MetroPlusHealth Expands Gold Plan Benefits for New York City Employees and Families

MetroPlusHealth Expands Gold Plan Benefits for New York City Employees and Families

New enhancements include doula services for expecting families, no specialist referrals, $0 urgent care copays, and expanded wellness benefits

Jul 01, 2026

MetroPlusHealth, New York City's high quality, affordable health plan, today announced a significant expansion of its Gold Plan benefits, offering greater access, flexibility, and value for City employees and their families.

Beginning July 1, 2026, Gold Plan members will no longer need referrals to see participating, in-network specialists - removing a key barrier to care and enabling faster, more seamless access to expert treatment.

"At MetroPlusHealth, we're focused on making healthcare more accessible and easier to navigate for our members," said Dr. Talya Schwartz, President and Chief Executive Officer of MetroPlusHealth. "Eliminating referral requirements gives New York City workers and their families greater control over their care while improving timely access to the specialists they need."

As part of its commitment to advancing maternal health outcomes, MetroPlusHealth will also introduce doula coverage starting January 1, 2027. This new benefit includes up to eight prenatal or postpartum visits, plus one in-person labor and delivery support visit per pregnancy - providing personalized care shown to improve outcomes for both parents and babies.

Gold Plan members will also gain access to an expanded range of physical, mental, and preventive care benefits, including:

Expanded Gold Benefits

• $0 monthly premium for individuals and families
• $0 deductible
• No referrals needed for in-network specialists
• $0 copay for 24/7 telehealth visits through MetroPlusHealth Virtual Visit
• Transportation for doctor's visits: Up to $60 per plan year

Prescription & Pharmacy Enhancements

• $0 cost on 125+ commonly used medications, 25% increase of medications included compared to last year
• The newly expanded list of medications now includes ibuprofen 600mg, tretinoin, fluticasone nasal spray, and ketoconazole shampoo
• Reduced Gold pharmacy rider cost* for Individual and family coverage

Wellness & Preventative Care

• 26 dietician 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 Members Rewards, per year

Additional Support Services, effective January 1, 2027

• Doula coverage: Eight visits plus one labor-and-delivery support visit per pregnancy
• $0 copay for urgent care visits
• Podiatry coverage: Up to eight routine foot care visits annually

"New York City's workforce deserves a health plan that works as hard as they do," said Dr. Schwartz. "With $0 premiums and deductibles, simplified access to specialists, and a wide range of no-cost services, MetroPlusHealth's Gold Plan is designed to make high-quality care both accessible and affordable. These enhancements reflect our ongoing commitment to the people who keep our great city running."

For more than 40 years, MetroPlusHealth has provided access to affordable, quality health care to the people of New York City. It serves nearly 700,000 members across New York City and its impressive network includes tens of thousands of providers, more than 40 hospitals and urgent care centers, including NYC Health + Hospitals, NYU Langone Health, Mount Sinai, CityMD, Montefiore Einstein, LabCorp, Lenox Hill Radiology, Memorial Sloan Kettering, Tribeca Pediatrics, and more. For more information about MetroPlusHealth's Gold Plan, please visit Gold Plan for NYC Employees - MetroPlusHealth.

*For non-grandfathered members only

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About MetroPlusHealth
MetroPlusHealth is a wholly owned subsidiary of NYC Health + Hospitals. For more than 40 years, MetroPlusHealth has provided access to affordable, quality health care to the people of New York City. It is a leader in addressing social determinants of health and the only New York State plan to dedicate resources specifically to ensuring members have access to food, housing, and transportation. MetroPlusHealth serves nearly 700,000 members across New York City and its network includes tens of thousands of providers and more than 40 hospitals and urgent care centers, including NYC Health + Hospitals, NYU Langone, Mount Sinai, CityMD, Montefiore, LabCorp, Lenox Hill Radiology, Memorial Sloan Kettering, Hospital for Special Surgery, and more. For more information about MetroPlusHealth, please visit metroplus.org.

About NYC Health + Hospitals
NYC Health + Hospitals is the largest public health care system in the nation serving more than a million New Yorkers annually in more than 70 patient care locations across the city's five boroughs. A robust network of outpatient, neighborhood-based primary and specialty care centers anchors care coordination with the system's trauma centers, nursing homes, post-acute care centers, home care agency, and MetroPlusHealth-all supported by 11 essential hospitals. Its diverse workforce of more than 46,000 employees is uniquely focused on empowering New Yorkers, without exception, to live the healthiest life possible. For more information, visit www.nychealthandhospitals.org and stay connected on Facebook, Twitter, Instagram and LinkedIn.