On Medicare? Annual Open Enrollment Is Now
Oct 15th - Dec 7th
Oct 15th - Dec 7th
Enroll for 2025 coverage

MetroPlus Platinum Plan (HMO)

Health Insurance Company: MetroPlus Health Plan

Medicare Advantage Plan Details

MetroPlus Health Plan
$92 /mo
monthly premium
MetroPlus Platinum Plan (HMO)
Additional Coverage
Overall Star Rating (2025)
  • Rx
  • Hearing
3
out of 5 stars

General Plan Details

Medical Deductible
$0
Out-of-Pocket Maximum
$9350
Rx Drug Coverage
Yes
Rx Deductible
$590
Primary Doctor Office Visit
$0 copay
Specialist Office Visit
$40 copay per visit

Additional Benefits

Dental Coverage
No
Vision Coverage
No
Mental Health Coverage
Yes
Transportation for non-emergency
No
Fitness Benefits
No
Worldwide emergency
No
Telehealth
Yes
Part B Give Back
No

Doctor & Hospital Coverage

Primary Doctor Office Visit
$0 copay
Specialist Office Visit
$40 copay per visit
Periodic Exam Coverage
$0 copay

Emergency Room

$100 copay per visit (always covered)

Ambulance Coverage

$100 copay

Lab, X-Ray, Radiology Coverage

Outpatient diag procs/tests/lab services:
Medicare-covered diagnostic procedures/tests: 20% coinsurance
Medicare-covered lab services: 20% coinsurance
Outpatient diag/therapeutic rad services:
Medicare-covered diagnostic radiological services (e.g., CT, MRI, etc): 20% coinsurance
Medicare-covered x-ray services: 20% coinsurance

Outpatient Surgery Coverage

Outpatient hospital:
Medicare-covered outpatient hospital services: 20% coinsurance per visit

Hospitalization Coverage

Inpatient hospital-acute:
$225 per day for days 1 through 8
$0 per day for days 9 through 90
Inpatient hospital psychiatric:
$195 per day for days 1 through 8
$0 per day for days 9 through 90

Rehabilitation Coverage

Occupational therapy services:
$25 copay
Physical therapy and speech and language therapy services:
$25 copay

Urgent Care Coverage

$0 copay

Skilled Nursing Facility (SNF)

Coming soon

Mental Health Coverage

Medicare-covered individual sessions: $40 copay
Medicare-covered group sessions: $40 copay

Dental, Vision, Hearing Benefits

Vision Benefits

Eye exams:
Routine eye exams: Not covered
Eyewear:
Contact Lenses: Not covered
Eyeglasses: Not covered

Hearing Benefits

Hearing exams:
Routine hearing exams: $20 copay
Hearing aids:
Hearing aids (all types): $0 copay

More Additional Benefits

Annual physical exams
No
Chiropractic Coverage
No
Acupuncture
No
Massage Therapy
No
Health Education
No
Counseling Services
No
Support for Caregivers of Enrollees
No
Personal Emergency Response System (PERS)
No
In-home support services
No
Home and bathroom safety devices
No
Meals for short duration
No

Plan Links

Ready to Enroll Online?

Or call and get free advice from licensed insurance agents

TTY 711
Mon-Fri: 8am-10pm, Sat-Sun: 8am-9pm ET
No Obligation to Enroll

Looking for other plans in your area?

Where This Plan is Available

State:
View all plans in your New York County

Additional Plan Info

Plan Year:
2025
Insurance Company Website:
MetroPlus Health Plan

Health Insurance Companies Offering Plans

Medicare Advantage and Part D plans and benefits offered by the following insurance companies:

  • Aetna Medicare
  • Anthem Blue Cross Blue Shield
  • Anthem Blue Cross
  • Anthem Blue Cross and Blue Shield
  • Aspire Health Plan
  • Baylor Scott & White Health Plan
  • Capital Blue Cross
  • Cigna Healthcare
  • Dean Health Plan
  • Devoted Health
  • Florida Blue Medicare
  • Freedom Health
  • GlobalHealth
  • Health Care Service Corporation
  • Healthy Blue
  • HealthSun
  • Humana
  • Molina Healthcare
  • Mutual of Omaha
  • Medica Central Health Plan
  • Optimum HealthCare
  • Premera Blue Cross
  • SCAN Health Plan
  • Simply
  • UnitedHealthcareⓇ
  • Wellcare
  • WellPoint