How to Access Healthcare

The right care, at the right time, in the right setting.

Choosing a Provider

Medical Associates contracts with local, regional, and national providers so you have access to the right care, at the right time, in the right setting. To ensure the highest level of coverage, you should choose a participating provider. We encourage all of our members to select a primary care provider to serve as the quarterback for your healthcare needs. Our healthcare service team will assist you with referrals to other contracted providers when needed. You can search the online Provider Directory for a list of our participating providers. Call our Member Services Department at 563-584-4885 or 1-866-821-1365 if you would like additional help in choosing a practitioner.

In Case of an Emergency

In the event of an emergency medical condition, go to the nearest emergency room or call 911 immediately. When possible, contact Health Care Services as soon as possible. Health Care Services will communicate with the hospital and doctor to confirm your coverage and communicate with your local provider to coordinate all aspects of your follow-up care.

Out-of-Area Emergency Care

Know your coverage when you’re out of town.

The Health Plan provides coverage for emergency care when you are outside your immediate hometown area.

Emergency Care can be defined as “medical and health services provided in cases of life-threatening, disabling, or serious illness or injury, including severe pain which arises or worsens suddenly and which, if not treated immediately, could result in loss of life or permanent damage to a person’s health.”

Minor medical problems require pre-approval of coverage, such as an office visit for a sore throat or earache. We recommend that you call ahead when possible to let us determine coverage and help you locate the appropriate source of care for your problems. Our Patient Services/HELP Nurses are available 24 hours.

  • Always carry your Health Plans Identification Card when you travel, and present it whenever medical care is sought.
  • Call the toll-free number on the back of your card before seeking medical care, if possible. If not, have a relative call for you.
  • Our Health Care Services nurses must be notified within 48 hours after an emergency hospital admission out of the area. They will communicate with the hospital and doctor to confirm your coverage and determine the most appropriate timeframe for the transfer of medical care back home.
  • If you experience a minor medical problem that may require attention before you return home, please do not hesitate to call the Health Care Services nurses. With the proper pre-approval from the Health Plans, coverage can be granted on a limited basis, and any necessary medical follow-up provided back home.
  • Receipts for pre-approved services you’ve paid for or billings you’ve received should be forwarded to us for review and handling. Reimbursement for approved care out of the area is made based on your contract stipulations such as copays, deductibles, and usual/customary allowables.

Health Care Services: 563-584-4885 or 1-866-821-1365

Out-of-Area Prescriptions (RX)

You can fill a prescription when you’re out of town.

If you need a prescription filled when out of the service area (vacation, traveling, school, etc):

  • Please utilize a national pharmacy chain whenever possible.
  • Have your MAHP Identification card with you and present to the pharmacist.

If your prescription does NOT process, you have several options:

  1. Contact Pharmacy Services at 563-584-4885 or toll-free at 866-821-1365 and staff will assist you and the pharmacy in the processing of your prescription, or
  2. Pay for the prescription in full and send the prescription receipt to:
    Medical Associates Health Plans
    1605 Associates Drive, Suite 101
    Dubuque, IA 52002
    Attn: Pharmacy (This address is listed on the back of your MAHP Identification Card) or
  3. Ask the pharmacist to fill the prescription and to process it the next business day. You would remain responsible for the applicable copay.

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