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MetroPlus Plans

Medicare

MetroPlus Medicare: Now Available on Staten Island!

If you are Medicare eligible and live in the Bronx, Brooklyn, Manhattan, Queens -- and now, Staten Island -- you may be eligible to join one of our plans. We offer quality, affordable care - and exciting new member extras designed with you in mind, as well. MetroPlus is the only Medicare plan backed by NYC Health + Hospitals, the largest municipal health system in the U.S.

Learn more about which Medicare plan works best for you by reviewing the plan information below.

 

Medicare Advantage Plan 2019

MetroPlus Medicare Advantage Plan (HMO SNP) provides all the benefits of Original Medicare PLUS.

MetroPlus Medicare Advantage Plan (HMO SNP) is a dual eligible Special Needs Plan designed for those Medicare beneficiaries who reside in the MetroPlus service area, are eligible for Medicare Parts A and B and receive assistance from New York State Medicaid.

 

Medicare Platinum Plan 2019

MetroPlus Medicare Platinum Plan (HMO) provides all the benefits of Original Medicare PLUS

MetroPlus Medicare Platinum Plan (HMO) is a plan designed for those Medicare beneficiaries who reside in the MetroPlus service area and are eligible for Medicare Parts A and B. This plan has a low premium. Medicare beneficiaries who may not qualify for Extra Help for Part D may like this plan.

 

PLEASE NOTE: Effective January 1, 2019, CMS announced new strategies to further help Medicare Part D plans prevent and combat opioid overuse, including additional safety alerts at the time of dispensing as a proactive step to engage both patients and prescribers about overdose risk and prevention. Click here to learn more.

 
Medicare Resources
Frequently Asked Questions
Medication Therapy Management
Prescription Drug Information
Grievance, Coverage Determination and Appeals
 
Provider/Pharmacy Directories | Updated 06/2019
The Bronx Download
Kings (Brooklyn) and Richmond (Staten Island) Download
New York (Manhattan) Download
Queens Download
Comprehensive Formulary
Updated: 08/2019
Download
 

Request a Hard Copy of Provider/Pharmacy Directory:

Members can create a new account or sign in to an existing account on their member portal and follow the instructions to request a hard copy directory.

If you want a Provider/Pharmacy Directory mailed to you or if you need help finding a network provider/pharmacy, please call 1-866-986-0356 (TTY: 711). You may also request the directory by filling out our Contact form. You can always access our online directory on our Provider Directory page.

 

Member Extras

Join one of our Medicare plans, and in addition to your plan benefits, you'll receive exclusive member extras.

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Additional Information

 

Health Risk Assessments

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HRA can be returned to:
MetroPlus Health Plan
160 Water Street, 3rd Floor
New York, NY 10038
or by completing our Contact form by clicking here.

 

Star Ratings*

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*Medicare evaluates plans based on a 5-star rating system. Star ratings are calculated each year and may change from one year to the next.

 

Benefits, formulary, pharmacy network, provider network, premium, and/or copayments/coinsurance may change on January 1 of each year. You must use contracted network pharmacies to access your prescription drug benefit except under non-routine circumstances, in which case, quantity limitations and restrictions may apply. Premiums, copays, coinsurance, and deductibles may vary based on the level of help that beneficiaries may receive; beneficiaries should contact the plan for further details. This information is not a complete description of benefits. Call 1-866-986-0356 (TTY: 711) for more information.

MetroPlus Health Plan is an HMO plan with a Medicare contract and a Coordination of Benefits Agreement with the New York State Department. Enrollment in MetroPlus Health Plan depends on contract renewal. MetroPlus Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

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).