MVP Healthy NY

MVP Health Care, Inc., works as a family of companies providing a wide range of health care plans and programs in New York, Vermont, and New Hampshire. Today, over 750,000 members trust MVP for their health insurance coverage needs.  They also have 330,000 members in Greater Rochester.  MVP boasts of promoting a personalized approach to care.

One might wonder what MVP stands for. It goes back to their history. 25 years ago MVP was operating in eastern New York as Mohawk Valley Physicians Health Plan, originally offering just New York Health Insurance Plans.  As years went by, their operation went beyond Mohawk Valley and they changed their name to MVP Health Care. In 2006, Preferred Care merged with MVP and they chose to keep the name of the larger health plan.

MVP Health Care has been recently ranked among the top ten health plans by the National Committee for Quality Assurance (NCQA).

Healthy NY is among the health plans they offer.  It is a state-sponsored health insurance program that provides comprehensive coverage to individuals both self-employed and employed as well as sole-proprietors with not more than fifty employees.

There are certain qualifications for the Healthy NY application. Here are the eligibility requirements:
·         You should be a New York state resident;
·         You must be ineligible for Medicare;
·         Your total gross household income should be within the limit set by the Healthy New York program;
·         You must currently be a sole-proprietor or an employee on a full-time, part-time or periodic basis;
·         You must be uninsured for the past 12 months except for some qualifying reasons (see below)
·         You must have no health insurance benefits from your employer

Qualifying Reasons /Exceptions:

• Loss of employment
• Change to a new employer
• Death of a family member
• Change of residence
• Discontinuation of a group health plan
• Termination or cancellation of COBRA coverage
• Change in marital status
• Loss of eligibility for group health insurance coverage
• Reaching age limit for dependent coverage

Healthy NY Summary of Benefits:

·         Physician services including diagnostic, treatment, consultant, and referral services
·         Surgical services (including breast reconstruction surgery after a mastectomy) and anesthesia
·         Inpatient hospitalization including room and board, general nursing care, special diets,
·         and other hospital services and supplies

·         Outpatient hospitalization including diagnostic and treatment services and surgical facility charges
·          Pre-admission testing
·         Emergency services (ambulance not covered)
·         Second opinion for surgery and cancer treatment
·         Post-surgery or post-hospitalization home health care, up to 40 visits per calendar year
·         Post-surgery or post-hospitalization physical therapy, up to 30 visits per calendar year
·         Adult preventive services including mammogram, Pap test, prostate cancer screening,
physical examinations no more than once every three years, and adult immunizations
·         Prenatal care, well-child visits, and children’s immunizations
·         Diabetic supplies, equipment, and self-management education
·         Diagnostic, X-ray, and laboratory services
·         Radiation therapy, chemotherapy, and dialysis
·         Blood and blood products provided with surgery or inpatient hospitalization

MVP offers 4 Healthy New York plans –

• Healthy NY HMO 1 (without prescription coverage) -Current premium rate may range from    $209.18 – $289.67
• Healthy NY HMO 2 (with prescription coverage) – Current premium  rate may range from   $277.89 – $356.58
• MVP Healthy NY High Deductible Health Plan 1 (without prescription coverage) – Current premium  rate may range from    $160.76 – $220.51
• MVP Healthy NY High Deductible Health Plan 2 (with prescription coverage) – Current premium  may range from  $214.27 – $288.45

*MVP Healthy NY rates vary depending on your location and they increase annually.

There are certain services that will not be included in the streamlined benefit package of the Healthy NY Health Insurance such as :

·         Mental health services and prescription drugs related to mental health conditions,
including treatment for depression, anxiety, and attention deficit hyperactivity
disorder (ADHD)
·         Alcohol and substance abuse treatment and prescription drugs related to alcohol
and substance abuse treatment
·         Chiropractic care
·         Physical therapy, unless post-surgery or post-hospitalization
·         Home health care, unless post-surgery or post-hospitalization
·         Hospice
·         Ambulance
·         Dental, vision, and hearing aids
·         Out-of-state treatment, unless in the case of an emergency

For queries and additional information regarding  MVP Healthy NY  just visit the MVP Health Care website.