MetroPlus PlatinumPlus-P2 (New York)

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Company MetroPlus Health Plan
Plan Year 2014
State New York
Metal Tier Platinum
Plan Type
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Cost Sharing Benefits (In Network)

Policyholders are generally responsible for 100% of costs until the deductible amount is met. After the deductible has been met the policyholder is responsible for the coinsurance / copay until the out of pocket maximum is reached at which point the insurance company assumes 100% of all costs.

Deductible (Individual) $0
Deductible (Family) $0
Coinsurance $0
Out of Pocket Maximum (Individual) $2,000
Out of Pocket Maximum (Family) $4,000

Doctors Visits

Primary Care Visit $15 copay
Specialist Visit $35 copay
In Patient Hospital Services $500 copay
Emergency Room Services $100 copay

Tests and Imaging

Imaging (CT/PET Scans, MRIs) $35 copay
Laboratory Outpatient and Professional Services $35 copay
X-ray and Diagnostic Imaging $35 copay


Mental / Behavioral Health $15 copay
Rehabilitative Speech Therapy $25 copay
Rehabilitative Occupational & Physical Therapy $25 copay
Outpatient Facility $100 copay
Outpatient Surgery $100 copay

Prescription Drugs

Generic Rx $10 copay
Preferred Brand Rx $30 copay
Non Preferred Brand Rx $60 copay
Specialty Drugs 60

Other Plans

Other plans that are available in the state.

Plan Name
PlatinumPlus Standard
GoldPlus Standard
SilverPlus Standard
BronzePlus Standard
MedPlus Catastrophic
PlatinumPlus Non-Standard
GoldPlus Non-Standard
SilverPlus Non-Standard
BronzePlus Non-Standard
PlatinumPlus Standard Age 29 Rider
GoldPlus Standard Age 29 Rider
SilverPlus Standard Age 29 Rider
BronzePlus Standard Age 29 Rider
PlatinumPlus Non-Standard Age 29 Rider
GoldPlus Non-Standard Age 29 Rider
SilverPlus Non-Standard Age 29 Rider
BronzePlus Non-Standard Age 29 Rider
PlatinumPlus Child Only
GoldPlus Child Only
SilverPlus Child Only
BronzePlus Child Only

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