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Medicare 2022

Get all that traditional Medicare can offer—plus all the benefits that Medicare Managed Care provides.

IMPORTANT INFORMATION: MONKEYPOX CASES ARE RISING IN NYC.

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

IMPORTANT NEWS for our Medicare & MAP Members: Beginning January 1, 2022, as per CMS guidance, MetroPlusHealth will cover the COVID-19 Vaccine, approved boosters, along with its administration, without cost sharing for our Medicare and UltraCare (MAP) members. This means you should not pay anything for your COVID-19 vaccines or booster shots starting January 1.

If you are Medicare eligible and live in New York City, you may be eligible to join one of our plans. We offer quality, affordable care – and exciting new member extras designed with you in mind, as well. MetroPlusHealth is also the only plan backed by NYC Health + Hospitals, the largest municipal health system in the U.S.

Ready to enroll in a 2022 MetroPlusHealth Medicare plan? Call us at 1-866-986-0356 (TTY: 711) now. Our representatives can enroll you by phone! Or, want us to contact you? Fill out this form and one of our representatives will reach out to you.

Still have questions about Medicare?

Learn more about which Medicare plan works best for you by reviewing the plan information below.

MetroPlus Advantage Plan

MetroPlus Advantage Plan (HMO-DSNP) is a Dual-Eligible Special Needs Plan designed for those Medicare beneficiaries who live in New York City, are eligible for Medicare Parts A and B, and receive assistance from New York State Medicaid. Depending on your level of Medicaid eligibility, you may pay as low as $0 for covered services.

MetroPlus Platinum Plan

MetroPlus Medicare Platinum Plan (HMO) is a plan designed for those Medicare beneficiaries who live in New York City and are eligible for Medicare Parts A and B. When you join our Platinum plan, you will receive your traditional Medicare benefits, plus the extra benefits offered by MetroPlusHealth. Medicare beneficiaries who may not qualify for Extra Help for Part D may like this plan.

MetroPlus UltraCare Plan

MetroPlus UltraCare (HMO-DSNP) is a Medicaid Advantage Plus plan designed for people who are dual eligible for Medicare and full Medicaid, live in New York City, and need long-term care services such as home care and personal care. The plan covers most Medicare and Medicaid benefits, including long-term care or home and community-based services, plus Prescription Drug coverage. Premiums may be as low as $0 per month for those that receive Extra Help paying for their prescription drug premium.

MetroPlus Medicare also offers free 24/7 access to a 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. Click here to learn more or to access care.

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. If you have Medicaid, you MUST apply for Medicare as a condition of continuous eligibility.

You can apply for Medicare by calling the Social Security Administration (SSA) at 1-800-772-1213 or by applying on-line at: 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 online receipt from SSA.

Learn more here.

If you have more questions, please call our Member Services team at 1-866-986-0356 (TTY: 711).

PLEASE NOTE: CMS has new strategies to further help Medicare Part D plans prevent and combat opioid overuse, including additional safety alerts at the time of dispensing as a proactive step to engage both patients and prescribers about overdose risk and prevention. Click here to learn more.

MEDICARE PROVIDER/PHARMACY DIRECTORIES
The BronxDownload
Kings (Brooklyn) and Richmond (Staten Island)Download
New York (Manhattan)Download
QueensDownload
ULTRACARE Provider/Pharmacy Directories2022
The BronxDownload
Kings (Brooklyn)/Richmond (Staten Island)Download
New York (Manhattan)Download
QueensDownload
FORMULARY
Comprehensive FormularyDownload
Step TherapyDownload
Prior AuthorizationDownload
MEDICARE ENROLLMENT RESOURCES
Enrollment Request FormsEnglishEspañol中文
Short Enrollment FormsEnglishEspañol 中文
Scope of AppointmentEnglishEspañol 中文 

IMPORTANT – All fully completed Medicare Forms in grid above should be sent to:

MetroPlus Health Plan
50 Water Street, 7th Floor
New York, NY 10004
Attn: Sales & Marketing Dept.

Request a Hard Copy of Provider/Pharmacy Directory/Evidence of Coverage

Members can create a new account or sign in to an existing account on their member portal and follow the instructions to request a hard copy directory.

If you want a Provider/Pharmacy Directory or Evidence of Coverage (EOC) mailed to you or if you need help finding a network provider/pharmacy, please call 1-866-986-0356 (TTY: 711). You may also request the directory or EOC by filling out our Contact form. You can always access our online directory on our Provider Directory page or your EOC on the Get the Details page.

Member Extras

Join one of our Medicare plans, and in addition to your plan benefits, you’ll receive exclusive member extras.

MEMBER EXTRAS
EnglishEspañol Coming Soon中文 Coming Soon
Care Management

Our staff works with our Medicare members to ensure they have everything they need to manage their health and wellness. Learn more.

CARE MANAGEMENT
EnglishEspañol Coming Soon中文 Coming Soon
Additional Information
  • For more information about Medicare or for assistance with Medicare issues, click here.
  • Click here for important information regarding protecting your identity and your Medicare card.
  • Ombudsman Information at Medicare.gov
  • Looking to stay safe and active?  Click here to join virtual programming for older adults and caregivers.
  • Click here for resources for seniors from the New York City Department for the Aging.
  • Find a MetroPlusHealth representative in-person or at a virtual location that suits you. Visit MetroPlus Near You.
Star Ratings

*Medicare evaluates plans based on a 5-star rating system. Star ratings are calculated each year and may change from one year to the next.

  • MetroPlusHealth Medicare Multi-Language Interpreter Services (PDF)
  • View the MetroPlusHealth Privacy Notice
  • View the MetroPlusHealth Disaster Information Policy (PDF)
PREVENTIVE SERVICES RESOURCES
Preventive Health Care GuideEnglish Espanol (PDF)

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.

For more information and to sign up go to nychealthandhospitals.org/mychart/

MetroPlus Health Plan is a HMO, HMO SNP plan with a Medicare contract. MetroPlus Health Plan has a contract with New York State Medicaid for MetroPlus UltraCare (HMO-DSNP) and a Coordination of Benefits Agreement with the New York State Department of Health for the MetroPlus Advantage Plan (HMO-DSNP). Enrollment in MetroPlus Health Plan depends on contract renewal.

MetroPlus Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATENCIÓN:  si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística.  Llame al 1.866.986.0356 (TTY: 711). 注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電1.866.986.0356 (TTY: 711).

H0423_MKT22_2142_M_2022

last updated: November 2, 2022

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