MVP Health Care Insurance Review & Complaints: Health Insurance

MVP Health Care rates for a single person are as low as $373.09/mo and as high as $1,902.95/mo. A regional insurer, MVP Health Care offers individual and family plans to over 700,000 members in New York and Vermont.

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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 place to get it.

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Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc...

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Reviewed by Leslie Kasperowicz
Farmers CSR for 4 Years

UPDATED: May 4, 2021

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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.

What is MVP health insurance?

MVP was founded in 1982 and has its headquarters in Schenectady, NY to this day. They offer a range of health 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 Health Care, Inc. 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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What MVP health plan type is offered?

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.

What are the rates for MVP services?

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.

How are claims processed?

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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Are ratings and consumer reviews positive?

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.

What is the bottom line?

MVP is an insurance company that 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.

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