CONCEPTS
Hospitals YOUR HOMECARE PLAN MANHATTAN Bellevue Hospital Center Harlem Hospital Metropolitan Hospital NY Eye and Ear BRONX Jacobi Medical Center Lincoln Hospital North Central Bronx Hospital Calvary Hospital BROOKLYN Coney Island Hospital Kings County Hospital Long Island College Hospital University Hospital of Brooklyn Woodhull Medical Center QUEENS Elmhurst Hospital Queens Hospital Center Forest Hills Medical Center STATEN ISLAND Richmond University Medical Center Only care rendered at these hospitals will be paid by the Plan, with the exception of emergency room services. This is your health benefits package. Please read it carefully, and call the number at the back of this booklet to address any of your questions. FINDING YOUR PLAN There are five levels of benefit plans. Here s how we determine which benefit level you will be enrolled in, according to the amont of hours you work per week: 36-40 hours per week > 40 Hour plan 31-35 hours per week > 35 Hour plan 26-30 hours per week > 30 Hour plan 21-25 hours each week > 25 Hour plan Less than 21 hours per week > 20 Hour plan We will reassess your enrollment monthly, based on the hours you worked during that month. HOW IT WORKS Your health benefit plan features a wide array of primary care physicians and specialists to choose from. In order to receive benefits, you must use a MagnaCare physician. You may visit any doctor in the MagnaCare network, show them your card with the MagnaCare logo, and they will simply charge you the copayment applicable to your plan. Before you visit the doctor, make sure you have not exceeded the visit maximums outlined in the Benefits Schedule. You will not pay a copay for preventive care. The plan pays for an annual exam in full, as well as screenings and counseling services for members at appropriate ages or risk status, in accordance with the Affordable Care Act. The Plan has contracted with various hospitals to provide our members with services. To the left is a list of our network hospitals. Only care rendered at these hospitals will be paid by the Plan, with the exception of emergency room services. To the extent the Plan provides coverage for medical and surgical benefits with respect to a mastectomy, it will also provide coverage for reconstructive surgery in a manner determined in consultation with the attending physician and the patient. Coverage includes reconstruction of the breast on which the mastectomy was performed, surgery and reconstruction of the other breast to produce a symmetrical appearance, and prostheses and treatment of physical complications at all stages of the mastectomy, including lymphedemas. The applicable coinsurance, copays, plan maximums and requirements apply to reconstructive surgery in connection with a mastectomy and follow those established for comparable benefits under the Plan.
MAGNACARE DOCTOR LOOKUP Go to www.magnacare.com and click on the first tab labeled Find a Healthcare Provider. Click Providers. Under Find a Provider click By Location The network is Magnacare PPO. Enter your state.
CONCEPTS P.O. Box 40328, Brooklyn, NY 11204 718-435-6000 For precertification please call: 718-576-1034