Which Medicaid managed care plans can I choose in NYC?
All seven plans below take Medicaid enrollees in the Bronx, Brooklyn, Manhattan, Queens and Staten Island. The state’s availability table marks every one of them “C, M” in every borough, meaning Child Health Plus and Medicaid Managed Care. The state adds that not every plan may be accepting new enrollment at a given time.
| Plan (state name) | Bronx | Brooklyn | Manhattan | Queens | Staten Island | Overall rating, NYC | Members, 2024 (statewide) | Member services |
|---|---|---|---|---|---|---|---|---|
| Healthfirst PHSP | Yes | Yes | Yes | Yes | Yes | 5 of 5 | 1,238,371 | 1-866-463-6743 |
| MetroPlus Health Plan | Yes | Yes | Yes | Yes | Yes | 4 of 5 | 468,586 | 1-800-303-9626 |
| HIP (EmblemHealth) | Yes | Yes | Yes | Yes | Yes | 3 of 5 | 143,957 | 1-855-283-2146 |
| Molina Healthcare (Affinity by Molina) | Yes | Yes | Yes | Yes | Yes | 3 of 5 | 262,607 | 1-800-223-7242 |
| Anthem BlueCross and BlueShield HP | Yes | Yes | Yes | Yes | Yes | 2 of 5 | 394,425 | 1-888-809-8009 |
| Fidelis Care New York | Yes | Yes | Yes | Yes | Yes | 2 of 5 | 1,706,637 | 1-888-343-3547 |
| UnitedHealthcare Community Plan | Yes | Yes | Yes | Yes | Yes | 1 of 5 | 294,723 | 1-888-617-8979 |
Ratings come from the Health Department’s 2024 Consumer Guide for Medicaid and Child Health Plus in New York City. Member counts and phone numbers come from the state’s 2024 plan profiles; members are counted statewide, not only in the city. Every plan’s enrollment fell from 2023 to 2024, by 7% (Healthfirst) to 17% (Molina and UnitedHealthcare), according to the same profiles.
How does the state rate each NYC plan?
The Consumer Guide scores each plan from 1 to 5 stars in ten areas, using quality data the plans report and member surveys run by certified vendors. The overall rating is the last column.
| Plan | Behavioral health | Heart care | Respiratory | Diabetes | Adult care | Child care | Maternal care | Women’s preventive | Experience, adult | Experience, child | Overall |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Healthfirst | 5 | 3 | 5 | 4 | 5 | 4 | 3 | 5 | 3 | 3 | 5 |
| MetroPlus | 5 | 5 | 4 | 5 | 3 | 4 | 5 | 4 | 1 | 2 | 4 |
| HIP (EmblemHealth) | 4 | 5 | 2 | 3 | 2 | 2 | 2 | 3 | 3 | 4 | 3 |
| Molina | 2 | 2 | 4 | 2 | 3 | 3 | 2 | 4 | 3 | 3 | 3 |
| Anthem | 3 | 2 | 2 | 3 | 3 | 2 | 2 | 3 | 4 | 2 | 2 |
| Fidelis Care | 2 | 1 | 3 | 2 | 3 | 2 | 2 | 2 | 3 | 3 | 2 |
| UnitedHealthcare | 3 | 3 | 1 | 3 | 2 | 1 | 1 | 2 | 2 | 1 | 1 |
Two patterns are worth reading closely. MetroPlus scores at or near the top on clinical care but gets 1 star for adult member experience, the survey of how members feel about access and service. Anthem is the reverse: weak clinical scores, the best adult experience score in the table. If you mostly need a smooth phone line, the experience columns matter more to you than the overall star.
What is the same in every NYC Medicaid plan?
More than most people expect. New York decides the Medicaid benefit package, so dental, vision, hospital care, mental health care, maternity care and rides to appointments are covered by all seven plans. Since April 1, 2023, prescriptions for Medicaid managed care members go through NYRx, the state’s Medicaid pharmacy program, so the drug list is no longer a reason to pick one plan over another. NYRx.
The state’s guide lists what every managed care member gets: a regular primary care provider, regular checkups, no limit on visits to your doctor, the ability to reach the provider’s office or plan 24 hours a day, 7 days a week, and access to clinics, laboratories, specialists and hospitals.
What differs is narrower: which doctors, hospitals and dentists are in network, how the plan handles referrals and prior authorization, and how well its member services work. Dental networks also vary. DentaQuest, for example, lists Medicaid dental plans for EmblemHealth, Fidelis, Healthfirst and MetroPlus, so ask your plan which dental vendor it uses before you book. Finding a dentist who takes your plan.
How should I choose a plan?
Start from your own care, not the ranking. A 5-star plan without your cardiologist is a worse plan for you than a 2-star plan with her.
- List your providers: primary care doctor, specialists from the last two years, the hospital you would use, your dentist and your pharmacy.
- Call each office and ask: “Which Medicaid managed care plans do you take, and are you accepting new patients under them?” Offices answer this every day.
- Cross out plans that miss your primary doctor or your hospital.
- Among the rest, use the star table. Look at the columns that match your situation: maternal care if you are pregnant, behavioral health if you are in treatment, the experience columns if service problems are what wore you down before.
- Call NY Medicaid CHOICE at 1-800-505-5678 (TTY 1-888-329-1541) to enroll or switch, or choose your plan on your NY State of Health application.
The weak spot in this method: a phone answer can be wrong too, and the state’s ratings describe 2024, not next month. Ask for the answer in writing if a specialist is the reason you are switching.
Which plan for which situation?
| Your situation | Plans to check first | Why |
|---|---|---|
| Your care is already at a public hospital or a Gotham Health clinic | MetroPlus | Owned by NYC Health + Hospitals |
| You use community hospitals in the outer boroughs | Healthfirst | Founded by NYC hospitals; highest overall NYC rating |
| A family member has GHI or HIP through a city job | HIP (EmblemHealth) | Same company as the employer plan, different product |
| You move between the city and upstate | Fidelis Care | Statewide carrier |
| You are pregnant | Compare the maternal care column | MetroPlus scores 5, several plans score 2 |
| You have HIV | Ask about HIV special needs plans (Amida Care, MetroPlus, SelectHealth) | Separate HIV SNP category in the state profiles |
| You need long-term care at home | Not this list | Look at MLTC plans |
These are starting points. Your own doctors decide. Healthfirst vs MetroPlus · All carriers compared.
Can I switch Medicaid plans later?
Yes. Medicaid managed care is a year-round program, and you can change plans through NY Medicaid CHOICE. New York Medicaid CHOICE is the state’s managed care enrollment program, run by Maximus for the Department of Health. Its line is open Monday to Friday, 8:30am to 8pm and Saturday, 10am to 6pm; long-term care customer service is 1-888-401-6582.
When you call, have the ID number from your New York State Medicaid benefit card and the name of the plan you want. Ask the date the new plan starts, and keep using your current plan until then. If a problem with your plan cannot wait for a switch, the state Health Department’s complaint hotline for managed care is 1-800-206-8125. Phone numbers for every agency.
Questions people ask
What are the Medicaid managed care plans in New York City?
Seven plans serve all five boroughs: Anthem BlueCross and BlueShield HP, Fidelis Care, Healthfirst, HIP (EmblemHealth), MetroPlus, Molina Healthcare and UnitedHealthcare Community Plan, per the state’s 2024 availability table.
Which NYC Medicaid plan has the best rating?
In the state’s 2024 Consumer Guide for New York City, Healthfirst received 5 of 5 stars overall and MetroPlus 4. UnitedHealthcare Community Plan received 1 star.
Do all NYC Medicaid plans cover the same services?
Yes. New York sets the Medicaid benefit package. Plans differ in their networks of doctors, hospitals and dentists, and in service.
How do I change my Medicaid plan in NYC?
Call NY Medicaid CHOICE at 1-800-505-5678 (TTY 1-888-329-1541), Monday to Friday 8:30am to 8pm or Saturday 10am to 6pm. The state’s model member handbook (2019 revision) gives 90 days from enrollment to change plans for any reason; after that you may stay nine more months unless you have good cause, such as moving out of the plan’s area. We found no newer version of that rule, so confirm it when you call.
Which Medicaid plan is biggest in New York?
Fidelis Care, with 1,706,637 Medicaid managed care members statewide in 2024, followed by Healthfirst with 1,238,371.
Sources
- NYS Department of Health: model member handbook for Medicaid managed care plans, 90 days and changing plans (checked 2026-11-05)
- NYS Department of Health — Managed Care Regional Consumer Guides: 2024 plan performance, Medicaid and Child Health Plus, New York City (checked 2026-11-03)
- NYS Department of Health — 2024 availability of Medicaid managed care plans by county (checked 2026-11-03)
- NYS Department of Health — Medicaid managed care plan profiles, eQARR 2024 (checked 2026-11-03)
- NYS Department of Health — Medicaid managed care by county (checked 2026-11-03)
- New York Medicaid Choice — contact and hours (archived copy of January 7, 2026) (checked 2026-11-03)
- DentaQuest — New York Medicaid dental plans (archived copy of April 12, 2026) (checked 2026-11-03)
More in Medicaid in New York: Who Qualifies, How to Apply, How to Keep It
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This page explains how the system works. It is not medical advice. More.