MetroPlus Gold 2019

MetroPlus Gold 2018


MetroPlus Gold is our high-quality, low-cost health plan available to ALL New York City employees, their qualified domestic partners and eligible dependents, and non-Medicare eligible retirees, as well!

The Premium Health Plan with no EMPLOYEE Premium, no-copays*, and no deductible.
  • Comprehensive benefit package
  • NO employee premium with basic plan, NO deductibles and NO co-insurance
  • NO co-pays* 
  • Low-cost optional prescription drug rider is available
  • Extensive network of participating physicians and hospitals, with providers in over 31,000 sites across New York City.
  • Exciting new member extras! Includes online doctor appointments, wellness programs, member website, expanded in-network urgent care centers, gym reimbursements**, and more
Employees can enroll at the time they are hired or during the Fall Open Enrollment period. Contact your benefits manager where you work for more information or call MetroPlus Gold Member Services at 1.877.475.3795, Monday through Saturday, 8 am to 8 pm.

To take advantage of all the benefits this plan offers, you need to see providers in the MetroPlus network. You can get covered services from any provider within this network. Receiving care from out-of-network doctors or providers is not covered under MetroPlus. You may have to pay for the medical services if you go out of network. In cases of emergency outside of our service area, your care is covered at an Emergency Room, regardless of the provider’s network status; you will be completely covered at an Emergency Room nationwide

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MetroPlus Gold 2019 Resources
Schedule of Benefits Download
Schedule of Benefits (with Drug Coverage) Download
Certificate of Coverage Download
Certificate of Coverage (with Drug Coverage) Download
Young Adult Rider Download
Summary of Benefits  Download
Summary of Benefits (with Drug Coverage) Download
Formulary Take Me There
Gym Reimbursement Form Download
Guide  Download
MetroPlus Gold Health News
Member Newsletter
Take Me There
Women’s Health and Cancer Rights Act Download

To learn more about the drugs covered by our Gold Plan, please visit the MetroPlus Formulary Page 

MetroPlus 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. Access our gym reimbursement form here.

All MetroPlus Gold members have access to a mail order option for their medications. Access the mail order form here:

To search the provider network for our Gold Plan, please view our MetroPlus Gold provider directories below or click here.

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MetroPlus Gold - Provider Directories 
The Bronx  Download
Kings (Brooklyn) Download
New York (Manhattan) Download 
Queens  Download
Richmond (Staten Island)  Download
Updated: 01/2019

* No-copays for in-network services except emergency room, $150.00 but waived if admitted.
** The amount of the rewards and payout may be considered taxable income, and subject to state and federal taxes in the tax year it is paid. We recommend that you consult a tax expert with any questions about your tax needs.