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Plan year 2027 · Medicare AdvantageCMS files of Sept. 22 and Oct. 1, 2026

MetroPlus Platinum Plan, 2027

H0423Contract004Plan

HMO · 5 counties in New York

Run by Metroplus Health Plan, Inc. (contract H0423), sold as MetroPlus Health Plan, owned by New York City Health and Hospitals Corporation

Renews for 2027

2026 star rating, contract H0423: 4 of 5

MetroPlus Platinum Plan (H0423-004) costs $0 a month in 2027, down $58.80 from 2026, with an in-network out-of-pocket limit of $9,850 ($9,250 in 2026).

What changes from 2026 to 2027?

The changed lines are marked and come first. In-network amounts; members keep paying the Part B premium unless the plan reduces it.
What you pay or get20262027Change
Monthly premium$58.80$0down $58.80
In-network out-of-pocket limit$9,250$9,850up $600
Drug deductible$615$700up $85
Comprehensive dental, yearly limitnot offered$1,500 a yearadded
Hearing aids, yearly limit for both ears$166.67 a year$2,000 a yearup $1,833.33
Over-the-counter items, yearlynot offered$240 a yearadded
10 lines do not change
Part B premium reduction, monthlynonenoneno change
Primary care visit$0 copay$0 copayno change
Specialist visit$40 copay$40 copayno change
Emergency room$100 copay$100 copayno change
Medical deductible, in networknonenoneno change
Hospital stay, in network$225 a day for days 1–8, then $0 a day for days 9–90$225 a day for days 1–8, then $0 a day for days 9–90no change
Skilled nursing facility, in networknot filednot filedno change
Ground ambulance, in network$100 copay$100 copayno change
Eyewear, yearly limit$500 a year$500 a yearno change
Counties served55no change

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS plan benefit package files, 2027 and 2026; CMS plan crosswalk from 2026 to 2027 (Oct. 1, 2026). Plan details can change during the year; confirm on Medicare Plan Finder.

How does it compare with plans sold where it is?

In the counties it serves, 46 plans open to everyone are sold for 2027, this one included. Against the others, 14 plans have a lower out-of-pocket limit, 31 the same. On the premium, 25 the same, 20 a higher one.

Out-of-pocket limits of the 46 plans open to everyone

$0 to under $2,0000 plans
$2,000 to under $4,0000 plans
$4,000 to under $6,0001 plan
$6,000 to under $8,0002 plans
$8,000 to $10,000 (this plan)43 plans

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Where is it sold, and what does it cost there?

The premium and the out-of-pocket limit are the same in all 5 counties: $0 a month and $9,850.

New York

BronxKingsNew YorkQueensRichmond

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision).

Who runs this plan?

Plan ID
H0423-004
Legal name of the contract
Metroplus Health Plan, Inc.
Sold as
MetroPlus Health Plan
Parent company
New York City Health and Hospitals Corporation
Plan type
HMO
2026 star rating of the contract
4 of 5 overall; health plan 3.5 of 5, drug plan 3.5 of 5
Members, September 2026
959
Plan website, as filed with CMS
www.metroplusmedicare.org

Source: CMS Medicare Advantage and Part D landscape files for 2027 (Sept. 22, 2026, revised Sept. 30) and 2026 (Sept. 2, 2026 revision); CMS 2026 Star Ratings (October 2025); CMS monthly enrollment by plan and by county, September 2026 (CMS hides counts under 11). CMS publishes the 2027 Star Ratings in October 2026.

What else should you check?

Data, not advice. These are the plan's filed amounts, not a quote for you; confirm on Medicare Plan Finder or call the plan before you enroll.