MetroPlusHealth provider helping a senior patient in New York City with Medicare Platinum Plan benefits.

MetroPlus
Platinum Plan (HMO)

Beyond basic Medicare coverage.

MetroPlus Platinum Plan (HMO) offers comprehensive Medicare Advantage coverage in NYC designed to help you stay healthy and get the care you need with confidence. Combining medical, hospital, and prescription drug coverage in one convenient plan, MetroPlus Platinum provides access to a broad network of doctors, specialists, hospitals, and preventive services. Members can take advantage of valuable benefits, wellness programs, and coordinated care that support their overall health and well-being. If you’re looking for a Medicare Advantage plan in New York that delivers quality coverage, trusted care, and added value, the MetroPlus Platinum Plan (HMO) is designed to help you make the most of your Medicare benefits.

Smiling Medicare-aged adult enjoying an active lifestyle while enrolled in the MetroPlus Platinum Plan (HMO).
The MetroPlus Platinum Plan (HMO) helps members stay healthy with comprehensive Medicare Advantage coverage, prescription drug benefits, preventive care, and access to a trusted provider network.

 

On this page:

Why Choose MetroPlus? | Benefits | InComm Guide | Eligibility | Enrollment | Plan Materials | Disenrollment | View our 2026 MetroPlus Platinum Plan (HMO)

Why choose MetroPlusHealth?

Quality Care When and Where You Need It

Access Top-Rated Health Care Providers in NYC

MetroPlus Platinum Plan (HMO) connects you with NYC’s finest healthcare network:

  • 34,000+ top doctors across the city
  • 40+ premiere hospitals including Mount Sinai, NYU Langone, and NY Health + Hospitals
  • 110+ urgent care locations including convenient CityMD sites

Perfect for families: Our health insurance for families covers everyone’s needs with one simple plan.
Care on your schedule: Access online doctor visits and virtual urgent care from home, work, or anywhere with our telemedicine health insurance coverage.

Other providers available in our network

Why Choose a New York-Only Health Care Plan?

Is a not-for-profit organization (prioritizing you, not profits)
Was created by New Yorkers, for New Yorkers
Proudly provides customer service from real people who live in NYC
Offers you 34,000+ providers across all five boroughs

National Health Care Chains

Prioritize their bottom line profits (not you)
Are based outside of NYC
Provide impersonal customer service
Offer uncertain provider networks

MetroPlus Platinum Plan (HMO) provides all the benefits of Original Medicare PLUS:

Senior enjoying time with his grand-daughter.

 

Premiums

  • You pay $0
Prescription Drug Coverage
Primary and urgent care visits

  • You pay $0.
Preventive Care

  • You pay $0.
World-wide Emergency

  • Covered
Telehealth

  • $0, 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.

Disclaimer: Limitations may apply.

NEW for 2027
Hearing Aids

  • $2000 per year
NEW for 2027
Preventative Dental

  • oral exams, x-rays, cleanings, fluoride treatments, all with visit limitations
NEW for 2027
Comprehensive Dental

  • $1500 per year, no implants
OTC

  • $60 quarterly, through InComm

How to Access Your InComm My Benefits: A Step-by-Step Guide

Learn how to manage all your benefits in one place:

  • Access your benefit information online
  • Check your available balance
  • Find participating retailers
  • Redeem your benefits easily
  • Use both the website and mobile app

Our step-by-step guide makes it simple to navigate the InComm My Benefits Center website and the OTC Network mobile application.

Get complete Medicare coverage plus extra benefits all in one plan.

MetroPlus Platinum Plan (HMO) provides traditional Medicare coverage with additional Medicare managed care benefits, quality, affordable healthcare designed specifically for New York City residents and is uniquely backed by NYC Health + Hospitals—the largest municipal health system in the U.S

Access your prescription benefits:

  • Visit the CVS Caremark website.
  • Register using your MetroPlusHealth Member ID card.
  • Follow the step-by-step instructions listed on the CVS Caremark website.
Smiling seniors enjoying the at the park with family.

Who is eligible for MetroPlus Platinum Plan (HMO)?

  • Have Medicare Part A
  • Are enrolled in Medicare Part B
  • Live in New York City

Experience enhanced Medicare coverage designed to provide you with more benefits and greater peace of mind.

Simplify your healthcare journey with expanded Medicare coverage that offers more benefits with less hassle.

Find out if you’re eligible today

We are available 6 days a week

Monday – Friday | 8am – 6pm (ET), Saturday | 9am – 5pm (ET)

How to Enroll in MetroPlus Platinum Plan (HMO) for 2027:

  • Call 833.965.1526 (TTY: 711)
  • Speak with our helpful representatives to enroll by phone.
  • Start enjoying your comprehensive benefits.

Medicare Platinum Plan Materials

MetroPlusHealth has updated the MetroPlus Platinum Plan (HMO) Summary of Benefits, Evidence of Coverage, and Annual Notice of Changes for 2027 with 2027 Medicare Part A coinsurance amounts. Please review the updated documents for more information.

Evidence of Coverage (EOC) 

A detailed explanation of your coverage, what we must do, your rights, and what you must do as a member of our plan.

Annual Notice of Change (ANOC)

A summary of changes to your benefits and costs for the next year. These changes take effect on January 1, 2027.

Member Guide

Coming Soon

Pharmacy Information

Formulary

Coming Soon

Comprehensive Formulary

Step Therapy Criteria

Prior Authorization

Low Income Subsidy (LIS) Premium Table

Coming Soon

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”.

Directories

Medicare Provider / Pharmacy Directories    

Coming Soon

Kings (Brooklyn) / Richmond (Staten Island)

New York (Manhattan)

Forms

NYS Standard Form to Designate a Representative to Assist with Health Insurance Authorizations, Complaints, Grievances, and Appeals

Coming Soon

Health Risk Assessment

Coming Soon

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.

Ending Your Membership: Understanding Your Disenrollment Rights

  • You can make changes to your plan during applicable enrollment periods.
  • Your membership typically ends on the first day of the month after we receive your request.

How to End Your Membership

Option 1: Join another plan

  • This automatically ends your MetroPlus coverage.

Option 2: Switch to Original Medicare

  • Submit a written request, complete the disenrollment form, and mail it to us.
  • Contact Medicare directly: 1.800.MEDICARE (1.800.633.4227)

Questions? Call Member Services: 866.986.0356 (TTY: 711) – Monday to Friday, 8am to 8pm; Saturday, 9am to 5pm; and after-hours, at 800.442.2560.

Legal Information:

MetroPlus Health Plan, Inc. offers HMO and HMO D-SNP plans with contracts with Medicare and the New York State Medicaid program. Enrollment in MetroPlus Health Plan, Inc. depends on contract renewal.

MetroPlusHealth is not affiliated with, endorsed by, or otherwise related to the the federal government, CMS, HHS, and /or Medicare. Enrollment in MetroPlus Health Plan, Inc. depends on contract renewal.

MetroPlus Health Plan, Inc. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATTENTION: Language assistance services and other aids, free of charge, are available to you. Call 1.866.986.0356 (TTY: 711).

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_MPHwebsite_M_2027 Approved 10012026

last updated: September 30, 2026
MetroPlusHealth

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