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Fallon Community Health Plan
Founded in 1977, Fallon Health (formerly Fallon Community Health Plan) is a Worcester, Massachusetts-based provider of health insurance and health care services. In partnership with Weinberg Campus, Fallon Health also operates Fallon Health Weinberg, a health insurance company based in Amherst, New York. Products Fallon Health's product portfolio includes HMO, POS and PPO plans as well as Medicaid and Medicare Advantage plans. In addition, Fallon Health offers a Program of All-inclusive Care for the Elderly, called Summit ElderCare®, and a Medicare Advantage Special Needs Plan/Senior Care Options program, called NaviCare. Fallon Health Weinberg offers a Program of All-Inclusive Care for the Elderly (PACE), a Managed Long Term Care (MLTC) plan and a Medicare Advantage Health Maintenance Organization Special Needs Plan (HMO SNP) to dual-eligible residents of the Western New York counties of Erie Erie (; ) is a city on the south shore of Lake Erie and the county seat of ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Health Insurance
Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among many individuals. By estimating the overall risk of health risk and health system expenses over the risk pool, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to provide the money to pay for the health care benefits specified in the insurance agreement. The benefit is administered by a central organization, such as a government agency, private business, or not-for-profit entity. According to the Health Insurance Association of America, health insurance is defined as "coverage that provides for the payments of benefits as a result of sickness or injury. It includes insurance for losses from accident, medical expense, disability, or accidental death and dismemberment". Background A health i ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Preferred Provider Organization
In U.S. health insurance, a preferred provider organization (PPO), sometimes referred to as a participating provider organization or preferred provider option, is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at reduced rates to the insurer's or administrator's clients. Overview A preferred provider organization is a subscription-based medical care arrangement. A membership allows a substantial discount below the regularly charged rates of the designated professionals partnered with the organization. Preferred provider organizations themselves earn money by charging an access fee to the insurance company for the use of their network, unlike the usual insurance with premiums and corresponding payments paid either in full or partially by the insurance provider to the medical doctor. They negotiate with providers to set fee schedules and handle disput ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Health Maintenance Organization
In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. It is an organization that provides or arranges managed care for health insurance, self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care providers (hospitals, doctors, etc.) on a prepaid basis. The Health Maintenance Organization Act of 1973 required employers with 25 or more employees to offer federally certified HMO options if the employer offers traditional healthcare options. Unlike traditional indemnity insurance, an HMO covers care rendered by those doctors and other professionals who have agreed by contract to treat patients in accordance with the HMO's guidelines and restrictions in exchange for a steady stream of customers. HMOs cover emergency care regardless of the health care provider's contracted status. Operation HMOs often require members to select a primary care phy ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Medicaid
Medicaid in the United States is a federal and state program that helps with healthcare costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, including nursing home care and personal care services. The main difference between the two programs is that Medicaid covers healthcare costs for people with low incomes while Medicare provides health coverage for the elderly. There are also dual health plans for people who have both Medicaid and Medicare. The Health Insurance Association of America describes Medicaid as "a government insurance program for persons of all ages whose income and resources are insufficient to pay for health care." Medicaid is the largest source of funding for medical and health-related services for people with low income in the United States, providing free health insurance to 74 million low-income and disabled people (23% of Americans) as of 2017, as well as paying for half of all U.S. births i ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Medicare Advantage
Medicare Advantage (Medicare Part C, MA) is a capitated program for providing Medicare benefits in the United States. Under Part C, Medicare pays a private-sector health insurer a fixed payment. The insurer then pays for the health care expenses of enrollees. Insurers are allowed to vary the benefits from those provided by Medicare's other parts. Part C plans are required to offer coverage that meets or exceeds the standards set by the other parts, but they do not have to cover every benefit in the same way (actuarial equivalence is required). Plans must be approved by the Centers for Medicare and Medicaid Services (CMS). If a MA plan reduces some benefits, the savings may be passed along to consumers by lowering co-payments for doctor visits (or any other plus or minus aggregation approved by CMS). Coverage must include inpatient hospital (Part A) and outpatient (Part B) services. Typically, the plan also includes prescription drug (Part D) coverage. Many plans also offer add ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Program Of All-Inclusive Care For The Elderly
Program of All-inclusive Care for the Elderly (PACE) are programs within the United States that provide comprehensive health services for individuals age 55 and over who are sufficiently frail to be categorized as "Nursing home care, nursing home eligible" by their state's Medicaid program. The ultimate goal of PACE programs is to keep eligible older adults out of nursing homes and within their communities for as long as possible. Services include primary and specialty medical care, nursing, nutrition, social services, therapies (Occupational therapy, occupational, Physical therapy, physical, Speech Therapy, speech, recreation, etc.), pharmaceuticals, day health center services, home care, health-related transportation, minor modification to the home to accommodate disabilities, and anything else the program determines is medically necessary to maximize a member's health. If you or a loved one are eligible for nursing home level care but prefer to continue living at home, a PACE pr ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Worcester, Massachusetts
Worcester ( , ) is a city and county seat of Worcester County, Massachusetts, United States. Named after Worcester, England, the city's population was 206,518 at the 2020 United States census, 2020 census, making it the second-List of cities in New England by population, most populous city in New England after Boston. Worcester is approximately west of Boston, east of Springfield, Massachusetts, Springfield and north-northwest of Providence, Rhode Island, Providence. Due to its location near the geographic center of Massachusetts, Worcester is known as the "Heart of the Commonwealth"; a heart is the official symbol of the city. Worcester developed as an industrial city in the 19th century due to the Blackstone Canal and rail transport, producing machinery, textiles and wire. Large numbers of European immigrants made up the city's growing population. However, the city's manufacturing base waned following World War II. Long-term economic and population decline was not reversed ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Amherst, New York
Amherst () is a town in Erie County, New York, United States. Amherst is an inner ring suburb of Buffalo. As of 2020, the town had a total population of 129,595. This represents an increase from 122,366 as reported in the 2010 census. The second largest in area and the most populous suburb of Buffalo, the town of Amherst encompasses the village of Williamsville as well as the hamlets of Eggertsville, Getzville, Snyder, Swormville, and East Amherst. The town is in the northern part of Erie County and borders a section of the Erie Canal. Amherst is home to the north campus of the University at Buffalo, the graduate campus of Medaille College, a satellite campus of Bryant & Stratton College, and Daemen College. History The town of Amherst was created by the State of New York on April 10, 1818 from part of the town of Buffalo (later the city of Buffalo), which itself had previously been created from the town of Clarence. Amherst was named after Lord Jeffrey Amherst, commande ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Erie County, New York
Erie County is a county along the shore of Lake Erie in western New York State. As of the 2020 census, the population was 954,236. The county seat is Buffalo, which makes up about 28% of the county's population. Both the county and Lake Erie were named for the regional Iroquoian language-speaking Erie tribe of Native Americans, who lived in the area before 1654. They were later pushed out by the more powerful Iroquoian nations tribes. Erie County, along with its northern neighbor Niagara County, makes up the Buffalo-Niagara Falls metropolitan area, the second largest in New York State behind New York City. The county's southern part is known as the Southtowns. The county has seen one of the highest growth rates of any county in New York State from the 2010 to 2020 census. History When counties were established by the English colonial government in the Province of New York in 1683, present-day Erie County was part of Indian territory occupied by Iroquoian-speaking peoples. It ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Niagara County, New York
Niagara County is in the U.S. state of New York. As of the 2020 census, the population was 212,666. The county seat is Lockport. The county name is from the Iroquois word ''Onguiaahra''; meaning ''the strait'' or ''thunder of waters''. Niagara County is part of the Buffalo–Niagara Falls metropolitan area, and across the Canada–US border is the province of Ontario. It is the location of Niagara Falls and Fort Niagara, and has many parks and lake shore recreation communities. In the summer of 2008, Niagara County celebrated its 200th birthday with the first settlement of the county, of Niagara Falls. History When counties were established in the New York colony in 1683, the present Niagara County was part of Albany County. Prior to the British, the area was part of New Netherland. Albany was an enormous county, including the northern part of New York State as well as all of the present State of Vermont and, in theory, extending westward to the Pacific Ocean. This cou ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Health Maintenance Organizations
In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. It is an organization that provides or arranges managed care for health insurance, self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care providers (hospitals, doctors, etc.) on a prepaid basis. The Health Maintenance Organization Act of 1973 required employers with 25 or more employees to offer federally certified HMO options if the employer offers traditional healthcare options. Unlike traditional indemnity insurance, an HMO covers care rendered by those doctors and other professionals who have agreed by contract to treat patients in accordance with the HMO's guidelines and restrictions in exchange for a steady stream of customers. HMOs cover emergency care regardless of the health care provider's contracted status. Operation HMOs often require members to select a primary care phy ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Medical And Health Organizations Based In Massachusetts
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Contemporary medicine applies biomedical sciences, biomedical research, genetics, and medical technology to diagnose, treat, and prevent injury and disease, typically through pharmaceuticals or surgery, but also through therapies as diverse as psychotherapy, external splints and traction, medical devices, biologics, and ionizing radiation, amongst others. Medicine has been practiced since prehistoric times, and for most of this time it was an art (an area of skill and knowledge), frequently having connections to the religious and philosophical beliefs of local culture. For example, a medicine man would apply herbs and say prayers for healing, or an ancie ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
