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Medicare Advantage

The Medicare Market.

In 1965 the original Medicare market was created under the Social Security Act of 1965. At the time all eligible Medicare members received free access to inpatient hospital, hospice, home health and skilled nursing care, with physician and outpatient hospital services offered optionally. The original inpatient services received freely are referred to as Medicare Part A while the optional outpatient services are knows as Medicare Part B.

Today, Medicare has evolved to include Part C, which is commonly known as Medicare Advantage, and Part D, which offers prescription drug coverage. Both of these programs work to offer more medical coverage and choices to qualifying Medicare members.

In 2007 Prime Health began offering national networks for all Medicare programs consisting of inpatient, outpatient and ancillary care. Prime is committed to offering the best healthcare network available at costs to patients and providers on par with national reimbursement methods.

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

Prime listens to the needs of both the patients and physicians. We perform customized contracting for patients to ensure the Medicare providers they trust are available for their medical needs. As payment for Medicare services is federally funded, providers enjoy guaranteed reimbursement for services.