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MVP Medicare WellSelect with Part D (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MVP Medicare WellSelect 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 with Part D (PPO) in 2025, please refer to our full plan details page.
MVP Medicare WellSelect with Part D (PPO) is a PPO plan offered by MVP Health Care, Inc. available for enrollment in 2025 to people living in Hudson Valley 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 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 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 with Part D (PPO), 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. Additionally, this plan comes with a Part B Premium reduction of $11.80. You must continue to pay paying your reduced 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 a $500.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $12500.00 (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 $12500.00 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 with Part D (PPO)
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Drug Coverage
The MVP Medicare WellSelect with Part D (PPO) plan has a $500 deductible for prescription drugs. After the deductible, you'll pay a copay or coinsurance depending on the drug tier and pharmacy. For preferred generic drugs, you'll pay a $15 copay at standard and mail-order pharmacies. Standard generic drugs have a $47 copay, and preferred brand drugs have 25% coinsurance at both standard and mail-order pharmacies. Non-preferred drugs have 26% coinsurance.
Additional Benefits
The MVP Medicare WellSelect with Part D (PPO) plan offers a range of benefits, including coverage for inpatient and outpatient services, with varying copays depending on the service. The plan also covers a wide variety of services such as hearing, vision, and dental. This plan provides coverage for preventive services, ambulance services, and medical equipment. Additionally, the plan includes coverage for home health services, skilled nursing facilities, and home infusion services, with specific copays and coinsurance amounts.
Inpatient Hospital See details
Inpatient Hospital benefits are covered by the MVP Medicare WellSelect with Part D (PPO) plan, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you will pay a $435 copay for days 1-5, and no copay for days 6-90. For Inpatient Hospital Psychiatric, you will pay a $400 copay for days 1-5, and no copay for days 6-90. Non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, and additional days for Inpatient Hospital Psychiatric and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered by the MVP Medicare WellSelect with Part D (PPO) plan, including outpatient hospital services, observation services, ambulatory surgical center services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital and observation services have a $400 copay, ambulatory surgical center services have a $300 copay, and outpatient substance abuse services have a $10 copay for both individual and group sessions.
Partial Hospitalization See details
Partial Hospitalization is covered by the MVP Medicare WellSelect with Part D (PPO) plan, but requires prior authorization. You will have a $65 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required. Ground ambulance services have a $300 copay, while air ambulance services have a $500 copay. Transportation Services to a Plan Approved Health-related Location are covered for 12 one-way trips per year, utilizing rideshare services, bus/subway, medical transport, and other modes of transportation.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the MVP Medicare WellSelect with Part D (PPO) plan. Emergency Services has a $110 copay, Urgently Needed Services has a $45 copay, Worldwide Emergency Coverage and Worldwide Urgent Coverage each have a $110 copay, and Worldwide Emergency Transportation has a $300 copay; all have no coinsurance.
Primary Care See details
Primary Care Physician Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Psychiatric Services, Physical Therapy, and Speech-Language Pathology Services are covered. Chiropractic Services, Other Health Care Professional, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered with a copay. Individual and Group Sessions for Mental Health and Psychiatric Services have a $10 copay, and Occupational Therapy and Physical Therapy have a $35 copay. Routine Chiropractic Care and Podiatry Services are not covered.
Preventive Services See details
The MVP Medicare WellSelect with Part D (PPO) plan covers preventive services, including annual physical exams and additional preventive services, with prior authorization required for some services. Some services, like in-home safety assessments, personal emergency response systems, and many others are not covered.
Hearing Services See details
Hearing services include coverage for hearing exams and prescription hearing aids, with no deductible. Routine hearing exams are covered once per year. Prescription hearing aids (all types) are covered with a copay between $699 and $999 for two hearing aids every year, but inner ear, outer ear, and over the ear hearing aids are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision Services include eye exams with a $40 copay, and eyewear with 20% coinsurance for contact lenses. There is a combined maximum of $225 per year for eyewear.
Dental Services See details
The MVP Medicare WellSelect with Part D (PPO) plan covers dental services with a $50 copay for Medicare dental services, and other services are covered up to a maximum of $1250 per year. Orthodontics is not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, with a copay of $35 for Medicare Part B Insulin Drugs, and coinsurance between 0% and 20% for Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the MVP Medicare WellSelect with Part D (PPO) plan, but require prior authorization. You will pay a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered by the MVP Medicare WellSelect with Part D (PPO) plan, with some services not covered. Durable Medical Equipment (DME) has a 20% coinsurance, and Prosthetic Devices have a 0-20% coinsurance; however, Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies - Non-Medicare benefit has a coinsurance, and Diabetic Therapeutic Shoes/Inserts have a 10% coinsurance, but Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a copay of $50, and Diagnostic Radiological Services with a copay between $60 and $350. Lab services are not covered, but Outpatient X-Ray Services have a $60 copay and Therapeutic Radiological Services have a 20% coinsurance.
Home Health Services See details
Home Health Services are covered by the MVP Medicare WellSelect with Part D (PPO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the MVP Medicare WellSelect with Part D (PPO) plan. 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 with Part D (PPO) plan, 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
Other Services includes coverage for Over-the-Counter (OTC) items and a meal benefit, with the OTC benefit offering up to $50 every three months. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, and many other services are not covered.
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