How Health Insurance Works with MDVIP

Health insurance works the same way in MDVIP-affiliated practices as it does in traditional primary care practices. You use insurance for sick visits and follow-ups.

If you’re joining an MDVIP-affiliated practice, you may be wondering how the program works with commercial health insurance and Medicare. The answer: Commercial insurance and Medicare work the same in MDVIP-affiliated practices as they do in traditional primary care practices.

Your MDVIP-affiliated physician will file with your insurer or Medicare for sick visits, follow ups and other covered wellness services. They will continue to charge copays, co-insurances and deductibles.

What’s different? Patients in MDVIP-affiliated primary care practices pay an annual fee for their membership. The fee covers services in the MDVIP Wellness Program. The advanced tests, screenings and consultations in the program are not typically covered by Medicare or commercial insurance.

Can I get my membership fee reimbursed?

The fee, which can be paid quarterly, semi-annually or annually, is not covered by Medicare or commercial insurance. It may be reimbursable with flexible spending accounts or health savings accounts. You can verify this with your insurance plan administrator.

How is the MDVIP Wellness Program different from other wellness exams or visits?

The advanced testing and diagnostic screenings that are part of the MDVIP Wellness Program go beyond traditional physicals or wellness exams and have been shown to help detect issues earlier and give your doctor a clearer view of the your overall health. For example, the program has been shown to identify 40 percent more people at risk for heart attack or stroke compared to the basic cholesterol tests that are part of typical wellness checks.

The program also includes one-on-one counseling with your doctor. You and your doctor will discuss the results of these tests and use them to develop a customized action plan.

This proactive, preventive medicine approach can result in big health benefits. Published studies have shown that members in MDVIP-affiliated practices:

• experience fewer hospital visits (70% fewer);

• utilize emergency rooms and urgent care facilities less often;

• and have better control over key chronic conditions like type 2 diabetes, hypertension and high cholesterol.

In fact, at-risk Medicare patients enrolled in the MDVIP program have a lower risk for heart attacks or strokes than patients in traditional primary care practices.

How to become a member

Joining an MDVIP-affiliated practice is easy. Find a physician by location or name. View their profile and then complete the form to join. Some physicians want to meet new patients before they join, and others may have a wait list. But we can help. Click here to get startedor call 1.866.249.6850.


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