2020 MVP Preferred Gold with Part D (HMO-POS) H3305-15-0 in NY from MVP | HealthPocket

MVP Preferred Gold with Part D (HMO-POS)

$210/mo

Benefits & Coverage

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderMVP
Plan IDH3305-15-0
Plan Year2020
CMS Rating
Plan TypeHMO-POS
Annual Deductible$0.00
Out-of-Pocket Maximum6700

What To Know About This Plan
  • This plan has health and drug coverage

Why We Like This Plan
  • has both Health and Drug Coverage

Overview

Premium
Total monthly premium$210.00
Health plan premium$132.20
Drug plan premium$77.80
Standard Part B premium$135.50
Part B premium reductionNo
Deductible
Health plan deductible$0
Drug plan deductible$0.00
Estimated yearly costs
Estimated total yearly costs for care$6,750.00
Out-of-pocket max
Out-of-pocket max$6,700 In-network

Benefits & costs

Doctor services
Primary doctor visitIn-network: $15 per visit
Out-of-network: 30% per visit
Specialist visitIn-network: $40 per visit
Out-of-network: 30% per visit
Tests, labs, & imaging
Diagnostic tests & proceduresIn-network: $10
Out-of-network: 30%
Lab servicesIn-network: $0-10
Out-of-network: 30%
Diagnostic radiology services (like MRI)In-network: $40-100
Out-of-network: 30%
Outpatient x-raysIn-network: $40
Out-of-network: 30%
Emergency care$90 per visit (always covered)
Urgent care$50 per visit (always covered)
Hospital services
Inpatient hospital coverageIn-network: $350 per day for days 1 through 5
$0 per day for days 6 through 90
Out-of-network: 30% per stay
Outpatient hospital coverageIn-network: $300 per visit
Out-of-network: 30% per visit
Skilled nursing facility
Skilled nursing facilityIn-network: $0 per day for days 1 through 20
$178 per day for days 21 through 100
Out-of-network: Not Applicable
Preventive services
Preventive servicesIn-network: $0 copay
Out-of-network: 30%
Ambulance
Ground ambulanceIn-network: $150
Out-of-network: $150-300
Therapy services
Occupational therapy visitIn-network: $20
Out-of-network: 30%
Physical therapy & speech & language therapy visitIn-network: $20
Out-of-network: 30%
Mental health services
Outpatient group therapy with a psychiatristIn-network: $40
Out-of-network: No Data
Outpatient individual therapy with a psychiatristIn-network: $40
Out-of-network: No Data
Outpatient group therapy visitIn-network: $40
Out-of-network: No Data
Outpatient individual therapy visitIn-network: $40
Out-of-network: No Data
Opioid treatment services
Opioid treatment servicesCovered
Other services
Durable medical equipment (like wheelchairs & oxygen)In-network: 20% per item
Out-of-network: 30% per item
Prosthetics (like braces, artificial limbs)In-network: 0-20% per item
Out-of-network: 30% per item
Diabetes suppliesIn-network: 10-20% per item
Out-of-network: No Data

Extra benefits & costs

Hearing
Hearing examIn-network: $40
Out-of-network: 30%
Fitting/evaluationIn-network: $0 copay
Out-of-network: No Data
Hearing aids - All typesIn-network: $499-799
Out-of-network: No Data
Preventive dental
Oral examIn-network: $0 copay
Out-of-network: No Data
CleaningIn-network: $0 copay
Out-of-network: No Data
Fluoride treatmentIn-network: $0 copay
Out-of-network: No Data
Dental x-raysIn-network: $0 copay
Out-of-network: No Data
Comprehensive dental
Non-routine servicesIn-network: $0 copay
Out-of-network: No Data
Diagnostic servicesIn-network: $0 copay
Out-of-network: No Data
Restorative servicesIn-network: $0 copay
Out-of-network: No Data
EndodonticsIn-network: $0 copay
Out-of-network: No Data
PeriodonticsIn-network: $0 copay
Out-of-network: No Data
ExtractionsIn-network: $0 copay
Out-of-network: No Data
Prosthodontics, other oral/maxillofacial surgery, other servicesIn-network: $0 copay
Out-of-network: No Data
Vision
Routine eye examIn-network: $20
Out-of-network: 30%
Contact lensesIn-network: $0 copay
Out-of-network: No Data
Eyeglasses (frames & lenses)In-network: $0 copay
Out-of-network: No Data
Eyeglass frames (only)In-network: $0 copay
Out-of-network: No Data
Eyeglass lenses (only)In-network: $0 copay
Out-of-network: No Data
UpgradesIn-network: $0 copay
Out-of-network: No Data
More benefits
Fitness benefitLimited coverage
Over the counter drug benefitsNot covered
In-home support servicesNot covered
Home and bathroom safety devicesNot covered
Meals for short durationLimited coverage
Annual physical examsLimited coverage
TelehealthNot covered
Special benefits
Reduced cost sharing for certain people with MedicareLimited coverage

Drug coverage & costs

Part B drugs
Chemotherapy drugsIn-network: 0-20%
Out-of-network: No Data
Other Part B drugsIn-network: 0-20%
Out-of-network: No Data

Coverage Area for MVP Preferred Gold with Part D (HMO-POS)

StateNew York
CountyKings

All cost-sharing assumes in-network healthcare providers.
Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit


30 Day SupplyPreferred Retail Pharmacies Drug CostStandard Retail Pharmacies Drug CostPreferred Mail-Order Drug CostStandard Mail-Order Drug Cost
Tier 1: Preferred GenericNot offereds$0 copayNot offered$0 copay
Tier 2: Non-Preferred GenericNot offereds$10 copayNot offered$10 copay
Tier 3: Preferred Brand NameNot offereds$40 copayNot offered$40 copay
Tier 4: Non-Preferred Brand NameNot offereds27% coinsuranceNot offered27% coinsurance
Tier 5: Specialty TierNot offereds33% coinsuranceNot offered33% coinsurance
Tier 6: Select Care Drugs

90 Day SupplyPreferred Retail Pharmacies Drug CostStandard Retail Pharmacies Drug CostPreferred Mail-Order Drug CostStandard Mail-Order Drug Cost
Tier 1: Preferred GenericNot offereds$0 copayNot offered$0 copay
Tier 2: Non-Preferred GenericNot offereds$30 copayNot offered$20 copay
Tier 3: Preferred Brand NameNot offereds$120 copayNot offered$80 copay
Tier 4: Non-Preferred Brand NameNot offereds27% coinsuranceNot offered27% coinsurance
Tier 5: Specialty Tier
Tier 6: Select Care Drugs

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Colorectal cancer screening
Annual flu vaccine
Improving or maintaining physical health
Improving or maintaining mental health
Monitoring physical ability
Adult BMI assessment

Managing Chronic Conditions

Special needs plan care managementNot Rated
Care for older adults – medication reviewNot Rated
Care for older adults – functional status assessmentNot Rated
Care for older adults – Pain assessmentNot Rated
Osteoporosis management in women who had a fracture
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Rheumatoid arthritis management
Reducing the risk of falling
Improving bladder control
Medication reconciliation post-discharge
Plan all-cause readmissions
Statin Therapy for Patients with Cardiovascular Disease

Member Experience with Health Plan

Getting needed care
Getting appointments and care quickly
Customer service
Rating of health care quality
Rating of health plan
Care Coordination

Member Complaints, and Changes in Health Plan's Performance

Complaints about the health plan
Members choosing to leave the health plan
Health plan quality improvement

Health Plan Customer Service

Plan makes timely decision about appeals
Reviewing appeals decisions
Call center – foreign language interpreter and TTY/TDD availability - Medical

Drug Plan Customer Service

Call center – foreign language interpreter and TTY availability
Appeals auto-forward
Appeals upheld

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Members choosing to leave the drug plan
Drug plan quality improvement

Member Experience with Drug Plan

Rating of drug plan
Getting needed prescription drugs

Drug Pricing and Patient Safety

MPF Price Accuracy
Medication adherence for diabetes medications
Medication adherence for hypertension - RAS antagonists
Medication adherence for cholesterol - Statins
MTM program completion rate for CMR
Statin use in persons with diabetes - SUPD

Physicians that accept MVP Preferred Gold with Part D (HMO-POS) for New York

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Steven, Liverpool
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Daphney, Maylor
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Charles, Medwynter
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Jerry, Uduevbo
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Akua, Boah
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Haydn, Briggs
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Prudence, Osei-tutu
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Gerald, Valme
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Marie, Conde
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Adelfino, Ignacio
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Erlinda, Ignacio
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Nasrullah, Khan
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Albert, Anglade
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Francois, Tellus
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Virgilio, Ansay
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Lionel, Lefevre
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Mayya, Fasolya
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William, Boah
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Max, Jean-gilles
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Sharmeen, Sultana
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Marie Edith, Lefevre
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Walter, Perez
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Natalie, Arnoff
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David, Tetrokalashvili
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Elsie, Alvarez
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Steven Liverpool, M.D.
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  • Phone Number
    (718) 282-1570
  • Office Locations
    322 Linden Blvd
    Brooklyn, NY 11226
322 Linden Blvd Brooklyn NY, 11226
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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Health Insurance Innovations, Inc. family of companies (NASDAQ: HIIQ).