Enhanced (HARP) Plan
MetroPlusHealth Enhanced is a Health and Recovery Plan (HARP) qualified by New York State and has specialized expertise, tools and protocols that are not part of most medical plans.
The MetroPlusHealth Enhanced (HARP) Plan gives New Yorkers with medical and behavioral health needs complete care beyond traditional Medicaid. It includes access to doctors, mental health services, substance use treatment, care management, and wellness support. With this plan, members can get affordable, high-quality care and resources to live healthier, more independent lives across New York City.
Member Rewards Program for Enhanced (HARP) Plan Members
MetroPlusHealth Enhanced (HARP) is a plan that manages the physical health, mental health, and substance use services in an integrated way for adults requiring specialized protocols and expertise not found within most medical plans. This plan does not require you to change your current health care providers.
Earn rewards for making healthy choices!
Who is eligible?
Questions? Ready to sign-up?
Our Member Services team is always here to help. We are here Monday through Saturday from 8:00AM to 8:00PM. Just call 1.800.303.9626 (TTY:711).
Our 24/7 Customer Service Hotline will answer your call at other times and on holidays.
Medicare members can call us 24/7 at 1.866.986.0356 (TTY: 711).
If you are experiencing a mental health crisis, our Behavioral Health Crisis after hours partner — Vibrant Emotional Health — can be reached 24/7 at 1.866.728.1885 (SMS capable for the hearing impaired).
Language assistance services and other aids, free of charge, are available to you.
Plan Materials
Your Member Handbook tells you about your covered benefits and services as defined by federal and New York State Medicaid laws and regulations. Learn about:
- limitations
- eligibility
- network providers
- how to access health care services
- your rights and responsibilities.
Benefits
MetroPlusHealth Enhanced (HARP) plan. For adult HARP eligibles, 21 years or older, enrolled in a Medicaid plan or in an HIV SNP plan, with conditions of Serious Mental Illness (SMI). Eligible members have access to all benefits covered in Medicaid, and an additional package of Behavioral Health Home and Community Based Services (BH HCBS).
Dental Services – Medicaid, PIC, HARP
Starting January 31, 2024, MetroPlusHealth will be covering crowns and root canals in certain circumstances so that you can keep more of your natural teeth.
Starting March 1, 2024, MetroPlusHealth will cover the Mobile Crisis Telephonic Triage and Response service for members under the age of 21. This service is already available to members 21 years of age and older.
Handbook Inserts
Member Notice
Effective date: June 1, 2025
Member Notice
Effective date: April 1, 2025
Member Notice – Family Planning
Effective: October 2024
Additional Resources
At MetroPlusHealth, we always want you to be at your best. That’s why we encourage you and your family to take advantage of preventive care services available to you at low or no cost. We’ve listed dozens of FREE preventive services here for adults, women and children that just may help you be your healthiest yet.
Rx Carveout
Beginning April 1, 2023, all Medicaid members enrolled in MetroPlusHealth Medicaid, Partnership In Care, and Enhanced (HARP) plans will receive their prescription drugs through NYRx, the Medicaid Pharmacy Program.
Information about the transition of the pharmacy benefit from MetroPlusHealth to NYRx, the Medicaid Pharmacy Program can be found here.
General information about NYRx, the Medicaid Pharmacy Program can be found here along with information for Members and Providers.
Plan Benefits
Comprehensive Guidance Regarding Use of Telehealth including Telephonic Services After the Coronavirus Disease 2019 Public Health Emergency
Comprehensive updated guidance regarding use of telehealth (including telephonic services) and billing guidance and criteria following the end of the Coronavirus Disease 2019 Public Health Emergency, released by the New York State Department of Health.
Resources to Help You Manage Your Plan
Complaints and Appeals
We hope our health plan serves you well. But if you have a problem, you can talk with your PCP, or call or write our Member Services. Most problems can be solved right away. If you have a problem or dispute with your care or services, you can file a complaint with us. Problems that are not solved right away over the phone — and any complaint that comes in the mail — will be handled according to our complaint procedure described here.
Did you know?
If you are turning 65 within the next 3 months or you are 65 years of age or older, you may be entitled to additional medical benefits through the Medicare program. Learn more here. If you have questions, please call Customer Services team at 1-800-303-9626. If you have Medicaid, you MUST apply for Medicare as a condition of continuing eligibility.
You can apply for Medicare by calling the Social Security Administration at 1-800-772-1213 or by applying on-line at: https://www.ssa.gov/medicare/. You may be required to submit proof that you have applied for Medicare so please keep your award or denial letter from SSA or your on line receipt from SSA.
If you have more questions, please call our Customer Services team at 1-800-303-9626.
Pharmacy Network Change
Access to a doctor—whenever and wherever you need it!
MetroPlusHealth Virtual Visit is the fast, easy way for our members to see a provider for common physical, mental, emotional, and behavioral health issues that are not emergencies. MetroPlusHealth Virtual Visit is available anytime, from anywhere in New York State, 24/7 – and in your language.
Know your rights and protections against surprise medical bills!
When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible.
Are you receiving care at an NYC Health + Hospitals facility?
Manage your health online with MyChart. Members who receive care at NYC Health + Hospital facilities now have access to MyChart. MyChart is a free secure portal you can use to manage your health information. MyChart allows you to:
- Message your primary care provider’s office
- Request refills of your prescription drugs
- Access your test results
- Schedule appointments
