Orlando Harmon
MedCost is a health and wellness benefits provider founded in 1983 and headquartered in Winston-Salem, North Carolina. The company offers health insurance plans in North and South Carolina, with a focus on providing access to a network of healthcare providers within these states. MedCost insurance plan holders can utilize the company's website to manage their health and review resources to maintain their well-being. MedCost also offers prescription drug coverage and allows individuals to seek treatment from out-of-network providers.
| Characteristics | Values |
|---|---|
| Year founded | 1983 |
| Headquarters location | Winston-Salem, North Carolina |
| Services | Health and wellness benefits |
| Service area | North and South Carolina |
| Partners | American Healthcare Alliance (AHA) |
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What You'll Learn
MedCost is a common health insurance provider in North and South Carolina
MedCost has also contracted with other companies to expand its network. For example, MedCost contracted with American Healthcare Alliance (AHA), a national PPO based in Missouri, to give AHA access to its North and South Carolina networks. This allowed residents of the Carolinas who were insured by AHA to access the MedCost network. MedCost also approved the use of the UltraMed insurance identification card for its network in the Carolinas, which resulted in losses for MedCost and healthcare providers when the coverage turned out to be worthless.
MedCost has been involved in legal proceedings related to its approval of the UltraMed insurance identification card. In the case of MEDCOST v. LOISEAU (2005), the Receiver argued that MedCost was liable for losses resulting from the failure of certain entities to pay claims. The Receiver argued that MedCost allowed unauthorized healthcare coverage to insureds using its network by approving the insurance identification card. However, MedCost disputed that it purposefully availed itself of doing business in Texas, where the entities in question were based.
Overall, MedCost plays a significant role in providing health insurance to individuals in North and South Carolina, and its network extends to various healthcare providers and companies within and beyond the Carolinas.
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MedCost offers prescription drug coverage
MedCost is a provider of health and wellness benefits, founded in 1983 and based in Winston-Salem, North Carolina. MedCost is a common health insurance provider in South Carolina. MedCost Benefit Services offers a range of resources to keep companies and their employees well.
It is important to note that online pharmacies may not always deliver on their promises of convenience and savings. The National Association of Boards of Pharmacy (NABP) has found that many websites offering prescription-only drugs operate illegally and do not follow patient safety practices. MedCost members can refer to the NABP's findings to make informed decisions about their prescription drug coverage and ensure they are receiving safe and legitimate medications.
MedCost provides a network of healthcare providers, including therapists and nutritionists, who are in-network with MedCost insurance. Members can manage their health using the My MedCost service, which allows them to access their benefits and resources while on the go.
MedCost offers a comprehensive approach to health and wellness, including prescription drug coverage, to support the well-being of its members.
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MedCost contracted with American Healthcare Alliance, a national PPO
MedCost is a health and wellness benefits provider founded in 1983 and headquartered in Winston-Salem, North Carolina. The company has a significant presence throughout the Carolinas and Virginia, with a strong network of hospitals, physicians, and other healthcare providers. MedCost members have open access to a large number of healthcare providers in the network, ensuring minimal disruption if a provider is out-of-network.
To meet the needs of employers and members outside its primary service areas, MedCost maintains relationships with other strong national and regional networks. One such example is their contract with American Healthcare Alliance, a national PPO. By partnering with American Healthcare Alliance, MedCost can offer its members an extended network of providers when travelling or residing outside of the MedCost Network footprint.
American Healthcare Alliance specializes in providing EDI claims repricing and transmission, database design, web applications, and administration software for the managed care community. Their services include claimEDIx, a claims repricing system, CRM software, geocoding analysis, healthcare software, and a PPO billing system.
Through its contracts with national networks like American Healthcare Alliance, as well as its own vast network of providers, MedCost ensures that its members have access to quality care at a reasonable price, both within and outside of its primary service regions. This commitment to member satisfaction and accessibility makes MedCost a competitive choice for employers seeking comprehensive healthcare options for their workforce.
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MedCost's liability in the MEDCOST v. LOISEAU (2005) case
In the case of MedCost v. Loiseau (2005), the appellant MedCost, a preferred provider organization (PPO), filed a special appearance concerning the receivership of certain health insurance companies. The receiver, appellee Robert Loiseau, joined MedCost as a defendant to collect for claims made against the entities in receivership, known as the Neal entities.
Loiseau alleged that MedCost committed torts in the State of Texas and entered into contracts with one or more of the receivership defendants in Texas. He claimed that MedCost profited from their involvement with ABP in the insurance scheme, to the detriment of Texas and its residents. Loiseau alleged that the receivership entities collected money (as premiums) from Texas residents, which were then passed to MedCost.
Loiseau claimed that MedCost was liable for negligence, gross negligence, breach of fiduciary duty, violation of the Texas Insurance Code, conspiracy, and negligent misrepresentation. Specifically, he alleged that MedCost agreed to "market, sell, manage and administer the unlicensed and unauthorized health insurance programs," and negligently failed to use due diligence in determining whether ABP was authorized to sell insurance in Texas.
MedCost, however, argued that it did not enter into contracts with the receivership entities and that it only approved the UltraMed insurance identification card for use in its network in the Carolinas. It received $3 per month from AHA for each of the 379 individual insureds in the Carolinas who had access to the MedCost network through the NAWA UltraMed plan. When the NAWA UltraMed coverage turned out to be worthless, MedCost terminated access to its network.
The district court initially denied MedCost's special appearance, but the Texas Court of Appeals reversed this decision, holding that the district court could not properly exercise personal jurisdiction over MedCost as it was not a resident of Texas and did not have sufficient minimum contacts with the state. The Court of Appeals dismissed the receiver's claims against MedCost.
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MedCost Benefit Services provides resources for members
MedCost Benefit Services provides a range of resources for its members. Founded in 1983, MedCost is a provider of health and wellness benefits and is headquartered in Winston-Salem, North Carolina.
MedCost offers a website specifically designed for members whose benefits are administered by MedCost Benefit Services. This website provides resources to keep members' companies well. MedCost also offers a mobile app, My MedCost, which allows members to manage their health on the go.
In addition to these digital resources, MedCost members can access a network of healthcare providers who accept MedCost insurance. This includes therapists and nutritionists and dietitians in North Carolina. MedCost members can also make claims on their MedCost insurance for out-of-network providers.
MedCost also offers prescription drug coverage and life insurance benefits. MedCost LLC is an integrated benefits solutions company that utilizes a patented audit process for claims against ERISA-based occupational accident insurance plans. This process includes automated billing, and MedCost mails coverage and cost information to members.
Overall, MedCost Benefit Services provides a comprehensive range of resources to support the health and wellness of its members.
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Frequently asked questions
Founded in 1983, MedCost is a provider of health and wellness benefits. It is headquartered in Winston-Salem, North Carolina.
MedCost is a common health insurance provider in North and South Carolina. It also provides occupational accident insurance plans.
MedCost Benefit Services provides an online platform called 'My MedCost' that allows users to manage their health.
