Amerigroup Contracting & Appointment 2019
Amerigroup is transforming health care with trusted and caring solutions that improve health care access and quality for their members, while proactively reducing the overall cost of care.
Amerigroup believes in a whole person approach that connects members to the services and support they need for physical health, mental health and substance use. Addressing the needs and preferences of each member is at the heart of what they do every day. They have invested the time and resources necessary to fully understand and serve nearly 5.6 million members in state-sponsored programs across the country.
Wellness, early detection, and prevention are all critical components of an effective health care delivery system. Amerigroup’s commitment to the health and well-being of each member is unwavering. Amerigroup reinvests in communities to reduce gaps in care and services, address chronic health conditions, and promote wellness. They provide members and their families with tools, knowledge, and self-care techniques to help achieve lifelong health.
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Medicare Advantage plans (Medicare Part C) are a form of private health insurance that provide the same coverage as Medicare Part A and Part B (Original Medicare) and may include additional benefits such as dental, vision, and prescription drug coverage. There are 5 major types of Medicare Advantage plans: Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service (PFFS) plans, Special Needs Plans (SNPs), and Medical Savings Accounts (MSAs). The type of plan may affect the prescription drug coverage options, referral requirements, and network restrictions.
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Insurance carriers don't offer Medicare Advantage plans in all states or in all counties within a state. Complete this form and we will be glad to check county availability for you.
We will also send you a contracting kit with that carrier's Medicare Advantage information, including Applications, Brochures, Commissions, and Rates.
What Medicaid covers for Medicare Enrollees
Medicare has four basic forms of coverage: Part A: Pays for hospitalization costs; Part B: Pays for physician services, lab and x-ray services, durable medical equipment, and outpatient and other services; Part C: Medicare Advantage Plan (like an HMO or PPO) offered by private companies approved by Medicare; and Part D: Assists with the cost of prescription drugs.
Medicare enrollees who have limited income and resources may get help paying for their premiums and out-of-pocket medical expenses from Medicaid (e.g. MSPs, QMBs, SLMBs, and QIs). Medicaid also covers additional services beyond those provided under Medicare, including nursing facility care beyond the 100-day limit or skilled nursing facility care that Medicare covers, prescription drugs, eyeglasses, and hearing aids. Services covered by both programs are first paid by Medicare with Medicaid filling in the difference up to the state's payment limit.
Amerigroup, Managed Care Organization (MCO) offers Special Needs Plans to those who receive Medicare and Medicaid. These individuals are sometimes referred to as ‘dual eligible’.
For dual eligibles, Medicaid supplements Medicare-covered services by paying for Medicare premiums, members’ cost-sharing requirements and long-term services and supports (LTSS).
Many of the added Amerigroup services make health care more accessible and help individuals to live independently in their homes and communities.
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