The PHCS MVP Advantage plan is the most comprehensive option in the MVP lineup. It’s a limited benefit plan that provides the highest number of covered visits and hospital days, all with predictable copays and no deductible. Unlike traditional major medical insurance, it doesn’t offer unlimited coverage, but it gives families and individuals a generous allowance of outpatient and inpatient services each year. Compared to the DVP Essentials plans, the MVP series eliminates deductibles, expands visit limits, and replaces coinsurance with simple copays — making costs easier to budget and understand.
- Plan type: Limited benefit plan (not major medical)
- Network: PHCS PPO — national access; plans are not insured by PHCS
- Deductible (individual/family): $0 / $0 (no deductible required)
- Out-of-pocket maximum (individual/family): $5,000 / $10,000
- Preventive care: $0 copay for non-hospital-based services
- Primary care visits: $15 copay, limited to 12 visits per year (Essentials allow only 2–4)
- Specialist visits: $25 copay, limited to 12 visits per year (Essentials allow only 2–4)
- Urgent care: $35 copay, limited to 3 visits per year
- Telemedicine: Unlimited $0 copay visits
- Labs & radiology: $50 copay, limited to 4 visits per year (Essentials apply deductible + 50%)
- Advanced imaging (CT/MRI/PET): $350 copay, limited to 3 visits per year (prior authorization required)
- Inpatient hospitalization: $350 copay, limited to 10 days per year (Essentials apply deductible + 50%)
- Inpatient surgery: Included in hospitalization copay, limited to 4 surgeries per year
- Outpatient surgery: $350 copay, limited to 2 visits per year
- Emergency room: $350 copay, limited to 2 visits per year
- Ambulance (ground only): $250 copay, limited to 2 transports per year
- Pharmacy: Preventive generics $0; non-preventive generics $5 copay; brand and specialty drugs not covered
- Pregnancy benefits: $350 copay per admission (Essentials do not cover pregnancy at all)
- Rehabilitation/Habilitation services: $50 copay per day, up to 12 visits per year
Why MVP Advantage is Great for Families
The MVP Advantage plan is especially well-suited for families because it offers the highest number of covered visits and hospital days in the MVP series. With 12 primary care and 12 specialist visits per year, parents can take children to the doctor more often without worrying about hitting limits too quickly. The plan also includes pregnancy coverage, making it valuable for growing families. Predictable copays for labs, imaging, ER visits, and hospital stays mean you can budget more easily, and the absence of deductibles ensures you don’t face large upfront costs before coverage begins. Compared to the Essentials lineup, MVP Advantage provides more flexibility, more visits, and stronger family-friendly benefits — all while keeping costs capped at a manageable out-of-pocket maximum.
This plan is best for families who want predictable copays, no deductible, expanded visit limits, maternity coverage, and added rehabilitation benefits. It’s not comprehensive major medical insurance, but it helps reduce out-of-pocket costs for preventive care, frequent office visits, urgent care, labs, imaging, and hospital stays. If you’d like to confirm whether your doctors participate in the PHCS PPO network, check which medications qualify under the formulary, or get a personalized cost estimate, contact Fage Financial today — we’ll walk you through the details, and help you decide if the MVP Advantage plan is the right fit for your family.