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 (2022)

State New York
Plan Type HMO
Exchange On
Metal Level NA
Annual In-Network Deductible (Single/Family) $8,700 / $17,400
Annual Out-of-Network Deductible N/A
Annual In-Network Out-of-Pocket Limit (Single/Family) $8,700 / $17,400
Annual Out-of-Network Out-of-Pocket Limit N/A
Primary Care Visit 0% coinsurance (First 3 visits no Deductible)
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. 30 day retail/90 day mail order.; $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 2022 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 20% discount on CVS brand health-related items
Well-Being Features $600 WellBeing Rewards
Availability January 1, 2022