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Medicare Advantage

The Medicare Market.

The Social Security Act of 1965 marked a significant turning point in healthcare in the United States, with the creation of the original Medicare market. Eligible Medicare members were granted free access to inpatient hospital, hospice, home health, and skilled nursing care, while physician and outpatient hospital services were optional. The free inpatient services were classified as Medicare Part A, while the optional outpatient services were known as Medicare Part B.

Since then, Medicare has undergone several transformations, including the addition of Part C, or Medicare Advantage, which provides more comprehensive medical coverage and choices for qualifying Medicare members. Additionally, Part D was introduced to offer prescription drug coverage to Medicare beneficiaries.

At Prime Health, we recognized the need for national networks for all Medicare programs, including inpatient, outpatient, and ancillary care. In 2007, we began offering these networks to ensure that Medicare members have access to the best possible healthcare options at costs that are in line with national reimbursement methods. We are dedicated to providing top-quality healthcare services to both patients and providers alike, and we remain committed to delivering on this promise every day.

MEDICARE NATIONAL PPO NETWORK

Prime Health Services has a preferred provider network that is available to preserve the underlying costs of medical care for Medicare Advantage members.

CUSTOM NETWORK DEVELOPMENT

Recognizing that our PPO network is not a “one size fits all” solution, we are willing and able to tailor the network of medical providers to a client’s needs.

Customized Contracting & Guaranteed Reimbursement