Medicare Platinum Plan 2023
If you’re eligible for Medicare, take advantage of our MetroPlus Platinum Plan (HMO) and receive all the benefits of traditional Medicare—plus so much more.
To be eligible for our MetroPlus Platinum Plan (HMO), you must have Medicare Part A, be enrolled in Medicare Part B, and live in New York City.
MetroPlus Platinum Plan (HMO) provides all the benefits of Original Medicare PLUS:
Primary Care Visits: You pay nothing.
Specialist Visits: $40 copay per visit
Preventive Care: You pay nothing.
Urgently Needed Services: You pay nothing.
Hearing Services: $20 copay – $0 copay for hearing aid (up to $500 coverage every 3 years)
Prescription Drug Coverage
Telehealth: Free 24/7 virtual access to doctors and therapists from your smart phone, tablet or computer
Member Rewards: Earn points by keeping your health appointments and participating in wellness activities. Points can be exchanged for items from our exclusive catalog
Medications pre-packaged and delivered to you at no extra cost. Available through PillPack or CVS Pharmacy. Learn more below.
The Inflation Reduction Act (IRA): Changes to Your Drug Coverage
How do I enroll?
Free or Low-Cost Preventive Health Care Services
At MetroPlusHealth, we always want you to be at your best. That’s why we encourage you and your family to take advantage of preventive care services available to you at low or no cost. We’ve listed dozens of FREE preventive services here for adults, women and children that just may help you be your healthiest yet.
Plan Benefits
Medications can be pre-packaged and delivered to you at no extra cost. Available through PillPack or CVS Pharmacy. Learn more below.
Plan Materials
MetroPlusHealth has updated the MetroPlus Platinum Plan (HMO) Summary of Benefits, Evidence of Coverage, and Annual Notice of Changes for 2023 with 2023 Medicare Part A coinsurance amounts. Please review the updated documents for more information.
A detailed explanation of your coverage, what we must do, your rights, and what you must do as a member of our plan.
A summary of changes to your benefits and costs for the next year. These changes take effect on January 1, 2023.
Low Income Subsidy is available under the Medicare Part D prescription drug program. Eligible beneficiaries who have limited income may qualify for a government program that helps pay for Medicare Part D prescription drug costs. If you receive “Extra Help” from Medicare, your monthly plan premium will be lower. The Low Income Subsidy (LIS) Premium Table shows you what your monthly premium will be if you get “Extra Help”.
Ready to enroll in a 2023 MetroPlus Platinum Plan (HMO)?
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.
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