Find key documents and additional information to help you manage your plan. The documents and notices below are organized by plan type and region/coverage area.
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Medicare Advantage
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UVM Health Advantage
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DualAccess
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Individual & Family
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Small Group Employer
2024 Plan Documents
Benefits at a Glance
Annual Notice of Coverage (ANOC)
Capital District, Southern Tier, Hudson Valley, Central New York
Capital District, Southern Tier, Hudson Valley, Central New York, Vermont
East Region
- Medicare WellSelect with Part D (PPO)
- Medicare WellSelect Plus with Part D (PPO)
- MVP Medicare Patriot Plan with Part D (PPO)
Hudson Valley
- Medicare WellSelect with Part D (PPO)
- MVP Medicare WellSelect® with Part D (PPO)(Spanish)
- MVP Medicare Patriot Plan with Part D (PPO)
Rochester and Buffalo
Evidence of Coverage (EOC)
Capital District, Southern Tier, Central New York
Capital District, Southern Tier, Hudson Valley, Central New York
- Medicare Preferred Gold without Part D
- Medicare Preferred Gold with Part D
- Medicare Secure with Part D
Capital District, Southern Tier, Hudson Valley, Central New York, Vermont
Hudson Valley
Rochester and Buffalo
Summary of Benefits (SB)
Capital District, Southern Tier, Hudson Valley, Central New York
- Medicare Secure with Part D (HMO-POS), Medicare Preferred Gold with Part D (HMO-POS)
- Medicare WellSelect Plus with Part D (PPO)
Capital District, Southern Tier, Hudson Valley, Central New York, Vermont
- Medicare Secure Plus with Part D (HMO-POS), Medicare Preferred Gold without Part D (HMO-POS
- Medicare WellSelect with Part D (PPO)
Hudson Valley
- Medicare WellSelect with Part D (PPO), Medicare WellSelect Plus with Part D (PPO)
- MVP® Medicare WellSelect® with Part D (PPO) and MVP® Medicare WellSelect® Plus with Part D (PPO) (Spanish)
Rochester and Buffalo
- Medicare Secure with Part D (HMO-POS), Medicare Preferred Gold with Part D (HMO-POS) and Medicare Preferred Gold without Part D (HMO-POS)
- Medicare WellSelect Plus with Part D (PPO), MVP Medicare Patriot Plan with Part D (PPO)
UVM Health Advantage
Medicare Pharmacy Information
Medicare Star Rating
2023 Plan Documents
Benefits at a Glance
Annual Notice of Coverage (ANOC)
All Regions
Capital District, Southern Tier, Hudson Valley, Central New York
Capital District, Southern Tier, Hudson Valley, Central New York, Vermont
East Region
Hudson Valley
- Medicare WellSelect with Part D (PPO)
- Medicare WellSelect Plus with Part D (PPO)
- MVP Medicare WellSelect® with Part D (PPO)(Spanish)
- MVP Medicare WellSelect® Plus with Part D (PPO) (Spanish)
Rochester and Buffalo
Evidence of Coverage (EOC)
Capital District, Southern Tier, Central New York
Capital District, Southern Tier, Hudson Valley, Central New York
Capital District, Southern Tier, Hudson Valley, Central New York, Vermont
Hudson Valley
- Medicare WellSelect with Part D
- MVP Medicare WellSelect with Part D (PPO) (Spanish)
- Medicare WellSelect Plus with Part D
- MVP Medicare WellSelect Plus with Part D (PPO)(Spanish)
Rochester and Buffalo
Summary of Benefits (SB)
All Regions
Capital District, Southern Tier, Hudson Valley, Central New York
- Medicare Secure with Part D (HMO-POS), Medicare Preferred Gold with Part D (HMO-POS)
- Medicare WellSelect Plus with Part D (PPO)
Capital District, Southern Tier, Hudson Valley, Central New York, Vermont
- Medicare Secure Plus with Part D (HMO-POS), Medicare Preferred Gold without Part D (HMO-POS
- Medicare WellSelect with Part D (PPO)
Hudson Valley
- Medicare WellSelect with Part D (PPO), Medicare WellSelect Plus with Part D (PPO)
- MVP® Medicare WellSelect® with Part D (PPO) and MVP® Medicare WellSelect® Plus with Part D (PPO) (Spanish)
Rochester and Buffalo
Medicare Pharmacy Information
Medicare Star Rating
2024 Plan Documents
Benefits at a Glance
Annual Notice of Changes (ANOC)
Evidence of Coverage (EOC)
Summary of Benefits (SB)
Provider Directory
LIS Premium Grid
Medicare Star Rating
All Regions
2023 Plan Documents
Annual Notice of Changes (ANOC)
Evidence of Coverage (EOC)
Summary of Benefits (SB)
Provider Directory
LIS Premium Grid
Medicare Star Rating
2024 Plan Documents
Annual Notice of Coverage (ANOC)
Evidence of Coverage (EOC)
Summary of Benefits (SB)
LIS Premium Grid
Pharmacy Information
Medicare Star Rating
2023 Plan Documents
Annual Notice of Coverage (ANOC)
Evidence of Coverage (EOC)
Summary of Benefits (SB)
Member Guide & Handbooks
LIS Premium Grid
Pharmacy Information
Medicare Star Rating
New York
Standard Individual Plans – Product Description/Summary of Benefits
Non-Standard Individual Plans – Product Description/Summary of Benefits
| Platinum | |
| Gold | Summary of Benefits and Coverage (SBC) |
| Silver | Summary of Benefits and Coverage (SBC) |
| Bronze | Summary of Benefits and Coverage (SBC) |
Vermont
- MVP VT Bronze 2
- MVP VT Bronze 2 AI-AN
- MVP VT Bronze 3 AI-AN U300
- MVP VT Bronze 3 HDHP
- MVP VT Bronze 3 HDHP AI-AN
- MVP VT Bronze 4 AI-AN U300
- MVP VT Bronze 4 AI-AN
- MVP VT Bronze 4
- MVP VT Gold 1 AI-AN U300
- MVP VT Gold 1 AI-AN
- MVP VT Gold 1
- MVP VT Platinum 1
- MVP VT Platinum 1 AI-AN
- MVP VT Platinum 1 AI-AN U300
- MVP VT Plus AIAN U300
- MVP VT Plus Bronze 1 AI-AN
- MVP VT Plus Bronze 1 AI-AN U300
- MVP VT Plus Bronze 1
- MVP VT Plus Bronze 5
- MVP VT Plus Bronze 5 AI-AN
- MVP VT Plus Bronze 5 AI-AN U300
- MVP VT Plus Gold 2
- MVP VT Plus Gold 2 AI-AN
- MVP VT Plus Gold 2 AI-AN U300
- MVP VT Plus Gold 3 AI-AN U300
- MVP VT Plus Gold 3 HDHP
- MVP VT Plus Gold 3 HDHP AI-AN
- MVP VT Plus Reflective Silver 1
- MVP VT Plus Reflective Silver 2 HDHP
- MVP VT Plus Silver 1
- MVP VT Plus Silver 1 73
- MVP VT Plus Silver 1 77
- MVP VT Plus Silver 1 87
- MVP VT Plus Silver 1 94
- MVP VT Plus Silver 1 AI-AN
- MVP VT Plus Silver 1 AI-AN U300
- MVP VT Plus Silver 2 94
- MVP VT Plus Silver 2 AI-AN U300
- MVP VT Plus Silver 2 HDHP
- MVP VT Plus Silver 2 HDHP 77
- MVP VT Plus Silver 2 HDHP 87
- MVP VT Plus Silver 2 HDHP AI-AN
- MVP VT Plus Silver 2 HDHP CSR 73
- MVP VT Reflective Silver 3
- MVP VT Reflective Silver 4 HDHP
- MVP VT Secure
- MVP VT Silver 3
- MVP VT Silver 3 73
- MVP VT Silver 3 77
- MVP VT Silver 3 87
- MVP VT Silver 3 94
- MVP VT Silver 3 AI-AN
- MVP VT Silver 3 AI-AN U300
- MVP VT Silver 4 94
- MVP VT Silver 4 AI-AN U300
- MVP VT Silver 4 HDHP
- MVP VT Silver 4 HDHP 73
- MVP VT Silver 4 HDHP 77
- MVP VT Silver 4 HDHP 87
- MVP VT Silver 4 HDHP AI-AN
New York
Small Group EPO – Product Description/Summary of Benefits
| Platinum | Summary of Benefits and Coverage (SBC) |
| Gold | Summary of Benefits and Coverage (SBC) |
| Silver | Summary of Benefits and Coverage (SBC) |
| Bronze | Summary of Benefits and Coverage (SBC) |
Small Group HMO – Product Description/Summary of Benefits
| Platinum | Summary of Benefits and Coverage (SBC) |
| Gold | Summary of Benefits and Coverage (SBC) |
| Silver | Summary of Benefits and Coverage (SBC) |
| Bronze | Summary of Benefits and Coverage (SBC) |
Vermont
- SG - MVP VT Bronze 2
- SG - MVP VT Bronze 3 HDHP
- SG - MVP VT Bronze 4
- SG - MVP VT Gold 1
- SG - MVP VT Platinum 1
- SG - MVP VT Plus Bronze 1
- SG - MVP VT Plus Bronze 5
- SG - MVP VT Plus Gold 2
- SG - MVP VT Plus Gold 3 HDHP
- SG - MVP VT Plus Reflective Silver 1
- SG - MVP VT Plus Reflective Silver 2 HDHP
- SG - MVP VT Plus Silver 1
- SG - MVP VT Plus Silver 2 HDHP
- SG - MVP VT Reflective Silver 3
- SG - MVP VT Reflective Silver 4 HDHP
- SG - MVP VT Silver 3
- SG - MVP VT Silver 4 HDHP