An important benefit of the Health Plan is the MagnaCare Medical Panel. MagnaCare is a Preferred Provider Organization that has established a network of Physicians, Radiologists and Laboratories. These network providers have been screened by MagnaCare’s enrollment procedures to assure quality services.
Each Participant of the Plan has been given a MagnaCare Card and a MagnaCare Directory upon request. The Directory is the list of network providers You should use to find the providers You
need. When using a network provider, You must show Your MagnaCare Card. You do not need a Local 25 Health claim form for MagnaCare Providers.
Services rendered by providers that are not a MagnaCare provider will be subject to deductible and co-payment where applicable. Participants should realize that non-panel doctors have no limit to what they can charge for any given service. Any amount of charges billed by non-panel providers over the Fund’s allowance for a given service will be the responsibility of the Participant.
If an eligible Participant chooses to use one of the over 46,000 health care providers with agreements with MagnaCare in the Metropolitan, New York, Long Island area, out-of-pocket costs will be reduced substantially by utilizing MagnaCare providers. A provider list is available on the MagnaCare website at www.magnacare.com. An example of a schedule is set forth below:
|MAGNACARE IN NETWORK||OUT OF NETWORK|
|Deductible||None||$400 per person|
|Co-Pay/Coinsurance||$25 medical office visits||20% coinsurance|
|$100 Cat Scan & M.R.I.||20% coinsurance|
|$25 diagnostic & lab
$15 allergy treatment
|Forms||no claim forms||requires claim forms|
OUT-OF-POCKET EXPENSES IN NETWORK WILL NOT BE APPLIED TO OUT-OF-NETWORK DEDUCTIBLES.
Excluded from MagnaCare are spouses covered through another health plan if the other plan is primary, and dependent children, if the other plan is primary. In addition, Participants covered by Medicare are also excluded.