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MetroPlusHealth offers the following Medicare plans:

MetroPlus Advantage Plan (HMO D-SNP)
MetroPlus Platinum Plan (HMO)
MetroPlus UltraCare (HMO D-SNP)

MetroPlus Advantage Plan (HMO D-SNP): MetroPlus Advantage Plan (HMO D-SNP)
is a Dual-Eligible Special Needs Plan designed for those Medicare beneficiaries who
live in New York City, are eligible for Medicare Parts A and B, and receive assistance
from New York State Medicaid. Depending on your level of Medicaid eligibility, you
may pay as low as $0 for covered services.

MetroPlus Platinum Plan (HMO): MetroPlus Platinum Plan (HMO) is a plan designed
for those Medicare beneficiaries who live in New York City and are eligible for
Medicare Parts A and B. When you join our Platinum plan, you will receive your
traditional Medicare benefits, plus the extra benefits offered by MetroPlusHealth.
Medicare beneficiaries who may not qualify for Extra Help for Part D may like this plan.

MetroPlus UltraCare (HMO D-SNP): is a Medicaid Advantage Plus plan designed for
people who are dual eligible for Medicare and full Medicaid, live in New York City, and
need long-term care services such as home care and personal care. The plan covers
most Medicare and Medicaid benefits, including long-term care or home and
community-based services, plus Prescription Drug coverage. Premiums may be as low
as $0 per month for those that receive Extra Help paying for their prescription drug
premium.

Selecting the right plan can be overwhelming, but affordability, convenient access to care, and excellent customer service are all things to consider as you select your plan.

Everyone is different, but if a plan has affordable premiums, a wide network of providers (including hospitals, doctors, and specialists), excellent customer service, convenient access to care, and programs to help you earn rewards and points, it might be the right plan for you.

MetroPlusHealth offers affordable premiums, over 34,000 providers, excellent customer service professionals, and programs that reward you for taking care of your health.

You can enroll in the MetroPlusHealth Medicare Plan by phone, or in person.

Wherever you live in New York City, our Marketplace Facilitated Enrollers (FEs), navigators, brokers, and agents are available to help you complete your application in the NY State of Health Marketplace. Call us at 833-965-1536, TTY: 711, Monday through Friday, 8AM – 8PM, and Saturday, 9AM – 5PM to make an appointment.

You should receive your welcome kit and ID mailed within the first 15 days of membership.

If you have not received your welcome kit and ID card within the first 15 days of membership, you can contact MetroPlusHealth customer service at 866-986-0356 Monday through Friday, 9AM – 5PM.

It all depends!

If you are enrolled in the MetroPlusHealth Essential Plan, your coverage will last for 12 months. You can renew your coverage for an additional 12 months if you continue to meet the eligibility requirements.

Creating an account on the member portal is quick and easy. It is the best way to manage all of your plan benefits.

• Go to “Metroplus.org”
• Click on the “For members” tab
• Click on the link that says “Member Portal”
• Click “Create an Account”
• Follow the prompts to create an account, and access your plan benefits, ID card, and more.

If you already have an account, accessing the Member Portal is quick and easy.

MetroPlusHealth does have a mobile app. Downloading the app is a quick way to manage your health plan and benefits while you are on the move.

Want quick access to your plan benefits?

• Download the MetroPlusHealth mobile app from Google Play (Android) or App Store
  (iOS).
• Search for “MetroPlusHealth Member”
• Get, or select Download
• Open the app
• Create an account to log on for the first time, or sign in with your userID and password
  you have already created.
• Begin accessing your plan information.

You would use the same user ID and password for the desktop login, and the mobile app. The mobile app is essentially a different view of the member portal.

The Medicare Plan benefit highlights include $0 preventative care. Urgent and emergent care are also plan benefits.

MetroPlus Adavantage, MetroPlus UltraCare, plans offer*:

Transportation- 48 no cost, one-way rides to your clinic or doctor’s office. No prior approval is needed

$450 for supplemental eyewear coverage per year

8 foot care visits per year.

20 meals after hospitalization

$500 for hearing aides per year.

MetroPlus Platinum Members get:
Vision Services
Exams to diagnose and treat diseases and other issues

Yearly glaucoma screening at no cost 20% cost on Medical Equipment and Supplies
Durable Medical Equipment (DME)
Prosthetics (braces, artificial limbs)
Diabetic supplies

*Coverage varies by plan.

You can obtain care from a Primary Care Physician, via a Virtual Visit, from an Urgent Care Center, or in extreme situations, from an Emergency Room.

You can obtain care via the following methods:

Primary Care Physician (PCP):
Your primary care physician should be your main source of contact. See your PCP for your yearly wellness visit, vaccinations and referrals to specialists. Your wellness visit and vaccinations cost $0.

Virtual Visit:
Our program offers a choice to get care from board certified doctors. Use your phone or video chat on your computer. It is available 24/7 and has a $0 copay for MetroPlus Advantage Plan (HMO D-SNP) and MetroPlus UltraCare (HMO D-SNP) plans. Use for non-emergency issues such as allergy, sore throat, earache, nausea, vomiting and after hours care.

Urgent Care:
Also known as a walk-in-clinic. Use for nonserious medical issues when your doctor is not available. Visit an Urgent Care for colds/flu, fevers, cuts/sprains/strains, sore throats.

Emergency Room:
If you feel you are experiencing serious medical situations. Visit an Emergency Room if you are experiencing a heart attack, stroke, difficulty breathing, broken bones, severe allergic reaction or a sudden change in your health that is causing you concern.

Yes.

The MetroPlusHealth Member Rewards program is designed to encourage members to live healthier lives.

To participate in MetroPlusHealth Rewards, you must first enroll in the program.

You can do this by visiting the MetroPlusHealth website or by calling MetroPlusHealth at 866-986-0356 (TTY:711), Monday to Friday, 8am to 8pm, Saturday, 9am to 5pm.