Metroplus Medicaid is a managed care health insurance program that provides comprehensive coverage to low-income New Yorkers, including children, adults, families, and individuals with disabilities. The program offers a wide range of benefits, including doctor visits, hospital care, preventive care, and prescription drugs. Metroplus Medicaid is designed to help people get the health care they need to stay healthy and productive members of their communities. The program works with a network of providers to offer a variety of services, including primary care, specialty care, mental health care, and dental care. Metroplus Medicaid also offers a variety of programs to help people stay healthy, such as nutrition counseling, smoking cessation, and diabetes management.
MetroPlusHealth Managed Care
MetroPlusHealth Managed Care is a managed care plan that provides health insurance coverage to Medicaid recipients in New York City.
The plan is offered by MetroPlus Health, a not-for-profit health insurance company that has been serving New Yorkers for over 30 years.
MetroPlusHealth Managed Care offers a variety of benefits to its members, including:
- Access to a network of more than 26,000 providers in New York City
- Coverage for a wide range of medical services, including doctor visits, hospital stays, and prescription drugs
- Affordable premiums and copays
- A variety of member services, including a 24-hour helpline and online access to your health information
MetroPlusHealth Managed Care is a great option for Medicaid recipients in New York City who are looking for a quality health insurance plan.
Eligibility
To be eligible for MetroPlusHealth Managed Care, you must be:
- A resident of New York City
- Enrolled in Medicaid
- Not currently enrolled in another managed care plan
If you meet these eligibility requirements, you can apply for MetroPlusHealth Managed Care online or by calling the plan.
Benefits
MetroPlusHealth Managed Care offers a variety of benefits to its members, including:
- Access to a network of more than 26,000 providers in New York City
- Coverage for a wide range of medical services, including doctor visits, hospital stays, and prescription drugs
- Affordable premiums and copays
- A variety of member services, including a 24-hour helpline and online access to your health information
MetroPlusHealth Managed Care also offers a number of special programs and services for its members, including:
- A Healthy Families program that provides support and resources to families with young children
- A Healthy Seniors program that provides services and resources to seniors
- A Healthy Living program that provides members with information and resources to help them live healthy lifestyles
Costs
MetroPlusHealth Managed Care offers a variety of plans with different premiums and copays. The cost of your plan will depend on the type of plan you choose and your income.
Here is a table that shows the monthly premiums and copays for some of the most popular MetroPlusHealth Managed Care plans:
| Plan | Monthly Premium | Copay for Doctor Visits | Copay for Hospital Stays | Copay for Prescription Drugs |
|---|---|---|---|---|
| MetroPlusHealth Basic | $0 | $10 | $20 | $5 |
| MetroPlusHealth Standard | $20 | $15 | $25 | $10 |
| MetroPlusHealth Plus | $40 | $20 | $30 | $15 |
How to Enroll
To enroll in MetroPlusHealth Managed Care, you can:
- Apply online
- Call the plan at 1-800-922-0400
You can also enroll in MetroPlusHealth Managed Care through your local social services office.
Customer Service
MetroPlusHealth Managed Care offers a variety of customer service options to its members, including:
- A 24-hour helpline
- Online access to your health information
- A mail-order pharmacy
- A network of community health centers
MetroPlusHealth Managed Care also offers a variety of resources to help its members stay healthy, including:
- A healthy living website
- A health education program
- A support group program
MetroPlus Managed Care
MetroPlus Managed Care is a health insurance plan that provides comprehensive coverage to eligible New Yorkers. The plan is available to individuals and families who qualify for Medicaid, Child Health Plus, and Medicare.
Eligibility Requirements for MetroPlus Medicaid
To be eligible for MetroPlus Medicaid, you must meet the following requirements:
- Be a New York State resident
- Be a U.S. citizen or eligible immigrant
- Meet the financial eligibility criteria
- Be enrolled in a Medicaid or Family Health Plus program
The financial eligibility criteria for MetroPlus Medicaid are based on your income and household size. Refer to the table below for more details.
| Family Size | Gross Monthly Income |
|---|---|
| 1 | $1,614 |
| 2 | $2,178 |
| 3 | $2,742 |
| 4 | $3,306 |
| 5 | $3,870 |
| 6 | $4,434 |
If you are pregnant, you may be eligible for MetroPlus Medicaid regardless of your income. You can apply for MetroPlus Medicaid online, by mail, or by phone. You will need to provide documentation to verify your eligibility, such as your Social Security number, proof of income, and proof of residency.
Benefits of MetroPlus Medicaid
MetroPlus Medicaid covers a wide range of healthcare services, including:
- Doctor’s visits
- Hospital stays
- Prescription drugs
- Mental health services
- Substance abuse treatment
- Dental care
- Vision care
- Transportation to medical appointments
MetroPlus Medicaid also offers a variety of preventive care services, such as:
- Well-child visits
- Cancer screenings
- Immunizations
- Family planning services
If you are eligible for MetroPlus Medicaid, you can choose from a variety of health plans. Each plan offers different benefits and providers. You can compare plans and choose the one that best meets your needs.
MetroPlus Medicaid: Coverage and Benefits
MetroPlus Medicaid is a health insurance plan for New York residents who meet certain eligibility requirements. This program offers various benefits and services to its members. These benefits include:
Medical Services
- Doctor visits
- Specialist care
- Hospital stays
- Emergency services
- Maternity care
- Mental health services
- Substance abuse treatment
- Prescription drugs
- Durable medical equipment
- Home health care
- Long-term care
Preventive Care and Wellness Services
- Well-child visits
- Adult preventive services
- Immunizations
- Screenings
- Health education and counseling
Additional Services
- Transportation to medical appointments
- Interpreter services
- Case management
- Dental services
- Vision care
- Hearing aids
Individuals who qualify for MetroPlus Medicaid can enroll in the program by contacting their local Medicaid office or by applying online.
| Category | Age | Income | Other Requirements |
|---|---|---|---|
| Children | Under 19 | Up to 138% of the federal poverty level | U.S. citizen or qualified immigrant |
| Pregnant Women | Any age | Up to 138% of the federal poverty level | U.S. citizen or qualified immigrant |
| Parents and Caregivers | Under 65 | Up to 138% of the federal poverty level | U.S. citizen or qualified immigrant; responsible for the care of a child under 19 |
| Adults | 65 or older | No income limit | U.S. citizen or qualified immigrant |
| People with Disabilities | Any age | No income limit | U.S. citizen or qualified immigrant; determined to be disabled by the Social Security Administration |
MetroPlus Medicaid: An Overview
MetroPlus Medicaid is a health insurance program provided by the state of New York. It offers comprehensive medical coverage to eligible individuals and families with low incomes. The program is available to children, adults, seniors, and people with disabilities.
Benefits of MetroPlus Medicaid
- Comprehensive medical coverage, including doctor visits, hospital stays, prescription drugs, and mental health services.
- Low or no cost for covered services.
- Access to a statewide network of providers.
- Free or low-cost health screenings and preventive care.
Eligibility for MetroPlus Medicaid
To be eligible for MetroPlus Medicaid, you must meet certain income and asset requirements. You must also be a New York State resident and a U.S. citizen or eligible immigrant.
Income limits vary depending on your family size and household composition. In general, you must have an income below 138% of the federal poverty level to qualify for MetroPlus Medicaid.
Asset limits also vary depending on your family size and household composition. In general, you cannot have more than $2,500 in assets or $5,000 in combined assets for a couple to qualify for MetroPlus Medicaid.
How to Apply for MetroPlus Medicaid
- Contact your local department of social services. You can find contact information for your local department online or by calling the New York State Department of Health at 1-800-541-2831.
- Complete the MetroPlus Medicaid application form. You can download the application form online or pick it up at your local department of social services.
- Submit the completed application form and all required documents to your local department of social services.
- Attend an interview if required. You may be required to attend an interview with a social services caseworker to verify your eligibility for MetroPlus Medicaid.
Once your application is approved, you will receive a MetroPlus Medicaid card. You can use this card to access covered services at any provider that accepts MetroPlus Medicaid.
Table of MetroPlus Medicaid Benefits
| Benefit | Copay |
|---|---|
| Doctor visits | $0 |
| Hospital stays | $0 |
| Prescription drugs | $0 – $10 |
| Mental health services | $0 |
| Health screenings and preventive care | Free or low-cost |
That’s about all I got to say about Metroplus Medicaid for now. Thanks for hangin’ with me and readin’ the article. It’s always fun shootin’ the breeze about these kinda things. If you got any more questions about Metroplus Medicaid, feel free to hit me up. I’m always down to talk. And remember, knowledge is power, so keep on learnin’. Until next time, ciao!