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MARKETPLACE
PLANS

We offer a wide variety of comprehensive health plans for individuals and families with great benefits and services – and at very competitive prices.

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New Yorkers shopping for a Qualified Health Plan can compare our plan options for 2024 and choose the plan that’s best for them and their families. And, for 2024, MetroPlusHealth is offering some of the lowest rates on the NYSOH.

We offer a wide variety of comprehensive health plans for individuals and families with great benefits and services – and at very competitive prices.

You can enroll with us in a MetroPlusHealth Marketplace plan directly by clicking here (“Off Exchange”) or through the NY State of Health (NYSOH), the Official Health Plan Marketplace (“Exchange”).

Check out our 2024 plans below. Interested in one? Think you might be eligible for a NYSOH premium subsidy? Call us at 1-855-809-4073 or contact us. One of our representatives will contact you to review your plan options.

Earn rewards for making healthy choices!

To view our 2024 Plain English Premium Rate Changes

Already a MetroPlusHealth Marketplace plan member?

We can help you stay covered!
Questions or ready to re-enroll for 2023?
Email us at [email protected]
Call us, Monday – Friday, 8am to 6pm, and Saturday from 9 AM to 5 PM, at 212.908.3300
Or make a virtual appointment with us using the button below.
We’re here to help.

How do I enroll?

Enrolling is hassle-free and easy as one, two, three! All you need is your:

  1. Proof of residency in the 5 boroughs of NYC
  2. Proof of immigration status
  3. Proof of relationship status for any dependents

Enroll online today. Or call us at 855-809-4073. A representative will contact you shortly to help you enroll.

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It’s always easy to get in contact with someone when needed. Best insurance I’ve had!

Alicia S.
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2024 Final Premium Rates

2024 Final Premium Rate Filing Information 

Additional Member Resources

Marketplace Individual Young Adult Rider
Pill Pack 

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 below.

Gym Reimbursement

MetroPlusHealth wants our members to be healthy. Take advantage of our gym reimbursement program and maximize your results at minimal cost to you.

Stay Covered!

You must renew your plan once a year during the Open Enrollment Period to use your benefits without interruption.

Here’s what you need to know for 2023 Open Enrollment:

  1. During Open Enrollment, you can renew or change your plan online with New York State of Health at https://nystateofhealth.ny.gov/.
  2. To maintain your coverage for January 2023 complete your renewal by 12/15/2022.
  3. Enhanced Tax Credits You might get more financial help due to the American Rescue Plan and Inflation Reduction Act

We’re here to help!

  1. You can email us at [email protected] for any questions.

USEFUL LINKS

GREAT NEWS! Advance Premium Tax Credits (APTC) are available to people who enroll through the NY State of Health, the state’s health plan marketplace.

What could this mean for you?

  • Tax credits are available to people with higher incomes, and people who are unemployed for one week or more in 2021 are now eligible for significant tax credits.
  • This means you may be able to pay less for one of the most comprehensive health plans in town!

How can you find out if you can save money on your health plan now?

  • Call MetroPlusHealth at 1-855-809-4073, option 3, or Click here to choose a MetroPlusHealth representative who can help explain how these new tax credits may benefit you.

We are here to ensure you get the best health plan for the best price possible.
You can also call 1-855-355-5777 or  visit the NY State of Health website here for more details.

Exclusively for our Marketplace members! Discover the Meditation benefit for mental wellbeing with “The Art of Living” Journey App.

MetroPlusHealth Marketplace QHP members are eligible for a FREE three (3) month membership to a meditation program through the “Art of Living” Journey app. The Journey app provides access to multiple guided meditation modules focused on your specific needs, including sleep, contentment, and calm. Members and their covered dependent(s) can sign up for the new meditation benefit.

Learn more here about the Journey app and what it offers you.

To sign-up, email at [email protected]. We will provide you with a code used to access the online app.

For a step-by-step guide to signing up, click here.

Earn rewards by keeping your health appointments and participating in wellness activities. Rewards can be exchanged with the MetroPlus Rewards Card. Click here to see our member rewards program.

All MetroPlusHealth Marketplace members have access to a mail order option for their medications. Access the mail order form here.

Wondering what health care costs when you don’t have health insurance?
LEARN ABOUT HEALTH CARE COSTS AND MORE HERE

Complaints and Appeals

We hope our health plan serves you well. But if you have a problem, you can talk with your PCP, or call or write our Member Services. Most problems can be solved right away. If you have a problem or dispute with your care or services, you can file a complaint with us. Problems that are not solved right away over the phone — and any complaint that comes in the mail — will be handled according to our complaint procedure described here.

Important Update

Pharmacy Network Change

Starting January 1, 2022, Walgreens and Duane Reade will no longer be in the pharmacy network for members of these plans:

  • Medicaid Managed Care (including Partnership in Care and HARP Plans)
  • Child Health Plus
  • Exchange / MarketPlace Plans

Where can I find a list of participating network pharmacies?

Members can find a list of network pharmacies or use our online provider search tool.

What do I do if I get my medications from Walgreens or Duane Reade?

Members who have an ongoing prescription including medications, certain supplies such as pen needles, test strips, continuous glucose monitors, and blood glucose test strips at a Walgreens or Duane Reade should call their health care providers to get a new prescription to be sent to a different pharmacy.

Who can I call if I have questions?

If you have any questions, please call the CVS Caremark® Customer Care Team at 1-(855) 656-0361 for Medicaid Managed Care and Child Health Plus members or 1-(855) 383-9426 for Exchange Plan members.

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MetroPlusHealth Virtual Visit

Access to a 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.

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.

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
Preventive Services Resources

Learn about all of the free preventive services for adults, women and children. Preventive care includes immunizations, physical exams, lab tests and prescriptions. If you have any questions, call one of our Member Services Representatives. We’re here to help.

Explore all MetroPlusHealth Plans

last updated: February 6, 2024

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