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MVP Healthcare Medicare Review

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UPDATED: Nov 30, 2018

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MVP Healthcare serves members in New York and Vermont, offering a range of health insurance options. They have a broad range of individual and family and group health plans, as well as Medicare Advantage plans available with HMO, PPO, and HMO-POS choices.

About MVP Healthcare

MVP was founded in Schenectady, New York in 1982, where the company headquarters remain today. The company operates as a not-for-profit serving both New York and Vermont and has more than 700,000 members and 1,700 employees, which is pretty big for a regional healthcare company. Coverage is not available in all counties, although an expansion in 2018 added six new counties in New York and eight in Vermont.

MVP writes major medical health plans for individuals as well as group plans for employee benefits. They offer several Medicare Advantage plans but do not write either Supplement or Part D plans. They do, however, have a Medicare Savings Account (MSA) available.

The company’s plans include access to a variety of local health systems with which MVP partners to provide care.

MVP Medicare Plans

Plan selection from MVP varies by county. For the purpose of this review, we selected the same county as the company’s headquarters, and those plans are listed below. Your choices may be different in other parts of the company’s coverage area.

Medicare Advantage

There are four Medicare Advantage plans available in our sample county. Two are PPO and two are HMO-POS plans.

WellSelect is a PPO plan with no monthly cost above the regular Medicare premium. In-network primary care visits do not have a copay, and specialist visits have a $50 copay. Hospital copay is $350 a day for the first five days.

This plan includes Part D prescription drug coverage, with a $400 deductible that applies only to Tiers 3 and up. Tier 1 drugs have a $0 copay. The plan also includes dental and hearing benefits, but it does not offer coverage for eyewear.

GoldValue is an HMO-POS plan that also has a $0 copay for primary care visits. Specialist visits have a $0 copay and hospital stays have a $335 per day copay for the first five days. Part D coverage does not have a deductible and copays start at $0 for Tier 1 drugs.

This plan includes dental, vision, and hearing coverage. As an HMO plan, out-of-network coverage is not offered except in emergencies.

GOLD PPO has $0 copays for primary care visits and $50 for specialist visits. Hospital stays are $320 a day for the first five days.

This plan does not have a deductible for prescription drug coverage and starts at $0 for Tier 1 drugs. The plan includes dental and hearing but does not offer an eyewear allowance, like the other PPO plan.

Preferred Gold is an HMO-POS plan that offers the option of including Part D coverage or purchasing coverage without prescription drugs. It has no deductible for Part D if you choose to include it, and again Tier 1 starts at a $0 copay.

Primary care has a $0 copay if you include Part D in your plan; if you choose not to, the primary care copay is $15. Specialist visits are $50 with or without Part D, and hospital stays are $305 a day for the first five days with Part D and $350 a day for the first five days without it. This plan includes dental, vision, and hearing as well.

MSA Plans

MVP offers the option of their SmartFund MSA plan, which is a high deductible Medicare Advantage Plan that uses a Medicare Savings Account to help pay out of pocket costs. Neither plan includes Part D coverage, but a rider can be added that adds dental, hearing, and vision, as well as the fitness plan.

Under this plan, MVP deposits $2,400 into an MSA on your behalf (you can add more). The plan then has an $8,000 deductible, towards which the deposited amount can be used. There is no out-of-pocket cost after that deductible is met.

Rates

MVP’s rates are made clear on the site – the ones we looked at are the numbers for the particular county we chose, so these will vary depending on where you live.

WellSelect is a $0 premium plan, meaning you pay nothing beyond your regular Medicare premiums. GoldValue came in at $80.80 a month, Gold PPO at $105 a month, and Gold Preferred is $120 a month with Part D and $59.20 without Part D.

The SmartFund plan does not have a monthly premium unless you choose to add the dental, vision, and hearing rider, which has a premium of $22 a month.

These rates are not comparable on a national level since the company only provides coverage in two states. As a result, we are unable to really speak to what kind of value they offer without comparison rates in those particular locations. There are, however, two $0 premium options, and monthly rates seem reasonable for the coverage they provide.

Claims

Claims are handled directly with providers in most cases, the website does not offer claims information for Medicare. This is a common practice for most health insurance companies.

General claims forms can be downloaded on the main site, but we did not find anything Medicare-specific.

Ratings and Consumer Reviews

MVP Healthcare has an A+ rating with the Better Business Bureau (BBB) with only six complaints on file in the past three years. They have five reviews on the file, with an overall one-star rating. Complaints focus on billing issues and claims problems.

The National Committee for Quality Assurance gives both MVP’s HMO and PPO plans an overall four-star rating out of a possible five. That is above average and a good rating for a Medicare Advantage company.

Medicare gives MVP’s Advantage plan a 4.5-star rating out of five for 2019, which is excellent.

There are 18 complaints about MVP on Pissed Consumer. Most of them are centered on claims being denied. For the size of this company, the number of complaints is really quite low.

Overall, we see a lot of positive about this company and not much in the negative.

The Bottom Line

MVP Healthcare has some good plans available for Medicare Advantage customers, and that includes a $0 premium option. They rate well with consumer survey sources and have a low complaint volume for a solid reputation. If you are in their service area, they are well worth a look for your coverage needs.

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 Healthcare Medicare
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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.

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