Featuring an extensive doctor network and no referrals, MVP PPO Select offers an exciting choice for businesses and their employees. Here's how it works:

• You can see any doctor in the network – no referral required.
• You can visit doctors and hospitals in our network, OR visit out-of-network doctors and hospitals.
• Employers can customize their PPO with a range of copay, coinsurance, and deductible options, and a variety of valuable riders.
• Large businesses with some employees outside MVP's service area can add a rider to provide access to a national network for those employees.
• Your plan includes preventive care and hospital benefits.

MVP PPO and PPO Select Benefit Summary Sheets
MVP offers many different rider options that allow your company to enhance your benefit plan. Please discuss with your employer the plan your company offers and how additional riders may affect the plan's benefits.

New York State

MVP PPO Select Co-plan Charts:
$200/$500 Deductible
MVP PPO Select 20+

$500/$1,250 Deductible
MVP PPO Select 20+
MVP PPO Select 20 (w/ $250/$50 Hospital Copay)

$1,000/$2,500 Deductible
MVP PPO Select 20+
MVP PPO Select 20 (w/ $250/$50 Hospital Copay)
MVP PPO Select 20 (w/ $500/$100 Hospital Copay)

MVP PPO Co-plan Charts:
$200/$500 Deductible
MVP PPO 5+
MVP PPO 10+
MVP PPO 20+

$500/$1,250 Deductible
MVP PPO 5+
MVP PPO 10+
MVP PPO 20+
MVP PPO 10 (w/ $250/$50 Hospital Copay)
MVP PPO 20 (w/ $250/$50 Hospital Copay)

$1,000/$2,500 Deductible
MVP PPO 5+
MVP PPO 10+
MVP PPO 20+
MVP PPO 10 (w/ $250/$50 Hospital Copay)
MVP PPO 10 (w/ $500/$100 Hospital Copay)
MVP PPO 20 (w/ $250/$50 Hospital Copay)
MVP PPO 20 (w/ $500/$100 Hospital Copay)

MVP PPO Rx Options:
Please check with your employer to find out if this benefit is part of your plan.
NY$5/$15/$25
NY$10/$20/$30
NY$10/$25/$50
NY $10/30%/50%

Vermont

MVP PPO Co-plan Charts:
$200/$400 Deductible
MVP PPO 10 (W/90% In-Network Coinsurance)
MVP PPO 10 (W/80% In-Network Coinsurance)

$500/$1,000 Deductible
MVP PPO 10
MVP PPO 15

$1,000/$2,000 Deductible
MVP PPO 15
MVP PPO 25

$2,500/$5000 Deductible
MVP PPO 15
MVP PPO 25

$10,000/$20,000 Deductible
MVP PPO 25

MVP PPO Rx Options:
VT $5/$20/$40
VT $10/$30/$50
VT 50%