Frequently Asked Questions
Listed below are some common questions asked by MVP members. Click a question to get the answers you need.
Please note: The following questions and answers pertain to members with MVP's HMO coverage. If you have MVP POS, MVP PPO, MVP EPO, TriVantage, or MVP Indemnity, please ask your employer for coverage guidelines or contact MVP.
I.D. cards...copayments...how does MVP work?
Simply make an appointment with your Primary Care Physician. When you arrive for your appointment, present your MVP I.D. card. You simply need to pay a small fixed copayment (usually at the time of your visit). There are no claim forms to submit or deductibles to pay. All of MVP's participating physicians, hospitals and other health care providers "bill" MVP directly so you should never see a bill (beyond your copayment). You get the health care you need...we take care of the rest.
You can order an ID card or print a temporary ID card by clicking on the Manage My Coverage tab, and select ID cards from the left navigation bar.
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What is a Primary Care Physician?
Your Primary Care Physician (PCP) is who you'll see for routine check-ups, and for care when you are sick. Your PCP is your health partner, with whom you'll make all health care decisions. Your PCP will play a central role in helping you obtain high quality health care.
MVP fully supports our PCPs and we encourage and expect them to prescribe and coordinate comprehensive care plans and treatments for you and all of our members. You must choose your PCP from MVP's large network; your doctor is probably on our list of thousands of participating providers.
Click Provider Search to try a provider search now.
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Can I change my Primary Care Physician?
Yes! With MVP, you have the flexibility to change your Primary Care Physician at any time – either online or by calling 1-888-MVP-MBRS (1-888-687-6277).
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Do I have to contact my Primary Care Physician before I see a specialist?
Your health plan requires that you select a PCP. Please continue to use your PCP to coordinate all of your treatment, since depending upon your condition, you might not need to see a specialist. You will see your PCP for routine screenings, preventive health and well care. These services might not be covered if you see a practitioner other than your PCP to obtain them.
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Do I need to obtain a referral from my PCP before I see a specialist?
Most MVP plans do not require referrals for specialists. Referrals are only needed for the following plans:
- - MVP Option Child
- - MVP Option Family
- - Medicaid (also known as MVP Care)
- - CompCare
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Can women who enroll in MVP choose both a Primary Care Physician and an Obstetrician/Gynecologist?
There is no need to for you to do this – you only need to choose a PCP. Women may see a participating MVP Obstetrician/Gynecologist for appropriate services. Some MVP participating OB/GYNs are also listed as Primary Care Physicians, in which case, they may be selected as the Primary Care Physician for a woman, if she prefers.
Click Provider Search to find an OB/GYN now.
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Can I go to any doctor or hospital I want, or must I use MVP participating doctors and hospitals?
MVP has made arrangements with a large number of physicians, hospitals, laboratories and other health care organizations to provide services to our members. In order for your doctor visits to be covered by MVP, you must use providers who are part of our network. You may search for participating doctors, hospitals and labs, and pharmacies online. When medically necessary, the MVP Medical Director may make arrangements for members to receive care with non-participating physicians and/or hospitals. In such cases, prior written approval must be obtained. MVP will cover emergency care for members at non-participating hospitals or health care facilities, but the member must seek any necessary follow-up care from MVP providers. If you have MVP Direct Access, MVP POS, MVP PPO, or MVP Indemnity, please ask your employer for coverage guidelines.
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Are my prescriptions covered by MVP?
If your employer has MVP's prescription drug rider, you are covered for all prescriptions on MVP's approved list of medications – for the cost of a small copayment. In cases where we do not cover a certain drug, we usually cover an alternative drug. To find a specific drug on this list, use our Rx Search.
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Am I covered by MVP when I am away from home?
Yes. MVP members have 24-hour worldwide emergency coverage. If an emergency situation develops while you are outside the service area, you should seek care from the nearest physician or hospital emergency room. Notify MVP within 48 hours, or as soon as physically possible. (MVP reserves the right to retrospectively determine if the visit is of an emergency nature.) All routine, preventive, elective or non-emergency care must be provided by or arranged through your Primary Care Physician and obtained within the MVP service area. If your MVP benefit plan includes a "Student Rider," your covered student dependent children who are attending schools outside the service area of MVP are entitled to this same medically-necessary emergency care. Preventive and follow-up care, however, must be provided or arranged through the Primary Care Physician and obtained within the MVP service area. The out-of-area coverage includes doctor visits, physical therapy, allergy shots and lab work.
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Has MVP earned NCQA accreditation?
Yes! MVP recently earned an Excellent Accreditation for our HMO, MVP Health Plan Inc., from the National Committee for Quality Assurance (NCQA), an independent organization which rates the quality of health plans nationwide. This is a testament to the quality of our benefits and services and to the satisfaction of our members.
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How do I find out more about MVP?
Contact the Member Services Department with the phone number listed on the back of your ID card.
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