefits through the Medicare program. Learn more here. If you have questions, please call Customer Services team at 1-800-303-9626. If you have Medicaid, you MUST apply for Medicare as a condition of continuing eligibility.

You can apply for Medicare by calling the Social Security Administration at 1-800-772-1213 or by applying on-line at: https://www.ssa.gov/medicare/. You may be required to submit proof that you have applied for Medicare so please keep your award or denial letter from SSA or your on line receipt from SSA.

If you have more questions, please call our Customer Services team at 1-800-303-9626.

Important Update

Pharmacy Network Change

Starting January 1, 2022, Walgreens and Duane Reade will no longer be in the pharmacy network for members of these plans:

  • Medicaid Managed Care (including Partnership in Care and HARP Plans)
  • Child Health Plus
  • Exchange / MarketPlace Plans

Where can I find a list of participating network pharmacies?

Members can find a list of network pharmacies or use our online provider search tool.

What do I do if I get my medications from Walgreens or Duane Reade?

Members who have an ongoing prescription including medications, certain supplies such as pen needles, test strips, continuous glucose monitors, and blood glucose test strips at a Walgreens or Duane Reade should call their health care providers to get a new prescription to be sent to a different pharmacy.

Who can I call if I have questions?

If you have any questions, please call the CVS Caremark® Customer Care Team at 1-(855) 656-0361 for Medicaid Managed Care and Child Health Plus members or 1-(855) 383-9426 for Exchange Plan members.

Looking for a pharmacy with free delivery?Looking to get your medications sent to you pre-packaged? Want a pharmacy that you can text?

MetroPlusHealth has partnered with Medly Pharmacy to offer free delivery and more! Sign up here or call Medly at (929) 454-5090.

View over a man's shoulder of the phone he is holding and the table he is sitting at with a computer, notebook, and coffee
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.

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

Learn about all of the free preventive services for adults, women and children. Preventive care includes immunizations, physical exams, lab tests and prescriptions. If you have any questions, call one of our Member Services Representatives. We’re here to help.

Health Risk Assessment 

HRA can be returned to:
ATTENTION: QM Health Risk Assessment Unit
MetroPlus Health Plan
50 Water Street, 7th Floor
​New York, NY 10004
or by completing our Contact form by clicking here.

IMPORTANT INFORMATION: MONKEYPOX CASES ARE RISING IN NYC.

Monkeypox cases are rising in NYC. Learn more about Monkeypox, including prevention and treatment, here.

last updated: March 31, 2022

Ready to Join Us?

Talk to us about questions or concerns

Monday–Saturday | 8 am–8 pm (ET)

Already A Member?

Log into the Member Portal

See Plan information, Health Rewards, and Messages

Speak To Someone In Your Community

Find someone in your neighborhood and in your language