Standard Individual Catastrophic Plans
MVP Health Care standard individual catastrophic plans, part of MVP's suite of Premier plans offered on New York State of Health.
View all MVP NY Individual & Family Plans
MVP Secure FRNY-HMO-DC-001-S (2023) |
|
|---|---|
| State | New York |
| Plan Type | HMO |
| Exchange | On |
| Metal Level | NA |
| Annual In-Network Deductible (Single/Family) | $9,100 / $18,200 |
| Annual Out-of-Network Deductible | N/A |
| Annual In-Network Out-of-Pocket Limit (Single/Family) | $9,100 / $18,200 |
| Annual Out-of-Network Out-of-Pocket Limit | N/A |
| Primary Care Visit | 0% coinsurance (First 3 Combined PCP, MH, SA Visits Not Subject to DD) |
| Specialist Visit | 0% coinsurance |
| ER | 0% coinsurance Deductible applies. |
| Urgent Care | 0% coinsurance Deductible applies. |
| Generic Rx Coverage (Tier 1) | 0% coinsurance Deductible applies. 30 day retail/90 day mail order |
| Preferred Rx Coverage (Tier 2) | 0% coinsurance Deductible applies. $100 max out of pocket on 30 day supply of Insulin |
| Non Preferred Rx Coverage (Tier 3) | 0% coinsurance Deductible applies. 30 day retail/90 day mail order |
| Rx Formulary | 2023 MVP Marketplace Formulary (PDF) |
| Rx Drug Search | Pharmacy Information for New York’s Prescription Drug Program |
| Find a Doctor | Doctor Search |
| Summary of Benefits and Coverage (SBC) | Click here to open detailed plan benefit information |
| Plan Overview | Click here to open the plan overview document |
| Plan Highlights | Savings at preferred provider facilities, 20% discount on CVS brand health-related items |
| Well-Being Features | $600 Well-Being Reimbursement |
| Availability | January 1, 2023 |