Doctor smiling with senior patient, representing MetroPlusHealth Medicare Advantage Plan in New York City.


MetroPlus Advantage
Plan (HMO D-SNP)

Experience one of the most comprehensive health
plans for those with Medicare and
Medicaid in New York City with
MetroPlus Advantage Plan (HMO D-SNP).

The MetroPlus Advantage Plan (HMO D-SNP) is a Medicare Advantage Dual Eligible Special Needs Plan designed for individuals who qualify for both Medicare and Medicaid in NYC. With comprehensive medical coverage, prescription drug benefits, access to a broad network of providers, and valuable extra benefits, MetroPlus Advantage Plan helps members get the care they need while maximizing their healthcare coverage. Serving New Yorkers with personalized support, coordinated care, and affordable benefits, this plan makes it easier to manage your health and stay connected to quality healthcare services throughout the five boroughs and beyond.

MetroPlus Advantage Plan (HMO D-SNP) member meeting with a healthcare provider and receiving coordinated Medicare and Medicaid coverage.
The MetroPlus Advantage Plan (HMO D-SNP) provides comprehensive Medicare and Medicaid coverage, coordinated care, prescription drug benefits, and valuable extras for eligible members.

 

On this page:

Why Choose MetroPlus? | Benefits | Flex Card | InComm Guide | PERS Devices | Plan Materials | Disenrollment | View Our 2026 MetroPlus Advantage Plan (HMO D-SNP)

Why choose MetroPlusHealth?

Quality Care When and Where You Need It

Access Top-Rated Health Care Providers in NYC

MetroPlus Advantage Plan (HMO D-SNP) connects you with NYC’s finest healthcare network:

  • Tens of thousands of providers across the City
  • 40+ premiere hospitals including Mount Sinai, NYU Langone, and NY Health + Hospitals
  • 110+ urgent care locations including convenient CityMD sites

Perfect for families: Our health insurance for families covers everyone’s needs with one simple plan.
Care on your schedule: Access online doctor visits and virtual urgent care from home, work, or anywhere with our telemedicine health insurance coverage.

Other providers available in our network

Why Choose a New York-Only Health Care Plan?

Is a not-for-profit organization (prioritizing you, not profits)
Was created by New Yorkers, for New Yorkers
Proudly provides customer service from real people who live in NYC
Offers you 34,000+ providers across all five boroughs

National Health Care Chains

Prioritize their bottom line profits (not you)
Are based outside of NYC
Provide impersonal customer service
Offer uncertain provider networks

MetroPlus Advantage Plan (HMO D-SNP) Benefits

Senior enjoying time with his grand-daughter.

 

Extra benefits included with your Medicare Advantage plan in NYC:

  • $780 Flex Card (quarterly)* for:
    • Over-the-counter medications
    • Personal Emergency Response System
    • Bathroom safety devices
    • Chiropractic visits
    • Internet, phone and cable service
    • Electric and gas bills
    • Healthy food and pet supplies
  • Healthcare Services:
    • Dental: $0 coverage
    • Vision care
    • Hearing aids: Up to $2000 per year (both ears)
    • Podiatry: 12 visits annually
    • Nutrition counseling: Unlimited visits annually
    • Acupuncture: Unlimited visits annually
  • Wellness Support:
    • Fitness reimbursement: Up to $250 every 6 months
    • Post-hospital meals: 20 meals over 5 days
    • Non-Emergent Transportation: 50 one-way rides to medical appointments
  • Convenience Features:
    • Free prescription delivery for select medications
    • Personalized care coordination
    • Online member portal

Get More with Your MetroPlusHealth Flex Card in 2027

One card, multiple benefits—now with $780 quarterly allowance!

Your MetroPlusHealth Flex Card makes it easier to access:

  • Over-the-counter medications
  • Healthy food
  • Utility bill payments
  • NEW for 2027: Rent assistance (through Visa Network)

Where to use your card

You can use your card at over 3,500 retailers, including:

  • Amazon
  • Walmart
  • CVS
  • Family Dollar
  • Duane Reade
  • Walgreens
  • Dollar General
  • AHOLD Brand Stores
  • and participating Independent Drug Stores.

Find all participating locations via the link below: InComm My Benefits Portal

Important: Unused balances expire at the end of each quarter or upon disenrollment.

Need help with your Flex Card? 

Contact us:

  • Phone: 866.986.0356 (TTY: 711)
  • Hours: Monday–Friday, 8am–8pm Saturday, 9am–5pm, and after-hours, at 800.442.2560.

Accessing Your InComm My Benefits: A Step-by-Step Guide

Everything you need to manage your benefits in one place. Learn how to:

  • Access your benefit information online.
  • Check your available balance.
  • Find participating retailers.
  • Redeem your benefits easily.
  • Use both the website and mobile app.

Our step-by-step guide makes it simple to navigate the InComm My Benefits Center website and the OTC Network mobile application.

Stay Safe with a Personal Emergency Response System

Now available through your MetroPlus Advantage Plan benefits

As a MetroPlus Advantage Plan (HMO D-SNP) member, you can use your Flex benefits to get a Personal Emergency Response System (PERS), designed to help you stay safe and independent at home and on the go.

Benefits of a PERS Device

  • 24/7 emergency assistance at the push of a button
  • Support to help you maintain your independence
  • Protection wherever you are, at home or away
  • Greater peace of mind for you and your loved ones

How it works
A simple device connects you to help whenever and wherever you need it—simply press the button to get immediate assistance.

Learn More About PERS Services

  • Learn About PERS Benefits
  • Order Your PERS Device
Your safety matters.
PERS devices provide quick access to help, giving you added confidence and support every day.
Personal Emergency Response System (PERS) Services
Portrait of a senior woman on the city in São Paulo

Who is eligible for MetroPlus Advantage Plan (HMO D-SNP)?

You’re eligible if you:

  • Have Medicare Part A
  • Are enrolled in Medicare Part B
  • Qualify for Medicaid or Medicare cost-sharing assistance
  • Live in New York City

Experience one of New York City’s most comprehensive healthcare solutions with coverage designed specifically for dual-eligible individuals.

Find out if you’re eligible today

We are available 6 days a week

Monday – Friday | 8am – 6pm (ET), Saturday | 9am – 5pm (ET)

Ready to Join MetroPlus Advantage Plan (HMO D-SNP)?

Enrolling in MetroPlus Advantage Plan (HMO D-SNP) for 2027 is simple.

Here’s how:

  • Call 833.965.1526 (TTY: 711) to enroll by phone.
  • Our representatives will guide you through every step.

Access Your Prescription Benefits:

  1. Visit the CVS Caremark website: caremark.com/wps/portal.
  2. Register using your MetroPlusHealth Medicare Member ID card.
  3. Follow the step-by-step instructions on the site.

Medicare Advantage Plan Materials

MetroPlusHealth will update, as needed, the MetroPlus Advantage Plan (HMO D-SNP) Summary of Benefits, Evidence of Coverage, and Annual Notice of Changes for 2027 with 2027 Medicare Parts A & B deductibles and coinsurance amounts.

Evidence of Coverage (EOC)

A detailed explanation of your coverage, what we must do, your rights, and what you must do as a member of our plan.

Annual Notice of Change (ANOC)  

A summary of changes to your benefits and costs for the next year. These changes take effect on January 1, 2027.

Member Guide

Coming Soon

Directories

Medicare Provider / Pharmacy Directories    

Coming Soon

Kings (Brooklyn) / Richmond (Staten Island)

New York (Manhattan)

Pharmacy Information

Formulary

Coming Soon

Comprehensive Formulary

Step Therapy Criteria

Prior Authorization

Low Income Subsidy (LIS) Premium Table

Low Income Subsidy is available under the Medicare Part D prescription drug program. Eligible beneficiaries who have limited income may qualify for a government program that helps pay for Medicare Part D prescription drug costs. If you receive “Extra Help” from Medicare, your monthly plan premium will be lower. The Low Income Subsidy (LIS) Premium Table shows you what your monthly premium will be if you get “Extra Help”.

Forms

NYS Standard Form to Designate a Representative to Assist with Health Insurance Authorizations, Complaints, Grievances, and Appeals

Coming Soon

Understanding Your Disenrollment Rights

  • You can make changes to your plan during applicable enrollment periods.
  • Membership typically ends on the first day of the month after we receive your request.

How to End Your Membership

Option 1: Enroll in another plan

  • Most common method
  • Automatically ends your MetroPlus coverage

Option 2: Return to Original Medicare

  • Submit a written request to us.
  • Complete and mail our disenrollment form [link coming soon].
  • Contact Medicare directly: 1.800.MEDICARE (1.800.633.4227)

Need Help? Call Member Services: 866.986.0356 (TTY: 711) – Monday to Friday, 8am to 8pm; Saturday, 9am to 5pm; and after-hours, at 800.442.2560.

Legal Information:

MetroPlus Health Plan, Inc. offers HMO and HMO D-SNP plans with contracts with Medicare and the New York State Medicaid program. Enrollment in MetroPlus Health Plan, Inc. depends on contract renewal. MetroPlusHealth is not affiliated with, endorsed by, or otherwise related to the the federal government, CMS, HHS, and /or Medicare. Enrollment in MetroPlus Health Plan, Inc. depends on contract renewal.

MetroPlus Health Plan, Inc. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATTENTION: Language assistance services and other aids, free of charge, are available to you. Call 1.866.986.0356 (TTY: 711).

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_MPHwebsite_M_2027 Approved 10012026

last updated: October 1, 2026
MetroPlusHealth
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