MVP Health Care Insurance Review & Complaints: Health Insurance (2024)

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MVP Health Care is large for a regional insurer, with more than 700,000 members in New York and Vermont. The company offers individual and family plans as well as Medicare coverage.

What is MVP health insurance?

MVP was founded in 1982 and has its headquarters in Schenectady, NY to this day. They offer a range of health plans, including HMO-POS plans for individuals and families, groups, Medicare Advantage, and other supplemental plans. We specifically focused on MVP’s Medicare plans in a separate review, so we will focus this review on the other plans they offer.

MVP Health Care, Inc. employs 1,600 people throughout the coverage area, and partners with other medical groups in order to expand the network available to their members. Insurance can be purchased directly or through a broker. Plan availability is based on the zip code of the customer’s residence.

What MVP health plan type is offered?

For the purpose of this review, we pulled up the plans available to those living in the same zip code as the company’s headquarters. Our search returned numerous plans, with several options at each of the metal levels. There are six each at the bronze, silver, and gold levels, and three plans at the platinum level. Some plans include the option of an HSA. None of the plans have coverage for out-of-network care.

Bronze Plans

There are six bronze-level plans, with varying levels of deductibles, co-pays, and coinsurance amounts. The highest deductible amount is the Premier Plus HDHP Bronze 6, which has deductibles of $6,550 per person and $13,100 per family. The lowest deductibles are found with the Premier Plus Bronze 1, with a $3,900 per person and $7,800 family deductible.

Co-pays range from a 50% coinsurance to a $0 copay for office and specialist visits with the Bronze 6 plan. Tier 1 prescription drugs range from a $0 copay to a $10 copay and go up from there.

Silver Plans

Again, there are six plans and some are HSA compatible. The highest deductible amount with the silver plans is found in the Premier Plus Silver 9, at $4,000 per person and $8,000 for the family. The lowest deductible is found in the Premier Plus Silver 1, which has an individual deductible of $1,800 and a family deductible of $3,600.

Co-pays range from $30 to $45 for primary care visits, while specialist visits range from $50 to $70. Prescription coverage starts at $10 for Tier 1 drugs, with some plans starting at $15.

Gold Plans

Of the six gold plans, one, the Premier Plus Gold 4, has a $0 deductible. Deductibles rise from there to $1,600 per person and $3,200 per family for the Premier Plus HDHP Gold 2 plan. The rest of the plans have deductibles falling in between, with several options that are quite low.

Co-pays for primary care range from $5 to $40, while specialist visit co-pays range from $25 to $50. All plans start at either $5 or $10 for Tier 1 prescription drugs.

Platinum Plans

All three of the Platinum plans have a $0 deductible, with primary care visits ranging from $5 to $15 and specialist visits from $35-$45.

Prescription coverage starts at either $5 or $10 for Tier 1 generic drugs. It is no surprise to see that these are the most expensive plans in terms of monthly premiums.

What are the rates for MVP services?

MVP makes it simple to obtain rate information, as it is listed right along with the basic summary of benefits for each plan. During the search process, customers can provide information regarding their preferences – how much they would like to spend a month and what deductible level they prefer. This allows the search to return more focused results. We ran a search that gave us all the available plans.

New York is well known for being one of the most expensive states for health insurance. As a result, it is not a surprise to see that MVP’s rates are higher than we see in other states.

The lowest rate found was $373.09 per month for a single person on the Premier Plus Bronze 2 plan. The highest rate is the Premier Platinum plan, coming in at $667.70 for one person. Family rates reach as high as $1,902.95 per month for the Platinum plan, with the lowest again being the Premier Plus Bronze 2 at $1,063.31.

MVP Health Care Claims Process

Ease of Filing a Claim (Online, Over the Phone, Mobile Apps)

When it comes to filing claims with MVP Health Care, policyholders have multiple convenient options. They can file claims online through the insurer’s website or mobile app, making it easy for tech-savvy users.

Additionally, claims can also be filed over the phone, ensuring accessibility for those who prefer speaking with a representative. The availability of these different channels provides flexibility for policyholders to choose the method that suits them best.

Average Claim Processing Time

MVP Health Care’s status as an HMO provider generally results in quick claims processing. The direct connection between the insurer and healthcare providers streamlines the process.

Since MVP’s plans typically do not cover out-of-network care, claims for in-network services are usually processed efficiently. However, for out-of-network situations requiring pre-approval, policyholders may need to pay for care upfront and then seek reimbursement.

Customer Feedback on Claim Resolutions and Payouts

MVP Health Care has garnered positive feedback in terms of claims resolution and payouts. The company holds an A+ rating with the Better Business Bureau (BBB), and its low complaint volume, given its sizable member base, reflects a high level of satisfaction.

Consumer reviews also generally indicate a positive experience with claims processing. This positive reputation suggests that MVP Health Care is reliable when it comes to handling claims.

Digital and Technological Features of MVP Health Care

Mobile App Features and Functionality

MVP Health Care offers a mobile app that provides policyholders with a range of features and functionalities. Users can access their insurance information, view plan details, and even file claims directly through the app.

Additionally, the app may offer tools for locating healthcare providers, checking prescription drug coverage, and accessing virtual care services, enhancing the overall customer experience.

Online Account Management Capabilities

Policyholders can manage their MVP Health Care accounts conveniently through the insurer’s website. This online account management portal allows users to review their coverage, check claim statuses, make premium payments, and update personal information. The user-friendly interface simplifies the process of staying informed about their insurance and managing their policies.

Digital Tools and Resources

MVP Health Care provides a suite of digital tools and resources to assist policyholders in making informed healthcare decisions.

These resources may include access to health information libraries, cost estimators for medical procedures, and tools for finding in-network healthcare providers. These digital assets empower policyholders to take control of their healthcare and make well-informed choices.

In summary, MVP Health Care offers a streamlined claims process with various filing options and enjoys a positive reputation for claims resolution. Additionally, the insurer provides a user-friendly mobile app, online account management capabilities, and valuable digital tools to enhance the overall customer experience.

Are ratings and consumer reviews positive?

MVP Health Care currently has an A+ rating with the Better Business Bureau (BBB). A total of six complaints have been filed in the last 12 months, one of which has been closed in the past 12 months. It is not always easy to put complaint volume into perspective. However, in this case, with seven complaints and 700,000 members, the math is easy – one complaint per 100,000 members – which is very low.

There are 15 complaints on Pissed Consumer, most of which are regarding coverage denial issues and difficulty finding providers. Again, the complaint volume is low given the company’s size.

The National Committee for Quality Assurance ranks MVP at an overall 4.5, and they tend to rank high in most areas, particularly when it comes to consumer satisfaction. Only a few areas show low rankings, mostly in specific treatment areas.

The ratings, rankings, and complaint volume all add up to a pretty good reputation for MVP, with nothing that raises red flags in any of the ratings.

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What is the bottom line?

MVP Health Care is an insurance company that offers a good range of plan options, so many in fact that it may become confusing to insurance shoppers. Their prices are in line with New York health insurance, and there are options for a variety of budgets. For those who don’t mind the limited network of an HMO, MVP is a good choice.