Medicare Platinum Plan

Effective 4/1/2023, coinsurance for certain Part B rebatable drugs will be reduced, if the drug’s price has increased at a rate faster than the rate of inflation.

Effective 7/1/2023, insulin covered under Part B (for example, insulin administered via a pump that qualifies as an item of durable medical equipment (DME)) will not exceed $35 total for a one month’s supply and the Medicare Part B deductible will not apply.

Important Message About What You Pay for Vaccines – Our plan covers most Part D vaccines at no cost to you, even if you haven’t paid your deductible. Call Member Services for more information.

Important Message About What You Pay for Insulin – You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on, even if you haven’t paid your deductible.

Ready to enroll in a 2023 MetroPlus Platinum Plan (HMO)? Call us at 1-866-986-0356 (TTY: 711) now. Our representatives can enroll you by phone!

To access more information about your prescription drug benefits click here. You will be transferred to the CVS Caremark site. Use the information on your MetroPlusHealth Member ID card to register. Follow the step by step instructions located on the site.

Call us at 1-866-986-0356 (TTY: 711) now. Our representatives can enroll you by phone!

Rights and Responsibilities Upon Disenrollment

Ending your membership in MetroPlusHealth Medicare plans may be voluntary (your own choice) or involuntary (not your own choice).

You can disenroll or change coverage during applicable enrollment periods. The process for voluntarily ending your membership varies depending on what type of new coverage you are choosing. Your membership will usually end on the first of the month after we receive your request to change your plan.

How do you end your membership in our plan?

Usually, you end your membership by enrolling in another plan. However, if you want to switch from our plan to Original Medicare but you have not selected a separate Medicare prescription drug plan, you must ask to be disenrolled.

• You can make a request in writing to us or complete this form and mail it to us
• Or, you can contact Medicare at 1-800-Medicare or 1-800-633-4227, 24 hours a day, 7 days a week, TTY users should call 1-877-486-2048. For more information, review your EOC.

If you have any questions, please call Member Services at 1-866-986-0356 (TTY: 711), 24 hours a day, 7 days a week.

MetroPlus Health Plan is an HMO, HMO SNP plan with a Medicare contract. MetroPlus Health Plan has a contract with New York State Medicaid for MetroPlusHealth UltraCare (HMO-DSNP) and a Coordination of Benefits Agreement with the New York State Department of Health for the MetroPlus Advantage Plan (HMO-DNSP). Enrollment in MetroPlus Health Plan depends on contract renewal. MetroPlus Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

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_MKT23_2181_M Accepted 10012022

IMPORTANT INFORMATION: MONKEYPOX CASES ARE RISING IN NYC.

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