|
 Medical
Associates Health Plans, Inc. and Medical Associates Clinic Health Plan
of Wisconsin are Medicare-Approved Cost Plans.
Medical
Associates Health Plans offers a complete line of affordable Medicare
options:
The
Medical Associates SmartPlan (Cost):
- Medicare Plan
with Medical Associates Health Plan participating provider network including Finley Hospital
and Mercy Medical Center
- No deductibles
or copayments
- Virtually no paperwork
- 2012 Premium - $97.00/month
The
Medical Associates Community Plan (Cost):
- Medicare Plan
option includes the Medical Associates Health Plan network plus providers from the Tri-State
Independent Physicians Association (IPA) including Finley Hospital and
Mercy Medical Center
- No deductibles
or copayments
- Virtually no
paperwork
- 2012 Premium - $125.00/month
The
Medical Associates Freedom Plan (Cost):
- Medicare Plan option
includes the Medical Associates Health Plan network, providers from the Tri-State Independent Physicians Association (IPA),
plus any out-of-network provider who accepts Medicare
- Copayments applicable
for out-of-network providers ($15.00 office visit copay, $15.00 rehabilitative service copay, $75.00 outpatient surgery copay, $100.00 inpatient copay - up to $500 maximum); no copayment for network providers
- Great for snowbirds
- 2012 Premium - $140.00/month
CMS Plan Ratings
Plan Details
Eligibility
- If you are enrolled
in the Federal Medicare Program hospital insurance “Part A”
and the medical insurance “Part B” or the medical insurance
“Part B” only
- If you reside
within our Service Area:
In Iowa: Allamakee, Dubuque, Clayton, Delaware, Jackson and Jones Counties.
In Illinois: Jo Daviess County
In Wisconsin: Grant, Crawford, Lafayette, and Iowa Counties
- Medicare beneficiaries
diagnosed with End Stage Renal Disease may not be eligible to enroll
Features
- You are not required
to answer any health questions
- Your coverage
is good for Medicare eligible services and supplies
- Your contract
cannot be cancelled because of your age or the amount of benefits you
use
- Your premium
cannot be changed due to the amount of benefits you use
- No pre-existing
condition limitation
Enrollment
Your application
needs to be completed and received by our office by the last day of the
month to be eligible for coverage to begin the first of the following
month, (i.e. sign up by January 31st to be eligible for February 1st)
Payment Options
- Automatic withdrawal
directly from your checking or savings account on a monthly basis;
- Coupon Payment
book
Network
You must use the
participating physicians, hospitals and providers of the Medical Associates
Health Plans you are enrolled in unless medical care is required under
emergency conditions or if you are covered by the Freedom Plan (then applicable MAHP copayments). Only those services provided by or arranged through
a Medical Associates Health Plans provider will be covered. A current
list of participating providers is available upon request.
Out of Area
Coverage
Urgent and Emergency
services are covered for Medicare eligible services. If you experience
an illness or injury of an urgent or emergency nature away from the area
and treatment cannot be postponed until you get home, you are still covered.
After you receive care, you should notify the Health Plans within 48 hours.
Referral
Care
If medical services
are not available within the network, your Medical Associates Health Plans
physician will arrange for necessary referral care. When a Medical Associates
Health Plans participating physician refers you outside of the network
for a Medicare eligible service, the Medical Director reviews all referrals.
You will receive an authorized referral letter if the referral is approved
by the Medical Director.
Medical Associates Health Plans, Inc. has a contract with the Centers for Medicare and Medicaid Services (CMS) that is renewed annually and the availability of coverage beyond the end of the current contract year is not guaranteed.
If you are interested in speaking to an MAHP representative about becoming a member:
(563) 556-8070 Locally
1 (800) 747-8900 Toll free
TTY/TDD users: (800) 735-2943
Office Location:
Medical Associates Health Plans, Inc.
1605 Associates Drive, Suite 101
P.O. Box 5002
Dubuque, IA 52002
Hours of Operation:
Monday through Friday, 8:00 a.m. to 5:00 p.m.
If you are a current member and want to speak with an MAHP Member Services representative about coverage and/or benefits:
| CALL |
(563) 584-4885 or 1-866-821-1365 Hours are 8:00 a.m. to 8:00 p.m. Central Standard Time, 7 days a week (please note that access to a representative is limited on the weekends and holidays during certain times of the year) and calls to these numbers are free.
Member Services also has free language interpreter services available for non-English speakers. |
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| TTY |
1-800-735-2943
This number requires special telephone equipment and is only for people who have difficulties with hearing or speaking.
Calls to this number are free. Hours are 8:00 a.m. to 8:00 p.m. Central Standard Time, 7 days a week (please note that access to a representative is limited on the weekends and holidays during certain times of the year) |
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| FAX |
(563) 584-4760 |
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| WRITE |
Medical Associates Health Plans
1605 Associates Drive, Suite 101
Dubuque, IA 52002
Email at: memberservices@mahealthcare.com |
Provider Directory - Click on Directory to review
SmartPlan - CMS Approved 10/19/2009, Revised 9/27/2011
Community Plan - CMS Approved 10/19/2009, Revised 9/27/2011
Freedom Plan - CMS Approved 10/19/2009, Revised 9/27/2011
Privacy Notice - Click on State to review
Iowa Privacy Notice
Illinois Privacy Notice
Wisconsin Privacy Notice
Appeals and Grievance Process - Click to review
Appeals and Grievance Information -CMS Approved 01/06/2010
Medicare Complaint Form
Quality Improvement Program - Click to review
Quality Improvement Program Description
This page describes
the essential features of the Medical Associates Health Plans Medicare
Products in general terms, and is not intended to be a full description.
The complete program is described in the Evidence of Coverage which is
issued to all members and is available upon request.
Y0045 MAHP 486
CMS Approved 12222011
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