MetroPlus GoldCare I

MetroPlus GoldCare I

MetroPlus GoldCare I benefits include: 

Low-premium health care: MetroPlus GoldCare I  has monthly employee premiums as low as $15.

No deductibles: There are no deductibles for any covered services, so you start saving right away.

No paperwork: There are no bills or claims forms for in-network services.

Low co-pays for specialists, lab and X-rays.

Extensive provider and hospital network. 

Get The Details

MetroPlus GoldCare I

 
Deductible $0
Out of Pocket Maximum $6,850 single/$13,700 family
PCP office visits $20 co-pay per visit
Specialist office visits $40 co-pay per visit
Hospital admission $300 co-pay per hospital admission
Emergency room co-pay (waived if admitted) $100 co-pay per visit
Prescription drugs $25 generic / $50 brand / $75 non-formulary

MetroPlus Care Management Program

  • Help members with chronic conditions stay healthy  
  • Diabetes and Asthma programs to encourage members to partner with their PCPs to reduce complications from illnesses and lead healthier lives
  • Care Management for high-risk pregnant women
  • Partnership in Care helps people living with HIV/AIDS manage their condition and stay healthy
Care Management is also available for members with Behavioral Health or Complex Medical Transplant. The Care Management Action Line is 1.877.475.3795, TTY users: 711 
 

Eligibility

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, District Council 1707, Local 205, AFSCME and who work a minimum of 30 hours a week, are eligible for the Welfare Fund enrollment. 

For MetroPlus GoldCare I:
Part time employees working at least 20 hours but less than 30 hours per week are eligible to enroll in GoldCare I ONLY, with the same health insurance payroll deductions as employees working 30 hours or more per week.
 

MetroPlus GoldCare I Resources

 
Certificate of Coverage Download
Certificate of Coverage with Young Adult Rider Download
   
Provider Directory (all counties) Take Me There
Formulary Take Me There
   
Guide Download