Service Area for the Co-Created Medicare Advantage Product from MVP Health Care and UVM Health Network, to be Reduced to Northern New York
An evolving landscape for Medicare Advantage (MA) plans and economic pressures have led to the difficult decision to reduce the service area for UVM Health Advantage (UVMHA) for the upcoming plan year. The MA plan, co-created by MVP Health Care (MVP) and University of Vermont Health Network (UVMHN), will no longer be available in Vermont beginning January 1, 2025. However, the plan will continue to be available to residents in five designated northern New York counties. Vermonters currently enrolled in the plan will have an opportunity to transition to alternative options in the upcoming annual enrollment period beginning October 15th.
The current MA model is no longer sustainable in Vermont, given sharply increasing post-pandemic surges in care utilization and difficult regulatory changes on the horizon in 2025.
"In the face of necessary strategic change and given the knowledge that certain upcoming regulatory adjustments are inevitable, we find ourselves needing to narrow our focus," expressed Dr. Richard Dal Col, President of MVP Health Care. "Our partnership with UVMHN, characterized by a mutual commitment to innovation and improving the health of the communities we serve, remains robust and continues outside the context of the UVM Health Advantage plan."
The impact of providing increased amounts and more serious types of care is also exacerbated by Vermont-specific caps put on Medicare reimbursement set by the Centers for Medicare and Medicaid Services (CMS), and has led to financial challenges for the plan and care providers in the state.
“Across our region, we see the many challenges related to delivering sustainable health care, as costs continue to rise for both patients and the people who provide that care,” said Sunny Eappen, MD, MBA, President and CEO of UVM Health Network. “While UVM Health Advantage will no longer be offered in Vermont, we’re here to support our patients who are impacted by this change and we will continue to be here for them moving forward. We look forward to continuing our partnership with MVP in new ways and I’m incredibly thankful to our physicians who have influenced our joint MA plan.”
Who does this impact?
- This service area reduction only affects MVP’s MA customers in Vermont including MVP’s MA Employer Group Waiver Plans (EGWP).
- MVP’s commercially insured customers enrolled through the State of Vermont Health Connect or through employer sponsored insurance are not affected.
- All MVP customers will continue to have access to UVMHN providers.
- As a safety net provider, UVM Health Network will always provide emergency care to anyone who walks through the door, regardless of what insurance they have or whether they have insurance at all.
Next steps for those impacted in Vermont:
Vermont residents currently enrolled in a UVMHA plan will need to select an alternate health insurance coverage option during the forthcoming Annual Enrollment Period, which begins on October 15 th and ends on December 7 th .
To explore new health plan options, affected customers can:
- Call the Vermont State Health Insurance Assistance Program at 1-800-642-5119
- Counselors are available to answer questions, discuss needs, and give information about options. All counseling is free.
- Call 1-800-MEDICARE (1-800-633-4227)
- This toll-free help line is available 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048.
- Visit Medicare.gov
- Select Supplements & Other Insurance for information on Medigap policies and tools to find plans. Click the Find plans tab to compare plans.
Additional Resources and FAQ
For more information, MVP customers can call 1-833-303-4687.
For Vermont UVM Health Advantage Plan Members
What does this announcement mean? Is my insurance going away?
All Vermont patients currently enrolled in the UVM Health Advantage plan will no longer be covered by that plan beginning January 1, 2025. You will experience no changes in your coverage through the end of 2024. You will need to select alternate health insurance coverage in the upcoming Annual Enrollment Period, which begins on October 15 and ends on December 7 or return to regular Medicare with or without supplemental coverage. (See info in overview section for how to find a new plan.)
When will my insurance coverage end? When do I have coverage through?
All Vermont patients currently enrolled in the UVM Health Advantage plan will continue to be covered until December 31, 2024. You will need to select an alternate health insurance coverage during the Annual Enrollment Period, October 15 through December 7 or return to regular Medicare with or without supplemental coverage. (See info in overview section for how to find a new plan.)
When and how do I switch to another health insurance plan?
All Vermont patients enrolled in the UVM Health Advantage plan will continue to be covered until December 31, 2024. You will need to select an alternate health insurance coverage during the Annual Enrollment Period, October 15 through December 7 or return to regular Medicare with or without supplemental coverage. (See info in overview section for how to find a new plan.)
Can you help me switch to another health insurance plan? How are you going to help me transition to a new health plan?
Unfortunately, due to federal regulations we cannot help you switch plans. (See info in overview section for how to find a new plan.)
Do I need to switch to a new plan right away?
You will continue to be covered until December 31, 2024. You should select an alternate health insurance coverage during the Annual Enrollment Period, October 15 through December 7 or return to regular Medicare with or without supplemental coverage. (See info in overview section for how to find a new plan.)
Can I switch to a new plan before open enrollment if I want to just handle it now?
No, this announcement does not trigger a Special Enrollment Period. You will need to select an alternate health insurance coverage during the Annual Enrollment Period, October 15 through December 7 or return to regular Medicare with or without supplemental coverage.
What if I receive care at the end of the year and my doctor doesn’t bill you until 2025?
For specifics on your insurance coverage, you will need to call MVP Healthcare at the number on your insurance card.
Can I still see the same providers this year, or will there be network changes?
There are no changes for the balance of 2024. For 2025, you will need to call MVP Healthcare at the number on your insurance card to see if there are any network changes
Can I still see my providers or fill a prescription up until the end of the year?
Yes, you will continue to be covered by MVP until December 31, 2024. You can use your coverage as usual through the end of 2024.
What about next year - can I still see my same providers?
When selecting a health plan for 2025 during the Annual Enrollment Period, you can check if your current providers are in-network.
My doctor is part of UVM Health Network– does this mean I can no longer see them?
When you select a new health plan, you will have to ensure that UVMHN is part of that plan’s network.
I live in Vermont, but my doctor is in New York. Can I still see them?
You can continue to see your regular providers through the end of the year. When selecting a health plan for 2025 during the Annual Enrollment Period, you can check if your current providers are in-network.
I am getting care for something that will continue into 2025 (cancer treatment, etc.). How should I transition care? What if my provider isn’t covered under my new insurance?
For specifics on your insurance coverage, you will need to call MVP Healthcare at the number on your insurance card.
New York UVM Health Advantage Members
I am a New York customer, but my doctor is in Vermont. Can I still see them?
For specifics on your insurance coverage, you will need to call MVP Healthcare at the number on your insurance card.