Why choose MetroPlusHealth? Coverage for primary care, urgent care, & specialists
Up to $250 every six months for gym membership
Quality Care When and Where You Need It
Access Top-Rated Healthcare Providers
MetroPlus UltraCare Plan (HMO D-SNP) connects you with NYC’s finest healthcare network:
34,000+ top doctors across the city 40+ premiere hospitals including Mount Sinai, NYU Langone, and NY Health + Hospitals 110+ urgent care locations including convenient CityMD sites Perfect for families: Our health insurance for families covers everyone’s needs with one simple plan.Care on your schedule: Access online doctor visits and virtual urgent care from home, work, or anywhere with our telemedicine health insurance coverage.
Other providers available in our network
Why Choose a New York-Only Health Care Plan?
Is a not-for-profit organization (prioritizing you, not profits)
Was created by New Yorkers, for New Yorkers
Proudly provides customer service from real people who live in NYC
Offers you 34,000+ providers across all five boroughs
National Health Care Chains
Prioritize their bottom line profits (not you)
Provide impersonal customer service
Offer uncertain provider networks
Plan Materials Evidence of Coverage (EOC)
A detailed explanation of your coverage, what we must do, your rights, and what you must do as a member of our plan.
Annual Notice of Change (ANOC)
A summary of changes to your benefits and costs for the next year. These changes take effect on January 1, 2026.
Your MetroPlusHealth Flex Card: Healthy Eating Made Easier in 2026 One card, multiple benefits—$500 every quarter!
Your MetroPlusHealth Flex Card now provides access to:
Fresh fruits and vegetables Other healthy food items Over-the-counter medications Utility bill payments And more! Where to use your card:
CVS Duane Reade Rite Aid Many other participating retailers Need help with your Flex Card? Contact us:
Phone: 866.986.0356 (TTY: 711) Hours: Monday–Friday, 8am–8pm Saturday, 9am–5pm Find all participating locations : Incomm My Benefit Center Portal
Important: Your quarterly allowance of $500 does not roll over to the next quarter and unused balances expire at the end of each quarter or upon disenrollment.
How to Access Your InComm My Benefits: A Step-by-Step Guide Learn how to manage all your benefits in one place:
Access your benefit information online Check your available balance Find participating retailers Redeem your benefits easily Use both the website and mobile app Our step-by-step guide makes it simple to navigate the InComm My Benefits Center website and the OTC Network mobile application.
$0 Copay Benefits with MetroPlus UltraCare (HMO D-SNP) All these services and more at ZERO COST to you:
Healthcare Services:
Primary care visits Urgent care visits Specialist visits Fitness Benefits:
Up to $250 per evert six months for gym membership $500 quarterly flex card for:
Over-the-counter medications Utility payments Groceries and food Other qualifying expenses Unlimited non-emergency transportation Unlimited pet supplies Home Support:
Unlimited meal delivery to your home Long-term care services Enjoy comprehensive coverage designed to support your independence and quality of life—with zero copays and zero hassle.
Disclaimer: Limitations may apply.
Plan Benefits MetroPlus UltraCare Plan (HMO D-SNP) offers rides to and from your doctors appointments at no extra cost to you.
Medical Reimbursement Form
Prescription Drug Benefits Find the medications you need at a price you can afford. Coverage Information: Review our formulary (list of covered drugs) in the Plan Benefits section below With Extra Help, you may qualify for $0 copay prescriptions We partner with CVS Caremark to provide your prescription coverage Important Notes: MetroPlusHealth may update the formulary during the year You’ll receive notifications about changes that affect your medications Your coverage level depends on your Extra Help qualification Access Your Prescription Information: Visit your CVS Caremark account here . Use your MetroPlusHealth Member ID card to register or log in. View your complete prescription benefits and coverage details. Need help? Contact our Member Services team for assistance with any prescription questions.
Pharmacy Information Low Income Subsidy (LIS) Premium Table
Low Income Subsidy is available under the Medicare Part D prescription drug program. Eligible beneficiaries who have limited income may qualify for a government program that helps pay for Medicare Part D prescription drug costs. If you receive “Extra Help” from Medicare, your monthly plan premium will be lower. The Low Income Subsidy (LIS) Premium Table shows you what your monthly premium will be if you get “Extra Help”.
Directories Provider / Pharmacy Directories
Forms
NYS Standard Form to Designate a Representative to Assist with Health Insurance Authorizations, Complaints, Grievances, and Appeals
NEW MetroPlusHealth Rewards Program: MetroPlus UltraCare (HMO D-SNP) Our exciting new Rewards Program is now available! Learn More or Register
Need Help with MetroPlus UltraCare Enrollment? Contact us directly:
Call: 833.965.1526 (TTY: 711) Hours: 7 days a week, 8:00am-8:00pm Our representatives can answer all your questions. Who can call:
You Your family member Your caregiver Anyone who helps with your medical services New to Long-Term Care Services? Schedule a free evaluation with the New York Independent Assessor (NYIA):
Call: 1.855.222.8350 Hours: Monday-Friday, 8:30am-8:00pm Saturday, 10:00am-6:00pm
Our MetroPlus UltraCare Plan (HMO D-SNP) is specially designed for individuals who: Have both Medicare and full Medicaid coverage Need long-term care services Require assistance with home care and personal care Complete Coverage in One Plan: Medicare benefits Medicaid services Long-term care support Home and community-based services Prescription drug coverage Potential $0 monthly premium with Extra Help Personalized Support Your dedicated Primary Care Manager will:
Manage your everyday healthcare needs Identify potential health issues early Create a customized care plan Help you remain at home independently for as long as possible Enjoy comprehensive care with the support you need to maintain your independence and quality of life.
MetroPlus UltraCare (HMO D-SNP) Eligibility Requirements You qualify for this plan if you meet ALL of these criteria:
Basic Requirements:
Age 18 or older Resident of one of New York City’s five boroughs Have Medicare Parts A and B (or Part C) coverage Have full Medicaid coverage Health Assessment Requirements:
Qualify for nursing home level of care (determined by Uniform Assessment System or NYS-designated tool) Be able to safely live at home or in the community, as determined by NYS criteria Long-Term Care Needs:
You must need at least ONE of these services for more than 120 days:
Nursing services in the home Home therapy services Home health aide assistance Personal care services Adult day health care Private duty nursing Consumer-Directed Personal Assistance Services > View our MetroPlus UltraCare Plan (HMO D-SNP) 2025
Find out if you’re eligible today We are available 6 days a week
Monday – Friday | 8am – 6pm (ET), Saturday | 9am – 5pm (ET)
How to Enroll in MetroPlus UltraCare Plan (HMO D-SNP) for 2026 Ready to enroll? It’s simple:
Call 833.965.1526 (TTY: 711). Our representatives will guide you through enrollment by phone. New benefits begin January 1, 2026. Access Your Prescription Benefits: Visit caremark.com/wps/portal . Use your MetroPlusHealth Medicare Member ID card to register. Follow the step-by-step instructions on the Caremark website. Already Have Coverage?
Ending Your Membership: What You Need to Know
Important notes:
You can end your membership at any time. Changes typically take effect on the first day of the month after we receive your request. The process varies depending on your new coverage choice. How to End Your Membership Option 1: Join another plan
This automatically ends your MetroPlus coverage. Option 2: Switch to Original Medicare
If you haven’t selected a separate Medicare prescription drug plan, you must request disenrollment by:
Submitting a written request Completing our disenrollment form (Coming Soon) Contacting Medicare directly at 1.800.MEDICARE (1.800.633.4227 ), available 24/7 (TTY users: 1.877.486.2048 ) Questions? Call Member Services: 866-986-0356 (TTY: 711), available 24/7
Legal Information: MetroPlus Health Plan, Inc. is an HMO, HMO D-SNP plan with a Medicare contract. MetroPlus Health Plan has a contract with New York State Medicaid for MetroPlus UltraCare (HMO D-SNP) and a Coordination of Benefits Agreement with the New York State Department of Health for the MetroPlus Advantage Plan (HMO D-SNP). Enrollment depends on contract renewal.
Language Assistance:
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last updated: October 14, 2025
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