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MVP Medicare WellSelect Plus with Part D (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MVP Medicare WellSelect Plus with Part D (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on MVP Medicare WellSelect Plus with Part D (PPO) in 2025, please refer to our full plan details page.
MVP Medicare WellSelect Plus with Part D (PPO) is a PPO plan offered by MVP Health Care, Inc. available for enrollment in 2025 to people living in S.Tier NY, Central NY, Eastern NY. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that MVP Medicare WellSelect Plus with Part D (PPO) 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 WellSelect Plus with Part D (PPO).
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 WellSelect Plus with Part D (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $119.00. 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.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $11800.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $11800.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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 WellSelect Plus with Part D (PPO)
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Drug Coverage
The MVP Medicare WellSelect Plus with Part D (PPO) 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 the pharmacy you use. For example, you'll pay a $10 copay for preferred generic drugs at standard and mail order pharmacies. Once your total drug costs reach $2000, you enter the catastrophic coverage phase, where you pay nothing for covered Part D drugs. However, the plan's premium is $63.10.
Additional Benefits
The MVP Medicare WellSelect Plus with Part D (PPO) plan offers comprehensive coverage with varying cost-sharing. Inpatient hospital stays have a $375 copay for days 1-5, while outpatient services have a $300 copay. The plan also provides coverage for services such as ambulance and transportation, emergency services, primary care, preventive services, hearing, vision, dental, and home health services. Additional benefits include coverage for hearing aids with a copay, vision exams with a $20 copay, and dental services with a $50 copay, up to $1,750 per year. The plan also covers home infusion bundled services, dialysis services, medical equipment, and diagnostic and radiological services. This plan also offers an Over-the-Counter (OTC) items benefit, with a maximum coverage amount of $75 every three months.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, both of which require prior authorization. For Inpatient Hospital-Acute, you pay a $375 copay for days 1-5 and no copay for days 6-90, and for Inpatient Hospital Psychiatric, you also pay a $375 copay for days 1-5 and no copay for days 6-90. Additional Days for Inpatient Hospital-Acute are covered, but Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services, including Outpatient Hospital Services and Observation Services, have a $300 copay, while Ambulatory Surgical Center (ASC) Services have a $200 copay. Outpatient Substance Abuse services include individual and group sessions, each with a copay between $10.00 and $10.00.
Partial Hospitalization See details
Partial Hospitalization is covered by the MVP Medicare WellSelect Plus with Part D (PPO) plan, with a $50 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services, including services not usually covered by Medicare, are covered by the MVP Medicare WellSelect Plus with Part D (PPO) plan. Ground ambulance services have a $200 copay, and air ambulance services have a $300 copay, with no coinsurance. Transportation services to plan-approved health-related locations are covered for up to 24 one-way trips per year, while transportation to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the MVP Medicare WellSelect Plus with Part D (PPO) plan. Emergency Services and Worldwide Emergency Coverage and Worldwide Urgent Coverage have a $110 copay, and Worldwide Emergency Transportation has a $200 copay, with no coinsurance for any of these services. Urgently Needed Services have a $40 copay and no coinsurance.
Primary Care See details
The MVP Medicare WellSelect Plus with Part D (PPO) plan covers Primary Care Physician Services with no copay, Chiropractic Services with a $10 copay, Occupational Therapy Services with a $20 copay, Physician Specialist Services with a $40 copay, and Physical Therapy and Speech-Language Pathology Services with a $20 copay. Mental Health Specialty Services, Psychiatric Services, and Opioid Treatment Program Services have a $10 copay for individual and group sessions, and Other Health Care Professional services have a copay between $0 and $40. Podiatry Services are not covered.
Preventive Services See details
Preventive services include Medicare-covered services with no copay, annual physical exams, additional preventive services with prior authorization, health education, post-discharge in-home medication reconciliation, fitness benefits, remote access technologies, kidney disease education services with prior authorization, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit. In-home safety assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered.
Hearing Services See details
Hearing Services are covered, including hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids. Routine hearing exams are covered for one visit per year, and fitting/evaluation for hearing aids has no limit. Prescription hearing aids (all types) are covered with a copay between $699 and $999, for two visits per year, however, prescription hearing aids - 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. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
Dental Services offers coverage for Medicare dental services with a $50 copay. Other dental services include 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 and fixed), maxillofacial prosthetics, implant services, and oral and maxillofacial surgery; all are unlimited, with a maximum plan benefit of $1,750 per year. Orthodontics is not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the MVP Medicare WellSelect Plus with Part D (PPO) plan. Medicare Part B Insulin Drugs have a $35 copay and coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have no copay and coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the MVP Medicare WellSelect Plus with Part D (PPO) 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/Medical Supplies with coinsurance for Medicare-covered supplies, and Diabetic Therapeutic Shoes/Inserts with 10% 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, including diagnostic procedures/tests with a $15 copay. Diagnostic Radiological Services have a copay between $40 and $250, while Therapeutic Radiological Services have a 20% coinsurance, and Outpatient X-Ray Services have a $40 copay. Lab Services are not covered.
Home Health Services See details
Home Health Services are covered by the MVP Medicare WellSelect Plus with Part D (PPO) plan with no copay and no coinsurance. 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 WellSelect Plus with Part D (PPO) plan, including Additional Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the MVP Medicare WellSelect Plus with Part D (PPO) plan. There is no copay for days 1-20, and a $214 copay for days 21-100; additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The MVP Medicare WellSelect Plus with Part D (PPO) plan covers acupuncture with a 50% coinsurance, up to 10 treatments per year. This plan also offers an Over-the-Counter (OTC) items benefit, with a maximum coverage amount of $75 every three months. The plan's other services, including Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, are not covered.
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