Is MVP Healthcare a Medicare or Medicaid Plan?

MVP Healthcare offers both Medicare and Medicaid plans, depending on your state and which program you enroll in

MVP Healthcare is a regional health insurance company that operates in multiple states and administers coverage under both Medicare and Medicaid. Which one you have depends entirely on which program you chose when you signed up — they are separate enrollment processes with different rules, costs, and covered services.

If you enrolled in an MVP plan through Medicare, you have a Medicare Advantage plan (also called Part C) or a Medigap supplemental plan. If you enrolled through your state's Medicaid program, you have a Medicaid managed care plan. The name "MVP Healthcare" on your card does not tell you which one; you need to look at your plan documents or call the member services number on your card to confirm.

Key Takeaways

MVP Healthcare administers both Medicare Advantage and Medicaid plans in several states, so the company name alone does not indicate which program covers you.
Your plan documents, enrollment letter, or member ID card will specify whether you have Medicare or Medicaid coverage through MVP.
Medicare plans through MVP cover hospital, doctor, and prescription drug services for people 65 and older or with certain disabilities.
Medicaid plans through MVP cover low-income individuals and families and vary by state in what services are included.
Contacting MVP member services with your member ID is the fastest way to confirm which program you are enrolled in.

How to tell which program you have

The simplest way is to look at your plan documents. Your enrollment letter or welcome packet will state clearly whether you are enrolled in a Medicare plan or a Medicaid plan. If you have your member ID card, the back usually lists the member services phone number; call and tell them your member ID, and they will tell you when ready.

You can also check your enrollment records. If you enrolled through Medicare.gov or called 1-800-MEDICARE, you have a Medicare plan. If you enrolled through your state's Medicaid office or a Medicaid managed care enrollment broker, you have a Medicaid plan. Some people have both — for example, you might have Medicare because you are 65 and also be enrolled in Medicaid because your income is low enough to may have access to. In that case, you would have two separate MVP plans with two different member ID numbers.

MVP Healthcare Medicare plans

MVP offers Medicare Advantage plans in several states, including New York, Vermont, New Hampshire, and Pennsylvania. These plans bundle hospital coverage (Part A), doctor coverage (Part B), and usually prescription drug coverage (Part D) into one plan. You pay a monthly premium, and the plan covers your medical services up to an annual out-of-pocket limit.

Medicare Advantage plans through MVP typically include dental, vision, and hearing benefits that Original Medicare does not cover. However, you must use doctors and hospitals in the MVP network, except in emergencies. If you want to see an out-of-network provider, you may pay more or the plan may not cover the visit at all.

MVP also offers Medigap plans in some states. These are supplemental policies that work alongside Original Medicare (Parts A and B) to cover costs that Medicare does not pay, such as copayments and coinsurance. Medigap plans do not include prescription drug coverage; you enroll in Part D separately.

MVP Healthcare Medicaid plans

MVP administers Medicaid managed care plans in several states. Medicaid covers low-income individuals, families with children, pregnant people, people with disabilities, and seniors with limited income and assets. The specific services covered and the income limits vary by state.

When you enroll in an MVP Medicaid plan, the state pays MVP a monthly fee to manage your care. You typically pay little or nothing for covered services, though some states charge small copayments for certain visits or prescriptions. Like Medicare Advantage, Medicaid managed care plans require you to use in-network providers, though emergency care is covered anywhere.

Medicaid plans through MVP may cover services that Medicare does not, such as long-term care, transportation to medical appointments, and dental care for adults. The exact benefits depend on your state's Medicaid program and the specific MVP plan you are in.

Which states does MVP Healthcare serve

MVP Healthcare operates primarily in the Northeast. As of recent years, the company offers Medicare and Medicaid plans in New York, Vermont, New Hampshire, and Pennsylvania. However, the states where MVP offers plans and the specific plans available can change from year to year.

To confirm whether MVP offers plans in your state and what plans are available to you, visit Medicare.gov (for Medicare plans) or contact your state's Medicaid office (for Medicaid plans). Your state Medicaid office can also tell you which managed care companies, including MVP, operate in your area.

What to do if you are unsure about your coverage

Start by gathering your plan documents. Look for your member ID card, welcome letter, or any official correspondence from MVP. These documents will state whether you have Medicare or Medicaid coverage and will include the member services phone number.

Call MVP member services with your member ID ready. They can confirm your program type, explain your coverage, answer questions about your network providers, and help you understand your costs. If you cannot find your member ID, you can call and provide your name, date of birth, and address instead.

If you are still unsure after speaking with MVP, you can also contact Medicare (1-800-MEDICARE) or your state's Medicaid office. Both can look up your enrollment and tell you which program you are in and which plan you have.

Frequently Asked Questions

Can I have both an MVP Medicare plan and an MVP Medicaid plan at the same time?

Yes. If you are 65 or older and also have a low enough income to may have access to for Medicaid, you can be enrolled in both programs. You would have two separate MVP plans with two different member ID numbers. This situation is called "dual may be able to access." Each plan covers different services, and you use both to pay for your care.

If I switch from MVP Medicare to a different company, do I lose my coverage?

No. You can change Medicare plans during the Annual Enrollment Period (October 15 to December 7 each year) or if you experience a may have access to life event. Your new plan's coverage begins on January 1 or on the first of the month following your request, depending on when you enroll. There is no gap in coverage as long as you enroll in another plan before your MVP plan ends.

Does MVP Healthcare work the same way in every state?

No. Even though MVP operates under the same company name, the specific plans, benefits, costs, and network providers vary by state. A Medicare plan in New York may be different from an MVP Medicare plan in Pennsylvania. Always check your plan documents or contact MVP directly to understand your coverage in your state.

How do I find MVP Healthcare providers in my network?

You can search the MVP website using your member ID, or call the member services number on your card. They can tell you which doctors, hospitals, and specialists are in your network and help you find a primary care doctor if you need one. For Medicaid plans, your state's Medicaid office website may also have a provider search tool.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.