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MVP Health Care Review

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Eric Stauffer is a former insurance agent and banker turned consumer advocate. His priority is to help educate individuals and families about the different types of insurance they need, and assist them in finding the best...

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UPDATED: Nov 30, 2018

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MVP Health Care is large for a regional insurer, with more than 700,000 members in New York and Vermont. The company offers individual and family plans as well as Medicare coverage.

About MVP

MVP was founded in 1982 and has its headquarters in Schenectady, NY to this day. They offer a range of plans including HMO-POS plans for individuals and families, groups, Medicare Advantage, and other supplemental plans. We specifically focused on MVP’s Medicare plans in a separate review, so we will focus this review on the other plans they offer.

MVP employs 1,600 people throughout the coverage area, and partners with other medical groups in order to expand the network available to their members. Insurance can be purchased directly or through a broker. Plan availability is based on the zip code of the customer’s residence.

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MVP Health Plans

For the purpose of this review, we pulled up the plans available to those living in the same zip code as the company’s headquarters. Our search returned a large number of plans, with several options at each of the metal levels. There are six each at the bronze, silver, and gold levels, and three plans at the platinum level. Some plans include the option of an HSA. None of the plans have coverage for out-of-network care.

Bronze Plans

There are six bronze level plans, with varying levels of deductibles, copays, and coinsurance amounts. The highest deductible amount is the Premier Plus HDHP Bronze 6, which has deductibles of $6,550 per person and $13,100 per family. The lowest deductibles are found with the Premier Plus Bronze 1, with a $3,900 per person and $7,800 family deductible.

Copays range from a 50% coinsurance to a $0 copay for office and specialist visits with the Bronze 6 plan. Tier 1 prescription drugs range from a $0 copay to a $10 copay and go up from there.

Silver Plans

Again, there are six plans and some are HSA compatible. The highest deductible amount with the silver plans is found in the Premier Plus Silver 9, at $4,000 per person and $8,000 for the family. The lowest deductible is found in the Premier Plus Silver 1, which has an individual deductible of $1,800 and a family deductible of $3,600.

Copays range from $30 to $45 for primary care visits, while specialist visits range from $50 to $70. Prescription coverage starts at $10 for Tier 1 drugs, with some plans starting at $15.

Gold Plans

Of the six gold plans, one, the Premier Plus Gold 4, has a $0 deductible. Deductibles rise from there to $1,600 per person and $3,200 per family for the Premier Plus HDHP Gold 2 plan. The rest of the plans have deductibles falling in between, with several options that are quite low.

Copays for primary care range from $5 up to $40, while specialist visit copays range from $25 to $50. All plans start at either $5 or $10 for Tier 1 prescription drugs.

Platinum Plans

All three of the Platinum plans have a $0 deductible, with primary care visits ranging from $5 to $15 and specialist visits from $35-$45.

Prescription coverage starts at either $5 or $10 for Tier 1 generic drugs. It is no a surprise to see that these are the most expensive plans in terms of monthly premiums.

MVP Rates

MVP makes it simple to obtain rate information, as it is listed right along with the basic summary of benefits for each plan. During the search process, customers can provide information regarding their preferences – how much they would like to spend monthly and what deductible level they prefer. This allows the search to return more focused results. We ran a search that gave us all available plans.

New York is well known for being one of the most expensive states for health insurance. As a result, it is not a surprise to see that MVP’s rates are higher than we see in other states.

The lowest rate found was $373.09 per month for a single person on the Premier Plus Bronze 2 plan. The highest rate is the Premier Platinum plan, coming in at $667.70 for one person. Family rates reach as high as $1,902.95 per month for the Platinum plan, with the lowest again being the Premier Plus Bronze 2 at $1,063.31.

Claims

MVP is an HMO provider, which generally means claims are processed quickly due to the direct connection between insurer and provider. Because the plans do not offer out-of-network coverage – with the exception of special situations that may require pre-approval – this type of care would simply be paid out of pocket directly.

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Ratings and Consumer Reviews

MVP currently has an A+ rating with the Better Business Bureau (BBB). A total of six complaints have been filed in the last 12 months, one of which has been closed in the past 12 months. It is not always easy to put complaint volume into perspective, however, in this case, with seven complaints and 700,000 members, the math is easy – one complaint per 100,000 members – which is very low.

There are 15 complaints on Pissed Consumer, most of which are in regards to coverage denial issues and difficulty finding providers. Again, the complaint volume is low given the company’s size.

The National Committee for Quality Assurance ranks MVP at an overall 4.5, and they tend to rank high in most areas, particularly when it comes to consumer satisfaction. Only a few areas show low rankings, mostly in specific treatment areas.

The ratings, rankings, and complaint volume all add up to a pretty good reputation for MVP, with nothing that raises red flags in any of the ratings.

The Bottom Line

MVP offers a good range of plan options, so many in fact that it may become confusing to insurance shoppers. Their prices are in line for New York health insurance, and there are options for a variety of budgets. For those who don’t mind the limited network of an HMO, MVP is a good choice.

For a list of companies that we recommend, visit our Best Insurance Companies page.

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Review Information

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MVP Health Care
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About Eric Stauffer

Author: Eric StaufferI am a former insurance agent and banker turned consumer advocate. My priority is to help educate individuals and families about the different types of insurance they need, and assist them in finding the best place to get it.

7 Comments

  1. MVP is the absolute WORST insurance company I’ve ever dealt with in my life!!

    The copays are outrageous, they charge triple for RX’s that GoodRX does and they deny every surgery that is put in for approval.

    I’ve been denied 8 times to fix a recurring hiatal hernia and today I found out that I was denied for a very minor knee scope to fix a torn meniscus.

    They are the PITS and Should be shut down and the CEO sent to jail for such piss poor customer service!!

    It is ALL about how much they can rip you off for and NOTHING whatsoever about any health CARE.

    If it costs them money, even if you’re dying, you will be denied any help from them.

    Reply
  2. MVP never paid for the cardiologist visit that cost me $ 1568,

    that’s a lot of money to lose and they still owe me that money back because I m paying them to pay for that visit.

    Reply
  3. MVP claims to have an A+ rating,

    I believe that is also a lie! They do not serve their paying customers!

    They do not care how their Doctors offices treat their paying customers!

    MVP has to be the worst as we can see from most of their reviews. But still, give themselves an A+.

    The people are not giving you an A+, you are giving yourself an A+! You get an F!

    Reply
  4. Four weeks after my 19 September 2018 CT Scan procedure, MVP notified me by its 19 October 2018 letter that MVP is not covering any of that $1,927.82 CT scan for which MVP itself had pre-authorized insurance covered approval. MVP’s 19 October 2018 notification fraudulently states that CT Scan was done without MVP approval.

    Contrary to MVP’s fraud, the truth is that MVP pre-authorized its insurance approval of a CT Scan procedure that my urologist scheduled with radiology. MVP electronically even sent my urologist an MVP pre-authorized insurance approval code number [redacted] for that radiology CT scan. That 19 September 2018 CT Scan occurred weeks before the 02 November 2018 expiration date of that MVP pre-authorized insurance approval.

    And when I arrived on 19 September 2018 at the radiology unit for that CT, the radiology unit told me that MVP had pre-authorized insuring my CT Scan, and that I would only owe an MVP required $140 copay.

    Now, MVP is requiring me at my time and expense to initiate a formal written Appeals process internally with MVP solely caused by MVP’s own fraudulent actions, lies, and breach of contract.

    Reply
  5. MVP is shocking bad. Reps provide conflicting information. Hospital and provider networks are horrific. I needed to go out of network and they refused to approve even though their reps told me they could not give me a place in the network. Only when I found a place out of network did they tell me about places in the network. The in-network places were worse and long travel time from my house. They don’t care that I was out of work needing treatment.

    Reply
  6. MVP has the worst customer service on earth. Last year I ended paying some costs myself because MVP kept telling one, & only one, provider that my insurance had been canceled. This year, after making the binder payment of nearly $800, my pharmacist told me my insurance had been canceled.

    The first MVP person with whom I spoke two days ago spent a lot of time with me, finally handing it to the proper department, marked urgent.

    Yesterday, still no meds because still no insurance. The first representative hung up on me and the second simply wanted to leave it at “yep, it’s canceled.” After demanding repeatedly to speak with a manager, she finally confirmed that the woman the day before had put in an urgent request for a correction, but, oh well, they’d have it fixed within four days. More insistence and she said the manager, [Redacted], would have it done in “two or maybe four, or maybe more, hours,” and someone would call when it was done. Now it’s Saturday, I still have no insurance or medication, and MVP is closed. I hate MVP with a passion that can’t possibly be healthy.

    Reply
    • Sounds like MVP.
      They are the worst company I have ever dealt with of any kind!

      Reply

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