At Shield Medical Group, we offer concierge care to all managed care patients, where we put your needs first.
If you’re looking for personalized healthcare solutions tailored just for you, then being a patient at Shield Medical Group is the perfect answer.
What is Concierge Medicine?
Concierge medicine is a personalized approach to healthcare that focuses on providing the highest level of care for patients. Shield Medical Group is proud to offer a concierge medicine program that provides access to quality healthcare services and treatment plans tailored to each individual’s needs.
Let’s explore why concierge medicine could be the right fit for you.
Understanding the Program
At Shield Medical Group, our concierge medicine program begins with an initial appointment where you will meet with your physician and discuss your health history, current concerns, and any questions or goals you may have. We use a standardized Health Risk Assessment tool to evaluate your medical needs. From there, your physician will create a personalized care plan that can include everything from preventative health measures to treatments for chronic conditions. We also provide additional benefits such as access to hospital support and same-day/next-day appointments when needed. All of these services are provided under the umbrella of our convenient concierge medicine program.
Why choose our primary care practice if you have Medicare Advantage Plan?
Convenience: Our offices are highly visible and accessible with ample parking lots.
Personalized care: Shield Medical Group offers individualized care, focusing on building long-term relationships with patients, understanding their unique health needs, and working together to develop a personalized care plan.
Quality care: Shield Medical Group has a proven track record of providing high-quality care, focusing on preventive care and early detection and treatment of health problems. We have been awarded 4.7 Stars out of 5.
Wide range of services: Shield Medical Group provides most diagnostics, lab testing, and minor procedures in-house to minimize the need for referrals and reduce time and costs for patients.
Experienced healthcare team: Our physician and support staff is a knowledgeable and professional team dedicated to providing excellent care.
Integration with other healthcare providers: Shield medical Group has strong relationships with specialists, hospitals, and other healthcare providers to ensure patients receive the best care.
Patient-centered approach: We prioritize the patient’s needs and take a patient-centered approach to care, focusing on clear communication, respect, and a warm and welcoming environment.
Coordinated Care: We coordinate all aspects of your care. Our Team will help you navigate your prescriptions, Referrals, DMEs, education, Chronic disease management, a transition of care management, and preventive care.
Accountable Care: We do what we say and deliver what we promise.
24-Hour Access: You will have access to a physician 24/7, even after hours, on Weekends and holidays.
Shied Wellness Center: All our patients have access to our wellness center. We have multiple education classes and a physical exercise program.
The Whole Health: Shield Medical Group is designed to provide Holistic care. We care for your body, Mind, Intellect, Spirit, and Social Environment.
Medicare Advantage (MA) is a type of health insurance plan offered by private insurance companies and approved by Medicare. It is an alternative to the traditional Medicare program, which the federal government runs. Medicare Advantage plans provide Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) coverage. In some cases, they may offer additional benefits such as prescription drug coverage (Medicare Part D) and extra benefits not covered by traditional Medicare, such as routine dental and vision care.
These plans are required to cover all of the services covered by traditional Medicare, but they may have different rules, costs, and networks. Some Medicare Advantage plans also have a cap on out-of-pocket spending, which can provide additional financial protection for enrollees.
Enrollment in Medicare Advantage plans has been growing in recent years, as many beneficiaries find these plans to be an excellent alternative to traditional Medicare. Before enrolling in one, people need to consider their personal health needs and compare the costs and benefits of different Medicare Advantage plans.
here are several reasons why someone might choose to enroll in a Medicare Advantage plan:
Cost savings: Medicare Advantage plans often have lower monthly premiums than traditional Medicare, and some programs have a cap on out-of-pocket spending, which can provide additional financial protection for enrollees.
Additional benefits: Medicare Advantage plans may offer extra benefits not covered by traditional Medicare, such as routine dental and vision care, hearing aids, and wellness programs.
Convenience: Medicare Advantage plans often provide a more integrated approach to health care, with many programs offering a network of providers, a coordinated care team, and access to additional services, such as prescription drug coverage.
Personalized care: Some Medicare Advantage plans offer health management programs that provide customized support for people with specific health conditions, such as heart disease or diabetes.
Choice of provider: Medicare Advantage plans may offer a more extensive network of providers than traditional Medicare, giving enrollees more options for their healthcare needs.
It’s important to remember that Medicare Advantage plans are not suitable for everyone. Before enrolling in a Medicare Advantage plan, it’s essential to carefully review the plan’s benefits, costs, and network of providers to ensure it meets your healthcare needs and budget. It’s also good to compare Medicare Advantage plans with traditional Medicare and other health insurance options.
Medicare Advantage HMO and PPO plans are two types of Medicare Advantage plans that differ in the way they provide coverage and access to healthcare services.
Health Maintenance Organization (HMO) plans: HMO plans generally require you to see a healthcare provider within the plan’s network for all of your healthcare needs, except emergency or urgent care. HMO plans typically have lower out-of-pocket costs but less flexibility in seeing providers outside the network.
Preferred Provider Organization (PPO) plans: PPO plans generally give you more flexibility in seeing providers outside the network, but they often have higher out-of-pocket costs. With a PPO plan, you may be able to see any provider that accepts Medicare, but you will pay more if you see a provider outside of the plan’s network.
HMO and PPO plans provide Medicare Part A and Part B coverage. Some may offer additional benefits such as prescription drug coverage (Medicare Part D) and extra benefits not covered by traditional Medicare, such as routine dental and vision care.
Your best choice will depend on your specific healthcare needs, preferences, and budget. It’s important to carefully review each type of plan’s benefits, costs, and network of providers before enrolling to ensure the plan meets your healthcare needs and budget.
Here are a few reasons why someone might choose to enroll in a Medicare Advantage Health Maintenance Organization (HMO) plan:
Lower out-of-pocket costs: HMO plans generally have lower monthly premiums and out-of-pocket costs than other Medicare Advantage plans, such as Preferred Provider Organizations (PPOs).
Coordinated care: HMO plans often provide a coordinated approach to healthcare, with a network of providers and a care team that works together to manage your healthcare needs. This can lead to improved quality of care and better health outcomes.
Prescription drug coverage: Some HMO plans include prescription drug coverage (Medicare Part D), which can save you money on your medications.
No referral needed: HMO plans typically do not require a referral to see a specialist, which can save you time and provide more convenient access to care.
Stable network of providers: HMO plans usually have a stable network of providers, so you can feel confident knowing you will have access to the care you need.
It’s important to remember that HMO plans are not suitable for everyone. Before enrolling in an HMO plan, it’s essential to carefully review the plan’s benefits, costs, and network of providers to ensure it meets your healthcare needs and budget. It’s also a good idea to compare HMO plans with other Medicare Advantage plans and traditional Medicare to determine the best option for you.
Here are a few reasons why someone might choose to enroll in a Medicare Advantage Health Maintenance Organization (HMO) plan over a Preferred Provider Organization (PPO) plan:
Lower out-of-pocket costs: HMO plans generally have lower monthly premiums and out-of-pocket costs than PPO plans, which can help you save money on your healthcare expenses.
Coordinated care: HMO plans often provide a coordinated approach to healthcare, with a network of providers and a care team that works together to manage your healthcare needs. This can lead to improved quality of care and better health outcomes.
No referral needed: HMO plans typically do not require a referral to see a specialist, which can save you time and provide more convenient access to care.
Stable network of providers: HMO plans usually have a stable network of providers, so you can feel confident knowing you will have access to the care you need.
More cost-effective: HMO plans often offer a more cost-effective option for those who do not need to see providers outside of their network, as out-of-network care is usually not covered or is covered at a higher cost under PPO plans.
It’s important to remember that HMO plans may not be the right choice for everyone, as they generally have a more limited network of providers and do not cover out-of-network care. Before enrolling in an HMO plan, it’s essential to carefully review the plan’s benefits, costs, and network of providers to ensure it meets your healthcare needs and budget. It’s also a good idea to compare HMO plans with other Medicare Advantage plans and traditional Medicare to determine the best option for you.
Joining a Medicare Advantage Health Maintenance Organization (HMO) plan can provide additional benefits over traditional Medicare, including:
Prescription drug coverage: Many HMO plans include prescription drug coverage (Medicare Part D), which traditional Medicare does not cover. Having this coverage can save you money on your medications.
Lower out-of-pocket costs: HMO plans generally have lower monthly premiums and out-of-pocket costs than traditional Medicare, which can help you save money on your healthcare expenses.
Coordinated care: HMO plans often provide a coordinated approach to healthcare, with a network of providers and a care team that works together to manage your healthcare needs. This can lead to improved quality of care and better health outcomes.
Additional benefits: HMO plans often offer other benefits not covered by traditional Medicare, such as routine dental and vision care, which can provide more comprehensive coverage for your healthcare needs.
No referral needed: HMO plans typically do not require a referral to see a specialist, which can save you time and provide more convenient access to care.
It’s important to remember that HMO plans may have a more limited network of providers and that out-of-network care is often not covered or at a higher cost. Before enrolling in an HMO plan, it’s essential to carefully review the plan’s benefits, costs, and network of providers to ensure it meets your healthcare needs and budget. It’s also a good idea to compare HMO plans with other Medicare Advantage plans and traditional Medicare to determine the best option for you.
Medicare Advantage plans, including Health Maintenance Organizations (HMOs), are required to meet certain standards set by the Centers for Medicare & Medicaid Services (CMS) to ensure that they are delivering quality care to their members. Here are a few ways that Medicare Advantage plans control and monitor the quality of care delivered to their members:
Quality Improvement Programs: Medicare Advantage plans are required to participate in quality improvement programs that are designed to monitor and improve the quality of care provided to their members. These programs may include regular health screenings, preventive care services, and disease management programs.
Star Ratings: Medicare Advantage plans are assigned a Star Rating by CMS based on their performance in various categories, including customer satisfaction, preventive care, and health outcomes. These ratings are available to the public and can help consumers make informed decisions about which plan to choose.
Provider Networks: Medicare Advantage plans control the quality of care delivered to their members by carefully selecting and monitoring the providers in their network. Providers are typically required to meet certain standards and participate in ongoing quality improvement programs.
Utilization Management: Medicare Advantage plans use utilization management techniques to ensure that their members receive appropriate, cost-effective care. This may include pre-authorization requirements for certain procedures or treatments, and ongoing monitoring of healthcare utilization patterns.
Member Satisfaction Surveys: Medicare Advantage plans regularly survey their members to gather feedback on the quality of care they have received. This information is used to identify areas for improvement and make necessary changes to ensure that members are receiving the best possible care.
By utilizing these and other quality control measures, Medicare Advantage plans work to ensure that their members receive high-quality, cost-effective healthcare services.
Medicare Advantage plans are subject to regulations by the Centers for Medicare & Medicaid Services (CMS), the same agency that oversees traditional Medicare. However, there are some key differences in the regulations that apply to Medicare Advantage plans versus traditional Medicare.
Medicare Advantage plans are required to follow specific rules and standards set by CMS, including requirements for covered benefits, provider networks, and member cost-sharing. CMS also sets standards for quality of care, customer service, and member satisfaction, and regularly monitors plans to ensure that they are meeting these standards.
On the other hand, traditional Medicare is a fee-for-service program that provides coverage for a defined set of benefits, but leaves many details of how these benefits are delivered and how much they cost up to individual providers. While traditional Medicare is also subject to certain regulations, these regulations are typically less prescriptive and more focused on ensuring that providers are following basic standards of quality and safety.
In summary, both Medicare Advantage plans and traditional Medicare are subject to regulations, but the nature and extent of these regulations can differ depending on the type of coverage you have. Before choosing a Medicare coverage option, it’s important to carefully consider the regulations that apply to each option and how they may impact your healthcare costs and the quality of care you receive.
If you’re interested in joining a Medicare Advantage plan, there are several steps you can follow to enroll:
Determine your eligibility: To be eligible for Medicare Advantage, you must be enrolled in both Medicare Part A (hospital insurance) and Part B (medical insurance).
Research plans in your area: There are many different Medicare Advantage plans available, so it’s important to research and compare the options that are available to you. You can use the Medicare Plan Finder tool on the Medicare website to compare plans and find the one that best meets your needs.
Check the enrollment period: You can enroll in a Medicare Advantage plan during the annual enrollment period, which runs from October 15 to December 7, or during the open enrollment period, which runs from January 1 to March 31. You may also be able to enroll during a special enrollment period if you have a qualifying life event, such as moving to a new area.
Enroll in a plan: Once you’ve found the Medicare Advantage plan that you want to join, you can enroll online, by phone, or by mail, depending on the plan and your preference. You’ll need to provide your Medicare number and some personal information to enroll.
Start using your coverage: Once you’re enrolled in a Medicare Advantage plan, you can start using your coverage right away. You’ll need to choose a primary care doctor and follow the plan’s rules for accessing care, such as getting a referral to see a specialist.
By following these steps, you can join a Medicare Advantage plan and start taking advantage of the benefits it offers. Keep in mind that you can switch plans at any time, so if you’re not satisfied with your plan, you can always look for a different option that better meets your needs.
As of my knowledge cutoff in 2021, over 22 million Medicare beneficiaries were enrolled in Medicare Advantage plans. This represents about 38% of all Medicare beneficiaries, and the number of enrolled beneficiaries has been steadily growing in recent years. Medicare Advantage plans have become a popular alternative to traditional Medicare, offering more comprehensive benefits and often lower out-of-pocket costs.
However, Medicare Advantage enrollment can vary greatly by state, with some states having much higher enrollment rates than others. Factors that can influence Medicare Advantage enrollment include local healthcare provider availability, plan offerings, and cost and quality of care.
It’s important to note that Medicare Advantage enrollment is optional and not everyone with Medicare is required to enroll in a Medicare Advantage plan. Some Medicare beneficiaries choose to remain in traditional Medicare, either because they are satisfied with their current coverage or because they prefer the flexibility of fee-for-service options.
Overall, the number of Medicare beneficiaries who have enrolled in Medicare Advantage plans continues to rise, and the trend is likely to continue as more beneficiaries seek more affordable and comprehensive healthcare coverage.
