Medicare Coverage for Employer- and Union-Group Retirees
MVP is proud to offer Medicare Advantage plans to retirees of employer and union groups throughout our service area. Our plans offer comprehensive coverage beyond Medicare parts A and B, including prescription drug coverage, worldwide emergency room and urgent care coverage, and access to an extensive network of doctors and hospitals, plus out-of-area coverage and 24/7 virtual care through the Gia® by MVP mobile app.
Employer Group Medicare Advantage Plan Information
All MVP Employer Group Medicare Advantage plans include:
- $0 Preferred Generic Drugs
- $0 SilverSneakers™ fitness membership
- $0 Virtual Care services, including emergency, urgent, and primary care, as well as mental health and psychiatry
- Hearing aid discounts —save thousands of dollars off retail
- Programs to support your complete well-being, from chronic conditions to behavioral health
Learn more about your plan Health and Wellness benefits , and find important forms. Or sign into your MVP member account to view specific benefit information such as coverage and cost details, and to access plan documents.
Our Medicare Advantage plans provide comprehensive prescription drug coverage with access to Medicare-approved drugs and benefits that offer more than the standard Part D coverage.
For a full list of generic and brand name drugs covered by MVP Employer Group Medicare Advantage plans (also known as a formulary), view the documents below.
MVP Formulary Documents
- 2023 Medicare Part D Comprehensive formulary (PDF) (list of covered drugs) (updated 9/2023)
- Monthly Medicare Formulary Updates (PDF) (updated 9/2023)
$0 Preferred Generic Drugs
We cover many commonly used generic drugs at no cost. Tier 1 of the Formulary—Preferred Generic Drugs—includes select drugs to treat diabetes, blood pressure, bone health, and high cholesterol. Talk to your doctor to see if these drugs may be right for you.
Drugs With Restrictions
For safety reasons and/or cost savings, certain prescription drugs have added requirements for coverage or limits on coverage. These requirements and limits ensure that members use these drugs in the most effective way and help control drug plan costs. A team of doctors and pharmacists developed these requirements and limits for our health plans to help us provide quality coverage to our members.
Certain drugs have limits on the quantity that can be covered. See a full list (PDF) of drugs with quantity limits for 2023.
Some drugs require approval, also known as prior authorization, from us before they can be filled. See a full list (PDF) of drugs require prior authorizations for 2023
You can learn more about your prescription drug coverage, including participating pharmacies and cost-saving mail-order prescriptions on our Medicare Part D page.
MVP USA Care PPO™ Plan
If your employer offers USA Care, you have the freedom to see any provider in the U.S. who accepts Medicare for a fixed co-pay. You cannot be billed for any other amounts above your cost-sharing amount.
USA Care works just like traditional health insurance. Simply show your MVP USA Care Member ID card at the doctor’s office. You may have a co-pay due at that time.
To be eligible to provide care to a USA Care plan member, providers must be state-licensed and have a Medicare billing number, or be eligible to obtain one. Institutional providers treating USA Care members, such as hospitals and skilled nursing facilities, must contract with Medicare to treat Medicare beneficiaries. The Medicare program reports that over 90% of all health care providers accept Medicare payment. To find doctors, hospitals, and other providers who participate with Medicare, visit the website for Medicare.
If your doctor or other health care provider would like more information about USA Care, they may call MVP Provider Services at 1-800-684-9286 (TTY 711).
MVP Health Plan, Inc. is an HMO-POS/PPO/HMO D-SNP organization with a Medicare contract and a contract with the New York State Medicaid program. Enrollment in MVP Health Plan depends on contract renewal. MVP Health Plan, Inc. has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until 12/31/2024 based on review of MVP Health Plan’s Model of Care. Health benefit plans are issued by MVP Health Plan, Inc., an operating subsidiary of MVP Health Care, Inc. Not all plans available in all states and counties. Every year, Medicare evaluates plans based on a 5-star rating system. Out-of-network/non-contracted providers are under no obligation to treat MVP Health Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. For accommodationsofpersons with special needs at meetings, call 1-800-324-3899 (TTY 711).
Other physicians/providers are available in the MVP Health Care network. MVP virtual care services through Gia are available at no cost-share for most members. In-person visits and referrals are subject to cost-share per plan. Members enrolled in a Medicare Rx plan without additional MVP medical coverage do not have access to MVP virtual care services through Gia. SilverSneakers is a registered trademark of Tivity Health, Inc. SilverSneakers On-Demand is a trademark of Tivity Health, Inc. ©2023 Tivity Health, Inc. All rights reserved. GetSetUp is a third-party provider and is not owned or operated by Tivity Health, Inc. (“Tivity”) or its affiliates. Users must have internet service to access online services. Internet service charges are responsibility of user.
TruHearing® and (RE)TM are trademarks of TruHearing, Inc. All other trademarks, product names, and company names are the property of their respective owners. Retail pricing based on prices for comparable aids. Follow-up provider visits included for one year following hearing aid purchase. Free battery offer is not applicable to the purchase of rechargeable hearing aid models. Three-year warranty includes repairs and one-time loss and damage replacement. Hearing aid repairs and replacements are subject to provider and manufacturer fees. For questions regarding fees, contact a TruHearing hearing consultant.
©2023 NationsBenefits, LLC. and NationsOTC, LLC. NationsOTC is a registered trademark of NationsOTC, LLC. All other marks are the property of their respective owners. Mom’s Meals® is a registered trademark of PurFoods, Inc.
Y0051_9080 | Last Updated: 10/1/2023
Speak to a Representative
To shop for a plan, contact an MVP Medicare Advisor at 1-800-324-3899 (TTY 711)
From April 1-September 30, reach us Monday-Friday, 8 am-8 pm.
From October 1-March 31, reach us seven days a week, 8 am-8 pm.