Medicare Advantage Plans

Find the right plan for your needs and lifestyle.

UVM Health Advantage Select (PPO)


IN = In-Network; OUT = Out-of-Network


Monthly Plan Premium $0 with Part D
Part D Prescription Drug Coverage Tiers 1 and 2: No deductible.
Tiers 3-5: $350 deductible. You pay 100% of the cost of retail and mail order drugs until you spend $350.

Part D 30-Day Supply - Co-pays differ in the coverage gap. LIS or EPIC may reduce your co-pays. Tier 1 - $0
Tier 2 - $10
Tier 3 - $47
Tier 4 - 25% coinsurance
Tier 5 - 28% co-insurance
Primary Doctor Visit IN - $0 OUT - $5
Specialist Visit IN - $35 OUT - $50
Urgently Needed Care Worldwide Coverage $40
Emergency Room Care Worldwide Coverage $110
Inpatient Hospital Stays Emergency admissions covered worldwide IN - $375/day for days 1-3, $0/day for days 4+ OUT - $500/day for days 1-5, $0/day for days 6+
Ambulatory Surgical Center IN - $225 OUT - $325
Outpatient Hospital IN - $325 OUT - $400
X-ray IN - $35 OUT - $35
Lab IN - $0 OUT - 40% co-insurance
Hearing Aid Allowance Hearing aids for $699 or $999 per ear OR up to $600 per hearing aid toward your choice of top models. Batteries included!
Eyewear Allowance $225 per year
Dental Allowance $1,500 annual dental allowance. See any dentist for services.
SilverSneakers® Fitness Program Gym membership and SilverSneakers classes
Virtual Care Services through Gia® $0
Over-the-counter Purchases $50 allowance per quarter
Meal Delivery 14 free refrigerated meals after an in-patient hospital stay discharge
Transportation 12 free rides to or from medical appointments (60 miles max per ride)
Out-of-Network Coverage for Non-Urgent and Non-Emergency Services Up to $50 office visits; 40% co-insurance for most other services
Out-of-Pocket Protection That Includes Part B Drugs $7,900 max per year for your protection
Once met, MVP pays 100% of covered services

MVP Health Care offers Medicare Advantage plans in the following counties: New York - Clinton, Essex, Franklin, Hamilton, and St. Lawrence counties.

MVP Health Plan, Inc. is an HMO-POS/PPO organization with a Medicare contract. Enrollment in MVP Health Plan depends on contract renewal. Out-of-network/non-contracted providers are under no obligation to treat MVP Health Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. For accommodations of persons with special needs at meetings, call 1-800-324-3899 (TTY 711). Every year, Medicare evaluates plans based on a 5-star rating system. Other physicians/providers are available in the MVP Health Care network.

MVP virtual care services through Gia are available at no cost-share for most members. In-person visits and referrals are subject to cost-share per plan.

SilverSneakers is a registered trademark of Tivity Health, Inc. SilverSneakers On-Demand is a trademark of Tivity Health, Inc. ©2024 Tivity Health, Inc. All rights reserved. GetSetUp is a third-party provider and is not owned or operated by Tivity Health, Inc. ("Tivity") or its affiliates. Users must have internet service to access online services. Internet service charges are responsibility of user.

All content ©2024 TruHearing, Inc. All Rights Reserved. TruHearing® and (RE)TM are trademarks of TruHearing, Inc. All other trademarks, product names, and company names are the property of their respective owners. Retail pricing based on prices for comparable aids. Follow-up provider visits incuded for one year following hearing aid purchase. Free battery offer is not applicable to the purchase of rechargable hearing aid models. Three-year warranty includes repairs and one-time loss and damage replacement. Hearing aid repairs and replacements are subject to provider and manufacturer fees. For questions regarding fees, contact a TruHearing hearing consultant.

MVP Health Care complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex (including sexual orientation and gender identity).

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1 844 946 8010 (TTY 711). 注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 1-844-946-8010 (TTY 711).

©2024 MVP Health Care

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Last updated: 10/1/2024

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