What Is Magnacare Health Insurance?

Magnacare Health Insurance is a health insurance provider that specializes in coverage for corporations, individuals and non-profit entities in the New Jersey and New York area. The company aims to differentiate itself by going out of its way to educate individuals and companies in the tenets of healthy living and creating a multi-disciplinary service network in the two states.

Coverage

• Magnacare Health Insurance has a network of 70,000 healthcare providers in the New York and New Jersey area, and over 510,000 providers nationwide. Magnacare states on its website that members in its network can expect a competitive fee schedule, fee reimbursement within 30 days, reimbursement for office labs and x-rays, and 24x7 customer support.

Extended Care

• A key feature in Magnacare's business model is its focus on extended chronic care. In a white paper released by the company, it stressed the importance of close monitoring and coordinated movement between health providers for patients with chronic conditions. The company believes that 75 percent of health-care spending in the 21st century will be on this type of treatment. According to the company, this type of treatment is important because it prevents small conditions from turning into serious diseases that are expensive to treat.

Process

• One goal of the company is to streamline the administrative work flow for patients and providers, specifically claims payment, care management, and provider reimbursement. Doing so promotes patient data sharing, which allows the company to identify patients who have not had their recommended screenings, or are engaging in unhealthy lifestyle practices. Applying these business policies results in a healthier population and cost savings in health services.

Case Management

• According to Magnacare, an interdisciplinary approach to health insurance prevents unnecessary medical expenses. The company cites excessive emergency room visits and a lack of attention to high-risk lifestyles as some of the largest drivers of health-care spending increases. To solve these problems the company recommends employers partner with a case manager in their network to work with their employees. The case manager can provide customized health plans for employees that integrate plans for healthy living, that will reduce the need for insurance spending.