2026 Highlights for Commercial Health Plans
Explore MVP Health Care’s 2026 commercial health plan updates, including new plan features, expanded benefits, and virtual care enhancements for New York and Vermont plans.
2026 New York Plan Updates
New York Small Group and Individual Plans
New York Small Group Gold 14 HMO and EPO and New York Gold 14 Individual HMO plans cover more of the essential care members need, including:
- $0 deductible
- $0 primary care and/or mental health visits (5 combined visits)
- $0 Tier 1 drugs
ACA Pediatric Dental Benefit
MVP New York Individual Premier Plus ® (Non-Standard) plans now include the embedded ACA pediatric dental benefit.
New York Large Group Plans
All EPO/PPO non-grandfathered plans will include:
- $0 primary care visits and Tier 1 drugs to anyone under the age of 19
- Acupuncture benefits at the specialist cost-share1
The Large Group product portfolio now includes:
- A plan with a $9,500 deductible and a $19,000 out-of-pocket maximum
- A plan that offers $0 primary care, specialist, and urgent care co-pays, as well as Tier 1 drugs
2026 Vermont Plan Updates
Vermont Large Group Plans
- Autism treatment services, following the primary care visit cost-share (this benefit excludes devices)
- Outpatient hospice, following the specialist visit cost-share
- Variable product approval, allowing for more flexible and competitive plan designs
- Embedded ACA pediatric dental benefit
Exceptional Benefits. Comprehensive Coverage.
MVP makes it easy for you to deliver the coverage employers want and the care members deserve—so you can sell with confidence.
New for 2026!
Gia® virtual care services
$0 Gia® virtual care services—including 24/7 primary and urgent care, nutrition, and some behavioral health services—are available on all New York and Vermont Commercial Large Group, Small Group, and Individual plans, now including qualified high-deductible plans before the deductible effective January 1, 2026.
Some specialty virtual care providers included in Gia, in-person visits, and referrals may be subject to the plan’s applicable co-pay/cost-share. Estimated visit costs will be listed in Gia at the time of service.
New for 2026!
Empowering the Well-Being of Women
Women’s health needs are unique, yet too often underserved. MVP supports clinical programs across the full life journey with women at the center—now including a complete maternity care experience from fertility to first steps, menopause and hormonal transition care, and ongoing coaching support.
Members can also receive a $1,500 reimbursement per contract, per year, for support services from a certified and/or trained doula upon 2026 plan renewal.2
Coast-to-Coast Coverage
A regional network of top providers, hospitals, and pharmacies—and access to over 1,000,000 providers nationwide with select plans.
Integrated Health Reimbursement Arrangements
Pairing seamlessly with group plans, HRAs simplify administration and boost employee satisfaction—making them an easy win for employers.
$600 Well-Being Reimbursement
Members can get reimbursed up to $600 per contract, per calendar year for well-being services, items, and activities.3
CVS Caremark Cost Saver™
MVP Commercial plan members will have access to GoodRx® prescription pricing, lowering their out-of-pocket costs for many generic prescription drugs. To receive the savings benefit, members simply present their MVP Member ID card at in-network pharmacies.
Resources to Help You Sell
Review the plan highlight and change flyers to become an expert on 2026 plan and spending account options.
Diversified Services
Vision plans, dental plans, spending accounts, COBRA administrative services, and more!
Learn More1Available on Large Group EPO plans only (unless customized or grandfathered in)
2Benefits and services vary by plan type.
3$600 reimbursement, per contract, per calendar year for eligible expenses. Available on select plans.
Health benefit plans are issued or administered by MVP Health Plan, Inc.; MVP Health Insurance Company; MVP Select Care, Inc.; and MVP Health Services Corp., operating subsidiaries of MVP Health Care, Inc. Not all plans available in all states and counties.
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