Medicare Advantage Cov Kev Npaj Pab Nyiaj Tau Li Cas?

Zoo Siab

• Muaj feem cuam tshuam dab tsi rau koj cov nqi rau Medicare Advantage txoj kev npaj?
• Cov phiaj xwm Medicare Advantage yog dab tsi?
• Kuv puas tsim nyog rau Medicare Advantage cov phiaj xwm?
• Nqa Nyiaj

Medicare Advantage cov kev pab them nqi yog txhua txoj hauv kev xaiv cov qub Medicare uas muab los ntawm cov tuam txhab lag luam ntiag tug. Lawv tau pab nyiaj los ntawm Medicare thiab los ntawm cov neeg tau kos npe rau qhov phiaj xwm tshwj xeeb.

Khaws nyeem kom paub ntxiv txog Medicare Advantage cov kev npaj thiab cov nqi tawm ntawm hnab tshos rau cov phiaj xwm no.

Muaj feem cuam tshuam dab tsi rau koj cov nqi rau Medicare Advantage txoj kev npaj?

Tus nqi koj them rau Medicare Advantage yog raws ntau yam, suav nrog:

• Cov nqi them txhua hli. Qee qhov phiaj xwm tsis muaj kev tuav pov hwm.
• Cov nqi them Medicare Tshooj B txhua hli. Qee qhov phiaj xwm them tag nrho lossis ib feem ntawm Feem B.
• Nyiaj them ua lag luam niaj xyoo. Yuav suav nrog qhov kev txo tawm txhua xyoo lossis cov nyiaj txo ntxiv.
• Txoj kev them nqi. Qhov nyiaj them tus nqi them lossis tus nqi them koj them rau txhua qhov kev pabcuam lossis tuaj xyuas.
• Hom thiab zaus. Hom kev pabcuam koj xav tau thiab cov nquag tau txais ntau npaum li cas.
• Tus kws kho mob / khoom txais khoom. Cuam tshuam tus nqi yog tias koj nyob hauv PPO, PFFS, lossis MSA txoj kev npaj, lossis koj mus tawm sab nraum lub network.
• Cov kev cai. Raws li koj cov phiaj xwm txoj cai, xws li siv cov xaib xaib.
• Cov txiaj ntsig ntxiv. Koj xav tau dab tsi thiab cov phiaj xwm them rau.
• Cov kev txwv ib xyoos. Koj cov nyiaj hauv hnab ris tawm rau tag nrho cov kev khomob.
• Medicaid. Yog tias koj muaj nws.
• Kev pabcuam hauv lub xeev. Yog tias koj tau txais nws.

Cov xwm txheej no hloov pauv txhua xyoo raws li:

• nqi them
• tshem tawm
• cov kev pab cuam

Cov tuam txhab muab cov phiaj xwm, tsis yog Medicare, txiav txim siab koj them nyiaj npaum li cas rau cov kev pab them nyiaj.

Cov phiaj xwm Medicare Advantage yog dab tsi?

Qee zaum hu ua MA cov phiaj xwm lossis Tshooj C, Medicare Advantage cov phiaj xwm tau muaj los ntawm cov tuam txhab ntiag tug uas pom zoo los ntawm Medicare. Cov tuam txhab no sib cog lus nrog Medicare los lawb cov kev pab cuam Medicare no ua ke:

• Medicare Tshooj A: pw hauv tsev kho mob, pw hauv tsev kho mob, saib xyuas hauv tsev laus, thiab qee tus neeg saib xyuas mob hauv tsev
• Tshooj Medicare B: qee yam kev khomob ntawm kws khomob, kev khomob sab nraud, khoom siv khomob, thiab kev tiv thaiv
• Medicare Tshooj D (feem ntau): tshuaj kho mob

Qee qhov phiaj xwm Medicare Advantage muaj cov kev pab ntxiv, xws li:

• kho hniav
• kev pom kev
• hnov

Cov phiaj xwm Medicare Advantage feem ntau yog:

• HMO (lub koom haum saib xyuas kev noj qab haus huv) cov phiaj xwm
• PPO (cov koomhaum muab kev pabcuam xav tau) cov phiaj xwm
• PFFS (ntiag tug them nqi-rau-kev pabcuam) cov phiaj xwm
• SNPs (cov phiaj xwm tshwj xeeb)

Muaj tsawg hom phiaj Medicare Advantage muaj xws li:

• Cov ntawv faj seeb kho mob Medicare kev them nyiaj kho mob (MSA)
• HMOPOS (HMO point of service) cov phiaj xwm

Kuv puas tsim nyog rau Medicare Advantage cov phiaj xwm?

Koj tuaj yeem koom nrog feem ntau Medicare Advantage cov phiaj xwm yog tias koj:

• muaj Medicare Tshooj A thiab Tshooj B
• nyob hauv thaj chaw pabcuam phiaj xwm
• tsis txhob mob raum ntu kawg (ESRD)

Nqa Nyiaj

Medicare Advantage Plans - tseem hu ua MA Cov Tswv Yim lossis Tshooj C - yog muab los ntawm cov tuam txhab ntiag tug thiab them los ntawm Medicare thiab los ntawm Medicare cov neeg tsim nyog tau txais Medicare uas kos npe rau cov phiaj xwm.

Cov ntaub ntawv ntawm lub vev xaib no tuaj yeem pab koj txiav txim siab tus kheej txog kev tuav pov hwm, tab sis nws tsis yog yuav pab tswv yim txog kev yuav khoom lossis kev siv cov khoom pov hwm lossis kev tuav pov hwm. Healthline Media yuav tsis hloov lag luam ntawm kev tuav pov hwm tsis hais yam twg thiab tsis tau ntawv tso cai raws li cov tuam txhab pov hwm lossis cov neeg tsim khoom hauv ib cheeb tsam ntawm Teb Chaws Asmeskas. Healthline Media tsis tau qhia lossis pom zoo rau ib tog neeg thib peb uas ua lag luam ntawm kev tuav pov hwm.