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Magnacare

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LAST UPDATED: March 16th, 2021

MagnaCare offers health plans and workers' compensation to employers and Labor Funds in Connecticut, New Jersey, and New York. It also offers health plan administrative services, network access, and medical management services to employees, Labor Funds, brokers, Third-Party Administrators (TPAs), and carriers across the United States.

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The Good

  • Health Plans and Health Plan Management
  • Medical Management

Health Plans and Health Plan Management

MagnaCare offers health plans and health plan management services to employers and unions with a Taft-Hartley Fund.

MagnaCare also offers Minimum Essential Coverage (MEC) plans that help employers meet the Affordable Care Act requirements.

Some of MagnaCare’s health plans include networks that are customizable to save costs and meet plan sponsor needs. For example, employers can use tiered networks to encourage members to take advantage of low-cost, preferred providers.

Medical Management

MagnaCare also offers several medical management services to its members:

  • Pain Management and Opioid Oversight
  • Nurse Case Management
  • Mental Wellness

These programs help MagnaCare members reach wellness goals, lower costs, and receive appropriate care.

The Pain Management and Opioid Oversight program helps members manage pain medications, detox, deal with substance abuse, and lower costs. Case managers from these programs also work with a Pharmacy Benefits Manager on prior authorization for medications.

The Nurse Case Management program offers support to members with catastrophic or complicated conditions. This program offers assistance with scheduling appointments, connecting with local resources, reviewing treatment options, and more.

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The Bad

  • Primarily for Unions and Commercial Employers
  • Limited Service Area

Primarily for Commercial Employers and Unions

MagnaCare primarily offers its services and health plans to employers and unions. If a MagnaCare health plan is available through your employer or union, it’s a great option. If not, you will need to consider other health insurers.

Limited Service Area

MagnaCare’s network is in Connecticut, New Jersey, and New York. However, even if your network needs are beyond MagnaCare’s primary network, you still may be able to work with MagnaCare as your TPA. MagnaCare partners with other TPAs that service other areas across the United States. If you’re interested, you should contact MagnaCare directly for more information.

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The Bottom Line

MagnaCare offers good support to employers and unions, especially in Connecticut, New Jersey, and New York. Its support includes health plans, health plan administration, medical management services for members, and workers’ compensation. Even if you aren’t in MagnaCare’s primary service area, you may still be able to work with MagnaCare because it partners with other Third-Party Administrators (TPAs) across the United States.

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Stuart Schnitzer Edison, NJ

They have too many deductibles and sometimed deny coverage not based on medical need causing more problems and more expensive treatments

3 years ago

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