Daycare worker reading a book to the children

GoldCare Plan

Thousands of doctors across all of NYC, with access to 33 hospitals. Low monthly premiums. Plus the same low cost for office visits and medications.

Who is it for?

  • All New York City day care workers of the Day Care Council Of NY, Local 205, DC 1707 Welfare Fund

  • Their eligible spouses and dependents

Plan Features

$0
Monthly Premium
$0
Deductible

Eligibility

Monthly Premium

Deductible

Out of Pocket Maximum

PCP Office Visits

Specialist Office Visits

Hospital Admission

Emergency room co-pay (waived if admitted)

Prescription Drug Coverage

NYC Daycare Employees

$59.23–$172.05 (see chart below)

$0

$6,850 single / $13,700 family

$10 copay per visit

$20 copay per visit

$150 copay per hospital admission

$100 copay per visit

$5 generic / $20 brand / $50 non-formulary / Mail-Order Discounted

What does the GoldCare Plan provide?

  • Low-premiums starting at $59.23 per month

  • No deductibles for any covered services

  • No paperwork (bills, claims, forms) for in-network services

  • Low co-pays for specialists, lab and X-rays

A woman stands in a subway car and holds a bar for balance

Thank you. It was super easy to get appt and to be able to speak to my doctor.

Lourdes S.
Google Review

Eligibility

All verified permanent and non-administrative employees who work in an Administration for Children’s Services/Agency for Child Development (ACS/ACD) funded Day Care and/or Family Day Care Centers that are a party to a Labor-Management contract with the Community and Social Agency Employees Union, District Council 1707, Local 205, AFSCME and who work a minimum of 30 hours a week, are eligible for the Welfare Fund enrollment.

Extensive provider and hospital network

MetroPlusHealth has providers in over 27,000 sites in Manhattan, Brooklyn, Queens, the Bronx and Staten Island. PCPs are located in private doctor’s offices, neighborhood family care sites and hospitals. GoldCare Plan members have access to 33 hospitals in NYC, including NYC Health + Hospitals’ facilities and Diagnostics and Treatment Centers.

The GoldCare Plan Provider Network includes primary, OB/GYN, behavioral health and specialty care at thousands of sites across New York City – and at these great hospitals:

METROPLUSHEALTH GOLDCARE PLAN MEMBERS
ManhattanBellevue Hospital Center
Mount Sinai Beth Israel
Harlem Hospital Center
Metropolitan Hospital Center
Mount Sinai Medical Center*
New York Eye and Ear Infirmary
NYU Medical Center
Mount Sinai Morningside
QueensElmhurst Hospital Center
Flushing Hospital Medical Center
Jamaica Hospital Medical Center
Mount Sinai Hospital
Queens Hospital Center
BrooklynMount Sinai – Kings Highway
Coney Island Hospital
Kings County Hospital Center
NYU Langone Medical Center
Maimonides Medical Center
SUNY Downstate Medical Center – University Hospital of Brooklyn*
Woodhull Medical Center
Wyckoff Medical Center
The BronxJacobi Medical Center
Lincoln Medical Center
Montefiore Medical Center*
North Central Bronx Hospital
BronxCare Hospital
Staten IslandRichmond University Medical Center
Staten Island University Hospital

Only specialty services at these hospitals*

Additional Facilities for Care

NYC Health + Hospitals Diagnostic & Treatment Centers
Cumberland D&TC
East New York D&TC
Gouverneur Health
Morrisania D&TC
Renaissance Health Care Network
Segundo Ruiz Belvis D&TC
…and at more than 40 Urgent Care Centers

To learn more about the drugs covered by our GoldCare Plan, please visit the MetroPlusHealth Pharmacy page

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 coming soon).

All MetroPlusHealth GoldCare Plan members have access to a mail order option for their medications. Access the mail order form here.

GoldCare Plan Materials

For a comprehensive listing of benefits, review your Certificate of Coverage.

For a quick review of GoldCare, including monthly rates, review your Summary of Benefits.

Summary of Benefits
Certificate of Coverage
Member Guide
Women's Health and Cancer Rights Act
NYS Standard Form to Designate a Representative to Assist with Health Insurance Authorizations, Complaints, Grievances, and Appeals
MPH_4646_ChristianThomas_0223
MetroPlusHealth Virtual Visit

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.

GREAT NEWS: STARTING JANUARY 1, 2023, METROPLUSHEALTH MEMBERS WILL RECEIVE THEIR DENTAL BENEFITS FROM DENTAQUEST.

Recently, we sent you an announcement along with your new ID Card about our new partnership with DentaQuest, a dental vendor. Starting January 1, 2023, you can begin to use your new ID Card for all your health care needs, including dental services with DentaQuest. Remember to bring your new ID card when you visit your dentist.

Your oral health is important to us. Partnering with DentaQuest, we are able to bring their experience and passion for improving oral health care to you. Their dental network is 65% larger than what we have been offering, with more dentists and specialists available than before. Learn more about your new dental benefit here.

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.

Explore all MetroPlusHealth Plans

last updated: September 28, 2023

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