MetroPlusHealth Expands Gold Plan Benefits for NYC Employees: What It Means for Your Medical Equipment Coverage
New York City employees enrolled in MetroPlusHealth’s Gold plan just got easier access to specialist care — a change that also makes it simpler to get durable medical equipment (DME) like CPAP supplies, mobility aids, and diabetic care products.
What’s New in the Gold Plan
MetroPlusHealth announced an expansion of benefits under its Gold plan, available to New York City employees and their families. The key updates:
No more specialist referrals. As of July 1, Gold plan members no longer need a referral to see in-network specialists — meaning faster access to the providers who prescribe and authorize home medical equipment.
Zero copay for urgent care visits. Members can visit urgent care centers at no additional cost.
Doula services now covered. Additional maternity support benefits are included in the plan.
More benefits coming January 1, 2027, including in-person labor and delivery support for each pregnancy.
MetroPlusHealth has provided affordable health coverage to New Yorkers for more than 40 years and serves roughly 700,000 members across a network that includes NYC Health + Hospitals, NYU Langone Health, Mount Sinai, Montefiore Einstein, and other major providers.
Why This Matters If You Use Home Medical Equipment
Removing the referral requirement isn’t just about convenience — it directly affects how quickly you can get the paperwork needed for insurance-covered medical supplies. Many DME items, from CPAP machines and masks to orthopedic braces and diabetic shoes, require a prescription or documentation from a specialist before a supplier can process an order through insurance.
With the new Gold plan rules, NYC employees can now:
See a specialist faster, without waiting on a referral from a primary care provider
Get equipment prescriptions processed sooner, reducing delays for items like CPAP masks, nebulizers, or mobility aids
Use urgent care at no cost for issues that come up between specialist visits
How Stark Medical Supplies Can Help
Stark Medical Supplies is a Brooklyn, NY-based medical equipment and supply store offering a full range of home medical equipment — from CPAP masks and respiratory supplies to wheelchairs, orthopedic shoes, and diabetic care products. If your MetroPlusHealth Gold plan or other NYC employee insurance now makes it easier to see a specialist, we can help you turn that prescription into the equipment you need, with guidance on what your plan covers.
Have a new prescription or referral for medical equipment? Reach out to Stark Medical Supplies to check your coverage and place your order.
Frequently Asked Questions
Does the MetroPlusHealth Gold plan cover CPAP machines and masks?
Coverage for respiratory equipment like CPAP machines depends on your specific plan and medical necessity documentation. Check with MetroPlusHealth or your equipment supplier to confirm what’s included.
Who is eligible for the new Gold plan benefits?
The expanded benefits apply to New York City employees and their family members enrolled in the MetroPlusHealth Gold plan.
When did the referral waiver take effect?
The elimination of specialist referral requirements for in-network providers took effect July 1.
What benefits are coming in 2027?
Starting January 1, 2027, MetroPlusHealth Gold plan members will also receive additional maternity support, including in-person labor and delivery assistance.
Source: MetroPlusHealth announcement, reported via ForumDaily NewYork, May 2026.