MVP Health Care
[MVP VT] Gold 1
Plan ID77566VT0040002
Plan year2026Sold on Vermont Health Connect
Plan typeHMONo referral needed
Metal levelGoldNot HSA-eligible
Sold inEvery countyStatewide
These are the plan's 2026 details. Vermont's 2027 plan details are not public yet, so prices, benefits or doctors may change for 2027. Check Vermont Health Connect before you enroll.
Deductible$1,500$3,000 family
Out-of-pocket max$5,700$11,400 family
Coinsurance30%after the deductible
Having a baby$4,170CMS example
Monthly premiums are not shown: they depend on age, county and income. NPI Profile does not sell insurance; Vermont Health Connect lists premiums and handles enrollment.
Doctor search is not available for this plan
MVP Health Care does not send its provider directory to CMS, so we cannot show which doctors are in this plan's network. Call MVP Health Care or the doctor's office.
What you pay with this plan
Which services this plan covers, from the plan files Vermont Health Connect sends to CMS. Those files do not include copays; the plan's Summary of Benefits and Coverage from MVP Health Care or Vermont Health Connect lists them.
Doctor visits
- Primary care visit
- Covered
- Specialist visit
- Covered
- Nurse practitioner or PA visit
- Covered
- Preventive care and vaccines
- Covered
- Urgent care
- Covered
Prescription drugs
- Generic drugs
- Covered
- Preferred brand drugs
- Covered
- Non-preferred brand drugs
- Covered
- Specialty drugs
- Covered
Tests and imaging
- Lab work
- Covered
- X-rays
- Covered
- MRI, CT and PET scans
- Covered
Emergencies and hospital
- Emergency room
- Covered
- Ambulance
- Covered
- Hospital stay
- Covered
- Outpatient surgery (facility)
- Covered
Mental health
- Therapy and counseling visits
- Covered
- Inpatient mental health care
- Covered
Pregnancy
- Prenatal and postnatal care
- Covered
- Delivery and hospital stay
- Covered
Other care
- Physical and occupational therapyLimit: 30 visits a benefit period
- Covered
- Chiropractic care
- Covered
- Eye exam for childrenLimit: 1 exam a year
- Covered
- Glasses for childrenLimit: 1 item a year
- Covered
- Adult dental
- Not covered
$4,170Having a baby (CMS example)
$2,600Managing type 2 diabetes for a year
$1,310A simple fracture
Every service in the plan file (68)
| Service | You pay | Limits and notes |
|---|---|---|
| Abortion for Which Public Funding is Prohibited | Not covered | |
| Accidental Dental | Covered | |
| Acupuncture | Not covered | |
| Allergy Testing | Covered | |
| Bariatric Surgery | Covered | |
| Basic Dental Care - Adult | Not covered | |
| Basic Dental Care - Child | Covered | |
| Chemotherapy | Covered | |
| Chiropractic Care | Covered | |
| Cosmetic Surgery | Not covered | |
| Delivery and All Inpatient Services for Maternity Care | Covered | |
| Dental Check-Up for Children | Covered | 1 exam every 6 months |
| Diabetes Education | Covered | |
| Dialysis | Covered | |
| Durable Medical Equipment | Covered | |
| Emergency Room Services | Covered | |
| Emergency Transportation/Ambulance | Covered | |
| Eye Glasses for Children | Covered | 1 item a year |
| Gender Affirming Care | Covered | |
| Generic Drugs | Covered | |
| Habilitation Services | Covered | 30 visits a benefit period |
| Hearing Aids | Covered | 1 item every 3 years |
| Home Health Care Services | Covered | |
| Hospice Services | Covered | |
| Imaging (CT/PET Scans, MRIs) | Covered | |
| Infertility Treatment | Not covered | |
| Infusion Therapy | Covered | |
| Inpatient Hospital Services (e.g., Hospital Stay) | Covered | |
| Inpatient Physician and Surgical Services | Covered | |
| Laboratory Outpatient and Professional Services | Covered | |
| Long-Term/Custodial Nursing Home Care | Not covered | |
| Major Dental Care - Adult | Not covered | |
| Major Dental Care - Child | Covered | |
| Mental/Behavioral Health Inpatient Services | Covered | |
| Mental/Behavioral Health Outpatient Services | Covered | |
| Non-Preferred Brand Drugs | Covered | |
| Nutritional Counseling | Covered | 3 visits a benefit period |
| Orthodontia - Adult | Not covered | |
| Orthodontia - Child | Covered | |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | Covered | |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | Covered | |
| Outpatient Rehabilitation Services | Covered | 30 visits a benefit period |
| Outpatient Surgery Physician/Surgical Services | Covered | |
| Preferred Brand Drugs | Covered | |
| Prenatal and Postnatal Care | Covered | |
| Preventive Care/Screening/Immunization | Covered | |
| Primary Care Visit to Treat an Injury or Illness | Covered | |
| Private-Duty Nursing | Covered | |
| Prosthetic Devices | Covered | |
| Radiation | Covered | |
| Reconstructive Surgery | Covered | |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | Covered | 30 visits a benefit period |
| Rehabilitative Speech Therapy | Covered | 30 visits a benefit period |
| Routine Dental Services (Adult) | Not covered | |
| Routine Eye Exam (Adult) | Not covered | |
| Routine Eye Exam for Children | Covered | 1 exam a year |
| Routine Foot Care | Not covered | |
| Skilled Nursing Facility | Covered | |
| Specialist Visit | Covered | |
| Specialty Drugs | Covered | |
| Substance Abuse Disorder Inpatient Services | Covered | |
| Substance Abuse Disorder Outpatient Services | Covered | |
| Transplant | Covered | |
| Treatment for Temporomandibular Joint Disorders | Covered | |
| Urgent Care Centers or Facilities | Covered | |
| Weight Loss Programs | Not covered | |
| Well Baby Visits and Care | Covered | |
| X-rays and Diagnostic Imaging | Covered |
How this plan works
HMO: You pick a primary care doctor in the network, and most specialists need a referral from them. Care outside the network is not covered, except emergencies.
- Referral for specialists
- Not required
- Coinsurance
- 30% after the deductible
- Works with an HSA
- No
- Network
- Vermont Individual On Exchange (VTN001)
- Sold in
- Every Vermont county
Other MVP Health Care plans on the same network
The same doctors and hospitals, with different costs.
| Plan | Metal | Deductible | Out-of-pocket max |
|---|---|---|---|
| [MVP VT] Platinum 1 HMO | Platinum | $500 | $1,600 |
| [MVP VT HDHP] Silver 4 HMO | Silver | $2,300 | $7,250 |
| [MVP VT Plus] Silver 1 HMO | Silver | $2,600 | $8,000 |
| [MVP VT Plus HDHP] Gold 3 HMO | Gold | $3,200 | $3,200 |
| [MVP VT] Silver 3 HMO | Silver | $3,500 | $10,150 |
| [MVP VT Plus] Gold 4 HMO | Gold | $5,000 | $8,000 |
| [MVP VT Plus HDHP] Silver 2 HMO | Silver | $5,925 | $5,925 |
| [MVP VT HDHP] Bronze 3 HMO | Expanded Bronze | $6,000 | $7,600 |
| [MVP VT] Bronze 2 HMO | Expanded Bronze | $6,450 | $10,150 |
| [MVP VT Plus] Bronze 1 HMO | Expanded Bronze | $7,250 | $8,800 |
| [MVP VT Plus] Bronze 5 HMO | Expanded Bronze | $9,950 | $9,950 |
| [MVP VT] Bronze 4 HMO | Expanded Bronze | $10,150 | $10,150 |
| [MVP Secure] HMO | Catastrophic | $10,600 | $10,600 |
Questions about [MVP VT] Gold 1
What kind of plan is [MVP VT] Gold 1?
It is an HMO plan: you pick a primary care doctor in the network, and most specialists need a referral from them. Care outside the network is not covered, except emergencies. It is a Gold plan.
How much is a doctor visit with [MVP VT] Gold 1?
A primary care visit costs Covered. A specialist visit costs Covered. These are in-network costs for one person. "After deductible" means you pay the full cost until you reach the $1,500 deductible.
Where is [MVP VT] Gold 1 sold?
It is sold to people who live in every Vermont county, through Vermont Health Connect.
Why is there no monthly premium on this page?
Premiums depend on your age, county, household size and income, and most people get a subsidy, so a single price would mislead. Vermont Health Connect shows the price for your household.
About this data
NPI Profile is not an insurance company, agent or broker, and it does not sell insurance or enroll anyone in a plan. It is a free reference tool built on public files that CMS and insurers publish, to help you compare Marketplace plans and check whether your current or future doctor is in a plan's network. It is not affiliated with CMS, HealthCare.gov, any state exchange or any insurer. Confirm costs and networks with the insurer and the doctor's office, and enroll on Vermont Health Connect.
| Source | What it provides here | Source date |
|---|---|---|
| CMS public use files for Vermont Health Connect | This plan's costs, covered services, coverage examples and the counties where it is sold | Plan year 2026 |
| MVP Health Care's provider directory | The doctors and facilities listed in this plan's network. Only providers with an address in Vermont are counted. | As of November 8, 2026 |
| NPPES NPI registry | Provider names, practice addresses and primary specialties | Matched November 8, 2026 |
- Costs are for the standard version of the plan, for one person, in network. People who qualify for cost-sharing reductions pay less. CMS does not publish copays for plans sold on Vermont Health Connect, so this page shows what is covered, without per-visit costs.
- Monthly premiums are not shown: they depend on age, county, household and income. Vermont Health Connect lists them for your household.
- Confirm costs in the plan documents and with the insurer, and confirm with the doctor's office that they take this plan.
