MVP Medicare Advantage plans are available in two northeastern states — New York and Vermont. The policies provide hospitalization and outpatient medical insurance, as well as prescription drug coverage and extra perks.
Some MVP costs, such as monthly premiums and hospitalization copayments, may vary among the different plan options.
This article gives an overview of Medicare Advantage and the different types of plans. It then introduces MVP Health Care and examines the plans’ coverage, new features, and costs.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Private companies administer Medicare Advantage plans, which people sometimes refer to as Medicare Part C.
Medicare Advantage plans are an alternative to original Medicare, which comprises Part A, inpatient hospitalization insurance, and Part B, outpatient medical insurance.
In addition to providing the same benefits as parts A and B, most Medicare Advantage plans offer prescription drug coverage.
Some also include benefits that original Medicare does not provide, such as dental and vision care.
Medicare Advantage plans vs. original Medicare
A primary way in which Medicare Advantage plans differ from original Medicare involves the choice of providers.
While a person with original Medicare may choose from any healthcare provider that accepts Medicare, someone with a Medicare Advantage plan must usually choose from in-network providers, who often have contracted and lower healthcare costs.
The other difference is that Medicare Advantage plan providers set annual limits on out-of-pocket costs. Once a person’s costs exceed this amount, they pay nothing for Medicare-approved services.
There are many different types of Medicare Advantage plans, but those below are the most common:
- Health Maintenance Organization (HMO) plans, most of which include prescription drug coverage, usually require a person to choose an in-network healthcare provider. There are a few exceptions, such as if the person needs emergency care.
- Preferred Provider Organization (PPO) plans offer someone the flexibility of selecting from in-network or out-of-network healthcare providers. However, in-network providers usually have lower costs.
- Private-Fee-for-Service (PFFS) plans have set fees that they pay providers, along with set fees that a person pays for their care. An individual with a PFFS plan may choose from in-network or out-of-network providers, but as with PPO plans, the in-network ones have lower costs.
- Special Needs Plans (SNPs) limit membership to people with specific medical conditions, such as end stage renal disease. Medicare tailors the plans’ drug formularies, benefits, and healthcare provider choices to meet people’s particular needs.
Two less common types of Medicare Advantage plans are:
- Health Maintenance Organization Point of Service (HMO-POS): These plans differ from HMO plans in one way: Individuals with HMO-POS plans may receive services from some out-of-network providers, but the costs are higher.
- Medicare Medical Savings Account (MSA): These plans deposit funds from Medicare into a person’s bank account. Someone may use the funds to pay their healthcare expenses, but only Medicare-covered services count toward the deductible.
MVP Health Care are an insurance company that offer health plans in New York and Vermont. The company provide several Medicare Advantage plans that fall into either the HMO-POS or PPO category.
The National Committee for Quality Assurance (NCQA) have awarded MVP’s HMO-POS plans an accredited status with an overall score of 4.0 out of 5.0.
Medicare gives the HMO-POS plans a 4.5-star rating and the PPO plans a 4-star rating.
MVP Medicare Advantage plans provide hospitalization benefits in addition to medical services, such as doctor visits, lab tests, and cardiac rehabilitation.
They also offer coverage of prescription drugs, chiropractic care, and diabetic supplies.
Some plans include extra benefits, such as dental, hearing, and vision care.
All plans include:
- free SilverSneakers gym membership, which gives people access to exercise classes and online videos
- free telemedicine services
- access to 24-7 expert health advice
- a free home visit from a nurse practitioner to evaluate a person’s health
- home-delivered meals for a limited time following discharge from a hospital
- free medication review program
- free health management support
- free MPV Living Well program — a health education program that comes with free or discounted exercise classes
New 2021 MVP Advantage plan features
In 2021, new features for some MVP Medicare Advantage plans will include:
- the option to add a $1,000 per year dental benefit
- up to $200 for over-the-counter medications
- free one-way transportation for up to 12 doctor appointments
People with Medicare Advantage must pay the Part B monthly premium, which is $148.50 in 2021.
Aside from this expense, a person with an MVP Medicare Advantage plan must pay deductibles, copays, coinsurance, and monthly premiums.
Some expenses may vary by plan, but below are a few costs to expect:
- monthly premiums ranging from $0 to $149
- copayments of $90 for emergency room services
- copayments of $320 to $385 per day for days 1–5 of in-network hospitalizations
The following have zero dollar copayments:
- $0 for in-network primary doctor visits
- $0 for in-network provider lab tests
- $0 per day for in-network hospitalizations from day 6 onward
Choosing a Medicare Advantage plan is an important decision, and there are many aspects to consider.
A person may wish to compare all the plans’ costs and weigh these against their benefits.
It may help to seek advice before making a final decision.
An individual can call 800-324-3899 to speak with an MVP Medicare Advisor. A deaf person can call 800-662-1220.
People can also contact the MVP Medicare customer care center on 800-665-7924, or 800-662-1220 if they are deaf.
Before selecting a health plan, it may be advisable to check the options that other companies offer. A person can use Medicare’s search tool to view policies from all companies in their area.
An individual may call 800-MEDICARE (800-633-4227) for impartial advice, and a deaf person may call 877-486-2048.
Alternatively, the State Health Insurance Assistance Program (SHIP) also offer impartial advice. People can contact them by phone on 877-839-2675 or via email at info@shiptacenter.org.
MVP Medicare Advantage plans are an alternative to original Medicare, so they provide the same benefits as parts A and B.
They also offer prescription drug coverage and other perks, such as disease management support, medication review, and telemedicine.
Some plans also include dental, vision, and hearing care.
It can be difficult for a person to choose a Medicare plan that best suits their needs, and they may wish to seek impartial advice. A Medicare representative or the SHIP can provide unbiased guidance.