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Company Overview
Health Advantage is the state's largest and oldest health maintenance organization
(HMO), serving almost 190,000 members. The
Health Advantage provider network includes almost 6,000 health professionals
and 130 hospitals. Health Advantage provides health plans to large and small employers.
Health Advantage is the trade name of HMO Partners, Inc., a company jointly owned
by USAble Corporation and Baptist Health HMO, Inc. USAble Corporation is a wholly
owned subsidiary of Arkansas Blue Cross and Blue Shield.
Advantages
Health Advantage offers big advantages you won't find with other HMOs:
- Health Advantage is the first HMO in the state to be authorized to offer its HMO
products in all 75 counties. This means that Health Advantage has the provider network
in place in all 75 counties to provide primary, specialty, inpatient and emergency
care.
- The consolidated strength of Health Advantage assures our customers a high degree
of stability and continuity — advantages that cannot be underestimated in today's
uncertain health-care environment.
Major Benefits
Health Advantage members enjoy a long list of benefits, including:
- Coverage options that include both traditional HMO point-of-service (POS) coverage,
and open access POS (no referral requests for in-network benefits). The
POS provides the benefits of a traditional HMO with an added value of out-of-network
services or services not referred by the member's PCP;
- Fully insured and self-insured administration options;
- Health savings account health plans (Blue~by~design, consumer-directed health plans
with preferred banking financial administrators);
- Increased benefits with no claim forms;
- Coverage of preventive care;
- A network of almost 6,000 health-care professionals;
- Choice of Health Advantage network or self-funded employer-specific networks;
- Well-child care;
- Immunizations;
- In-network claims filed by the health-care provider, eliminating paperwork for the
customer;
- Out-of-state benefits through the national BlueCard® Program.
Cost Control
The HMO network, member benefit coverage and member newsletter help coordinate patient
care and promote health and wellness through preventive benefits and health education
programs. Members choose a primary-care physician (PCP) to coordinate their care,
including referrals to specialists, hospitals and other health-care providers for
HMO and POS plans. The PCP serves as a coordination point to ensure that appropriate
care is given in the proper setting. For network coverage, the member's PCP must
prescribe, arrange and authorize referral to other in-network providers. Out-of-network
coverage is only available in point-of-service (POS) programs. Open access POS plans
provide in-network service without PCP referral plus out-of-network coverage.
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