MetroPlus
Health
Gold Plan

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.

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

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.

IMPORTANT INFORMATION: MONKEYPOX CASES ARE RISING IN NYC.

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