MVP Basic

PHCS / Multiplan Network

MVP Basic is an entry-level limited benefit plan on the PHCS network designed for generally healthy individuals who primarily need coverage for routine doctor visits and basic medical services. It has no deductible, straightforward copays, and starts coverage immediately with no waiting period. This plan is best suited for those who want predictable, low out-of-pocket costs for everyday care but don't anticipate major medical needs.

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Monthly premiums

member_only: $572.07/mo
child: $802.75/mo
spouse: $907.09/mo
family: $1,137.79/mo

MVP Basic is a limited benefit plan that keeps things simple with no deductible and flat copays for most covered services. You'll pay $25 to see a primary care doctor and $50 for a specialist visit, with up to 8 visits allowed for each per year. Urgent care is also $50 per visit, with 2 visits covered annually. Telemedicine is included at no cost, giving you an easy way to access care for minor issues without leaving home. Preventive care is covered at no cost when received outside of a hospital setting, and a list of preventive generic prescriptions is available at $0 — with non-preventive generic drugs available for a $5 copay. Brand-name and specialty drugs are not covered under this plan. For more serious medical needs, the plan covers inpatient hospital stays at a $350 copay per admission (up to 5 days per year), up to 2 inpatient surgeries and 1 outpatient surgery per year, and 1 emergency room visit at a $350 copay. Lab work and minor diagnostic services (like ultrasounds) are covered at a $50 copay for up to 3 combined visits per year, but only when performed outside of a hospital — hospital-based lab work is not covered. Major imaging like MRIs and CT scans require prior authorization and carry a $350 copay, limited to 1 per year. The individual out-of-pocket maximum is $8,700, and out-of-network services are not covered. This plan is a good fit for budget-conscious individuals who are generally healthy and mainly want coverage for routine primary care, specialist visits, and basic prescriptions. It covers a meaningful range of everyday services with predictable copays and no waiting period, so your benefits begin right away. However, it is not traditional major medical insurance, and it has significant limitations to be aware of — maternity care, pregnancy, durable medical equipment, rehabilitative therapies, radiation, chemotherapy, dialysis, and many other services are excluded entirely. Most services beyond primary and specialist care require prior authorization, and failing to get it can result in reduced benefits. Before enrolling, carefully review the full schedule of benefits and exclusions to make sure this plan fits your anticipated healthcare needs. If you have ongoing or complex health conditions, require specialty medications, or anticipate significant medical care, a more comprehensive plan may be a better fit.

Plan details

Deductible (Individual): $0
Deductible (Family): $0
Primary Care Copay: $25
Specialist Copay: $50
Urgent Care Copay: $50

Benefits

Deductible
$0 / $0
Copay
$25 / $50 / $50
PCP / Specialist / Urgent Care
Doctor Visits
8 PCP / 8 Specialist (separate) per year
Rx Coverage
$0 / $5
Preventive / Non-preventive · Brand/Specialty: Not Covered
Hospitalization
$350 copay/admission
5 days/yr
Surgeries
2 inpatient / 1 outpatient per yr
ER
$350 copay
1 visit/yr
Urgent Care
2 visits/yr
Lab Work
3 per year. NOT covered at a hospital.

MVP Basic

Monthly premiums

Plan details

Benefits

Plan documents

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