MVP Value

PHCS / Multiplan Network

The MVP Value plan is a limited benefit plan with no deductible and low copays for doctor visits, making it a budget-friendly option for generally healthy individuals who mainly need coverage for routine office visits and basic medical care. It works best for people who want predictable, low out-of-pocket costs for everyday healthcare needs and can access the wide PHCS network. Keep in mind this is not traditional major medical insurance and has annual limits on most services.

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Monthly premiums

member_only: $631.49/mo
child: $909.73/mo
spouse: $1,037.84/mo
family: $1,316.07/mo

The MVP Value plan offers straightforward, low-cost access to everyday medical care with no deductible — meaning you pay a flat copay from your very first visit. You'll pay just $15 for primary care visits (up to 10 per year), $25 for specialist visits (up to 10 per year), and $35 for urgent care (up to 3 visits per year). Telemedicine is included at no cost with unlimited visits, making it easy to get care from home. Preventive care is also covered at no cost when done outside a hospital setting. The plan runs on the large PHCS / Multiplan network, which includes providers across all 50 states — and you do not need a referral to see a specialist. For more serious medical needs, the plan covers inpatient hospitalization with a $350 copay per admission (up to 7 days per year), up to 3 inpatient surgeries and 2 outpatient surgeries per year, and emergency room visits at a $350 copay (limited to 1 visit per year). Lab work and minor diagnostic services are covered up to 3 visits per year, but only when done outside of a hospital — hospital-based labs are not covered. Major imaging like MRIs and CT scans are covered at a $350 copay for up to 2 per year at non-hospital facilities, with prior authorization required. Prescription coverage includes preventive generic drugs at $0 and non-preventive generic drugs for $5 — brand-name and specialty drugs are not covered. This plan is best suited for individuals who are generally healthy, expect to use mainly routine doctor visits, and want low, predictable copays without the complexity of a deductible. It is also a good fit for those who want access to telemedicine and can take advantage of the broad PHCS network. Coverage starts right away with no waiting period for most services, though maternity benefits have a 12-month waiting period. Because this plan requires health questions for enrollment (it is not guaranteed issue), applicants will need to qualify based on their health history. There are important limitations to be aware of: this is not traditional major medical insurance, and many services have strict annual visit or day limits. Out-of-network care is not covered at all — you would be responsible for 100% of those costs. Several services are excluded entirely, including brand-name and specialty prescriptions, durable medical equipment, rehabilitative therapies, radiation and chemotherapy, dialysis, skilled nursing facilities, and routine vision and dental care. Prior authorization is required for most hospital and surgical services, and failing to get it can result in reduced benefits. This plan works well as an affordable safety net for routine care but may not be sufficient for those with complex or ongoing medical needs.

Plan details

Deductible (Individual): $0
Deductible (Family): $0
Primary Care Copay: $15
Specialist Copay: $25
Urgent Care Copay: $35

Benefits

Deductible
$0 / $0
Copay
$15 / $25 / $35
PCP / Specialist / Urgent Care
Doctor Visits
10 PCP / 10 Specialist (separate) per year
Rx Coverage
$0 / $5
Preventive / Non-preventive · Brand/Specialty: Not Covered
Hospitalization
$350 copay/admission
7 days/yr
Surgeries
3 inpatient / 2 outpatient per yr
ER
$350 copay
1 visit/yr
Urgent Care
3 visits/yr
Lab Work
3 per year. NOT covered at a hospital.

MVP Value

Monthly premiums

Plan details

Benefits

Plan documents

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