What Happens After I Enroll?

Learn What to Expect After You Become a Member 

At MVP, we’re here for you throughout your Medicare journey. Once you find your plan and enroll, you’ll receive the following items by mail: 

• Your confirmation letter. We’ll let you know we have your application and that Medicare has approved your
  enrollment in your plan. You’ll receive this about 10 days after you enroll. 
• Your MVP Member ID card. Always show your member ID card when you visit your doctor or pharmacy.
  Keep your Medicare card at home for your records. 
• A dental plan ID card if your plan includes dental coverage.
  This is separate from your member ID card. 
• A new Medicare member guide. This includes your Evidence of Coverage (your contract with us) and other
  important items to read and keep. 
• A verification letter if you’re leaving an employer group plan. Medicare requires this to verify that you’re familiar
  with your new health plan’s terms. 
  
  

Until you receive your member ID card, you can use your confirmation letter at doctor’s appointments. 

Prior Authorization 

Prior authorization is a process in which we review a proposed treatment to make sure you’re receiving the care you need at a reasonable cost. Some treatments and services require prior authorization from us. This applies whether you receive them from providers within our network or outside it. 

 
Some types of care and services that need prior authorization include: 

• Admissions to transitional care units, acute rehabilitation, and skilled nursing facilities 
• Diagnostic services, such as CT scans and MRIs 
• Durable medical equipment 
• Home care services 
• Implants and internal prosthetics 
• Select prescription drugs 
  
  

Your doctor will usually request prior authorization whenever we need it. If you need or want a medical service that isn’t available from a provider in our network, you may refer yourself to a provider outside the network. Remember: It may cost you more to receive care from a provider who is outside our network. 

MVP Health Plan, Inc. is an HMO-POS/PPO/HMO D-SNP organization with a Medicare contract and a contract with the New York State Medicaid program. Enrollment in MVP Health Plan depends on contract renewal. MVP Health Plan, Inc. has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until 12/31/2024 based on review of MVP Health Plan’s Model of Care. Health benefit plans are issued by MVP Health Plan, Inc., an operating subsidiary of MVP Health Care, Inc. Not all plans available in all states and counties. Every year, Medicare evaluates plans based on a 5-star rating system. 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).

Other physicians/providers are available in the MVP Health Care network. Gia virtual care services are available at no member cost-share for medical plans, including qualified high-deductible health plans (QHDHPs). Exceptions may apply for self-funded plans. In-person visits and referrals are subject to cost-share per plan. Members enrolled in a Medicare Rx plan without additional MVP medical coverage do not have access to MVP virtual care services through Gia. 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.

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 included for one year following hearing aid purchase. Free battery offer is not applicable to the purchase of rechargeable 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.

©2024 NationsBenefits, LLC. and NationsOTC, LLC. NationsOTC is a registered trademark of NationsOTC, LLC. All other marks are the property of their respective owners. Mom’s Meals® is a registered trademark of PurFoods, Inc.

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Last Updated: 10/1/2024