EPO Silver 2 by MVP
Scroll down to the Summary of Benefits PDF
Plan Information
- Plan Name
- EPO Silver 2
- Insurance Company
- MVP
In Network Benefits
- Office Co-pay
- $40 ($0 first 3 visits)
- Specialist Co-pay
- $70 after deductible
- Hospital Co-pay
- 20% after deductible
- Emergency Room
- $500
- Referrals Needed
- No
- Rx: Generic/Brand/High Brand
- $15/$40/$70 after deductible
- In-Network Deductible (single/family)
- $3,700/$7,400
- In-Network Co-Insurance
- 20%
- Max Out of Pocket (single/family)
- $7,900/$15,800
Out Of Network Benefits
- Co-Insurance
- N/A
- Deductible
- N/A
- Out of Pocket Max (single/family)
- N/A
Other Benefits
- Vision/Dental
- Pediatric Vision and Dental; Adult Vision Only
- Renewal Date
- Annual
- HSA Eligible
- No
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