Important Update – Referral Requirements Waived for Gold Members (NYC Employees)
TO: All Providers
Dear MetroPlusHealth Providers,
We are pleased to share an important update regarding the Gold Plan designed for our NYC workforce — those who help keep our city running.
Effective June 1st, 2026, MetroPlusHealth will waive referral requirements for all Gold members seeking care from participating (in-network) specialists.
What does this mean for providers:
- Gold members no longer require a PCP referral to access in-network specialists.
- Prior authorization requirements remain unchanged and must continue to be followed where applicable.
Members enrolled in the MetroPlusHealth Gold plan will also receive official communication regarding this change. We anticipate this update will enhance access to care, empower members with greater autonomy in managing their healthcare, and contribute to a more seamless and integrated payer-provider experience.
Please ensure to document your referral in the members’ chart and continue to coordinate care with specialists as needed.
If you have any questions or require additional clarification, please contact Provider Relations Operations at [email protected].