Business Profile

Medical Plans

MVP Health Care

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Complaints

This profile includes complaints for MVP Health Care's headquarters and its corporate-owned locations. To view all corporate locations, see

Customer Complaints Summary

9 total complaints in the last 3 years.
4 complaints closed in the last 12 months.

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The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

Initial Complaint
Date:07/02/2025
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
MVP Health Care denies paying for primary care visit because they don't consider it preventative. This has not been explicitly stated when they advertised their choices for health care coverage, or I would have picked a different option. What they consider preventative are vaccinations and immunizations which have not been explicitly stated nor discussed during open enrollment.
Business Response
Date: 07/07/2025
Dear Better Business Bureau, In order to protect the personal health information of our members, an Authorization to Disclose Information Form is required, which can be found on MVP's website at *********************. If the member is receiving a bill or has any questions regarding their benefit plan, they may contact MVP’s Customer Care Center directly at *************** Sincerely, MVP Member Appeals Department
Customer Answer
Date: 07/07/2025
I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint. Prior to coming to Better Business Bureau, I have reached out first to MVP. So I'm not doing it again especially that they do not have the plan of action to resolve it. Regards,

**** *******
Initial Complaint
Date:05/29/2025
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
When I call MVP to place an order, the representatives are extremely difficult to communicate with, they do not seem to understand U.S. English at all.
Business Response
Date: 06/04/2025
Dear Better Business Bureau, Inc.: MVP Health Care is in receipt of Mr. **********s complaint, which states: "When I call MVP to place an order, the representatives are extremely difficult to communicate with, they do not seem to understand U.S. English at all". In order to thoroughly review this issue, can you please provide additional information, such as what type of order Mr. ********* attempted to place with MVP?  Sincerely, MVP Member Appeals Department
Customer Answer
Date: 06/04/2025
I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint.
I do not accept the response made by the business to resolve this complaint I called MVP Health to find out which of my current medications have refills left. I had to repeat the name of one medication 3 time, and she was still confused. I didn’t feel her understanding of the English language was proficient enough to communicate with customers in the United States of America. It was a very frustrating telephone conversation.

Regards,
****** *********
Business Response
Date: 06/04/2025
Good Afternoon Better Business Bureau, MVP appreciates Mr. ********* taking the time to discuss his recent
experience with MVP. This feedback from our members assists us with focused
review of processes and helps in our strive for excellent customer service. Mr. **********s concerns have been submitted to the appropriate departments. MVP sincerely apologies for any inconveniences that he may have encountered.  Sincerely,  Member Appeals Department
Customer Answer
Date: 06/05/2025
I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint.   I Accepted, but this response is garbage, the way that it will work better is to move Customer Care offices back to the USA, the Asian, Arab, or Mexican offices provide terrible customer support. I will change to a different Medicare Advantage plan, for 2026.
Regards,

****** *********
Initial Complaint
Date:02/07/2025
Type:Billing Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I have a pacemaker device that I was implanted with. Upon receiving my new device, I have been getting charged a significant amount of bills where MVP refuses to cover their portion of the bills deeming them my responsibility under the “deductible category”. This is a complete abuse of services. I should not have to pay when I have a copay. This was not an emergency visit. This company should be held accountable for refusing to cover services that should 100% be covered by my policy. Last year alone I paid nearly 20,000 in health insurance with bills totaling in excess of $5,000. MVP must pay me back. Why should I pay for a policy when they refuse to cover their responsibility?
Business Response
Date: 02/07/2025
Dear Better Business Bureau, A review of the member's plan indicates that outpatient surgical services are subject to a $100.00 co-payment after the deductible of $600.00 per year. Plan members are responsible for any applicable copayments and/or deductible amounts. If the member has any questions regarding coverage under their medical plan, they may contact MVP's Customer Care Center at ************ for assistance. Sincerely, Member Appeals Department
Initial Complaint
Date:01/14/2025
Type:Service or Repair Issues
Status:
ResolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I am going to go on Medicare this year. My healthcare provider, MVP, suggested that I get a separate policy from my husband until I go on Medicare in April to make the transition easier. My husband, ***** ****, upgraded his policy within MVP. Last year while on my MVP plan after spending 8 months fighting with MVP to approve a prescription for a **** ********* (because of the side effects of statins). He was finally approved in October and has been on the medication. Now since he had to change his policy (within the same insurance provider) they are using this opportunity to once again deny the claim.
Business Response
Date: 01/23/2025
Dear Better Business Bureau, The
member was initially approved for 3 months of therapy, and the approved
authorization ended on December 11, 2024. On January 13, 2025, the new request
was denied due to lack of current labs. The documentation provided by the
healthcare provider did not include a lipid panel obtained within the previous
30 days of the request. Therefore, the request does not meet MVP Clinical
Coverage Criteria for ***** **********. Sincerely, Member Appeals Department
Customer Answer
Date: 01/27/2025
We have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve ******* complaint.

In ******* first denial from MVP concerning praluent there was no mention of the necessity of the need for a lipid profile. ***** received a phone call stating that the renewal for the medication had been denied because it was deemed "unnecessary" and that he should seek treatment in the form of another statin. There was no mention of a lipid panel until he received a written notice two weeks later. ***** has been denied his medication that has been prescribed by both his GP and his cardiologist and was approved by MVP 3 months ago. As a result he has not had his medication in his system for over two weeks. His cholesterol is rising to unhealthy levels. Repeated use of statins at a dose that effectively lowers his ldl cholesterol causes hip pain, muscle pain, weakness and tendonapathy thus the need for a ***** ********* the most effective tool for lowering lipids in patients with hypercholesterimia and a history of coronary heart disease. MVP's denial is an obvious attempt to obfuscate, gaslight and renege on an agreement that was hard won and ultimately approved by MVP after 8 months of repeated petitioning by my doctors. After being informed that he needed a lipid panel upon MVP's rejection of the praluent prescription, he had a lipid panel drawn immediately on 1/20/2025. However, he received his second denial on 1/24/2025. This medicine is critical to his wellbeing.

Regards,

******* *** ***** ****
Business Response
Date: 01/28/2025
Dear Better Business Bureau, MVP has reviewed
the member’s case. The member's provider sent in additional information under a new case
which has been approved. This approval is valid until January 27, 2026. Sincerely, Member Appeals Department MVP Health Plan, Inc.
Customer Answer
Date: 01/28/2025
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to us. Thank you! You were a tremendous help!

Regards,

******* ****
Initial Complaint
Date:05/29/2024
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I need my ****** which is medicine for blood clots which almost killed me a couple years ago. I am allergic to ******* and ******* so I need ****** or generic insurance does not want to give that to me cause they need prior authorization which doctor gave them the authorization and they needed to also know that I am allergic to anything else and he told them just as they requested. Meanwhile this is going two weeks on phone with doctors and insurance and drug store everyday I am out of medicine now and I don’t know what I do now I want everyone to know this company is a rip off. If I don’t get my medicine I will wind up at Westchester hospital again. Please help me. Thank you
Business Response
Date: 06/05/2024
Good Morning Better Business Bureau, In order to review the submitted complaint, please confirm the MVP Member's Identification Number and Date of Birth. Sincerely, Lisa M****** Associate, Senior Complaints Coordinator MVP Health Care
Initial Complaint
Date:04/17/2024
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I am writing to file a complaint against MVP Health Care regarding their denial of coverage for my psychotherapy sessions with Headway. I have been attending these sessions for the past two months, and I recently discovered that my insurance plan with MVP Health Care does not cover services provided by Headway due to its out-of-network status.

As a policyholder, I believe that MVP Health Care's denial of coverage for my psychotherapy sessions violates federal laws, including the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act (ACA). These laws require insurance plans to provide equal coverage for mental health services compared to medical and surgical services. If my plan covers out-of-network services for medical care, it must also cover out-of-network services for mental health care in a comparable manner.

Furthermore, I was not adequately informed about the out-of-network status of Headway before initiating my sessions. The lack of transparency regarding network coverage has led to confusion and frustration on my part.

I have attempted to resolve this matter directly with MVP Health Care, but my efforts have been unsuccessful. Therefore, I am seeking assistance from the Better Business Bureau to address this issue and ensure that I receive the coverage to which I am entitled under my insurance plan.

I respectfully request that the Better Business Bureau investigate this complaint and facilitate a resolution between myself and MVP Health Care. I am committed to continuing my treatment and am hopeful that this matter can be resolved promptly and fairly.

Thank you for your attention to this complaint. I look forward to your assistance in resolving this matter.
Business Response
Date: 04/29/2024
Dear Better Business Bureau, MVP's Appeals Department has reviewed the member's concerns, and this issue has been resolved. Both the provider and member have been contacted directly with the resolution to the member's appeal. Sincerely, Lisa M****** MVP Health Care
Customer Answer
Date: 04/29/2024
I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint.---Dear Better Business Bureau, I appreciate your assistance in addressing my concerns with MVP Healthcare. However, I must express my dismay as the statement provided by Lisa M****** is inaccurate. To my knowledge, no appeal has taken place, and the assertions made are misleading. I urge the BBB to investigate this matter further, as MVP Healthcare's actions appear to be in bad faith. Thank you for your attention to this matter. Sincerely,
***** *****
Business Response
Date: 05/06/2024
Dear Better Business Bureau, MVP received an appeal from the member on March 15, 2024. The Appeal Acknowledgement letter was mailed on March 29, 2024, and the Appeal Determination letter was mailed on April 19, 2024. The letters were mailed to both the member and provider. Additionally, MVP's Senior Appeals Coordinator, contacted the member on April 16, 2024 and April 17, 2024 but were unsuccessful reaching the member and voicemail messages were left. MVP's Senior Appeals Coordinator did speak with the provider's office on April 24, 2024, and they communicated that they would speak with the member directly regarding any billing concerns. Sincerely, Lisa M******Associate, Senior Complaints Coordinator MVP Health Plan, Inc.
Customer Answer
Date: 05/07/2024
Dear Better Business Bureau, I am writing to express my serious concerns regarding MVP Healthcare's handling of my mental health services claim. Despite their assertion that an appeal was received and determined, I have not received any correspondence regarding such an appeal or its determination. This lack of communication raises doubts about the transparency and fairness of MVP Healthcare's processes. Furthermore, I believe MVP Healthcare's actions may constitute bad faith in accordance with insurance regulations. By denying or failing to properly investigate my claim for mental health services, they may be in violation of the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act (ACA). Both of these laws mandate that insurance plans provide coverage for mental health services at parity with medical benefits. MVP Healthcare's failure to acknowledge the equal importance of mental health services compared to medical services is not only unjust but also potentially harmful to policyholders. Denying or delaying coverage for mental health services can have serious consequences for individuals in need of such care. I urge the Better Business Bureau to investigate this matter thoroughly and ensure that MVP Healthcare complies with all relevant laws and regulations. It is imperative that insurance companies uphold their obligations to act fairly and honestly towards their policyholders, especially when it comes to accessing essential health services. Thank you for your attention to this matter. Sincerely, ***** *****
Business Response
Date: 05/09/2024
Dear Better Business Bureau, MVP's Professional Relations Department is working with the provider directly as this issue relates to the manner in which the provider is submitting their claims. The provider is aware of the billing error has agreed to resubmit the denied claims to MVP for further review. If the member has further questions regarding this issue, please have them contact MVP's Customer Care Center at *************** Sincerely, Lisa M******Associate, Senior Complaints Coordinator MVP Health Plan, Inc.
Customer Answer
Date: 05/10/2024
Dear Better Business Bureau, I appreciate the response from MVP Healthcare's Professional Relations Department. However, I must emphasize that the issue at hand extends beyond billing errors. My concern revolves around MVP Healthcare's failure to recognize the importance of mental health services and their potential violation of laws such as the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act (ACA). While addressing billing errors is important, it does not address the broader issue of ensuring equal access to mental health services for policyholders. I urge MVP Healthcare to take proactive steps to rectify this situation and to prioritize compliance with all relevant laws and regulations. Sincerely, ***** *****
Initial Complaint
Date:04/04/2024
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
The issue involves how MVP of Schenectady NY is billing me for physical/occupational therapy services received at ******* ******** ******* ****** ****** during the period from 12/12/23-3/14/24. MYP is billing me for occupational therapy (applied towards deductible), as opposed to physical therapy ($40 x specialist visit), resulting in a difference of me being billed for approximately $800 more than I would have if these visits were considered "specialist" visits. I have received physical therapy on a number of different occasions at other venues, and they've always been billed through MYP (subscribing to the same policy) as specialist visits, so why is this different? I even got the billing codes from my current therapist @ **** to compare them with the codes for services I've received in the past, and they are exactly the same for the same procedures and codes!: evaluation *****, ultrasound *****, manual therapy *****, exercises *****. The only difference is that MYP is considering the services delivered @ **** as "occupational" as opposed to "physical" therapy.
I have attempted to resolve this issue with both the insurance company and the hospital, and both entities just keep insinuating that it's the problem of the other business, resulting in me getting bounced between the two. MVP says all **** needs to do is label their services as "physical" instead of "occupational" therapy, while **** insists the problem lies with MVP for creating the billing distinction between physical and occupational therapy. I have spoken with ****** financial counseling office on at least two occasions, as well with as my therapist @ ****, ***** ***** and her immediate supervisor **** *****. I have called MVP on 2/1/24, 2/7/24, 2/11/24, 3/12/24, and have received 1 ambiguously worded encrypted email from MVP representative Angel P******.
I have paid $400 to **** to date, at the rate of the $40x visit I think I should be billed for the 10 therapy sessions I received.
Business Response
Date: 04/16/2024
MVP's Claims Department has thoroughly researched the member's concerns. MVP has contacted the member directly with the findings to this issue. Sincerely, Lisa M****** Associate, Senior Complaints Coordinator MVP Health Plan, Inc.
Initial Complaint
Date:04/03/2024
Type:Service or Repair Issues
Status:
UnresolvedMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I received an email from MVP saying that a credit card I have on file for payment is about to expire. I have used this credit card before for one time payments but this is not the credit card I use for auto pay. What’s worse is the card isin’t even on the account anywhere for me to remove so MVP is illegally storing peoples credit card information without consent. I contacted the company and spoke to a rude rep who told me she would forward to billing and someone would get back to me. No one has gotten back to me. I have since reported that card as stolen since I have absolutely no idea what they are doing with my credit card information or where it’s being stored
Business Response
Date: 04/16/2024
MVP's Premium Billing & Collections Department has thoroughly researched the member's concerns and will contact our member directly to provide the resolution to this issue.Sincerely,Lisa M******Associate, Senior Complaints CoordinatorMVP Health Plan, Inc.
Customer Answer
Date: 04/19/2024
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below.
No one from company has reached out to me . I still have no answers as to why my credit card info was being stored
Regards,
****** ************
Initial Complaint
Date:12/18/2022
Type:Service or Repair Issues
Status:
AnsweredMore info
Complaint statuses
Resolved:
The complainant verified the issue was resolved to their satisfaction.
Unresolved:
The business responded to the dispute but failed to make a good faith effort to resolve it.
Answered:
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Unanswered:
The business failed to respond to the dispute.
Unpursuable:
BBB is unable to locate the business.
I am trying to get a medication I have not tried called ******** for severe clinical depression. I have tried the others MVP has suggested and none of them help. I and my doctor have been trying to get this authorized since September, 2022. We have done everything asked of us to no avail. MVP refused to let me speak to the person/department that makes the decision. I am in desperate need of this medication.
Business Response
Date: 12/28/2022
Ms. *******'s request for a formulary exception for ******** was denied. All documentation submitted has been reviewed by an MVP Medical Director. The request does not meet regulations for a Formulary Exception under section 40.5 of the Parts C & D Enrollee Grievances, Organization/Coverage Determinations, and Appeals Guidance.
Thank you,
Lisa M******
Associate, Senior Complaints Coordinator
MVP Health Plan, Inc.

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MVP Health Care is NOT a BBB Accredited Business.