If your plan includes this benefit, review your Evidence of Coverage to find your exact quarterly allowance amount. The number to contact is given at the start of this article if you need further information about your plan benefits. Continued collaboration with New York State remains critical to aid this effort. In this version, you'll experience bug fixes and improved app performance. Contact Line for Current Members: Please first call the number found on the back of your member ID card for accurate and faster service. MetroPlusHealth doesnt just cover its members when theyre ill or injured. If you are a New Yorker looking for affordable health care options, you can get all the enrollment information you need, right here on our site, to find the best plan for you. Members Managing Your Health Has Never Been Easier At NationsBenefits, your well-being is our top priority. Type in your current Password in the field provided. The OTC benefit offers eligible members an easy way to get generic over-the-counter health and wellness products by phone or online. If it does, you must also check the plans specific OTC allowance frequency, as it can be either monthly or quarterly. However, the "Google Translate" option may help you to read it in other languages. MetroPlusHealth also increased member and provider education and participation in closing gaps in care by modernizing outreach through texting programs and ongoing social media postings. Privacy practices may vary, for example, based on the features you use or your age. Find below the easy methods where active members of this program can submit their orders: Members must make sure to review the Summary of Benefits of their existing personal plan to verify if their plan has this benefit included in it. What do I do if I get my medications from Walgreens or Duane Reade? Click "Create an Account" below. Enter your MetroPlusHealth username and password. Arabic. Thank you MetroPlus for caring about my health and checking on me consistently!. Please enter search text. MEMBER SERVICES Contact Line:Please first call the number found on the back of your member ID card for accurate and faster service. The New York State Office of the State Comptroller's website is provided in English. These credits may be consumed to purchase some over-the-counter medications and supplies, comprising of digestive health treatments, allergy medication, pain relievers, first aid supplies, and so many more. When the PHE expires, the continuous enrollment provision will conclude as well as other enrollment flexibilities granted during the PHE. (Read about all our Care Management Programs here.). Type in a valid Email Address and confirm in the spaces provided. Urdu Help from a registered dietitian and nutritionist. All rights reserved. Auto Services MetroPlusHealth 1.7 (149 reviews) Claimed Health Insurance Offices Open 9:00 AM - 5:00 PM See hours Write a review Add photo Photos & videos See all 9 photos Add photo Services Offered Verified by Business helpful About the Business In addition to Medicaid Managed Care, Metroplus Health Plan offers dozens of quality health plans, 1801 NW 66th Ave. Suite 100 Plantation, FL 33313 Do Not Sell My Information. Without the dedication and hard work done by each and every one of our staff, as well as our partners at NYC Health + Hospitals, we would not have topped the rankings this way, she added. Need to contact or place a phone call to OTC Health Solutions: 1-888-628-2770 (TTY: 711). NOTE: The information provided here is not a comprehensive explanation of the benefits available to you. $0 copay for up to 14 one-way trips to health-related locations annually. Strictly Necessary Cookie should be enabled at all times so that we can save your preferences for cookie settings. Privacy Policy This Google translation feature is provided for informational purposes only. We work hard to constantly improve your experience. Learn about all of the free preventive services for adults, women and children. If you have any questions, please call the CVS CaremarkCustomer Care Team at1-(855) 656-0361 for Medicaid Managed Care and Child Health Plus members or 1-(855) 383-9426 for Exchange Plan members. 877-439-2665, Members: 800-928-1558 (TTY: 711) Need help getting started? Members who are qualified may receive up to $64 quarterly in food vouchers for buying fresh and healthy food from different participating vendors. Plan awarded coveted 5-Star rating by its membership in annual survey of New York Citys state-sponsored health insurance plans. Products and services are provided exclusively by our partners, but not all offer the same plans or options. Visit: www.cvs.com/otchs/metroplus in your internet browser on your device. Type in your ZIP Code in the space provided. Choosing MetroPlus Advantage Plan (HMO-DSNP) will give members an access to the most complete health plans in New York City. If you wish to download the catalog, please visit the link below: Want to view more articles on this topic? Looking for a health plan that knows New York? MetroPlus enrollment reached a record high of 670,915, an increase of 159,284 members (31 percent) between February 2020 and June 2022, the period impacted by the COVID-19 pandemic (see Figure 1). They will order from a list of approved OTC items, and OTC Health Solutions will mail them directly to the home address provided. For more information, see the developers privacy policy. Ratings are based on a comparison of plan rates to statewide averages. A plan for New Yorkers who have or are eligible for Medicaid. 0 Providers Preventive care includes immunizations, physical exams, lab tests and prescriptions. All rights reserved. This person is a food and nutrition expert and will help give guidance and support in choosing healthy foods. For example, in 2017, MetroPlus and H+H established a housing taskforce to connect H+H patients in need of affordable and supportive housing, including those that are MetroPlus members. Any unused balance will automatically expire at the end of each quarter or upon disenrollment from the plan. According to federal guidance, the DOH will need to return to regular eligibility and enrollment operations and complete all renewals within 14 months, a daunting process as Medicaid enrollment has reached record levels and renewals have not been processed in almost two and a half years. Diversity of service. Plans Medicaid Managed Care Coronavirus Updates Here Medicaid Managed Care No premiums. Type in your date of birth in the field provided. MetroplusHealth members- Whether you're at home or on the go, the MetroPlusHealth app gives you an easy, secure way to manage your health in one place. Type in your current Password in the space provided. Shipping fee will not be charged to the member especially if this is inclusive in your plan. In New York City, MetroPlusHealth earned 5 stars in a number of categories and an overall rating of 5 stars, the highest possible score. In addition to hospital-based providers, our members can also obtain primary and specialty care services at many community-based doctor's offices and neighborhood family care sites. In preparation for the sunset of the PHE, the State has provided tools to assist stakeholders to inform enrollees about renewing their coverage. Want a pharmacy that you can text? Our innovative solutions are designed to help you achieve your desired health goals. MetroPlus Advantage Plan | OTCHS | CVS Health | Login. Using The App Once on the home screen, you can find information about: Your coverage and benefits, including vision and dental effective and termination dates This brief provides an update to MetroPlus enrollment trends as discussed in our report: NYC Health + Hospitals Check-Up: The Impact of COVID-19. 50 Water Street, 7thFloor Healthplex Member Services: 1.888.468.2189 DURABLE MEDICAL EQUIPMENT (DME) - Access prior authorization request form metroplus.org/provider/forms Requests submitted to Integra for all products except MLTC: Fax: 212.908.5185 Requests for MLTC only: Fax: 212.908.5282 The MetroPlus Provider Portal is now more ), places (hospitals, urgent care centers), and pharmacies in the MetroPlusHealth network. However, the State fiscal year 2023 Enacted Budget includes provisions that expand eligibility in public health plans offered through MetroPlus. By using this form, you acknowledge that you have read and agree to the Privacy Policy and Terms & Conditions. Click here to search our article database. Theyre arranged by plan and by location. Pay with your Visa, MasterCard, or Discover credit card or debit card, with Apple Pay, or with your bank account. Our network includes 34,000 doctors, specialists, and participating clinics including. More stars mean better healthcare. A credit or pre-determined allowance is given within the benefit. StartingJuly 1, 2021, MetroPlusHealth will cover Article 29-I Voluntary Foster Care Agency (VFCA) Health Facility services for children and youths under age 21 in foster careand other special populations, as indicated. MetroPlusHealth has offered low-cost, quality health care for New Yorkers for more than 35 years. 1-866-986-0356TTY users: 71124 hours a day, 7 days a week, 1-800-303-9626TTY users: 711Monday Saturday, 8 AM 8 PMAfter Hours: 1-800-442-2560, General Contact Phone Number: 1-866-986-0356, TTY users: 711. Medicaid Managed Care(including Partnership in Care and HARP Plans), children and youth placed in foster care in New York City, and, children and youth placed in foster care and a 29-I VFCA Health Facility. Enrollment in the Essential Plan, a subsidized basic health plan offered through NYSOH, experienced the largest growth rate of all plans at 44 percent (see Figure 2). The health plans 2020 5-star Overall Rating included 5 stars in the clinical areas of Cardiovascular Care, Diabetes Care, Child and Adolescent Care, and Adult Care. Another factor in increased member satisfaction and quality of care was the Plans Member Rewards Program, launched in 2017. There is normally no limit to the number of items you order. MetroPlus Gold plans are available for all city employees and NYC day care workers of the Day Care Council of NY Local 205, DC 37 Welfare Fund. You may click on the following links to view the entire details. GET to KnowNew York State ComptrollerThomas P. DiNapoli. What is the MetroPlus Advantage Plan Over-the-Counter Benefit? var d = new Date(); Talk To Us About Any Questions or Concerns. Metroplus Health Plan Pay your Metroplus Health Plan bill doxo enables secure bill payment on your behalf and is not an affiliate of or endorsed by Metroplus Health Plan. A wholly-owned subsidiary of NYC Health + Hospitals, the nations largest public health system, MetroPlusHealth is the plan of choice for over 600,000 New Yorkers and has a five-star rating based on the States 2020 Consumers Guide to Medicaid and Child Health Plus Managed Care Plans in New York City. HRA can be returned to: Additionally, MetroPlus experienced an increased market share in mainstream Medicaid Managed Care and Essential Plan enrollment in the City. Meet our leadership, join our team, or get in touch with MetroPlusHealth. This OTC benefit is intended for the members use only. MetroPlus in coordination with H+H is working to facilitate rapid reenrollment in Medicaid for those still eligible, and shift those who lose eligibility to Essential Plan coverage. The benefits you need to take good care of yourself. Internet Explorer presents a security risk. Call Medicare directly at 1-800-MEDICARE or 1-800-633-4227. To continue with your application you will need to create an account with us using the "Create Account/Login" button below. Sign up here or call Medly at (929) 454-5090. Continue to move forward and provide all the required information until you receive a successful registration confirmation. In 2020, during the first wave of the COVID-19 pandemic, MetroPlus ranked the highest of 15 Medicaid Managed Care plans across the State in the DOHs quality incentive program which assesses performance covering a wide range of quality measures. Possible options that may be offered include, but are not limited to, ACA-Qualified Plans, Medicare Plans, Short Term Plans, Christian/Health Sharing Plans, and Fixed Indemnity Plans. By using this form, you acknowledge that you have read and agree to the, 2021 MetroPlus Health Plan Over-the-Counter Item Catalog, Trillium Advantage | OTCHS | CVS | Health Solutions | Login, Preferred Care Partners Medicare Advantage | OTCHS | Login, Allwell by Sunflower Health Plan D-SNP | OTCHS | Login, Up to $250 every six months for membership to qualifying exercise facilities. NOTICE: This information is not a complete description of benefits available. Creating an account will enable you to save your application and return at a later time to complete it. Since 1985, MetroPlusHealth has built a reputation for providing access to affordable, quality health care to the people of New York City. Their goal is to provide benefits or arrange for benefits to be provided to those who are eligible and enroll or sign up. )Medicare for all, enough is enough. Health Information MetroPlus Near You Behavioral Health News & Alerts Pharmacy Member Rewards Program Provider Directory Frequently Asked Questions Back-to-School Support LOGIN NOT REGISTERED YET? To get started, you must create a new account. Just quality health care. document.write(d.getFullYear()); Click here to learn more. If you have Medicaid, you MUST apply for Medicare as a condition of continuous eligibility. They are a wholly-owned subsidiary of NYC Health + Hospitals, which is the biggest municipal health system in the US. FOR Qualified New Yorkers Partnership in Care (PIC) HIV - SNP For New Yorkers living with HIV/AIDS and other select groups. It is always best to communicate directly with the company to know more information about their available plans. However there is a restriction on the quantity limit per any single item, per order which is generally five (15). MetroPlus Gold: MetroPlus Health Plan Coverage Period: 7/1/2021-6/30/2022 Coverage for: Individual + Family | Plan Type: HMO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. To ensure the most secure and best overall experience on our website we recommend the latest versions of, Internet Explorer is no longer supported. Currently Metro Plus Health Plan works with OTC Health Solutions to allow their members to take advantage of their OTC benefit. Waste of time to try to use this app. You will need to make sure that the total amount due is within your allotted monthly benefit amount. Kings (Brooklyn)/Richmond (Staten Island), Kings (Brooklyn) and Richmond (Staten Island). Create and type in a password in the fields provided. Better yet, check out our online search tool. New York, NY 10004 Click here to find a representative near you. Geographic Diversity. Specialized Medicaid managed care plans include long-term care plans. The 2020 Consumers Guide rates plans on 10 distinct measures across three categories Preventive and Well-Care for Adults and Children, Quality of Care Provided to members with Illnesses, and Patient Satisfaction with Access and Services ultimately resulting in an Overall Rating of 0 to 5 stars. 2023 TomTom, 2023 Microsoft Corporation. To maximize revenues from MetroPlus, H+H is working with it to attract more of its members to utilize H+Hs health services and engage its members in routine chronic care management to avoid unnecessary high-cost utilization. | We are not an insurance agency and are not affiliated with any plan. MetroPlusHealth Medicaid Managed Care is our plan for people eligible for Medicaid, a government assistance program. These include, but are not limited to: Because Google Translate is intellectual property owned by Google Inc., you must use Google Translate in accord with the Google license agreement, which includes potential liability for misuse: Google Terms of Service. MetroPlus Advantage Plan works closely with CVS to enable their members to purchase common everyday medical and personal health care essentials. MetroPlusHealth attributes its 5-star rating, a feat shared by only one other plan in New York City, to a number of factors, including: The MetroPlusHealth Quality Management (QM) Department has been at the forefront of the health plans continuously improving quality measure scores. MetroPlus Health Plan announced today that it has been ranked New York Citys highest-rated health plan. NationsBenefits Staff Diversity. In these cases, you shouldnt be charged more than your plans copayments, coinsurance and/or deductible. Espaol If you are a Member calling about one of your supplemental benefits, please call the Toll-Free Number provided to you by your health plan related to that benefit, or you can access your account online. Our team is the reason we earned our stars.. New for MetroPlus Medicare Advantage (HMO SNP) members; they will receive $200 per quarter ($800 per calendar year) for purchase of OTC items (approved non-prescription drugs and health-related items). Bengali The MetroPlus share of citywide enrollment in mainstream Medicaid managed care plans, that covers the largest share of its members, increased from 14.8 percent in February 2020 to 15.8 percent in June 2022, the highest since 2014 (based on year over year February data) and the third largest plan in the City. To ensure the most secure and best overall experience on our website, we recommend the latest versions of. Select the red Continue button to proceed forward. No copays. The allowance amount varies and depends on the plan. Before continuing using our website you agree and accept our cookie policy & privacy. IMPORTANT: Go directly to the site to confirm and acquire more information. What is the MetroPlus Advantage Plan Over-the-Counter Benefit? $0 premiums, deductibles, and co-insurance. MetroPlus Health Plan is an HMO, HMO SNP plan with a Medicare contract. Hours of operation: 24/7/365. If you successfully registered you will receive an email verification showing that all is good with your registration. While the app appears a to have many useful functions like finding a PCP with a variety of filters like location, doctor type, etc., its overall usability is non existent existent because the app is buggy. Members get to earn points by keeping up with their health appointments and participating in wellness activities. MetroPlus is engaging City and State partners to continue to ease these transitions through effective use of public benefits data and eligibility flexibilities still available from the federal government to maintain members insurance coverage and prevent lapses in care. Better to just deal with the website. Extra benefits that are not covered by Medicare Part A or Part B Original Medicare. The change becomes effective (if accepted) within 1-3 days. The items you have ordered will be delivered within 7-10 working days as soon as you have successfully submitted your order. document.write(d.getFullYear()); You may click on the following links to view the entire details. You can revoke your consent to receive emails at any time by using the Unsubscribe link, found at the bottom of every email. Get an allowance per each quarter to use on a wide range of health-related items such as cold remedies and personal care items. Easy Access OTC orders are delivered straight to members homes. 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/. A brief guide is available for you so you can discover how you can login or activate a new online account and gain access. You can revoke your consent to receive emails at any time by using the Unsubscribe link, found at the bottom of every email. The Member Rewards Program enables members to earn points, redeemable for premium items, by completing essential healthcare services such as well-visits, colonoscopies, medication adherence, and more, and healthy activities such as the STEP-UP CHALLENGE, where members track and work to increase their physical activity. They may scroll down below and go through on how to set up an account online. An email verification will appear in your inbox once you have registered successfully. To request information on partnership opportunities or RFP requests, email sales@nationsbenefits.com. With this supplement benefit, their members can order items such as: These products are all provided at no extra cost when part of an eligible plan. When it comes to other doctors, you can pick from a comprehensive list of providers in all five boroughs. The card must be activated and the initial OTC dollar amount will be loaded onto the card. Starting May 16, 2022, the way Personal Care Services and Consumer Directed Personal Assistance Services (PCS/CDPAS) are initially assessed will be changing. If you disable this cookie, we will not be able to save your preferences. You'll be contacted by us within 24 hours. The MetroPlus Health Plan network includes primary care providers, specialists, behavioral health and OB/GYN providers at over 30,000 sites across New York City. The Essential Plan is a subsidized basic health plan offered with the NY State of Health. The financial stability of H+H is impacted by MetroPlus' ability to continue to attract new members and maintain its current membership, while focusing on better care management. If you have problems viewing any of the documents contact your Provider Services Representative. In late January 2020, the Secretary of the U.S. Department of Health and Human Services (HHS) declared a public health emergency (PHE) for COVID-19 which permits the Centers for Medicare & Medicaid Services (a federal agency in the HHS) to grant states emergency flexibilities to respond to the crisis. See Plan information, Health Rewards, and Messages, Find someone in your neighborhood and in your language. Covered services range from emergency visits to prenatal care. This website uses cookies so that we can provide you with the best user experience possible. The federal Families First Coronavirus Response Act, enacted in March 2020, authorized fiscal relief to states that created a requirement to keep most beneficiaries continuously enrolled in Medicaid during the PHE. Quality ratings are from information submitted by health plans. The MetroPlus Member Services phone line is available in 13 languages, and we can arrange for an interpreter to help with many others. Type in your Date of Birth in the space provided. We're here to help. The COVID-19 Public Health Emergency (PHE) is coming to an end May 11 and some changes may apply to your COVID-19-related coverage. Save your time one less trip to the pharmacy will mean that members may get to spend more valuable time on what matters most. Learn more here. All our most popular online features at your fingertips. Notes: NY State of Health includes health plans for individuals and small businesses. Just clickhereto find a representative in your neighborhood who speaks your language and is ready to help. Explore Qualified Health Plans (QHP) through the NY State of Health, The Official Health Plan Marketplace. Thank you for starting your application. 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. These efforts will enable H+H to work toward its goal of 45 percent of MetroPlus medical spending and therefore help to successfully execute on its strategic plan. New for MetroPlus Medicare Advantage (HMO SNP) members; they will receive $200 per quarter ($800 per calendar year) for purchase of OTC items (approved non-prescription drugs and health-related items). Descriptions are for informational purposes only and subject to change. MetroPlusHealthMedicaid Managed Care offers low- or no-cost health coverage to New Yorkers who live anywhere in New York City. Always attentive and great customer service! We believe in keeping them healthy, too. Download Acrobat Reader, a PDF viewer. MetroPlusHealth is certified under Section 4403-a of New York Public Health Law. Select the red Sign in button to move forward. Continue to move forward and provide all the necessary information until you receive a successful registration confirmation. They will keep getting services through regular Medicaid. At NationsBenefits, your well-being is our top priority. I have been a member for many years! To add to this, it can aid you in saving money on a vast array of generic branded health essential products like cold medicines, pain relievers, dental care, first aid supplies, and so much more. The share of MetroPlus spending at H+H facilities declined from 40 percent in fiscal year (FY) 2019 to 39.1 percent in FY 2021 and rebounded in FY 2022 to 42.6 percent, but has yet to reach the H+H target of 45 percent (see Figure 3). Click on the change PCP button on the top left of your screen and you will now be directed to a page that has information on your old and newly-selected PCP. MetroPlus share of citywide enrollment in the Essential Plan increased from about 17 percent to 19 percent during the same time period. Please click on the link below for more details. Our innovative solutions are designed to help you achieve your desired health goals. You may call the number provided at the beginning of this article for direction. Members must review the Evidence of Coverage of their plan to check if it is included in their benefit and to find out the exact amount of the monthly allowance provided. Pay Your Bills Securely with doxo State-of-the-art security NationsBenefits, LLC. If you will use the credit or pre-determined allowance that is provided within this benefit, all products you wish to get will be given to you at no extra cost. Are you receiving care at an NYC Health + Hospitals facility? Click here to learn more or to access care. NEW YORK--(BUSINESS WIRE)--MetroPlus Health Plan announced today that it has been ranked New York Citys highest-rated health plan, according to the New York State Department of Healths 2020 Consumers Guide to Medicaid and Child Health Plus Managed Care Plans in New York City, the annual rating of managed care plans on quality of care delivered and members satisfaction with the care and services they receive. You may need to log into your account again on the member portal. We can even enroll you over the phone. If not, please call or e-mail one of our representatives. Youre ready to go! Type in a valid email address in the fields provided. Language support services are available free of charge. MetroPlus Health Plan has been building a reputation for providing access to affordable and quality health care to the residents of New York City since 1985. Welcome To MetroPlus Enrollment Application. By submitting this form, you are consenting to receive marketing emails from: HealthManagementCorp (HMC). Despite MetroPlus and H+Hs efforts, the majority of MetroPlus members use health care providers other than H+H.
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