USA Care PPO Medicare Advantage Plan

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

• $0 cost generic drugs and select vaccines
• 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.
Access 24/7 online doctor visits with myVisitNow using a computer, tablet, or smartphone.
• A $75 Wellness Rewards incentive for staying current with yearly exams, tests and screenings.
SilverSneakerssm fitness program fitness center membership, 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


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



    Last Updated: October 2017

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    Contact Us

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


    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
    TTY: 1-800-662-1220


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



    220 Alexander St.

    Rochester, NY 14607


    24/7 Nurse Advice Line



    Request a Coverage Determination or Formulary Exception

    Phone: 855 853-4852



    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. 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.
    The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next. Out-of-network/non-contracted providers are under no obligation to treat MVP Health Plan members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. 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, BasiCare PPO, and/or WellSelect PPO through the CMS Medicare Online Enrollment Center located at

    Y0051_3606 Approved


    Y0051_3227 Approved