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Provider Manual

What are Medicare Advantage plans?

Last Updated on August 28, 2018

Medicare Advantage plans are offered by Security Health Plan, a health maintenance organization (HMO). In general, members must get care from affiliated providers and facilities. Medicare Advantage members are required to get Security Health Plan approval in advance (prior authorization) for services from nonaffiliated providers except for emergency or urgent care or out-of area renal dialysis services. Neither Security Health Plan nor Medicare will pay for other services from nonaffiliated providers without prior authorization.