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MVP Medicare Secure Plus with Part D (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MVP Medicare Secure Plus with 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 Secure Plus with Part D (HMO-POS) in 2025, please refer to our full plan details page.
MVP Medicare Secure Plus with 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 4.5 out of 5 stars in 2025.
It's important to know that MVP Medicare Secure Plus with Part D (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about MVP Medicare Secure Plus with 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 Secure Plus with Part D (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $96.20. 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.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $6000.00 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 Secure Plus with Part D (HMO-POS)
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Drug Coverage
The MVP Medicare Secure Plus with Part D (HMO-POS) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay or coinsurance depending on the drug tier and pharmacy used. For example, standard generic drugs have a $15 copay, while preferred brand drugs have a 25% coinsurance. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for Medicare Part D covered drugs. If you qualify for the low-income subsidy (LIS), you'll pay $20.60.
Additional Benefits
The MVP Medicare Secure Plus with Part D (HMO-POS) plan offers coverage for a wide range of services. It includes inpatient hospital stays with a $350 copay for days 1-5 and no copay for days 6-90, along with coverage for outpatient services, emergency services, primary care, and preventive services. This plan also provides benefits for hearing, vision, and dental care, with specific copays and coinsurance amounts for each. Additionally, it covers ambulance and transportation services, home health services, and skilled nursing facility stays, with varying cost-sharing arrangements.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric care, are covered. For days 1-5, there is a $350 copay, and for days 6-90, there is no copay; however, additional days and upgrades are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services and observation services, have a $300 copay. Ambulatory Surgical Center (ASC) Services have a $175 copay, while individual and group sessions for outpatient substance abuse have a $10 copay. Outpatient blood services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered under the MVP Medicare Secure Plus with Part D (HMO-POS) plan, but requires prior authorization. You will have a $40 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the MVP Medicare Secure Plus with Part D (HMO-POS) plan. Ground ambulance services have a $175 copay, while air ambulance services have a $300 copay; both have no coinsurance. Transportation services to a plan-approved health-related location are covered for up to 24 one-way trips per year, but transportation services to any health-related location are not covered.
Emergency Services See details
Emergency services are covered by the MVP Medicare Secure Plus with Part D (HMO-POS) plan with a $95 copay, and no coinsurance. Urgently needed services have a $30 copay, with no coinsurance. Worldwide emergency services are covered, with a $95 copay for Worldwide Emergency and Urgent Coverage, and a $175 copay for Worldwide Emergency Transportation; there is no coinsurance.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered. Chiropractic Services are covered with a $10 copay, while Routine Chiropractic Care is not covered. Individual and Group Sessions for Mental Health and Psychiatric Services have a minimum and maximum copay of $10. Physical Therapy and Speech-Language Pathology Services have a $20 copay.
Preventive Services See details
The MVP Medicare Secure Plus with Part D (HMO-POS) plan covers preventive services including annual physical exams, health education, post-discharge in-home medication reconciliation, remote access technologies, and fitness benefits, but does not cover in-home safety assessments, personal emergency response systems, medical nutrition therapy, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, home and bathroom safety devices, or counseling services. Additional services like kidney disease education, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit are also covered.
Hearing Services See details
Hearing services include routine hearing exams and fitting/evaluation for hearing aids, with no deductible. Routine hearing exams are covered once per year, and fitting/evaluation for hearing aids is unlimited. Prescription hearing aids (all types) are covered with a copay between $699 and $999 per year, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services include eye exams with a $20 copay, and eyewear with 20% coinsurance for contact lenses. Eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
The MVP Medicare Secure Plus with Part D (HMO-POS) plan covers Medicare Dental Services with a $40 copay, and other dental services with a $2,000 annual maximum. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable), maxillofacial prosthetics, implant services, prosthodontics (fixed), and oral and maxillofacial surgery are also covered. Orthodontics is not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by MVP Medicare Secure Plus with Part D (HMO-POS), requiring prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0% and 20%. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the MVP Medicare Secure Plus with Part D (HMO-POS) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 20% coinsurance, Prosthetics with 0-20% coinsurance, and Diabetic Therapeutic Shoes/Inserts with 5% coinsurance. Durable Medical Equipment for use outside the home, Medical Supplies and Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, with all diagnostic services requiring prior authorization and a copay for Medicare-covered lab services. Diagnostic Procedures/Tests have a copay of $10, while Lab Services are not covered. Diagnostic Radiological Services have a copay between $40 and $225, and Therapeutic Radiological Services have a 20% coinsurance. Outpatient X-Ray Services have a $40 copay.
Home Health Services See details
Home Health Services are covered by the MVP Medicare Secure Plus with Part D (HMO-POS) plan, with no copay and no coinsurance, but authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the MVP Medicare Secure Plus with Part D (HMO-POS) plan. The plan does not cover additional cardiac rehabilitation services, intensive cardiac rehabilitation services, pulmonary rehabilitation services, or SET for PAD services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by MVP Medicare Secure Plus with Part D (HMO-POS), but require prior authorization. There is no copay for days 1-20, and a $214 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The MVP Medicare Secure Plus with Part D (HMO-POS) plan covers acupuncture with a 50% coinsurance, up to 10 treatments per year, and also covers Over-the-Counter (OTC) items with a maximum benefit of $75 every three months. The plan also covers meal benefits, but requires prior authorization. However, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and other services are not covered.
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