. Get inspired on our Blog, find answers to your questions in our FAQs, and explore our health library. MetroPlusHealth serves eligible New Yorkers with health care at little to no cost. Starting May 16, 2022, the way Personal Care Services and Consumer Directed Personal Assistance Services (PCS/CDPAS) are initially assessed will be changing. Please be sure to complete this requiredMedicare Special Needs Program (SNP) Model of Care (MOC) provider trainingon or beforeDecember 31, 2022. A new experience is ahead You asked, we listened. You will find many offices right near you, along with local family care sites and 110 urgent care centers like CityMD, Northwell Health-GoHealth Urgent Care, and more. Once you click Submit, the change request should be registered. Our health insurance plans are affordable. Best of all, MetroPlusHealth Medicaid Managed Care comes with no monthly premiums or copays. Creating an account will enable you to save your application and return at a later time to complete it. Fo und email listings include: k***@metroplus.org. MetroPlus Health Plan 160 Water St, 3rd Floor New York, NY 10038. A plan for New Yorkers who have or are eligible for Medicaid. Did you know that you can get your medications pre-packaged for free? New York State is making this change in the initial assessment process to make it easier to get the services you need. Trying to find the "metroplus login provider" Portal and you want to access it then these are the list of the login portals with additional information about. Capital District Physicians Health Plan Inc. You can also choose from more than 34,000 top providers and sites. You can also contact ushere. Find a plan that's right for you. First, find the type of metroplushealth coverage plan you have, then the borough you live in (or need a provider in). Are you getting the services you need such as choice of provider or network? For questions about training requirements for CORE Services, please contact your host agency Unite. 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. Gold Plan for NYC Employees - MetroPlusHealth Plans for NYC Employees MetroPlusHealth Locations Pay My Premium Insurance FAQs Eligibility Monthly Premium Deductible Annual Checkup Doctors & Specialists $0 24/7 Telehealth Hospital Visits Prescription Drug Coverage Prepackaged Medications Fitness Reimbursement Weight Loss Program Reimbursement Meet our leadership, join our team, or get in touch with MetroPlusHealth. Attn: Operations If you are an existing member, you can find this information on our Member Portal. Medicare Special Needs Program (SNP) Model of Care (MOC) provider training, Office of Addiction Services and Supports, CORE provider Service Initiation Notification Form, Diabetes Self-Management Education and Support (DSMES), Early Hearing Detection and Intervention (EHDI), Newborn Hearing Screening (NHS), and Early Intervention Program (EIP), Early Periodic Screening Diagnosis and Treatment (EPSDT) Services, Foster Care Services Provider Orientation(, PCP In-Office Non-allowable Services List, Project TEACH, a Mental Health Consult for Pediatricians, Child and Adolescent Immunization Schedule, Immunization Schedules and Vaccine Billing Guide, for a Food and Drug Administration (FDA)-approved indication for which there are no alternative options. For registration assistance or to report technical issues: CPI Online Assistance Unit Hartford Life Insurance Company (NAIC # 88072) Health Insurance Plan of Greater New York, Inc. Health Republic Insurance of New York, Corp. (formerly Freelancer Health Service Corp) Healthfirst Health Plan, Inc. Healthfirst Insurance Company, Inc. Healthfirst PHSP, Inc. HealthNow New York Incorporated. Fax: 1-212-908-8601 If you are seeking information about a rate application that applies to you, select your Company Name from the listing in the Navigation Pane to the left. HEALTH PLANS. Care. for spouse, $100 every 6 mo. HRA can be returned to: Enter the code from your phone (please note: you will need to have a valid cellphone number connected to your account to receive this). MetroPlusHealth Goldhealth plan is available to ALL New York City employees, their qualified domestic partners and eligible dependents, and non-Medicare eligible retirees. Contact your benefits manager at work for more information about choosingMetroPlusHealth Gold. MetroPlus Health Plan Enrollment Application. New York, Off Exchange Enrollment Application Please visit the Center for Practice Innovations Homepage and FAQs for more information on the Learning Community. If you have more than one account, please make separate payments for each account number. Medicaid Managed Care. If you are turning 65 within the next 3 months or you are 65 years of age or older, you may be entitled to additional medical benefits through the Medicare program. MetroPlusHealth Virtual Visit is the fast, easy way for our members to see a provider for common physical, mental, emotional, and behavioral health issues that are not emergencies. Speak to a doctor NOW by clicking. Stay well! You can access the CORE Benefit and Billing Guidance here. Medicare. Preventive care includes immunizations, physical exams, lab tests and prescriptions. Call us at1-855-809-4073or visit us at our Virtual Office. Enter the code from your phone (please note: you will need to have a valid cell phone number connected to your account to receive this). Once on the home screen, you can find information about: Clicking on Find your Doctor (Provider) link will take you out of the app and into the member portal through a browser. Front Desk: 1-212-908-8600. Because changes in placement may occur requiring additional health assessments, MetroPlus will allow members to see participating PCP providers not listed on their ID card, Call MetroPlus Customer Services 800-303-9626 to verify coverage and notify about need for future visits. Unite. Didn't receive a code? Monkeypox cases are rising in NYC. If you have more questions, please call our Customer Services team at 1-800-303-9626. If you are making your first ever payment to MetroPlusHealth, please use the one-time payment option. We believe that Health care is a right, not a , Project Manager II Overview Current Company Experience Organization Chart Elizabeth Moo's Email and Phone Number Medical Management Quality Examiner at Metroplus Health Plan Elizabeth Moo is a Medical Management Quality Examiner at Metroplus Health Plan. Medicaid Managed Care, including Partnership in Care and HARP Plans(click. MetroPlus Health Plan 646-825-6300. Terms. We believe that Health care is a right, not a privilege. as a continuation of established therapy if another gonadotropin-releasing hormone (GnRH) product has been tried and failed or if transition to another GnRH is medically contraindicated. Sign up here or call Medly at (929) 454-5090. - Find a plan that's right for you. Kelia Brown's Phone Number and Email. - ), Member website to help you manage your account, MetroPlusHealth will reimburse you up to $300 per year for participating in a weight loss program. Beacon Health Options Contact Information: Non-Dental Practitioner Application of Fluoride Varnish in a Primary Care Setting. For additional security, we need to verify your identity before you can sign in to the account. Partnering with DentaQuest, we are able to bring their experience and passion for improving oral health care to you. Justclickhereto find a representativeready to help and answer anyof your MetroPlusHealth Gold questions. Health Insurance Plan of Greater New York, Inc. Health Republic Insurance of New York, Corp. (formerly Freelancer Health Service Corp). The user can click the training link, then view the training module by selecting Next. If you are seeking information about a rate application that applies to you, select your Company Name from the listing in the Navigation Pane to the left. To access the required trainings, log in to the CPI Learning Community using your username and password. In these cases, you shouldnt be charged more than your plans copayments, coinsurance and/or deductible. Click hereto choose MetroPlusHealth Gold now! These downloadable directories list all the people (doctors, dentists, psychologists, etc. Unite. When it comes to other doctors, you can pick from a comprehensive list of providers in all five boroughs. For Medicaid recipients 21 or older who need additional resources for behavioral health. Rate Applications by Company Introduction, Summary of Medicare Supplement 2023 Requested Rate Actions, American Family Life Assurance Company of New York, American Progressive Life and Health Insurance Company of New York. Request refills of your prescription drugs. Download our App. Afterlogging in, Select Make A Payment. For assistance with enrollment and metroplus health plan options. NY 50 Water Street, 7thFloor Starting October 15 through December 31, 2021, MetroPlusHealth will incentivize our Primary Care Providers for completing Covid-19 Vaccine Counseling with their unvaccinated Child Health Plus, Medicaid, HARP, HIV SNP and Medicare MetroPlusHealth patients. Once this training has been completed, our participating providers will be able to provide more effective care delivery to our members and help reduce health disparities. MetroPlusHealth Make a world of difference in the world's greatest city. Looking to get your medications sent to you pre-packaged? Our providers who may be serving members receiving CORE services are required by the DOH to take specific trainings. 50 Water Street, 7thFloor Available through PillPack or CVS Pharmacy. Find MetroPlusHealth offices, events, and local family care sites right near you. Were here to help. Prefer to pay your premium online or by telephone? Please allow 2 business days for account balance to update. Kelia is currently based in New York. Youre ready to go! Crystal Run Health Insurance Company, Inc. Fidelis (New York Quality Healthcare Corporation), First United American Life Insurance Company, The Guardian Life Insurance Company of America, Hartford Life Insurance Company (NAIC # 88072). Unite. Kreyl Ayisyen Care. HealthPlus HP, LLC. Write: MetroPlus Health Plan Care. ATTENTION: QM Health Risk Assessment Unit Starting January 1, 2022, Walgreens and Duane Reade will no longer be in the pharmacy network for members of these plans: Where can I find a list of participating network pharmacies? We are happy to walk you through the steps. From there, in the window directly below this one, you will be able to navigate to the application you're interested in by selecting the following options, each of which will lead you to the next: Once you find the application you're seeking, you will find all documents related to that application. Individual Provider and Group (single location) Use this signup option if you want access to an individual practitioner or group practice and have the TIN and NPI numbers available to you. Receiving care from out-of-network doctors or providers is not covered, and you may have to pay for the medical services if you go out of network. Metroplus health plans, in partnership with fair health, is pleased to bring you this free medical cost. Click hereto access the digital attestation form. WE'RE HERE FOR YOU. Your coverage and benefits, including vision and dental effective and termination dates, Selecting or changing your Primary care physician. Registration and Helpful Links The change becomes effective (if accepted) within 1-3 days. You will need: Sign up for our full-service payment option where you can: See Plan information, Health Rewards, and Messages, Find someone in your neighborhood and in your language. The Centers for Medicare and Medicaid Services (CMS) requires that providers receive Medicare Special Needs Program (SNP) Model of Care (MOC)training annually. Login Login Member Portal Provider Portal . If you encounter any issues with logging in, please email us athelp.memberexperience@metroplus.org. ), places (hospitals, urgent care centers), and pharmacies in the metroplushealth network. MetroPlus will cover these pharmacy issues: A 30- day supply (transition fill) for non-formulary or Prior Auth (PA) required drugs within the first 90 days of enrollment, If the member requires an additional transition fill because of new placement, providers should send the request to CVS and indicate the reason, Members can receive refill-too-soon overrides when transferring between foster homes, Members can fill prescriptions at pharmacies that are out of network when they are placed out of our service area, For MetroPlus Health Plan members: 1-855-371-9228, For provider referrals, authorization or clinical matters: 1-855-371-9228, View updated Medicaid COVID-19 Counseling. But, if an urgent medical issue happens outside of our service area, youwillbe completely covered if you go to an emergency room. k***@metroplus.org. 646-825-6399. 50 Water Street, 7thFloor Click here to learn more. The users attestation will be automatically sent to MetroPlusHealth for acknowledgement of training. Members can find a list of network pharmacies here or use our online provider search tool. Members who receive care at NYC Health + Hospital facilities now have access to MyChart. Care. Remember to bring your new ID card when you visit your dentist. Message your primary care providers office, Request refills of your prescription drugs. Fluoride varnish is a reimbursable service. For Groups, enter NPI & TIN for a practitioner then on the main screen click Add Provider and enter the next practitioner NPI & TIN. Want a pharmacy that you can text? Speak to a doctor NOW by clicking. If you are attesting on behalf of your group/organization, in doing so, you agree to communicate the information to other providers in your group/organization. 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. Click here to learn more or to access care. Or call us at1-855-809-4073or visit us at our Virtual Office. We are over 700,000 members strong across New York City. For additional security, we need to verify your identity before you can sign in to the account. Member | MetroPlus Health Plan HOW CAN WE HELP? Our employees make our health insurance plan great. If you have any questions, call one of our Member Services Representatives. Highmark Western and Northeastern New York Inc. NorthShore-LIJ CareConnect Insurance Company, Inc. State Farm Mutual Automobile Insurance Company, Talcott Resolution Life Insurance Company, Transamerica Financial Life Insurance Company, Transamerica Premier Life Insurance Company, United Healthcare Insurance Company of New York, Approved Applications (by Effective Date). We can even enroll you over the phone. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. Learn more about Monkeypox, including prevention and treatment,here. MetroPlusHealth has partnered with Medly Pharmacy to offer free delivery and more! 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. Additionally, some individuals enrolled in HIV-Special Needs Plans or Medicaid Advantage Plus Plans will be eligible for CORE. For Medicaid recipients 21 or older who need additional resources for behavioral health. . If you have not received the code or still have trouble signing in, please call member services. The training module can be accessed by logging into our provider website/portal, or you can access it through this link:MAP-MOC for providers. We are committed to supporting our people with professional development and training opportunities that enable them to develop their skills and further their professional growth, Empower. Read the CORE training memo here for more information. Low-cost plans for daycare workers in New York City. Be sure to use the correct account number when making your payment. Participamos en la gestin del servicio pblico de transporte masivo de mediana capacidad tipo brt (buses de trnsito rpido) del valle de aburr, a travs de la generacin de infraestructura, y la ejecucin, asesora y consultora de. MetroPlusHealth Virtual Visit is available anytime, from anywhere in New York State, 24/7 - and in your language. We're here to help. We are seeing an increase in RSV, COVID-19 and Flu cases in New York City. HRA can be returned to: Learn more here. See Plan information, Health Rewards, and Messages. New York, NY 10004. Learn more here. CORE services are covered by health insurance, at no cost to our members. Their dental network is 65% larger than what we have been offering, with more dentists and specialists available than before. MetroPlus Health Plan We believe that Health care is a right, not a , Utilization Review and Case Management Jobs. Funded by New York State Office of Mental Health. These downloadable directories list all the people (doctors, dentists, psychologists, etc. Thats anywhere nationwide, whether its in our network or not. For members who are 21 or older, covered by Medicaid, and enrolled in a Health and Recovery Program (HARP), CORE services may be just right. Talk To Us About Any Questions or Concerns. You can choose your own primary care physician (PCP). If you have any questions or have trouble getting the code, please email us at. Essential Plan. For children under 19 who are not eligible for Medicaid and have little or no health insurance. First, find the type of metroplushealth coverage plan you have, then the borough you live in (or need a provider in). If you have any questions, call one of . The NYSDOH has provided guidance for providers regarding face-to-face visits during the current health crisis. Find MetroPlusHealth offices, events, and local family care sites right near you. Please review the links below and register for trainings as soon as possible. They will keep getting services through regular Medicaid. If you are filling out the application for YOUR "CHILD ONLY" enter your information (parent or legal guardian's information) in the 'Applicant / Subscriber Information' Section and your Child (ren . Protect yourself and your loved ones. Our participating behavioral health providers will now work directly with us to ensure MetroPlusHealth members get the right mental health and substance use care. MetroPlusHealth wants our members to be healthy. Preventive Services. Due to changes in IRS regulations, if you would like a copy of your 1095-B form, please contact Member Services to request one. Certificate of Coverage (with Drug Coverage), Certificate of Coverage (with Drug Coverage/Grandfathered). Highmark Western and Northeastern New York Inc. NorthShore-LIJ CareConnect Insurance Company, Inc. State Farm Mutual Automobile Insurance Company, Talcott Resolution Life Insurance Company, Transamerica Financial Life Insurance Company, Transamerica Premier Life Insurance Company, United Healthcare Insurance Company of New York, Approved Applications (by Effective Date). MetroPlusHealth members can access the Member Portal, find doctors, specialists, and pharmacies, and view member benefits. Contact. Marketplace Individuals & Families 2023. Marketplace Individuals & Families. Do not check if you are on a public or shared computer. New York, Click here to find a representative near you. Experiential Marketing Product Associate Schedule an Office Visit. Providers may access the cultural competency training and virtual attestation form here. Preventive care includes immunizations, physical exams, lab tests and prescriptions. For children under 19 who are not eligible for Medicaid and have little or no health insurance. 1/12/2023 9:55 AM. Are you paying more and more out-of-pocket costs? If you have any questions or have trouble getting the code, please email us at help.memberexperience@metroplus.org . As part of our ongoing commitment to access, quality of service and care for our members, MetroPlusHealth provides this training annually and during the new orientation process to all network providers, as well as to providers who regularly see our SNP members. If you are turning 65 within the next 3 months or you are 65 years of age or older, you may be entitled to additional medical benefits through the Medicare program. Take Action Now! 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. A plan for New Yorkers who have or are eligible for Medicaid. What do I do if I get my medications from Walgreens or Duane Reade? Rate Applications by Company Introduction, Summary of Medicare Supplement 2023 Requested Rate Actions, American Family Life Assurance Company of New York, American Progressive Life and Health Insurance Company of New York. $0 premiums, deductibles, and co-insurance. HealthPlus HP, LLC. For general information about Project TEACH contact 716-878-2454 orinfo@projectteachny.org. After logging in to the MetroPlusHealth Portal, training forMAP-MOC for providersand attestation is required. This training must be initially completed by appropriate staff within the next 12 months and then on an annual basis. For Medicaid recipients who meet certain income, resource, age, or disability requirements. Also startingJuly 1, 2021, some children and youth must join a Medicaid managed care plan, including: Some children and youth placed in foster care cannot join a Medicaid managed care plan. Get rewarded for performing this important public service. We believe that Health care is a right, not a , Project Manager I For New Yorkers living with HIV/AIDS and other select groups. If you are suffering with respiratory symptoms such as runny nose, cough, sore throat, fever, etc., dont wait! MetroPlusHealth Virtual Visit is the fast, easy way for our members to see a provider for common physical, mental, emotional, and behavioral health issues that are not emergencies. Elizabeth Moo got their education from University At Buffalo in the field of Learnmoreabout this program and how to participate, and access the Vaccine Encounter form and instructionshere. Explore Qualified Health Plans (QHP) through the NY State of Health, The Official Health Plan Marketplace. MetroPlusHealth members can access the Member Portal, find doctors, specialists, and pharmacies, and view member benefits. If you are suffering with respiratory symptoms such as runny nose, cough, sore throat, fever, etc., dont wait! Contact your benefits manager at work for more information about choosing MetroPlusHealth Gold. Preventive care includes immunizations, physical exams, lab tests and prescriptions. These four services include Community Psychiatric Support and Treatment (CPST), Psychosocial Rehabilitation (PSR), Family Support and Training (FST), and Empowerment Services Peer Support (Peer Support). Health Insurance Plan of Greater New York, Inc. Health Republic Insurance of New York, Corp. (formerly Freelancer Health Service Corp). Login Start Your Free Trial Now! Espaol 222 East 41st Street, New York, NY 10017. Last Update. We are committed to doing our part to help prevent the spread of COVID-19, so we will be conducting phone and virtual interviews at this time. 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. Once you receive it, please enter it below. Metroplushealth members can access the member portal, find doctors, specialists, and pharmacies, and view member benefits. In these cases, you shouldnt be charged more than your plans copayments, coinsurance and/or deductible. Looking for a pharmacy with free delivery? 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/. NY Choose how you want to receive or enter your security code. With MetroPlusHealth Gold, you get $0 premiums, deductibles, copays, unlimited telehealth visits, unlimited mental health care, and more. Healthplex (for dental services) your insurance is accepted at the following hospitals: Metroplushealth members can access the member portal, find doctors, specialists, and pharmacies, and view member benefits. Announcing aNew Foster Care Transition to Medicaid Managed Care- Special Population for Medicaid and Special Needs Plan members. $0 premiums, deductibles, and co-insurance. Learn morehere. Find a plan that's right for you. Starting January 1, 2023, you can begin to use your new ID Card for all your health care needs, including dental services with DentaQuest. You can also pay by phone using our automated service. Quality, affordable healthcare for all New York City employees. Just clickhereto find a representative in your neighborhood who speaks your language and is ready to help. Members who have an ongoing prescription including medications, certain supplies such as pen needles, test strips, continuous glucose monitors, and blood glucose test strips at a Walgreens or Duane Reade should call their health care providers to get a new prescription to be sent to a different pharmacy. Physician Administered Drug Step Therapy, Effective January 1, 2022, Important Information for Insurers and Providers on Coverage for Mental Health Services for Essential Workers, 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. About Monkeypox, including prevention and treatment, here you asked, we need verify!, request refills of your prescription drugs training requirements for CORE services, please contact benefits. Are suffering with respiratory symptoms such as runny nose, cough, sore throat, fever, etc., wait! 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