Couple of Questions for anyone who has MVP Health Insurance
#1
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Hello everyone
I have been with Oxford medical for 10 years now and have never had any real issues until recently. Recently the cost for the premium has gone up some while benefits have gone down. I pay more out of pocket for my prescriptions and between hubby and I they add up to quite a bit. My medical condition is pretty intense and can cause blindness so I have to take them. My question is this. His job is now offering him a HDHP (High Deductible Health Plan) which he pays nothing out of pocket for as far as premium and the employer pays the deductible as well. So really the only cost we would ever have once the deductible is met is the copay for prescriptions which are $10, $30, $50 based on tier of medication (far cheaper than I am paying now).
Okay the questions-If you have MVP do you like it? Do you find you have any problems with your doctors taking it? (I already researched and all of our doctors are in the MVP network) Do you have a hard time getting approvals for things such as MRIs or surgeries?
Any and all input is much appreciated.
Hugs
April
I have been with Oxford medical for 10 years now and have never had any real issues until recently. Recently the cost for the premium has gone up some while benefits have gone down. I pay more out of pocket for my prescriptions and between hubby and I they add up to quite a bit. My medical condition is pretty intense and can cause blindness so I have to take them. My question is this. His job is now offering him a HDHP (High Deductible Health Plan) which he pays nothing out of pocket for as far as premium and the employer pays the deductible as well. So really the only cost we would ever have once the deductible is met is the copay for prescriptions which are $10, $30, $50 based on tier of medication (far cheaper than I am paying now).
Okay the questions-If you have MVP do you like it? Do you find you have any problems with your doctors taking it? (I already researched and all of our doctors are in the MVP network) Do you have a hard time getting approvals for things such as MRIs or surgeries?
Any and all input is much appreciated.
Hugs
April
#2
Super Member
Join Date: Mar 2009
Location: western Pa
Posts: 4,569
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April, I don't know anything about MVP HealthPlan per se, but the questions you need to ask are regarding your meds. I know you're on specialized meds and you have to find out if they're on the plans Formulary. I've found with a lot of my patients that when they switch insurance plans, the new plan will not pay for the exact same meds-they pay for what's on their list (formulary). Many times these don't work, they have to try another drug on the formulary, and then if that fails and the dr writes a letter explaining the failures then the original medication is approved and paid for. I'd hate to see you have to start over on trying to get your meds adjusted. Ask to see a formulary/list and find out if your specific meds are on there-not what many plans call "equivilent medications".
Good luck-I know how expensive insurance can be. DH is 2 1/2 yrs unemployed so some times we drop our insurance for a few months.
Good luck-I know how expensive insurance can be. DH is 2 1/2 yrs unemployed so some times we drop our insurance for a few months.
#3
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Originally Posted by janRN
April, I don't know anything about MVP HealthPlan per se, but the questions you need to ask are regarding your meds. I know you're on specialized meds and you have to find out if they're on the plans Formulary. I've found with a lot of my patients that when they switch insurance plans, the new plan will not pay for the exact same meds-they pay for what's on their list (formulary). Many times these don't work, they have to try another drug on the formulary, and then if that fails and the dr writes a letter explaining the failures then the original medication is approved and paid for. I'd hate to see you have to start over on trying to get your meds adjusted. Ask to see a formulary/list and find out if your specific meds are on there-not what many plans call "equivilent medications".
Good luck-I know how expensive insurance can be. DH is 2 1/2 yrs unemployed so some times we drop our insurance for a few months.
Good luck-I know how expensive insurance can be. DH is 2 1/2 yrs unemployed so some times we drop our insurance for a few months.
How are you and hubby doing? And adorable Patches? We would love to come meet you and Patches some day :-)
Hugs
April
#4
Super Member
Join Date: Apr 2010
Location: new hampshire
Posts: 1,550
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We had MVP for about 2 years. DH had neuropthy in his feet and was walking around with a broken ankle for 8 days. the only sign he was concerned about was swelling.
Ok so we are in the ankle spec office, he xrays finds the break, outs it in the cast. I hate to drive alone in the city so had to go get crutches for him to get him home. Got a perscription for them. Found the Medical store, got them, and MVP refused to pay for them because I did not call to get approval. Other biling problems and no or little customer service, was the reason we switched as soon as we could. But this is my story...Paying 500$ a month was too much too. Our perscriptions were with someone else
Ok so we are in the ankle spec office, he xrays finds the break, outs it in the cast. I hate to drive alone in the city so had to go get crutches for him to get him home. Got a perscription for them. Found the Medical store, got them, and MVP refused to pay for them because I did not call to get approval. Other biling problems and no or little customer service, was the reason we switched as soon as we could. But this is my story...Paying 500$ a month was too much too. Our perscriptions were with someone else
#5
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There are 2 other ways to check, too. Call your doctor's office and find out if they have any problems getting the money from them and/or if they have problems with the company approving the MRIs, etc.
Another way to check is to call your state insurance commissioner's office and find out if there are any complaints about the company...and what the ranking is. Most companies do have complaints but on average do they have a high amount or a low amount of complaints.
I believe every insurance company is set up in regions....may be by state or by sections of the US. How they pay on the east coast may be different than on the west coast.
good luck!
Another way to check is to call your state insurance commissioner's office and find out if there are any complaints about the company...and what the ranking is. Most companies do have complaints but on average do they have a high amount or a low amount of complaints.
I believe every insurance company is set up in regions....may be by state or by sections of the US. How they pay on the east coast may be different than on the west coast.
good luck!
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