MVP Medicare Preferred Gold without Part D (HMO-POS)

New York Medicare Advantage Plan (2024 Plan)


Monthly Premium

Your Cost
$0
by MVP HEALTH CARE

Additional Coverage

HearingVisionDental

Overall Government Star Rating

 4.5
out of 5 stars

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Plan Name
MVP Medicare Preferred Gold without Part D (HMO-POS)
Insurance Carrier
MVP HEALTH CARE
Plan Type
Medicare Advantage Plan Without Prescription Drugs
Network Type
HMO

MVP Medicare Preferred Gold without Part D (HMO-POS) is a Medicare Advantage Plan Without Prescription Drugs, which is available in New York and offered by the health insurance company MVP HEALTH CARE. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.

Monthly Premium
$0
Annual Deductible
$0
Max Out-of-Pocket
$6,700
Primary doctor visit
$0 copay
Specialist visit
$30 copay per visit
ER visit
$95 copay per visit (always covered)
Ambulance
$75 copay

MVP Medicare Preferred Gold without Part D (HMO-POS) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $6,700 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for MVP Medicare Preferred Gold without Part D (HMO-POS) are defined below.

No
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing

MVP Medicare Preferred Gold without Part D (HMO-POS) is a Medicare Advantage plan which does not include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. MVP Medicare Preferred Gold without Part D (HMO-POS) includes coverage for hearing, vision, dental.

Medicare Advantage health plans can offer even more additional benefits. MVP Medicare Preferred Gold without Part D (HMO-POS) includes coverage for the following additional benefits:

Other benefits

Fitness benefit
Limited coverage
Over the counter drug benefits
Limited coverage
In-home support services
Not covered
Home and bathroom safety devices
Not covered
Meals for short duration
Limited coverage
Annual physical exams
Limited coverage
Telehealth
Limited coverage

Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2024, MVP Medicare Preferred Gold without Part D (HMO-POS) received an overall government quality rating of 4.5 stars out of 5 stars.

MVP Medicare Preferred Gold without Part D (HMO-POS) performed better than New York’s State average overall quality score of 3.8 stars.

This Plan’s 5-star Gov’t Quality Score
New York State Average Score
Overall Government 5 Star Quality Rating
 4.5
 3.8
Summary rating of health plan quality
 4
 3.7
Staying healthy: screenings, tests, & vaccines
 5
 4.0
Managing chronic (long term) conditions
 3
 3.4
Member experience with health plan
 5
 3.3
Member complaints & changes in the health plan's performance
 4
 3.8
Health plan customer service
 4
 4.1

The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.

MVP Medicare Preferred Gold without Part D (HMO-POS) received 4 stars for its health plan quality score which is better than the New York State average health plan quality score of 3.7 stars.


Monthly Premium
$0
Health Portion of Premium
$0
Drug Portion of Premium
$0
Health Plan Deductible
$0
Health Plan Max Out-of-Pocket
$6,700 In-network
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
Yes
Dental Coverage included
Yes

Doctor Services

Primary doctor visit
In-network: $0 copay
Out-of-network: 30% coinsurance per visit
Specialist visit
In-network: $30 copay per visit
Out-of-network: 30% coinsurance per visit

Tests, labs, & imaging

Diagnostic tests & procedures
In-network: $10 copay
Out-of-network: 30% coinsurance
Lab services
In-network: $0-10 copay
Out-of-network: 30% coinsurance
Diagnostic radiology services (like MRI)
In-network: $30-75 copay
Out-of-network: 30% coinsurance
Outpatient x-rays
In-network: $30 copay
Out-of-network: 30% coinsurance
Emergency care
$95 copay per visit (always covered)
Urgent care
$50 copay per visit (always covered)

Hospital Services

Inpatient hospital coverage
In-network: $345 per day for days 1 through 5
$0 per day for days 6 through 90
Out-of-network: 30% per stay
Outpatient hospital coverage
In-network: $250 copay per visit
Out-of-network: 30% coinsurance per visit

Skilled nursing facility

Skilled nursing facility
In-network: $0 per day for days 1 through 20
$203 per day for days 21 through 100
Out-of-network: Not Applicable

Preventive services

Preventive services
In-network: $0 copay
Out-of-network: 30% coinsurance

Ambulance

Ground ambulance
In-network: $75 copay
Out-of-network: $75-150 copay

Therapy services

Occupational therapy visit
In-network: $20 copay
Out-of-network: 30% coinsurance
Physical therapy & speech & language therapy visit
In-network: $20 copay
Out-of-network: 30% coinsurance

Mental health services

Outpatient group therapy with a psychiatrist
In-network: $30 copay
Out-of-network: No Data
Outpatient individual therapy with a psychiatrist
In-network: $30 copay
Out-of-network: No Data
Outpatient group therapy visit
In-network: $30 copay
Out-of-network: No Data
Outpatient individual therapy visit
In-network: $30 copay
Out-of-network: No Data

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
In-network: 20% coinsurance per item
Out-of-network: 30% coinsurance per item
Prosthetics (like braces, artificial limbs)
In-network: 0-20% coinsurance per item
Out-of-network: 30% coinsurance per item
Diabetes supplies
In-network: $0 copay
Out-of-network: No Data

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

Part B Drugs

Chemotherapy drugs
In-network: 0-20% coinsurance
Out-of-network: No Data
Other Part B drugs
In-network: 0-20% coinsurance
Out-of-network: No Data

Hearing

Hearing exam
In-network: $0 copay
Out-of-network: 30% coinsurance
Fitting/evaluation
In-network: $0 copay
Out-of-network: No Data
Hearing aids - All types
In-network: $699-999 copay
Out-of-network: No Data

Preventive Dental

Oral exam
In-network: $0 copay
Out-of-network: 20-50% coinsurance
Cleaning
In-network: $0 copay
Out-of-network: 20-50% coinsurance
Fluoride treatment
In-network: $0 copay
Out-of-network: 20-50% coinsurance
Dental x-rays
In-network: $0 copay
Out-of-network: 20-50% coinsurance

Comprehensive dental

Non-routine services
In-network: $0 copay
Out-of-network: 20-50% coinsurance
Diagnostic services
In-network: $0 copay
Out-of-network: 20-50% coinsurance
Restorative services
In-network: $0 copay
Out-of-network: 20-50% coinsurance
Endodontics
In-network: $0 copay
Out-of-network: 20-50% coinsurance
Periodontics
In-network: $0 copay
Out-of-network: 20-50% coinsurance
Extractions
In-network: $0 copay
Out-of-network: 20-50% coinsurance
Prosthodontics, other oral/maxillofacial surgery, other services
In-network: $0 copay
Out-of-network: 20-50% coinsurance

Vision

Routine eye exam
In-network: $0 copay
Out-of-network: $0 copay
Contact lenses
In-network: $0 copay
Out-of-network: No Data
Eyeglasses (frames & lenses)
In-network: $0 copay
Out-of-network: No Data
Eyeglass frames (only)
In-network: $0 copay
Out-of-network: No Data
Eyeglass lenses (only)
In-network: $0 copay
Out-of-network: No Data
Upgrades
In-network: $0 copay
Out-of-network: No Data

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