GoldPlus Plans

GoldPlus

MetroPlus offers seven different GoldPlus plans, including Small Business (SHOP) plans. Each plan adds additional levels of customization to fit your needs. 

The plan has an individual deductible of $600 and a max out of pocket of $4,000. The family deductible is $1,200 and a max out of pocket of  $8,000. 

This plan also has a Native American / American Indian plan with a $0 deductible and $0 max out of pocket for those that qualify.

Learn if you qualify

Our cost treatment calculator is intended for individuals who are uninsured or covered by private insurance. Cost estimates reflect health care professional fees and are not the negotiated rates which may be available through insurance plan networks. 

Calculate Costs

Access the NY State of Health Tax Credit and Premium Rate Estimator 

Check Eligibility 

Get The Details

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GoldPlus*
Product G1 G2 G3 G5 (Adult) /
G3-4 (Child) 
G6
Product Type Standard Non-Standard Child-Only □ AI/NA-Standard □  AI/NA-Non-Standard
Premium $560.75 $567.70 $231.03 $0 $0
Deductible $600 $600 $600 $0 $0
Max out of Pocket $4,000 $4,000 $4,000 $0 $0
PCP $25 $25 $25 0% 0%
Specialist $40 $40 $40 0% 0%
Prescription Drug** $10/$35/$70 $10/$35/$70 $10/$35/$70 0% 0%
Adult Dental/Vision No Yes No No Yes
Pediatric Dental / Vision Yes Yes Yes Yes Yes
Mail Order RX Yes Yes Yes Yes Yes
Exercise Facility Reimbursement Yes Yes Yes Yes Yes
 

* This chart is a brief description of benefits for plan.
** Prescription Drug: Generic / Formulary Brand / Non-Formulary Brand
 Deductible must be met first before cost sharing begins. Family cost is multiplied by (2).
□ AI / NA - American Indian / Native Alaskan 

 

Premiums listed are example base rates for individuals. Rates may differ based according to family size, income level, and eligibility for tax credits.


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Certificate of Coverage
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Individual Standard GoldPlus G1 GoldPlus G1
Individual Non-Standard GoldPlus G2 GoldPlus G2
Child-Only GoldPlus G3 GoldPlus G3
American Indian / Child-Only GoldPlus G3-4 GoldPlus G3-4
American Indian Standard GoldPlus G5 GoldPlus G5
American Indian Non-Standard GoldPlus G6 GoldPlus G6
 
Child-Only Plans offer benefits to members who are under the age of 21 at the beginning of the year.
Non-Standard Plans offer additional benefits not included on the Standard Plans and allows members to purchase Adult Vision and Dental coverage.