USA Care PPO Medicare Advantage Plan

USA Care PPO is a Medicare Advantage plan that offers you the freedom to see any doctor in the country who accepts Medicare patients. Here are just a few of the benefits that add even more value to your health care experience:

• $0 cost Preferred Generic Drugs and cost-saving mail order services.
• No specialist referrals needed.
• Worldwide coverage for emergency room and urgently needed care.
• Freedom to see any doctor who accepts Medicare patients.
• Full coverage for preventive care, such as the Welcome to Medicare Visit, Annual Wellness Visits and mammograms.
• $0 myVisitNow® - 24/7 Onine Doctor Visits.
$75 Wellness Rewards for staying current with yearly exams, tests and screenings.
SilverSneakerssm membership, with access to 15,000 sites across the U.S., at no added cost to you!
• A dedicated team experienced in Medicare Advantage health plans.

When you visit your family doctor or specialist, or are admitted to the hospital, you will pay only a fixed co-pay or co-insurance. You cannot be billed for any other amounts above your cost-sharing amount.

It is important that you ask your doctor or other health care provider if they participate with Medicare. Most doctors do, but ask in advance to be sure. These providers submit claims directly to MVP.

Find doctors, hospitals, and other providers who participate with Medicare at Medicare.gov.

 

Provider Claim Forms

Part D Prescription Drug Coverage

  • CMS-1500 paper claim form (sample)
  • Employer Group Retirees Part D Coverage
  • UB-04 paper claim form (sample)
  • USA Care Medicare Part D Vaccine Billing
  • File USA Care Claims Electronically
  • Form - Prior Authorization (prescriptions)
  • EDI Enrollment Form
  • CVS Caremark Mail Service Pharmacy Order Form
  • CVS Caremark Medicare Part D Prescription Drug Claim Form
  • CVS Caremark Mail Service Pharmacy
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    Last Updated: December 2018

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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 - Mar 31, call seven days a week, 8 am to 8 pm

     

    MVP Medicare Team
    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

     


    Important Information

     

    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. Call 1-800-665-7924 (TTY: 1-800-662-1220) for more information.

    Every year, Medicare evaluates plans based on a 5-star rating system. Out-of-network/non-contracted providers are under no obligation to treat MVP Health Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. Medicare beneficiaries may also enroll in Preferred Gold HMO-POS, GoldValue HMO-POS, GoldSecure HMO-POS, Gold PPO, and/or WellSelect PPO through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.

     

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