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MVP Medicare Preferred Gold without Part D (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MVP Medicare Preferred Gold without Part D (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on MVP Medicare Preferred Gold without Part D (HMO-POS) in 2026, please refer to our full plan details page.
MVP Medicare Preferred Gold without Part D (HMO-POS) is a HMO-POS plan offered by MVP Health Care, Inc. available for enrollment in 2025 to people living in S.Tier NY, CNY, Eastern NY, Hudson Valley NY. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that MVP Medicare Preferred Gold without Part D (HMO-POS) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about MVP Medicare Preferred Gold without Part D (HMO-POS).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For MVP Medicare Preferred Gold without Part D (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $7200.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for MVP Medicare Preferred Gold without Part D (HMO-POS)
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Drug Coverage
Prescription drugs are not covered by MVP Medicare Preferred Gold without Part D (HMO-POS).
Additional Benefits
The MVP Medicare Preferred Gold without Part D (HMO-POS) plan provides robust medical coverage with no copay and no coinsurance for primary care visits, telehealth, and preventive services. For specialized medical needs, members will pay a $40 copay for specialists, a $115 copay for emergency room visits, and a $375 daily copay for the first five days of an inpatient hospital stay. Outpatient hospital services require a $350 copay, though most outpatient services feature no coinsurance. This plan also includes valuable everyday health benefits, offering routine hearing exams and many preventive dental services with no copay and no coinsurance. Routine eye exams are available for a $20 copay, while durable medical equipment and dialysis services require a 20% coinsurance with no copay. Additionally, skilled nursing facility care is covered with no copay for the first 20 days and a $218 daily copay for days 21 through 100.
Inpatient Hospital See details
MVP Medicare Preferred Gold without Part D (HMO-POS) covers inpatient hospital services with no coinsurance, requiring a $375 daily copay for days 1-5 and no copay for days 6-90 per stay. This partially covered benefit includes unlimited additional acute care days with no copay, but does not cover additional psychiatric days, upgrades, or non-Medicare-covered stays.
Outpatient Services See details
MVP Medicare Preferred Gold without Part D (HMO-POS) covers outpatient services with no coinsurance, although prior authorization is required for most services. Patients will pay a $350 copay for outpatient hospital and observation services, a $250 copay for ambulatory surgical center services, a $30 copay for outpatient substance abuse sessions, and no copay for outpatient blood services.
Partial Hospitalization See details
MVP Medicare Preferred Gold without Part D (HMO-POS) covers partial hospitalization services with a $50 copay and no coinsurance. Prior authorization is required to receive this care.
Ambulance and Transportation Services See details
MVP Medicare Preferred Gold without Part D (HMO-POS) covers ground ambulance services with a $200 copay and air ambulance services with a $400 copay, with no coinsurance for either service. Transportation services are partially covered with no copay or coinsurance for up to 12 one-way trips per year to plan-approved locations, though transportation to any health-related location is not covered.
Emergency Services See details
MVP Medicare Preferred Gold without Part D (HMO-POS) covers emergency services with a $115 copay and no coinsurance, which is waived if you are admitted to the hospital within 24 hours. Urgently needed services require a $40 copay and no coinsurance, while worldwide emergency and urgent services are covered with no coinsurance and copays of $115 for care and $200 for transportation.
Primary Care See details
MVP Medicare Preferred Gold without Part D (HMO-POS) provides primary care and telehealth services with no copay and no coinsurance. Specialist visits require a $40 copay, therapy services (physical, occupational, and speech) have a $20 copay, and mental health, psychiatric, and opioid treatments carry a $30 copay, all with no coinsurance. Chiropractic and podiatry services are not covered.
Preventive Services See details
Preventive services are partially covered by MVP Medicare Preferred Gold without Part D (HMO-POS) with no copay and no coinsurance for covered care, including annual physicals, kidney disease education, and glaucoma screenings. While memory fitness and health education are covered, several additional services are not, such as in-home safety assessments, medical nutrition therapy, weight management programs, and personal emergency response systems.
Hearing Services See details
MVP Medicare Preferred Gold without Part D (HMO-POS) covers routine hearing exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and a copay ranging from $699 to $999, while OTC hearing aids and inner ear, outer ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
MVP Medicare Preferred Gold without Part D (HMO-POS) partially covers vision services, offering one routine eye exam per year for a $20 copay and no coinsurance, while other eye exam services are not covered. Covered eyewear, including contacts and eyeglasses, features no copay and a 20% coinsurance for contact lenses up to a $150 annual limit, with no deductibles.
Dental Services See details
Dental services are partially covered by MVP Medicare Preferred Gold without Part D (HMO-POS), featuring Medicare-covered dental services for a $30 copay and no coinsurance, and other dental services with no copay and no coinsurance up to a $1,000 annual maximum. While most preventive, restorative, and surgical dental sub-services are covered with no copay and no coinsurance, orthodontics is not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by MVP Medicare Preferred Gold without Part D (HMO-POS) with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs feature no copay and no coinsurance to 20% coinsurance, while Part B insulin requires a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
MVP Medicare Preferred Gold without Part D (HMO-POS) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
MVP Medicare Preferred Gold without Part D (HMO-POS) partially covers medical equipment with no copays, though medical supplies and diabetic supplies are not covered. Covered benefits require prior authorization and include durable medical equipment (DME) with a 20% coinsurance, diabetic therapeutic shoes or inserts with a 10% coinsurance, and prosthetic devices ranging from no coinsurance to 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services under MVP Medicare Preferred Gold without Part D (HMO-POS) are partially covered and require prior authorization, though lab services are not covered. Diagnostic procedures require a $10 copay with no coinsurance, while outpatient x-rays and diagnostic radiological services require a $50 copay, and therapeutic radiological services carry a 20% coinsurance.
Home Health Services See details
Home Health Services are covered under the MVP Medicare Preferred Gold without Part D (HMO-POS) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
MVP Medicare Preferred Gold without Part D (HMO-POS) partially covers cardiac rehabilitation services, offering covered additional cardiac rehabilitation services with a $20 copay, no coinsurance, and a prior authorization requirement. Standard cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
MVP Medicare Preferred Gold without Part D (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered by MVP Medicare Preferred Gold without Part D (HMO-POS), featuring acupuncture with no copay and 50% coinsurance for up to 12 yearly treatments, and chronic illness meals with no copay and no coinsurance. Over-the-counter (OTC) benefits are also partially covered with no copay and no coinsurance up to $25 quarterly, excluding nicotine replacement therapy and naloxone.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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