Welcome To Maestro Health

Nice to see you here.

Healthcare can be confusing. We’re here to make it simple as we administer and manage your employer’s self-funded health plan.


Self-funded health plans are reshaping the healthcare industry by setting new standards for
fairer pricing. In other words, you and your employer have the power to make a difference.

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Self-funded health plan
noun 1. A health plan in which an employer provides health benefits directly to employees using the company’s own funds rather than contracting with an insurance company.


Let’s break this down.

Here are some of the most important details about how your self-funded health plan compares to a traditional (aka, fully-insured) health plan.

The main difference between a self-funded health plan and a traditional health plan is the way in which your care is paid.

  • In a self-funded health plan, your employer only pays for medical claims as they happen and pays your providers (aka, doctors, facilities, etc.) directly.
  • In a traditional health plan, your employer pays a monthly premium to an insurance company to cover the cost of potential medical claims and a profit for the health plan. The insurance company has preset cost agreements with hospitals and providers, and manages the payment.

More employers are opting to self-fund their health plans because it offers:

  • More Flexibility: Going self-funded means your employer can design their health plan around you and your coworkers’ needs and priorities, rather than choosing from cookie-cutter plans created by insurance companies that might not work for everyone.
  • Greater Savings: Your employer no longer pays for costly monthly premiums and taxes, resulting in more opportunity for cost savings for everyone.

Here’s where we come in.
Since your employer isn’t using an insurance company, they’ve partnered with Maestro Health to help administer the health plan they have designed for you. One of the ways we help is by reviewing your claims to make sure you’re not overpaying for healthcare.

LEARN MORE ABOUT MAESTRO HEALTH

What you need to know.

This is a lot of information to take in, and most of it may be new, so we’ve outlined the three most important takeaways here:


1

Maestro Health isn’t an insurance company.

iPhone with My Benefits screenWe’ve partnered with your employer to manage the self-funded health plan that your employer has designed and funded.

2

You have access to a provider network to seek care.

Finding an in-network provider (aka, doctor, facility, etc.) is as easy as using the Maestro Health My Benefits™ portal or going to the provider network site on your ID card.

Your providers may still be getting up to speed with your self-funded health plan. We have provider resources you can download, print and bring to your appointments.

DOWNLOAD PROVIDER RESOURCES
3

You can access your benefits on our web portal.

Access your benefits info anytime, anywhere with the Maestro Health My Benefits™ web portal, available via desktop or mobile app.

LEARN MORE
iPhone with My Benefits screen

FAQs

We’ve answered some of the most frequently asked questions about self-funded health plans.


Your employer has partnered with Maestro Health to administer and manage your health plan. Although it may be confusing, we’re not an insurance company. Your employer has chosen to operate and fund their own health plan with a self-funded health plan management model as opposed to purchasing a fully-insured plan from an insurance company. What does this mean? Since they’re not using an insurance company, they’ve entrusted us to help administer the health plan that they have designed. Claims are approved or denied based solely on your employer’s health plan. Our goal is to ensure that you receive care at a fair price and to be your advocate by helping you navigate the complexities of the healthcare system.

With your employer’s self-funded health plan management model, you have access to a provider network to seek care.

Easy, just check your employer’s provider network website (located on your health plan ID card and under the “Links” menu option in the Maestro Health My Benefits™ web portal), search for a provider in your area and call to make an appointment.

If your provider doesn’t understand your health plan or know of Maestro Health, please direct them to the Maestro Health My Benefits™ web portal where they can access all of your eligibility and benefits information, claim details and more. They can also quickly check eligibility and plan details in minutes without registering by clicking on “Access Quick Eligibility and Plan Details” from the home page.

Many employers are deciding to implement a self-funded health plan management model as it allows them to only pay for claims that happen, ultimately saving you and your employer money.

You can access your benefits info anytime, anywhere with the Maestro Health My Benefits™ web portal—available via desktop or mobile app.

The web portal has:

  • An overview of your benefits details
  • A summary of your health expenses, including payments, deductibles and more
  • Plan eligibility details
  • Claims history, including in-depth details from your five most recent doctor or hospital visits