activities · 15
what they do
direct service · 15
- Conducts member and community education programs Health Insurance Enrollment AssistanceHosts in-person neighborhood benefit seminars and virtual seminars to educate individuals about Medicare Advantage, prescription drug coverage, and Aspire Health Plan benefits, with sales agents available to provide applications. Also offers one-on-one informational tables with Health Plan Advisors for personalized support.
- Conducts member education and enrollment support activities Health Insurance Enrollment AssistanceHosts in-person and virtual seminars to educate individuals about Medicare Advantage, prescription drug coverage, and plan benefits, with sales agents available to assist; also offers one-on-one tables with Health Plan Advisors for personalized support.
- Delivers prescription home delivery service Community Pharmacy ServicesOffers home delivery of prescriptions through Birdi Rx for members who rely on regular or long-term medications, improving access and convenience.
- Ensures access to emergency and disaster-related care Union and Association Health Benefits AdministrationProvides coverage for urgent or emergent care anywhere in the United States without prior authorization, at in-network cost-sharing rates. During disasters, members can access prescription medications through a national pharmacy network even if out-of-network.
- Offers Medicare Advantage and prescription drug coverage plans Union and Association Health Benefits AdministrationOffers Medicare Advantage plans with integrated prescription drug coverage, created in collaboration with local doctors and hospitals in Monterey County. These plans include additional benefits such as transportation, chiropractic care, acupuncture, and fitness programs.
- Offers Medicare Advantage plans with supplemental benefits Union and Association Health Benefits AdministrationProvides Medicare Advantage plans that include prescription drug coverage and additional benefits such as transportation, chiropractic care, acupuncture, and fitness programs.
- Offers Medicare Advantage plans with supplemental benefits Union and Association Health Benefits AdministrationOffers Medicare Advantage plans that include prescription drug coverage and additional benefits such as transportation, chiropractic care, acupuncture, and fitness programs.
- Offers home delivery of prescription medications Community Pharmacy ServicesProvides home delivery of prescriptions through Birdi Rx for members who require regular or long-term medications.
- Offers home delivery of prescription medications Community Pharmacy ServicesProvides home delivery of prescriptions through Birdi Rx for members who rely on regular or long-term medications, improving access and adherence.
- Operates a local Medicare Advantage provider network Healthcare Provider Network CoordinationOperates a provider network of over 700 local doctors and healthcare providers and partners with all four hospitals in Monterey County to deliver Medicare Advantage and prescription drug coverage plans. The network includes Community Hospital of the Monterey Peninsula, Salinas Valley Health, Natividad Medical Center, and Mee Memorial Hospital.
- Operates a local Medicare Advantage provider network Healthcare Provider Network CoordinationOperates a provider network of over 700 local doctors and healthcare providers and partners with all four hospitals in Monterey County to deliver Medicare Advantage plans. Members have access to care at Community Hospital of the Monterey Peninsula, Salinas Valley Health, Natividad Medical Center, and Mee Memorial Hospital.
- Operates a local Medicare Advantage provider network Healthcare Provider Network CoordinationManages a network of over 700 local doctors and healthcare providers, including all four hospitals in Monterey County, to deliver Medicare Advantage and prescription drug coverage to thousands of members in the region.
- Provides Medicare education and enrollment support Health Insurance Enrollment AssistanceConducts in-person and virtual benefit seminars to educate individuals about Medicare Advantage, prescription drug coverage, and Aspire Health Plan benefits, with sales agents available to assist with applications. Also offers one-on-one informational tables where individuals can speak directly with Health Plan Advisors.
- Provides emergency and disaster-related care access Union and Association Health Benefits AdministrationEnsures members have access to out-of-network emergency care anywhere in the U.S. at in-network cost-sharing rates without prior authorization, and enables prescription access through a national pharmacy network during disasters.
- Provides emergency and disaster-related care access Union and Association Health Benefits AdministrationProvides coverage for urgent or emergent care anywhere in the United States at in-network cost-sharing rates without prior authorization. During disasters, members can fill prescriptions at out-of-network pharmacies through a national pharmacy network.
strategies · 21
how they think
Theories of action extracted from this org's own source material. Click any to see the full field of orgs running the same approach.
- Direct Consumer Education direct_consumer_educationProvides free educational events staffed by licensed advisors to empower individuals with clear, accurate information about their Medicare coverage options, supporting informed decision-making.
- Direct consumer education and support direct_consumer_educationProvides free educational events staffed by licensed advisors to empower individuals with knowledge about their Medicare coverage options and support informed decision-making.
- Direct consumer education on Medicare choices direct_consumer_educationHosts free educational events staffed by licensed advisors to empower individuals with clear, accurate information about their Medicare coverage options, supporting informed decision-making.
- Local Network Integration and Collaboration local_network_integrationDesigns and delivers Medicare Advantage plans in partnership with local hospitals, doctors, and providers to ensure services are tailored to the specific health needs of Monterey County residents.
- Local network integration and collaboration local_network_integrationIntegrates and collaborates with local hospitals, doctors, and providers in Monterey County to design and deliver tailored Medicare Advantage and Prescription Drug plans that reflect community-specific needs.
- Local network integration and provider collaboration local_network_integrationIntegrates and collaborates with local hospitals, doctors, and providers in Monterey County to design and deliver tailored Medicare Advantage and Prescription Drug plans that reflect community health needs.
- Member-Centered Plan Design member-centered plan designDesigns Medicare Advantage plans with a focus on user-centered accessibility and clarity, ensuring members can easily understand and navigate their health services.
- Member-centered plan design member-centered plan designDesigns Medicare Advantage plans with a focus on user-centered principles, ensuring accessibility, clarity, and ease of use in understanding and accessing health services.
- Member-centered plan design member-centered plan designDesigns Medicare Advantage plans with a focus on user accessibility and clarity, ensuring members can easily understand and navigate their health services.
- Network-Based Care Coordination (HMO and HMO-POS Models) hmo_network_modelUtilizes HMO and HMO-POS network models to coordinate care delivery, requiring use of in-network providers for non-emergency services while allowing flexibility in HMO-POS for out-of-network care through a primary care coordinator.
- Network-based care coordination models (HMO and HMO-POS) hmo_network_modelUtilizes HMO and HMO-POS models to coordinate care through in-network providers and a designated primary care physician, balancing structured care management with flexibility for out-of-network services when needed.
- Patient-Authorized Representation patient-authorized-representationAllows members to designate trusted representatives to assist with healthcare decisions and benefit inquiries, ensuring support while protecting privacy and autonomy.
- Patient-authorized representation for care decisions patient-authorized-representationAllows members to designate trusted representatives to assist with healthcare decisions and benefit inquiries, ensuring support while maintaining privacy and compliance with health information regulations.
- Patient-authorized representation for care support patient-authorized-representationAllows members to designate trusted representatives to assist with healthcare decisions and benefit inquiries while maintaining compliance with health information privacy standards.
- Personalized Care Coordination personalized care coordinationEmploys a coordinated, personalized care model where members are connected with a dedicated care team to manage all aspects of their healthcare, moving beyond traditional referral-based systems to proactively support member needs.
- Personalized care coordination model personalized care coordinationUses a coordinated, personalized care approach that connects members with a dedicated care team to manage all aspects of their healthcare, moving beyond traditional referral-based systems to proactively support member needs.
- Personalized care coordination model personalized care coordinationUses a coordinated, personalized care approach that assigns members a care team to proactively manage all aspects of their healthcare, moving beyond traditional referral-based systems to improve continuity and outcomes.
- Preventive Care and Wellness Model preventive_care_modelStructures health plans around preventive care and wellness to proactively maintain member health and reduce the incidence of chronic disease and hospitalization.
- Preventive care and wellness focus preventive_care_modelStructures health plans around preventive care and wellness promotion to maintain member health and reduce the need for acute interventions.
- Preventive care and wellness-focused plan design preventive_care_modelStructures health plans around preventive care and wellness promotion to proactively maintain member health and reduce the incidence of chronic disease.
- Structured network models with care coordination hmo_network_modelUtilizes HMO and HMO-POS network models that emphasize care coordination through a primary care physician, requiring in-network utilization for non-emergency services while allowing flexibility in care settings.
named programs · 4
what they call their work
Diabetes Prevention
Program focused on preventing diabetes among members; specific services not detailed but referenced as an upcoming offering.
Free Medicare Seminars
Hosts educational events to inform Medicare-eligible individuals about Medicare Advantage, prescription drug coverage, and Aspire Health Plan benefits; includes virtual and in-person sessions in English and Spanish.
Informational Table Events
Provides one-on-one opportunities at clinics and wellness centers for individuals to ask questions about Medicare and Aspire Health Plan benefits with a licensed advisor.
Medicare Options Simplified
Educational initiative to simplify understanding of Medicare options for prospective members; listed as an upcoming event series.
relationships · 16
who they work with
- Birdi Rx Partner — Partnership to provide home delivery of prescription medications for Aspire Health Plan members.
- Centers for Medicare and Medicaid Services Government — Has a contract with CMS to offer Medicare Advantage plans
- Community Hospital of Monterey Peninsula Partner — Hosts Aspire Health Plan informational tables in Monterey, CA.
- Community Hospital of the Monterey Peninsula Partner — Backs Aspire Health Plan as a founding organization.
- Community Hospital of the Monterey Peninsula Partner — Partner hospital in the Aspire Health Plan network providing care to members in Monterey County.
- Hartnell Professional Center Partner — Hosts Aspire Health Plan informational tables in Monterey, CA.
- MedImpact Partner — Pharmacy Benefits Manager that handles Part D prescription drug benefits, claims, and appeals for Aspire Health Plan.
- Mee Memorial Hospital Partner — Partner hospital in the Aspire Health Plan network providing care to members in Monterey County.
- Montage Medical Group Partner — Hosts Aspire Health Plan seminars and informational tables at multiple locations including the Hazen Room in Monterey, CA.
- Montage Wellness Center Marina Partner — Hosts Aspire Health Plan seminars and informational tables at its facility in Marina, CA.
- Natividad Medical Center Partner — Partner hospital in the Aspire Health Plan network providing care to members in Monterey County.
- Salinas Valley Health Partner — Backs Aspire Health Plan as a founding organization.
- Salinas Valley Health Partner — Partner hospital in the Aspire Health Plan network providing care to members in Monterey County.
- Salinas Valley Health Diabetes and Endocrine Center Partner — Hosts Aspire Health Plan seminars and informational tables in Salinas, CA.
- Taylor Farms Family Health and Wellness Center Partner — Hosts Aspire Health Plan informational tables in Gonzales, CA.
- medicare.gov Partner — Refers users to medicare.gov for additional information on Medicare plans