Staten Islanders, NYC Residents Working For The City Invited To Apply for MetroPlusHealth Gold Plan For No Copay, No Premium During Open Enrollment November 1st

METROPLUSHEALTH ANNOUNCES GOLD PLAN OPEN ENROLLMENT RESOURCES FOR NEW YORK CITY EMPLOYEES

Open enrollment runs November 1-30, with MetroPlusHealth Gold events across New York City and new concierge support for members

Editor’s note: Staten Islanders recently learned about the availability of free health insurance counseling, along with low or no premium plans for some residents, when the changes were being implemented.  As of right now, residents that qualify for Medicaid and want to volunteer for their hours, if they don’t also get SNAP, must volunteer a full 80 hours per month. Working even a minimum wage job for 20-30 hours a month generally covers this requirement, making volunteer activity a much less possible way for people to fulfill this new requirement under OBBBA. 

(New York, NY ) – MetroPlusHealth, New York City’s high quality, affordable health plan, today announced a series of resources and events to help eligible City employees and their families prepare for Gold Plan Open Enrollment, which runs November 1 through November 30.

Ahead of open enrollment, MetroPlusHealth will host Gold events at NYC Health + Hospitals facilities and other locations across the City, providing eligible employees with convenient opportunities to learn more about its Gold benefits and available member resources. New and existing Gold members will also have access to the Gold Signature Concierge Program, a new personalized support service designed to help members make the most of their benefits and make informed decisions about their care.

“City employees dedicate every day to serving New Yorkers, and they deserve health coverage that works just as hard for them and their families,” said Josiane Peluso, Vice President, Employer Solutions and Market Growth/Integration of MetroPlusHealth. “As open enrollment approaches, we want city employees to know that Gold offers more than comprehensive benefits – it provides personalized support to help members access the care they need and navigate their health with confidence.”

Personalized Support Through Gold Signature

New and existing Gold members will have access to the Gold Signature Concierge Program, providing personalized support to help them better understand their benefits and navigate their healthcare experience.

Gold members can access Gold Signature Concierge assistance by calling 877-475-3795 for support with:

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• Guiding members through their Gold plan benefits and available services
• Primary care provider selection and member ID card assistance
• Help scheduling appointments
• Prescription and pharmacy assistance
• Wellness program information
• Referrals to members’ union or benefit funds for vision and dental benefits
• Member Rewards program information
• MetroPlusHealth Member Portal registration and navigation assistance

Expanded Benefits for City Employees and Families

The upcoming enrollment period follows MetroPlusHealth’s expansion of Gold Plan benefits earlier this year, designed to provide City employees and their families with greater access, flexibility, and value.

Gold benefits include:

• $0 monthly premiums for individuals and families
• $0 deductible
• No referrals required for participating, in-network specialists
• $0 copays for primary and specialty visits
• $0 urgent care copay
• $0 copays for 24/7 telehealth visits through MetroPlusHealth Virtual Visit
• $0 cost on more than 125 commonly used medications through the Drug Discount Program on the Standard Plan (no pharmacy rider plan)
• 26 dietitian visits annually at no cost
• 10 acupuncture visits annually at no cost
• Fitness club reimbursement of up to $1,400 per year
• Wellness app reimbursement of up to $300 per year

• Up to $250 in Member Rewards per year for members and all eligible dependents, starting January 2027
• Reduced Rx formulary rider rates (pharmacy rider plan)

Beginning January 1, 2027, Gold members will also receive doula coverage, including up to eight prenatal or postpartum visits and one in-person labor and delivery support visit per pregnancy. Additional benefits taking effect January 1 include $0 urgent care copays and up to eight routine podiatry visits annually.

MetroPlusHealth’s expansion of doula coverage for City employees also complements New York City’s broader efforts to improve maternal health and expand access to doula care across the five boroughs.

Gold Events Across New York City

MetroPlusHealth will bring Gold enrollment information directly to City employees through a series of Gold events at NYC Health + Hospitals facilities and other locations across the city. Attendees will be eligible for giveaways and can explore Gold benefits and resources at four interactive stations:

• Gold Benefits Station: A Health Benefits Advisor will be available to answer questions and provide information about Gold benefits, including new and expanded offerings.
• Doula & Family Support Benefits Station: A provider will be onsite to educate attendees about MetroPlusHealth’s new Gold doula benefit.
• Dietician Benefits Station: Attendees will learn more about healthy eating and sample light plant-based bites and beverages.
• Wellness Benefits Station: A HYROX coach will be onsite to talk about fitness and physical activity.

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