Man puts hands together above table in a business meeting

Gold Plan

Quality, affordable healthcare for all New York City employees.

Who is it for?

  • ALL New York City employees, their qualified domestic partners and eligible dependents

  • Non-Medicare eligible retirees

  • NYC Health + Hospitals and MetroPlusHealth employees

Plan Features

$0
Monthly Premium
$0
Deductible

Eligibility

Monthly Premium

Deductible

Annual Checkup

Doctors & Specialists

$0 24/7 Telehealth

Hospital Visits

Prescription Drug Coverage

Prepackaged Medications

Fitness Reimbursement

Weight Loss Program Reimbursement

NYC Employees

$0 with basic plan

$0

$0

$250 every 6 mo. for member,
$250 every 6 mo. for spouse

$100 every 6 mo. for member,
$50 every 6 mo. for spouse

What does the Gold Plan provide?

  • $0 employee premium with basic plan

  • $0 deductibles

  • $0 co-insurance

  • Low-cost optional prescription drug rider is available

  • Participating physicians and hospitals in over 34,000 sites across New York City

  • New! $0 dietician visits***

  • Free 24/7 virtual access to doctors and therapists from your smart phone, tablet or computer

  • Fitness reimbursements** (up to $1000 per year!)

  • Wellness programs

  • Member website to help you manage your account

  • Expanded access to urgent care

  • MetroPlusHealth will reimburse you up to $300 per year for participating in a weight loss program

  • Medications pre-packaged and delivered to you at no extra cost. Available through PillPack or CVS Pharmacy.

View over a man's shoulder of the phone he is holding and the table he is sitting at with a computer, notebook, and coffee

Representative was very professional and helpful, showed empathy for my well being with no attitude …. Thank you….. 😊 👍👍

Betsy J.
Google Review

How do I enroll?

Contact your benefits manager at work for more information about choosing MetroPlusHealth Gold. Or call us at 1-855-809-4073 or visit us at our Virtual Office. Just click here to find a representative ready to help and answer any of your MetroPlusHealth Gold questions.

Work for NYC Health + Hospitals or MetroPlusHealth?

Click here to choose MetroPlusHealth Gold now!

Work for New York City?

With MetroPlusHealth Gold, you get $0 premiums, deductibles, copays, unlimited telehealth visits, unlimited mental health care, and more. You can also choose from more than 34,000 top providers and sites. You will find many offices right near you, along with local family care sites and 110 urgent care centers like CityMD, Northwell Health-GoHealth Urgent Care, and more. Our network of over 40 hospitals includes NYU Langone, Mount Sinai, NYC Health + Hospitals, and more. MetroPlusHealth Gold health plan is available to ALL New York City employees, their qualified domestic partners and eligible dependents, and non-Medicare eligible retirees.

NYC Employees:

  • Are you really satisfied with your current health plan?
  • Are you paying more and more out-of-pocket costs?
  • Are you getting the services you need such as choice of provider or network?
  • Did you know that you now have a choice?
  • If it’s your one-year anniversary as an NYC employee, you qualify to switch now to the plan that more and more city workers are choosing: MetroPlusHealth Gold.

Take Action Now! Contact your benefits manager at work for more information about choosing MetroPlusHealth Gold. Or call us at 1-855-809-4073 or visit us at our Virtual Office. Just click here to find a representative ready to help and answer any of your MetroPlusHealth Gold questions.

Current member?

Current members with questions can always call the dedicated MetroPlusHealth Gold Concierge Team at 1-877-475-3795, Monday through Saturday, 8 AM to 8 PM. From questions on enrollment & eligibility, benefits & extras, or claims, our Concierge Team is ready to help you every step of the way.

Gold Plan Materials

Certificate of Coverage
Certificate of Coverage (with Drug Coverage)
Certificate of Coverage (with Drug Coverage/Grandfathered)
Gym Reimbursement Form
Transportation Reimbursement Form
Weight Loss Program Reimbursement Form
Member Guide
Women’s Health and Cancer Rights Act

How Does it Work?

To get covered services, you need to see providers in the MetroPlusHealth network. Receiving care from out-of-network doctors or providers is not covered, and you may have to pay for the medical services if you go out of network.

But, if an urgent medical issue happens outside of our service area, you will be completely covered if you go to an emergency room. That’s anywhere nationwide, whether it’s in our network or not.

Did you know that you can get your medications pre-packaged for free? We offer two ways to do it: through any CVS pharmacy or home-delivered by PillPack. Get the details here (PDF).

MetroPlusHealth wants our members to be healthy. Take advantage of our gym reimbursement program and maximize your results at minimal cost to you. Learn more here.

All MetroPlusHealth Gold members have access to a mail order option for their medications. Access the mail order form here: https://www.caremark.com/portal/asset/mof_unauth.pdf

*Except for emergency room visits which have a $100.00 co-pay (waived if you’re admitted to the hospital) and urgent care visits which have a $25 copay.
**The payout may be considered taxable income, and subject to state and federal taxes in the tax year you get it. We recommend that you consult a professional tax expert with any questions.
***for those who qualify

Due to changes in IRS regulations, if you would like a copy of your 1095-B form, please contact Member Services to request one.

Call: 1-800-303-9626 (TTY: 711)

Write: MetroPlus Health Plan
Attn: Operations
50 Water Street, 7th Floor
​New York, NY 10004

View over a man's shoulder of the phone he is holding and the table he is sitting at with a computer, notebook, and coffee
MetroPlusHealth Virtual Visit

Access to your 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
Preventive Services Resources

Learn about all of the free preventive services for adults, women and children. Preventive care includes immunizations, physical exams, lab tests and prescriptions. If you have any questions, call one of our Member Services Representatives. We’re here to help.

Health Risk Assessment 

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.

IMPORTANT INFORMATION: MONKEYPOX CASES ARE RISING IN NYC.

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

last updated: July 19, 2022

Ready to Join Us?

Talk to us about questions or concerns

Monday–Saturday | 8 am–8 pm (ET)

Already A Member?

Log into the Member Portal

See Plan information, Health Rewards, and Messages

Speak To Someone In Your Community

Find someone in your neighborhood and in your language