MetroPlus UltraCare (HMO D-SNP) in New York County, New York — 2026 plan details
Last updated Jul 18, 2026
Reviewed by Jason Burns, Editorial Steward
Published by Senior Direct Answers · Licensed under Citation License 1.0
MetroPlus UltraCare (HMO D-SNP) (H0423-007) is a $59-premium Medicare Advantage HMO D-SNP from New York City Health and Hospitals Corporation available in New York County, New York in 2026, with a 3.5-star overall rating, a $9,250 in-network out-of-pocket maximum, and a $615 annual Part D drug deductible.
Plan facts (CMS CY2026 Landscape file)
| Organization | New York City Health and Hospitals Corporation |
|---|---|
| Plan name | MetroPlus UltraCare (HMO D-SNP) |
| Contract ID | H0423 |
| Plan ID | 007 |
| Segment ID | 0 |
| Contract year | 2026 |
| Contract category | SNP |
| Plan type | HMO D-SNP |
| SNP | Yes — Dual-Eligible |
| Monthly consolidated premium | $58.80 |
| Part C premium | $0.00 |
| Part D basic premium | $58.80 |
| Part D total premium | $58.80 |
| Annual Part D deductible | $615.00 |
| Maximum out-of-pocket (in-network) | $9250.00 |
| Overall star rating | 3.5 |
How this plan is structured
- $59 consolidated premium. A $0 or near-$0 consolidated premium does not remove the Part B premium — the standard 2026 Part B premium is $202.90 per month and still applies. See the 2026 Medicare Part B premium.
- HMO D-SNP plan type. In an HMO-style Medicare Advantage plan, in-network care and primary-care referral rules generally apply. See how Medicare Advantage HMO and PPO plans differ.
- $9,250 in-network out-of-pocket maximum. The MOOP is the annual cap on what a member pays in-network for covered Part A and Part B services. See how the Medicare Advantage MOOP works.
- Service area = New York County. Medicare Advantage plans are sold by service area; moving out of the plan's service area triggers a Special Enrollment Period to switch plans. See how moving changes your Medicare options.
How it compares in New York County
The CMS CY2026 Landscape file lists 75 Medicare Advantage plans in New York County, New York, of which 3 carry a 5.0-star overall rating and 22 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $252.00 per month, and in-network out-of-pocket maximums range from $0.00 to $9250.00.
Other 5.0-star Medicare Advantage plans in New York County (first three alphabetically):
| Plan | Organization | Premium | MOOP |
|---|---|---|---|
| Anthem HealthPlus Full Dual Advantage LTSS 2 (HMO D-SNP) | Elevance Health, Inc. | $58.80 | $9250.00 |
| Anthem Medicare Advantage 2 (HMO-POS) | Elevance Health, Inc. | $34.00 | $9250.00 |
| Anthem Veteran 2 (HMO-POS) | Elevance Health, Inc. | — | $6800.00 |
For the full county plan directory, see all Medicare plans in New York County, New York.
How to verify your doctors take this plan
Network participation changes throughout the year; we hold no provider-network data, so verify directly with these three sources before you decide:
- Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H0423-007.
- Call the plan (New York City Health and Hospitals Corporation) using the member-services number listed on that plan page and ask whether each doctor, hospital, and pharmacy is in-network for 2026.
- Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.
What H0423-007 means
CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H0423-007, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 0423 are the contract number issued to the organization, and the three-digit 007 is the plan benefit package under that contract. The segment ID 0 identifies the service-area segment within the plan (0 = the default single segment).
Frequently asked questions
Is MetroPlus UltraCare (HMO D-SNP) an HMO or PPO?
MetroPlus UltraCare (HMO D-SNP) is an HMO D-SNP — a Health Maintenance Organization-style Medicare Advantage plan, meaning in-network care and referral rules generally apply.
Does MetroPlus UltraCare (HMO D-SNP) include prescription drug coverage?
Yes — MetroPlus UltraCare (HMO D-SNP) is a Medicare Advantage plan with prescription drug coverage (MA-PD) and a $615.00 annual Part D drug deductible for 2026.
What is the maximum out-of-pocket cost for MetroPlus UltraCare (HMO D-SNP)?
The 2026 in-network maximum out-of-pocket limit for MetroPlus UltraCare (HMO D-SNP) is $9250.00, per the CMS CY2026 Landscape file.
What counties offer MetroPlus UltraCare (HMO D-SNP) (H0423-007)?
MetroPlus UltraCare (HMO D-SNP) (H0423-007) is offered in five New York counties: Bronx County, Kings County, New York County, Queens County, and Richmond County.
Sources
- CMS, Plan Year 2026 Medicare Advantage & Part D Landscape source file (March 2026) — retrieved 2026-07-18. Overall star rating year: 2026.
- Medicare.gov Plan Finder — compare plans and enroll.