Antidote Health

Antidote Health is a digital-first Health Maintenance Organization (HMO) that operates as a payvider, combining insurance coverage with integrated virtual care delivery. The company offers Affordable Care Act (ACA) compliant health insurance plans in Arizona and Ohio, featuring unlimited virtual care access and $0 primary care provider visits for members.

The company's platform integrates AI-assisted telehealth services directly into its insurance offerings, enabling 24/7 virtual care with minimal wait times through a proprietary mobile app. Members can manage claims, schedule appointments, and connect with virtual providers through a single interface. Antidote Health serves both individual/family plans and small group employers with 2-50 employees in select counties.

In 2024, Antidote Health received NCQA Health Plan Interim Accreditation for both Arizona and Ohio operations, achieving this milestone ahead of typical timelines. The company was also recognized with a Gold Merit Award in the 2024 Healthcare Awards for its innovative payvider model that integrates payment and delivery systems.

Organizations should consider Antidote Health when seeking a payvider partner that can demonstrate successful integration of insurance administration with virtual care delivery in ACA marketplace environments. The company excels in scenarios where telehealth accessibility, simplified member experiences, and cost containment through virtual-first care models are priorities.

Buyers can expect a modern technology platform with mobile-first member engagement, NCQA-accredited plan administration, and experience navigating state insurance regulations in Arizona and Ohio. The integrated model provides insights into reducing administrative friction between payer and provider systems.

Antidote Health operates exclusively in healthcare as a licensed Health Maintenance Organization with NCQA accreditation. The company specializes in ACA-compliant individual, family, and small group health insurance plans with integrated virtual care delivery. Their healthcare focus includes HIPAA-compliant telehealth services, claims processing, member portal functionality, and navigation of state insurance regulations in Arizona and Ohio.

The company demonstrates specific expertise in digital health insurance administration, virtual-first care model design, and payvider operations that combine insurance underwriting with owned provider networks. Their approach addresses healthcare affordability and accessibility challenges through technology-enabled care delivery.

The ideal client is a state health insurance exchange, health insurance marketplace, or small employer (2-50 employees) in Arizona or Ohio seeking affordable, virtual-first health plan options. Technology partners interested in payvider model implementation or telehealth integration with insurance platforms would also benefit from understanding Antidote Health's approach to unified payment and delivery systems.