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Manage Your Account


section of the website


 

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Contact Us

MVP Medicare Customer Care Center
1-800-665-7924
TTY: 1-800-662-1220

Hours

Monday - Friday

8 am - 8 pm (EST)

 

From Oct. 1 - Feb 14, call seven days a week, 8 am to 8 pm

 

MVP Medicare Product Advisors
1-800-324-3899
TTY: 1-800-662-1220

Hours

Monday - Friday, 8 am - 8 pm (EST)

 

Address

220 Alexander St.

Rochester, NY 14607

 

24/7 Nurse Advice Line

1-800-204-4712

 

Request a Coverage Determination or Formulary Exception

Phone: 855 853-4852

Fax:1-800-401-0915

MVP SMARTFUND™ MSA

SmartFund MSA® combines a high-deductible Medicare Advantage health plan with a medical savings account, giving you freedom to choose how you spend your health care dollars.

 

An MSA plan has two parts:


Part 1 is a Medicare Advantage health plan that covers hospital (Medicare Part A) and medical (Medicare Part B, including Part B drugs) services. MSAs do not cover Medicare Part D prescription drugs or non-Medicare-covered services. You pay the full cost for your Medicare-covered medical services until you reach your annual deductible. If you reach your deductible, the health plan then pays for your Medicare-covered medical services for the remainder of the year.

 

Part 2 is a tax-exempt trust or custodial savings account (as defined by the IRS). The bank account is set up and a yearly contribution amount is deposited by MVP. The contribution amount is pro-rated based on the month you enroll in SmartFund. You can use this money to help pay for Medicare-covered medical services.

 

Are you eligible to join SmartFund?


MVP SmartFund (MSA) A Medicare Medical Savings Account

 

Eastern NY Region +

Summary of Benefits

Summary of Benefits

Annual Notice of Change/Evidence of Coverage

Annual Notice of Change/Evidence of Coverage

Enrollment Form

2017 Medicare Star Rating

 

SmartFund MSA® 2017 Benefits

Monthly Plan Premium
You must continue to pay your Part B premium to Medicare.

$0 Medical Coverage Only
$20 With Optional Rider

Annual Deductible

$6,700

Annual Contribution

Western NY Region*: $1,500
Eastern NY Region+: $1,800
Contribution is adjusted based on the month you enroll.

Referrals

Not required

PCP/Specialist Visits
Emergency Room and Urgently Needed Care
Inpatient and Outpatient Hospital Stays
Ambulatory Surgical Center
Outpatient Surgery
Lab
X-rays, CT Scan, MRI
Preventive Services, such as annual physicals and screenings
Part B Drugs

Before deductible is met: You pay 100% of your Medicare-covered medical services.
After deductible is met: MVP pays 100% of your Medicare-covered medical services for the remainder of the year.

 

SmartFund MSA® Optional Rider

$20 monthly premium

SilverSneakers fitness program

Fitness center membership benefits

Eye Wear

$100 allowance every year

Dental

$240 allowance per year for preventive dental services

TruHearing® Select Hearing Aid Benefit

$699 or $999 co-pay per aid
Up to two aids per year

SmartFund does not cover Part D prescription drugs. To avoid a Medicare penalty, you must enroll in a separate Part D Prescription Drug Plan (PDP) or have creditable drug coverage, which is prescription drug coverage that is as good as Medicares standard.


Using Your Benefits

  • You are not limited to MVP network providers. You may see any doctor or other health care provider who participates with Medicare. Most doctors do, but ask in advance to be sure. If your provider would like more information about SmartFund MSA®, they can call MVP Provider Services at the phone number on the back of your MVP Member ID card.
  • When you visit a doctor or are admitted to the hospital, the doctor or hospital submits a claim to MVP. Do not pay at the time of your visit. MVP will process the claim to determine if it qualifies to count toward your deductible.
    • If you have not met your deductible, or if the service is not covered under your plan, you will receive a bill from the doctor or hospital.
    • If you have met your deductible, MVP pays for Medicare-covered medical services.
  • If you need to submit a claim for reimbursement of Medicare-covered medical services, complete a Medical Claim Reimbursement Request form.
  • Only Medicare-covered expenses count toward your deductible.

About Qualified Medical Expenses

  • Qualified Medical Expenses are medical expenses that can be deducted on your yearly income tax return.
  • For more information on Qualified and Non-Qualified Medical Expenses as defined by Medicare, refer to the Medicare & You handbook or publication 11206, Your Guide to Medicare Medical Savings Account (MSA) Plans. Call 1-800-MEDICARE or visit www.medicare.gov.
  • For more information on Qualified and Non-Qualified Medical Expenses as defined by the Internal Revenue Service, refer to IRS publication 502, Medical and Dental Expenses and IRS publication 969, Health Savings Accounts and Other Tax-Favored Health Plans. Call the IRS at 1-800-829-3676 or visit www.irs.gov.
  • To avoid a tax on withdrawals from your account, you need to file Form 1040, U.S. Individual Income Tax Return, and Form 8853 each year to report your Qualified Medical Expenses.

Manage Your SmartFund Plan Online
Sign In/Register for an MVP online account.

  • Check your Claims Status & History
  • Track your Deductibles & Limits
  • Compare the cost and quality of various health care services and providers with the Treatment Cost Calculator
  • Use the Payment Center to pay your monthly premium invoice (if your plan has a monthly premium)
  • Order replacement ID Cards or print a temporary copy
  • Manage your Communication Preferences to go paperless and get certain communications by email
  • And more!

For information about your SmartFund savings account, contact BenefitWallet at 1-888-769-4788. Monday - Friday from 8 am to 11 pm (EST) or visit www.mybenefitwallet.com/msa.

 

* Western NY Region: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Livingston, Monroe, Niagara, Ontario, Orleans, Schuyler, Seneca, Steuben, Wayne, Wyoming, and Yates counties.


+ Eastern NY Region: Albany, Broome, Cayuga, Chemung, Chenango, Clinton, Columbia, Cortland, Delaware, Dutchess, Essex, Franklin, Fulton, Greene, Hamilton, Herkimer, Jefferson, Lewis, Madison, Montgomery, Oneida, Onondaga, Orange, Oswego, Otsego, Putnam, Rensselaer, Rockland, St. Lawrence, Saratoga, Schenectady, Schoharie, Sullivan, Tioga, Tompkins, Ulster, Warren, Washington, and Westchester counties.

 

Grievances & Appeals


MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.


Medicare MSA Plans dont cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate Medicare Prescription Drug Plan.


There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan at1-800-665-7924 (TTY: 1-800-662-1220 for additional information.

 

You must file Form 1040, US Individual Income Tax Return, along with Form 8853, Archer MSA and Long-Term Care Insurance Contracts with the Internal Revenue Service (IRS) for any distributions made from your Medicare MSA account to ensure you arent taxed on your MSA account withdrawals. You must file these tax forms for any year in which an MSA account withdrawal is made, even if you have no taxable income or other reason for filing a Form 1040. MSA account withdrawals for qualified medical expenses are tax free, while account withdrawals for non-medical expenses are subject to both income tax and a fifty (50) percent tax penalty.


Tax publications are available on the IRS website at http://www.irs.gov or from 1-800-TAX-FORM (1-800-829-3676).

 

MVP Health Plan, Inc. is an HMO-POS/PPO/MSA organization with a Medicare contract. Enrollment in MVP Health Plan depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium.

 

 

Y0051_3228 Approved

Last updated March 2017

 

Y0051_3227 Approved