MetroPlus Health Plan
Have a MetroPlus plan? What is covered, what you pay, and which providers are in network depend on your specific plan. Confirm the details with the number on your card and Moses Medical before booking.
MetroPlus is not a private insurance company. It is New York City’s public health plan, run by NYC Health + Hospitals. Over 600,000 New Yorkers are enrolled. Moses Medical accepts MetroPlus Medicaid Managed Care at 871B Westchester Ave in the Bronx. If you bought a MetroPlus marketplace QHP through NY State of Health, network status depends on the specific plan, so call (646) 741-2111 with your card and we can check it before your visit.
Services Covered Under MetroPlus
New York Medicaid managed care generally has no copay for primary care. That includes annual physicals, sick visits, immunizations, and management of chronic conditions like diabetes and hypertension. Your exact cost share depends on your plan and the service, so ask MetroPlus what applies.
Specialist visits may also be covered. At Moses Medical, current care options include internal medicine for blood pressure, cholesterol, and chronic condition management, dermatology for skin concerns, mental health for mental health support, and podiatry for diabetic foot exams and routine foot care.
Our lab is in the building, so bloodwork can happen during the same visit when ordered. If your care requires imaging or therapy, our team can help coordinate the referral.
If you bought a MetroPlus marketplace QHP through NY State of Health, your copay structure is different from Medicaid members. Check your Summary of Benefits for exact amounts. Federal law requires marketplace plans to cover in-network preventive services at no cost to you, so confirm network status with MetroPlus first.
What to Bring
Your MetroPlus ID card. It has your member number, plan type, and PCP information. Have it out when you check in.
MetroPlus Medicaid members need a primary care provider on file. To pick a Moses Medical provider as your PCP, call MetroPlus at 1-800-303-9626 or go to metroplus.org. The change takes effect on the first of the next month. If you need care before the switch goes through, walk in during office hours and our staff will help you figure out the best path.
Medicaid Managed Care requires a referral from your PCP before seeing a specialist. Our team can prepare the referral at your visit. Your plan decides when the specialist visit can be scheduled.
Using Your Full MetroPlus Coverage
Most members only come in when something is wrong. That is understandable but expensive in the long run. Diabetes, high blood pressure, and high cholesterol are all easier and cheaper to manage with routine screenings, and Medicaid managed care generally covers them with little or no cost share.
If you manage a chronic condition, regular visits let your provider adjust medications and review labs before a manageable problem turns into an ER trip. A 20-minute office visit is always better than a 6-hour wait in an emergency room.
Mental health visits may be covered, including evaluation and medication management when appropriate. Therapy or counseling coverage and referral options depend on your plan; call with your insurance card to confirm.
For a side-by-side look at how MetroPlus compares to other Medicaid plans, read our Medicaid, MetroPlus, and Fidelis coverage guide. If you or a family member manages diabetes, our guide on diabetic wound care and prevention covers what to watch for between visits.
Call (646) 741-2111 to schedule or walk in during office hours.
Before the visit
Confirm the exact plan, provider, and service
A plan name alone does not confirm payment. Use the member number on your current card to ask about the specific product and visit. An eligibility response is not a guarantee that a claim will be paid.
- Is Moses Medical in network for this exact product?
- Is the requested provider in network?
- Does the visit need a referral or authorization?
- What copay, deductible, or coinsurance may apply?
- Are lab work, imaging, and medications billed separately?
- What should you bring to the appointment?
Moses Medical care options
Review the visit that matches your concern, then ask your plan and the office about network participation, referrals, authorization, and coverage for that specific visit.
Two calls can prevent confusion
Call the member-services number on your card for benefit and network questions. Then call Moses Medical at (646) 741-2111 with your current card and the care option you need. Final payment depends on the plan's rules and how the visit is billed.
Need help choosing?
Start with the care option that fits your concern.
Browse care options or call the office. We can help narrow down the choices.