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Medical Associates Health
Plans
Medical Associates Health Plans has served the employers and residents
of the Tri-State area for over 20 years with fully insured health insurance
products and a unique Medicare program. In addition, Medical Associates
Health Plans offers administrative services to employers who self-fund
their health insurance through its affiliated company, Health Choices.
Medical Associates Health Plans was established in 1982 by Medical Associates
Clinic, and was the Tri-State area’s first health maintenance organization.
Today, Medical Associates Health Plans provides comprehensive health benefits
to over 400 employers and 45,000 members.
 In
October, 2005 Medical Associates Health Plans received an “Excellent”
rating, the highest level of accreditation possible by the National Committee
for Quality Assurance (NCQA). Medical Associates has retained an "Excellent"
accreditation for six consecutive years.
Product Portfolio
We provide a wide range of innovative, flexible Managed Care plans to
meet every employer's benefit needs for their employees.
Fully Insured HMO Plans
We offer "full pay" benefit plans to our Preferred Plans that involve
cost sharing (copayments) by the members. We can put together any type
of benefit package that best meets your needs. We offer open access HMO
plans, where members can see our network specialists without a referral.
Fully Insured Point of Service Plans
This is a plan that blends HMO benefits and indemnity benefits into one
benefit plan. In contrast to true HMO plans, out-of-network providers
can be seen at anytime. With these providers, covered benefits have a
higher out-of-pocket cost, but members retain their "freedom of choice"
option.
Self-Funded HMO Style Benefit Plans
(EPO - Exclusive Provider Organization)
If you recognize the value of Managed Care and the HMO concept, but would
like to self-fund your health plan, you can do this through Health Choices,
Inc. This concept allows you to have the HMO style benefits and retain
the advantages of negotiated contracted fees.
Self Funded Indemnity Benefit Plans
If you choose to self-fund your employee health benefits, our experienced
claims staff will process claims efficiently and accurately. Each client
is assigned a specific claim examiner; your employee's questions will
be answered by the same person.
Fully Integrated Managed Care Plans
If you choose to be fully-insured with a Medical Associates HMO plan or
self-funded through Health Choices, you receive all components of Managed
Care:
- Pre-admission Authorization
- Concurrent Review
- Discharge Planning
- Individual Case Management
- Centers of Excellence
- Drug Formulary (if Rx is offered)
- Negotiated Fees with Contracted Providers
- 24-Hour HELP Nurse
Ancillary Products
We provide options for a full employee benefit package. These include
dental (fully-insured or self-funded), life, short-term disability and
long-term disability insurance. We also provide Flexible Spending (Section
125) and COBRA administration. |
