Medicare Platinum Plan 2025
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 and urgent care visits: You pay $0.
Preventive Care: You pay $0.
Specialist Visits: $40 copay per visit
Urgently Needed Services: You pay $0.
Hearing Services: A new hearing aid every 3 years
(limit up to $500)Prescription Drug Coverage
Telehealth: No additionl cost, 24/7 virtual access to doctors and therapists with MetroPlusHealth Virtual Visit
Member Rewards: Member Rewards program where you earn rewards just by completing healthy activities.
How do I enroll?
Get all that traditional Medicare can offer — plus all the benefits that Medicare Managed Care provides.
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 2025 MetroPlus Platinum Plan (HMO)? Call us at 833-965-1526 (TTY: 711) now. Our representatives can enroll you by phone!
To access more information about your prescription drug benefits click here. You will be transferred to the CVS Caremark site. Use the information on your MetroPlusHealth Member ID card to register. Follow the step by step instructions located on the site.
Plan Materials
MetroPlusHealth has updated the MetroPlus Platinum Plan (HMO) Summary of Benefits, Evidence of Coverage, and Annual Notice of Changes for 2025 with 2025 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, 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”.
Ready to enroll in a 2025 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
