MetroPlus Insurance Accepted at Our Pharmacy in Jackson Heights, Queens
A Pharmacy That Accepts MetroPlus Near Me
Your Neighborhood Latin Pharmacy for MetroPlus Members
Colombia Pharmacy, at 85-26 37th Ave in Jackson Heights, accepts MetroPlus insurance, along with OTC cards and benefit plans from other major New York insurers. Bring your member card and our bilingual team will check your coverage and eligibility right at the pharmacy, in English or Spanish, so you know where you stand before you pay.
Why Choose Colombia Pharmacy for Your MetroPlus Plan
We Accept MetroPlus
We accept MetroPlus and Medicaid, so you can take care of your health and wellness needs close to home.
Coverage Checked at the Pharmacy
Our team can verify your coverage and eligibility directly in the pharmacy, so there are no surprises at the register.
Service in English and Spanish
Our bilingual team explains your options in the language you feel most comfortable with.
Open Seven Days a Week
Monday to Friday from 10:00 AM to 7:00 PM, and Saturday and Sunday from 10:00 AM to 5:00 PM.
MetroPlus Health Plan Coverage: Which Plan Do You Have?
MetroPlus Medicaid
MetroPlusHealth offers Medicaid plans in New York City, including Partnership In Care and Enhanced (HARP) plans, and we accept Medicaid at Colombia Pharmacy. Since April 1, 2023, prescriptions for MetroPlus Medicaid, Partnership In Care and Enhanced (HARP) members go through NYRx, the Medicaid Pharmacy Program run by New York State, not through MetroPlus. At the pharmacy, you show either your New York State benefit card or your MetroPlus plan card. Call us at (718) 424-6660 if you want to confirm what we can do for your prescription before you come.
MetroPlus Essential Plan
The Essential Plan is a New York State health coverage program, and MetroPlusHealth offers it. According to MetroPlus, Essential Plan members get the MetroPlusHealth Wellness Card, which can be used for healthy groceries, over-the-counter items and essentials such as toiletries and personal care products. Prescription drug coverage for the Essential Plan comes from your MetroPlus plan; see the section below on the MetroPlus formulary and authorization form.
MetroPlus Medicare Plans
MetroPlusHealth offers Medicare plans for New York City residents: the MetroPlus Advantage Plan (HMO D-SNP), the MetroPlus Platinum Plan (HMO) and MetroPlus UltraCare (HMO D-SNP). The D-SNP plans are designed for people who have both Medicare and Medicaid. Benefits, costs and OTC allowances vary by plan and by year, so check your member materials or ask our team.
Your MetroPlus Insurance Card: Which Plan Do You Have?
Look at the front of your MetroPlus insurance card to find your plan name. If you have Medicaid, you may also have a New York State benefit card, and some plans come with a separate OTC or benefit card. If you are not sure which plan you have, bring your cards to the pharmacy and our team will help you confirm your coverage.
MetroPlus Benefits You Can Use at Our Pharmacy
MetroPlus OTC Benefits and OTC Card
Some MetroPlus plans include OTC benefits that members use with a prepaid card. According to MetroPlus, Essential Plan members get the MetroPlusHealth Wellness Card, and MetroPlus Advantage and UltraCare members get the Flex Rewards card. At Colombia Pharmacy we accept OTC cards and benefit plans from major New York insurers, including MetroPlus: if you have a MetroPlus OTC card, bring it and our team will check your balance and eligibility, so you can put your credits toward over-the-counter medicine, supplements and hygiene products. At the register, the eligible amount is deducted from your balance, and if your total is higher you can pay the difference with another accepted payment method. See our OTC card guide for the products you can buy with your OTC benefits.
Check Your OTC Balance Before You Shop
Call the number on your card, check your member account, or ask our team at the pharmacy. MetroPlus says the benefits on both cards expire each quarter, so it is best to use them on time.
Prescription Transfers and Special Medication Orders
Have a prescription at another pharmacy? We handle the transfer for you in minutes at no additional cost. If a medication is out of stock or hard to find, request it with us and we will have it ready for pickup at the store the next day. For questions about how your MetroPlus plan covers a specific drug, see the next section.
MetroPlus Formulary Drug List and Prior Authorization: Questions About Your Medications
MetroPlus Medicaid Drug List: Your Drug List Is the NYRx List
For MetroPlus Medicaid members, the drug list comes from NYRx, not from MetroPlus, because the Medicaid pharmacy benefit moved to NYRx on April 1, 2023. Look up your medication in the NYRx Preferred Drug List published by New York State, or call the member services number on your card.
MetroPlus Formulary for Medicare and Essential Plan Members
MetroPlus Medicare plans and the Essential Plan have their own plan-specific formularies, or drug lists, published on the MetroPlusHealth website. Check the one that matches your plan, or call the member services number on your card. Pharmacy networks also vary by plan, so confirm with MetroPlus, or call us at (718) 424-6660 before you come, if you want to know what we can do for your prescription.
MetroPlus Authorization Form and Prior Authorization Request Form for Prescriptions
Some medications need approval before they are covered. For MetroPlus plans such as the Essential Plan, MetroPlus uses a Prior Authorization Request Form for Prescriptions that your prescriber signs and submits to the plan. For Medicaid prescriptions covered through NYRx, your doctor requests prior authorization through the NYRx program instead. For Medicare plans, ask your doctor's office or contact MetroPlus using the number on your card. Colombia Pharmacy does not approve prior authorizations; ask your doctor's office to start the request.
How to Use Your MetroPlus Plan at Colombia Pharmacy
Step 1: Bring Your MetroPlus Cards
Bring your MetroPlus plan card, your New York State benefit card if you have Medicaid, and your OTC card if your plan includes one.
Step 2: We Verify Your Coverage
Our bilingual team checks your coverage and eligibility directly at the pharmacy.
Step 3: Choose Your Eligible OTC Products
Pick your eligible OTC items, such as vitamins, personal care products and over-the-counter medicine, and pay any remaining balance with another accepted payment method.
What Our Neighbors Say
Common Questions About MetroPlus at Colombia Pharmacy
Yes. We accept MetroPlus and Medicaid. Bring your member card and our team will verify your coverage and eligibility at the pharmacy.
We accept Medicaid. For MetroPlus Medicaid members, prescription coverage goes through NYRx, so bring your New York State benefit card or your MetroPlus plan card. Call us at (718) 424-6660 to confirm what we can do for your prescription.
We accept OTC cards and benefit plans from major New York insurers, including MetroPlus. Bring your card and our team will check your balance and eligibility. If your total is higher than your balance, you can pay the difference with another accepted payment method.
It depends on your plan. Medicaid members use the NYRx Preferred Drug List published by New York State. Medicare and Essential Plan members use their plan's own formulary, published on the MetroPlusHealth website.
Your doctor submits the request. For MetroPlus plans such as the Essential Plan, it is done with the MetroPlus Prior Authorization Request Form for Prescriptions; for Medicaid prescriptions covered through NYRx, it goes through NYRx. Colombia Pharmacy does not approve prior authorizations.
Yes. We transfer prescriptions from another pharmacy in minutes at no additional cost, and if a medication is out of stock we can order it for pickup at the store the next day.
No. Colombia Pharmacy is an independent pharmacy and is not affiliated with MetroPlus. We accept MetroPlus so members can use their benefits close to home.
Visit Colombia Pharmacy in Jackson Heights
Bring Your MetroPlus Card Today
Colombia Pharmacy, 85-26 37th Ave, Jackson Heights, NY 11372. Phone: (718) 424-6660. Open Monday to Friday from 10:00 AM to 7:00 PM, and Saturday and Sunday from 10:00 AM to 5:00 PM. Call ahead if you would like us to confirm your plan before you come.
Colombia Pharmacy is an independent pharmacy and is not affiliated with, sponsored by or endorsed by MetroPlus. MetroPlus, MetroPlusHealth and plan names are trademarks of their respective owners and are used only to identify the plans we work with. Benefits, OTC allowances and drug coverage vary by plan and plan year; please confirm the details with MetroPlus or NYRx. This page is for general information only; it is not an offer to enroll you in a plan and does not replace the advice of your doctor or pharmacist.