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