Liberty Platinum 1 by MVP
Scroll down to the Summary of Benefits PDF
Plan Information
- Plan Name
- Liberty Platinum 1
- Insurance Company
- MVP
In Network Benefits
- Office Co-pay
- $5 ($0 1st 3 visits)
- Specialist Co-pay
- $45
- Hospital Co-pay
- $300
- Emergency Room
- $100
- Referrals Needed
- No
- Rx: Generic/Brand/High Brand
- $5/$30/$50
- In-Network Co-Insurance
- 0%
- Max Out of Pocket (single/family)
- $3,300/$6,600
Out Of Network Benefits
- Deductible (single/family)
- N/A
- Co-Insurance
- N/A
- Out of Pocket Max (single/family)
- N/A
Other Benefits
- Vision/Dental
- Vision Only
- Renewal Date
- Annual
- HSA Eligible
- No
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