Please note: The following questions and answers pertain to members with MVP's HMO coverage. If you have MVP Direct Access, MVP POS, MVP PPO, or MVP Indemnity, please ask your employer for coverage guidelines or contact MVP.

I.D. cards...copayments...how does MVP work?
What is a Primary Care Physician?
Can I change my Primary Care Physician?
Do I have to contact my Primary Care Physician before I go to
  see a specialist in the health plan?
When I join MVP, must I get a referral voucher form for a
  specialist I am already seeing?
What services require your physician to obtain prior authorization?
Can women who enroll in MVP choose both a Primary Care Physician
  and an Obstetrician/Gynecologist?
With MVP can I go to any doctor or hospital I want, or must I use MVP
  participating doctors and hospitals?
Are my prescriptions covered by MVP?
Am I covered by MVP when I am away from home?
Has MVP earned NCQA accreditation?
How do I find out more about MVP Health Care?

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.

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What is a Primary Care Physician?
At MVP, that's just another name for your doctor – the physician you'll see for all check-ups, for care when you are sick or for referrals when you need to see a specialist. Your Primary Care Physician is your health partner, with whom you make all health care decisions. You must choose this doctor from MVP's large network of more than 12,000 providers. Click Doctor Search to find one 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?
Yes, you must first see your Primary Care Physician to determine if you need a specialist. If so, your Primary Care Physician can give you a Referral Voucher Form or fax your referral directly to the participating specialist. You must choose this specialist from MVP's large doctor network (although exceptions may be made for highly specialized forms of care, but prior written approval from the MVP Medical Director is required). As with all other physician services, all covered treatment costs are paid for by MVP Health Care, except for your office visit co-payment. Click Doctor Search to find a specialist now. For women, up to two well-care visits per year to a participating obstetrician/gynecologist and all pre-natal visits are covered with no specialist voucher required. If you have MVP Direct Access, MVP POS, MVP PPO, or MVP Indemnity, please ask your employer for coverage guidelines.

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When I join MVP, must I get a Referral Voucher Form for a specialist I am already seeing?
Yes. Once you join MVP, further treatment with the specialist (who must be part of MVP's network) requires a referral from your Primary Care Physician prior to your specialist visit.

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Can women who enroll in MVP choose both a Primary Care Physician and an Obstetrician/Gynecologist?
While only one Primary Care Physician per member is required, women can self-refer to a participating Obstetrician/Gynecologist twice a year for well-care and for pre-natal visits (with no copay after your initial pre-natal visit). Some of the MVP participating OB/GYNs are listed as Primary Care Physicians, in which case, they may be selected as the Primary Care Physician for a woman, if she prefers. Click Doctor Search to find an OB/GYN now.

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With MVP 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 our Member Services Department via e-mail or toll-free at 1-888-MVP-MBRS (1-888-687-6277).