MVP Health Care

Name

MVP Health Care

Legal name

MVP Health Plan, Inc.

Website

https://mvphealthcare.com

Company type

Private

Founded year

1982

Operating status

Operating

Headcount range

1,001–5,000 employees

Ownership category

akta.pro rank

Product category

Health Insurance

NAICS

Direct Health and Medical Insurance Carriers (524114), Direct Life, Health, and Medical Insurance Carriers (52411)

SIC

Services-Health Services (8000), Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

ACA Marketplace (On-Exchange) Individual Plans (FSAIAEAA)

akta.pro secondary industries

Large Group Health Insurance (Mid-Market & National Accounts) (FSAIAFAE), Membership/Subscription Concierge Virtual Care (HLALAAAH)

Keywords

• Health insurance plans
• Medicare advantage coverage
• Medicaid managed care
• Employer-sponsored health plans
• Virtual care platform

Headquarters

HQ city

Schenectady

HQ country

United States

HQ region

North America

Offices3 records

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

Operations, Personnel, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. Health Insurance Premiums: MVP generates revenue primarily through health insurance premiums paid by individuals, families, and employer groups. Premiums are collected monthly and vary based on plan type, coverage level, and member demographics.
2. Government Program Contracts: Revenue from government-sponsored health programs including Medicare Advantage, Medicaid, Child Health Plus, and Essential Plan. These programs involve capitated payments from federal and state governments for covered beneficiaries.

Pricing tiers

Go-to-market motion2 records

Distribution channels4 records

Marketing channels6 records

Core offering

MVP Health Care sells regulated health insurance plans to individuals, families, employers, and government-program beneficiaries across New York State and Vermont, including Medicaid, Child Health Plus, Essential Plan, Individual and Family, Employer-Sponsored, Medicare Advantage, and Dual Special Needs (D-SNP) products. Members also receive integrated virtual care through the Gia by MVP mobile app, which provides 24/7 urgent care, same-day treatment, pediatric care, and behavioral health therapy. Distribution combines direct website and phone sales with a broker channel and the NY State of Health marketplace.

Product overview

MVP Health Care is a health insurance provider offering a comprehensive portfolio of health insurance plans across New York and Vermont. The product portfolio includes Medicaid, Child Health Plus, Medicare Advantage, Dual Special Needs Plans (D-SNP), Essential Plan, Individual and Family Plans, Employer-Sponsored Plans, and Dental/Vision coverage. The core member-facing digital product is Gia by MVP, a virtual care mobile application providing 24/7 urgent care, same-day treatment, pediatric care, and behavioral health services. Additional services include menopause care through a partnership with Elektra Health and care gap closure programs through Grapefruit Health.

Differentiator

Problem solved

Functional benefit

Brands

• Gia by MVP: Virtual care platform offering 24/7 urgent care, same day treatment, specialized pediatric care, and behavioral health services through the MVP mobile app.

Products and services

• Medicaid Plans Free or low-cost health coverage from a top-rated plan in New York State for eligible residents.
• Child Health Plus (CHP) Affordable coverage with $0 co-pays for children under 19, available through NY State of Health.
• Medicare Advantage Plans All-in-one plans with combined medical and drug coverage for people over 65 and select others, available in multiple New York regions.
• Dual Special Needs Plans (D-SNP) Coordinated coverage for individuals who qualify for both Medicare and Medicaid benefits.
• Essential Plan Affordable health insurance plan with no deductible and a $0 monthly premium for eligible New York residents through NY State of Health.
• Individual and Family Plans Affordable, customized health coverage for individuals, spouses, and families.
• Employer-Sponsored Plans Affordable, customized group health coverage for large and small businesses.
• Dental and Vision Plans Additional coverage options for dental and vision services for members.
• Gia by MVP Virtual care mobile application offering 24/7 urgent care, same-day treatment for many conditions, specialized pediatric care, and behavioral health services through virtual therapy, distributed via Apple App Store and Google Play.

Quantifiable outcome

• Successfully engaged 14,000 Essential Plan members in outreach initiative with improved response rates and reduced hospital readmissions

Named customers2 records

Segments6 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration5 records

Feature3 records

Partnerships

Three partnerships are on record, tiered core and flagship.

• Independent HealthcoreStrategic or Co-development Partner · 18 November 2025Independent Health announced its intention to join MVP Health Care's family of companies, pending regulatory approvals. This strategic merger aims to enhance healthcare delivery across New York and Vermont by combining shared values and innovations. The combined entity will serve nearly one million members, creating a larger regional healthcare provider focused on innovation and community engagement while maintaining current services and pursuing future growth.
• Grapefruit HealthcoreStrategic or Co-development Partner · 23 October 2025Grapefruit Health partnered with MVP Health Care to engage 14,000 Essential Plan members in New York using a workforce of clinical students from local universities. The initiative successfully improved outreach response rates and reduced hospital readmissions and costs compared to traditional methods, demonstrating innovative approaches to closing care gaps through student workforce programs.
• Elektra HealthflagshipStrategic or Co-development Partner · 8 January 2025MVP Health Care partnered with Elektra Health to provide menopause care services to members in the Capital Region. Members can access virtual visits with board-certified menopause providers for hormone therapy and other treatment plans at standard copay. The partnership addresses a historically underserved area of women's health, providing specialized menopause care through telehealth appointments as an in-network benefit.

Scale indicators3 records

Recent moves6 records

Expansion highlights6 records

Broad incumbents

• Humana: Major US health insurer with a Medicare Advantage-led portfolio and growing Medicaid presence — broad incumbent comparable to MVP's Medicare Advantage and government-program emphasis.
• UnitedHealthcare: Largest US health insurer offering individual, group, Medicare Advantage, and Medicaid products nationwide — broad incumbent competing with MVP on Medicare Advantage, individual, and Medicaid lines.

Direct peers

• Excellus BlueCross BlueShield: Upstate NY regional Blue Cross Blue Shield plan offering individual, group, Medicare, and Medicaid products — closely comparable to MVP in product breadth and geographic concentration in New York.
• Fidelis Care: New York-focused health plan owned by Centene with strong government programs (Medicaid, Essential Plan, Medicare) concentration — comparable to MVP on state-contract-heavy mix.
• CDPHP: Albany, NY-based regional not-for-profit health plan serving Capital Region individuals, families, and employer groups — directly competing with MVP in the same geography and product categories.
• Healthfirst: NY-based not-for-profit health plan heavily concentrated in government programs (Medicaid, Medicare, D-SNP, Essential Plan) — directly comparable to MVP's Medicaid/MA-led business model.
• Independent Health: Buffalo, NY-based regional not-for-profit health plan offering commercial, Medicare, and Medicaid products; direct peer because it is the announced merger counterparty with overlapping NY footprint and similar product mix.
• EmblemHealth: New York City-based not-for-profit health plan offering individual, family, Medicare, and Medicaid coverage — comparable regional not-for-profit peer with similar multi-segment product portfolio.

Regional players

• Highmark: Northeast US regional not-for-profit Blue-affiliated health plan serving PA, WV, DE, and NY — comparable as a multi-state not-for-profit carrier with similar product breadth.
• BlueShield of Northeastern New York: Northeastern New York regional Blue plan offering commercial and Medicare products — directly competing with MVP in the upstate NY market.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks5 records

Key highlights7 records

Customer concentration

• Xx.com/mvphealthcare
• Facebookfacebook.com/mvphealthcare
• LinkedInlinkedin.com/company/22434

Compliance3 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles2 records

Subsidiaries3 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A1 record

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about MVP Health Care