Medicare Advantage Plan 2025
When you choose MetroPlus Advantage Plan (HMO D-SNP), you get one of the most complete health plans in New York City. If you are eligible for Medicare and Medicaid, you’ll receive all of your current benefits, plus much more.
To be eligible for our MetroPlus Advantage Plan (HMO D-SNP), you must have Medicare Part A, be enrolled in Medicare Part B, eligible for Medicaid or Medicare cost-sharing assistance under Medicaid, and live in New York City.
What’s New with your Flex Benefit for 2025!
You recently received a letter with important information about your Flex Card which is used to make over the counter purchases. We will soon be issuing a new card which you will receive in the mail by December 31st. You can begin using this card January 1st, 2025. This new card will allow you to enjoy the same amazing benefits that you currently use-$475 per quarter. THIS CARD WILL REPLACE YOUR CURRENT CARD. PLEASE MAKE SURE YOU USE THE FUNDS YOU HAVE NOW ON YOUR CARD BY December 31st, 2024, or you will lose the benefit amount on the old card. Please refer to your Annual Notice of Coverage for additional information or click “Learn More” to learn What’s New with your Flex Benefit for 2025!
MetroPlus Advantage Plan (HMO D-SNP) provides all the benefits of Original Medicare PLUS:
Disclaimer: Limitations may apply.
Flex card: Get $475 per quarter to use on over-the-counter drugs, groceries, utilities, bathroom safety devices, and more all on one card
Dental care: $0 dental coverage (limitations apply)
Vision Care
Fitness Reward: Up to $250 every 6 months for gym/ fitness membership (reimbursement)
Acupuncture: 20 acupuncture visits per year
Prescription Drugs: Select prescription drugs mailed to you at no additional cost.
Hearing aids: Up to $500 for both ears (every year)
Meal delivery after a hospital stay: 20 meals over 5 days
Transportation: 48 one way rides to doctor’s visits
Podiatry: 8 visits per year for podiatry (foot) care
Dietitian or Nutritionist: 6 visits per year with a healthy eating expert (dietitian or nutritionist
Personalized help getting the care you need
Member online portal
Get Healthy Foods with the MetroPlusHealth Flex Card
Good news, we’ve made eating healthy easier in 2025! All your healthy foods, OTC drugs, and utilities benefits are now available on one card, and you get more of the benefits you need! Simply use your MetroPlusHealth Flex Card at participating grocers and pharmacies to purchase fruits, vegetables, and other healthy foods. You can spend up to $475 each quarter*.
Some of the places you can use your benefits include CVS, Duane Reade, and Rite Aid. Visit the Member portal for a full list of retailers.
Talk to us about your Flex Card benefits!
Monday–Friday | 8 am–8 pm (ET)
Saturday | 9 am–5 pm (ET)
Call us at 866-986-0356 (TTY: 711)
*Unused balances will automatically expire at the end of each quarter or upon disenrollment from plan.
- Many retailers take the card, including [locally common chains]
- Your card had $475 of benefits per quarter ((no rollover to next quarter) to pay for healthy food, OTC drugs, utilities and more, all in one place
For a list of stores where you can use your flex card, click the button below.
How do I enroll?
Ready to enroll in a 2025 MetroPlus Advantage Plan (HMO D-SNP)? Call us at 833-965-1526 (TTY:711) now. Our representatives can enroll you by phone!
Please note new benefits above begin on January 1, 2025.
To access more information about your prescription drug benefits click here: https://www.caremark.com/wps/portal. You will be transferred to the CVS Caremark website. Use the information on your MetroPlusHealth Medicare Member ID card to register. Follow the step by step instructions located on the site.
How can I switch?
Switching to a MetroPlus Advantage Plan (HMO D-SNP) is easy. Get in contact with our team and find answers to FAQs here.
Plan Benefits
Applicable to MetroPlus Advantage Plan (HMO D-SNP) members with full Medicaid benefits
Fitness Reimbursement: up to $250 every six months for membership to qualifying exercise facilities
Plan Materials
MetroPlusHealth will update, as needed, the MetroPlus Advantage Plan (HMO D-SNP) Summary of Benefits, Evidence of Coverage, and Annual Notice of Changes for 2025 with 2025 Medicare Parts A & B deductibles and coinsurance amounts.
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, 2025.
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”.
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
