GoldCare I Plan
Thousands of doctors across all of NYC, with access to 19 hospitals. Low monthly premiums – and no monthly cost to you! Plus the same low cost for office visits and medications.
Who is it for?
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
ALL eligible Local 205, DC 1707 members, and AFSCME who work a minimum of 30 hours a week
Part time employees working at least 20 hours but less than 30 hours per week
Plan Features
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
$0–$28.02 (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 I Plan provide?
Low premiums starting at $0 per month
No deductibles for any covered services
No paperwork (bills, claims forms) for in-network services
Low co-pays for specialist, lab and X-Rays
I was so worried about my insurance ending but my counselor was fantastic and got it set up so quickly! It was a brief phone call and I was able to get the coverage I needed. She was pleasant to talk to and answered all of my questions.
GoldCare I Plan Materials
For comprehensive listing of benefits, review your Certificate of Coverage.
For a quick review of GoldCare I, including monthly rates, review your Summary of Benefits.
Access to your 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.
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
Explore all MetroPlusHealth Plans
