Skip to content

MVP 5500 Plan

Benefits at a Glance-Essential StaffCARE MVP 5500

ANNUAL MAXIMUM

Unlimited

MEMBER BENEFITS

In Network

Out of Network

Individual Deductible

$5,500

$11,000

Family Deductible

$11,000

$22,000

Coinsurance (payable by employee)

20%

40%

OUT-OF-POCKET MAXIMUM

Individual

$6,350

$12,700

Family

$12,700

$25,400

ESSENTIAL HEALTH BENEFITS (Coinsurance payable by employee after deductible)

Preventive Care/Screening/Immunization (if in network deductible is waived

0%

40%`

Physician Office Visits

20%

40%

Ambulatory Patient Services

20%

40%

Hospitalization (in-Patient and Out-Patient0

20%

40%

Hospice

20%

40%

Mental Health and Substance Abuse/Behavorial Health

20%

40%

Maternity and Newborn Care

20%

40%

Laboratory Service

20%

40%

Rehabilitative and Habilitative Services/Devices

20%

40%

Emergency Services

20%

40%

PRESCRIPTIONS DRUGS (coinsurance payable by employee after the deductible

Generic

20%

40%

Preferred Brand

30%

50%

Non-Preferred Brand

40%

50%

Specialty

50%

N/A