Compare Insurance Quotes
About MVP Healthcare
MVP Healthcare was founded in 1982 in Schenectady, New York and offers primarily employer benefit plans. They offer a variety of supplemental products as well, including dental insurance and flexible spending accounts. The also have individual and family products and write Medicare Advantage plans.
MVP’s website boasts more than 700,000 members, ranging across their coverage area which includes New York State and Vermont. For an insurer covering a relatively small geographical area, they are fairly big, employing 1,600 people. MVP partners with a large number of local and national providers to create a wider network of care for its members.
MVP offers a good selection of Medicare Advantage plans, although availability depends on the county of residence. For the purpose of this review, we selected the county in which MVP’s headquarters is located, Schenectady. There are both HMO-POS and PPO plans to choose from in this county. MVP also offers Medicare Savings Accounts as an alternative to the traditional plans.
BasiCare is MVP’s base Medicare insurance plan and is also the one $0 premium choice available. As a PPO plan it offers a wide range of provider options, and low co pays in network. For an office visit, in-network co pays are $15, $50 for a specialist, $60 for Urgent Care, and $75 for emergency care. Inpatient hospital care has a $450/day co pay for the first four days; there is a 40% coinsurance cost for non-emergency hospital admissions to out of network hospitals.
There is a benefit for hearing aids, but this plan doesn’t offer either dental or vision coverage. Part D prescription drug coverage is included with a $400 deductible for Tiers 2-5 (Tiers 1 and 6 have no deductible). Tier 1 drug co pays start at $2, Tier 2 at $10, Tier 3 at $47. Tiers 4 and 5 have a 50% and 25% coinsurance respectively, and there is no charge for Tier 6 drugs.
Gold Value HMO-POS is the next plan, which has the lowest premium of the rest of the options. Co pays under this plan are $20 for office visits, $40 for specialists and Urgent Care, and $75 for emergency. Hospital stays are covered at $350/day for the first five days with no charge thereafter. Gold Value is an HMO plan but does allow for out of network care. The plan will pay 70% of non-emergency or urgent care at out of network providers up to $2,500.
This plan has the same hearing aid benefit as the basic plan, but does include coverage for dental and vision services. Part D coverage is also included with no deductible on any tier and a $0 co pay for Tier 1 and 6. Tier 2 co pays are $15, Tier 3 $45, Tier 4 50%, and Tier 5 33%.
The Gold PPO is a step up in coverage as well as in premium. Like all PPO plans, this plan has lower in-network co pays than out of network, but is less limited than an HMO. Co pays are $10 for office visits, $50 for specialists and Urgent Care, and $75 for emergency care. The daily co pay for inpatient hospital care is $295 for days one through five, while non-emergency out of network hospital stays have a 40% coinsurance as with the basic plan. Non urgent or emergency out of network care is covered with a $60 co pay for office visits and 40% coinsurance for other services.
This plan has the same hearing aid benefit offered through the other plans, and again there is no dental or vision coverage at all. Part D coverage is included with no deductible. Tiers 1 and 6 have a $0 co pay, Tier 2 a $10 co pay, Tier 3 $35, and tiers 4 and 5 are covered with coinsurance of 50% and 33% respectively.
Preferred Gold is the top level HMO-POS plan, and is available with or without Part D coverage included. The choice to add Part D does impact some of the co pay amounts. The office visit co pay is $15 either way. For specialist and Urgent Care visits, the co pay is $35 with Part D and $30 without. Emergency services have a $75 co pay either way. Inpatient hospital stays have the same coverage as the gold PPO plan, without regard to Part D coverage. Other areas impacted by the choice of Part D coverage include outpatient hospital services, ambulatory surgical center services, and x-rays.
The Part D plan, if chosen, has no deductible and the same co pay amounts as the gold PPO plan. Hearing aid coverage is the same as all other plans, but this plan does include dental and vision coverage.
Medicare Savings Accounts
An option offered by MVP that isn’t seen at most insurance companies is the choice of a Medicare Savings Account (MSA), which is combined with a high deductible Medicare Advantage Plan.
There are two SmartFund MSA account options available from MVP. The first is a $0 premium plan that includes $1,800 deposited in your MSA account by MVP when you open the account. The deductible is $6,700 for the year, with all eligible medical services covered at 100% after the deductible is met.
The second plan is the same, but adds some additional coverage for $20 per month. This includes membership in the company’s fitness plan, hearing aid benefits, dental, and vision coverage.
Both plans allow money in the MSA account to roll over into the next year. These plans do not include Part D prescription drug coverage so those seeking that coverage will need to obtain a separate plan. Currently, MVP doesn’t offer Part D as an independent plan, which means if you choose an MSA plan, you will have to get drug coverage from another company.
Since MVP is a regional company, we can’t offer a national rate comparison, nor can we compare to our usual sample. Our search for plans on a local level did return some basic premiums. As noted, the MSA account plans have either a $0 premium option or a $20 premium option.
The Medicare Advantage Plans start at $0 monthly for the BasiCare plan. The Gold Value Plan came in at $98.80 per month, the Gold PPO at $150.70, and the Gold Preferred plan $42.20 per month without Part D and $166.80 per month with Part D.
These rates are specific to the county we used as a sample, and as a result we can’t compare them easily to any other insurance company in the area. Overall, the plans appear to be of a relatively good value.
Ratings and Reviews
MVP Health Care has an A+ rating with the Better Business Bureau. There are a total of six complaints over the past three years, with one of those being closed in the past 12 months. Although they are a regional company they are relatively large, which makes these very low numbers overall.
There are 15 reviews of the company on Pissed Consumer, with an overall negative rating. Again, based on the size of the company, that’s a pretty low number. It is unusual, however, to see any reviews at all for smaller, regional companies on these review sites. Many of the complaints center on denied claims; these are difficult to judge without knowing anything about the policy, and are common to most insurance companies.
Medicare rates the company’s plans at an overall 4.5 star ranking, which places them well above average. They have a rating of 4.5 from NCQA, as well.
MVP generally appears to enjoy a strong reputation and has a low number of complaints combined with high ratings from various agencies, making the overall picture very positive.
The Bottom Line
MVP covers a small regional area, but for residents of that area they offer a nice selection of plans with a variety of price points. They have a good reputation and are a solid choice for Medicare Advantage coverage. Plans are somewhat limited in a few areas, especially dental and vision benefits, but there are options to meet just about every need.
For a list of companies that we recommend, visit our Best Insurance Companies page.