Qhov Medicare Advantage Cov Kev Npaj Ua Zoo Li Cas Kev Muab Kev Pab Zoo Dua Hauv 2021?
Zoo Siab
- WellCare Medicare Advantage txoj kev npaj them nqi kev xaiv
- WellCare HMO cov kev pab them nqi
- WellCare PPO cov phiaj xwm
- WellCare Medicare Advantage Xav Tau Cov Phiaj Xwm Tshwj Xeeb
- WellCare Txoj Kev Npaj Them Nqi rau Cov Kev Npaj
- Cov xeev twg muab WellCare Medicare Advantage cov phiaj xwm?
- WellCare Medicare Advantage cov phiaj xwm duav tau dab tsi?
- WellCare Medicare Advantage cov phiaj xwm them nqi ntau npaum li cas?
- Medicare Advantage (Medicare Tshooj C) yog dab tsi?
- Cov nqa mus
- WellCare muaj Medicare Advantage cov phiaj xwm hauv 27 lub xeev.
- WellCare muaj PPO, HMO, thiab PFFF Medicare Advantage cov phiaj xwm.
- Cov phiaj xwm tshwj xeeb muaj rau koj yuav yog nyob ntawm koj nyob qhov twg.
- WellCare tau yuav los ntawm Centene Corporation, uas yog pabcuam 23 lab tus tswvcuab hauv txhua 50 lub xeev.
WellCare Health Plans yog Tampa, Florida-chaw pov hwm muab kev pabcuam uas muaj Medicare Advantage (Tshooj C) thiab Medicare Tshooj D (tshuaj noj) npaj rau Medicare cov muaj txiaj ntsig nyob hauv ntau lub xeev.
Tsab xov xwm no yuav tshawb nrhiav cov phiaj xwm phiaj xwm Medicare Advantage sib txawv uas WellCare muab rau, thiab tseem muab qee cov piv txwv ntawm cov nqi nyob hauv WellCare cov phiaj xwm thoob plaws teb chaws.
WellCare Medicare Advantage txoj kev npaj them nqi kev xaiv
Cov hauv qab no yog cov piv txwv ntawm cov phiaj xwm Medicare Advantage cov phiaj xwm uas yuav muaj nyob hauv tus neeg thaj tsam kev pab them nqi. Cov phiaj xwm feem ntau yog tshwj xeeb hauv thaj av, thiab WellCare yuav tsis muaj tag nrho cov hom phiaj npaj hauv ib cheeb tsam tshwj xeeb.
WellCare HMO cov kev pab them nqi
WellCare muab cov Koom Haum Saib Xyuas Kev Noj Qab Haus Huv (HMO) cov phiaj xwm ua ib feem ntawm lawv cov Medicare Advantage muab. Feem ntau, WellCare HMO txoj kev pab them nqi yuav koom nrog xaiv tus thawj kws kho mob (PCP) uas tswj hwm tus neeg mob. Qhov no txhais tau tias PCP yuav xa mus rau cov kws kho mob uas tau koom nrog WellCare.
Thaum ib tus neeg yog ib tus tswv cuab ntawm HMO, lawv yuav tau them tus nqi ntau dua lossis tag nrho yog tias lawv ntsib tus kws kho mob uas tsis nyob hauv cov koom nrog.
WellCare PPO cov phiaj xwm
WellCare muaj cov Kev Pab Cuam Tshuam Tshwj Xeeb (PPO) cov phiaj xwm hauv xeev xws li Florida, Georgia, New York, thiab South Carolina. Cov koom haum no tau txo tus nqi rau kev xaiv cov koom nrog koom nrog, tab sis ib tus neeg tseem yuav tau txais nyiaj rov qab yog tias lawv pom cov neeg muab kev pab tawm sab nrauv.
Feem ntau, ib tug neeg yuav tsis tas yuav xa nws mus ntsib tus kws kho mob tshwj xeeb. Txawm li cas los xij, tej zaum yuav muaj qhov xwm txheej uas tau txais kev xa mus lossis tau txais kev tso cai ua ntej rau cov txheej txheem yuav raug txhawb, tshwj xeeb yog tias cov kws zov me nyuam tawm sab nraum cov koom tes.
WellCare Medicare Advantage Xav Tau Cov Phiaj Xwm Tshwj Xeeb
Cov Kev Xav Tau Tshwj Xeeb (SNPs) yog Medicare Advantage cov phiaj xwm npaj rau cov neeg uas muaj kev mob nkeeg tshwj xeeb lossis xav tau nyiaj txiag.
Ntawm no yog cov sib txawv ntawm SNPS muaj rau cov neeg uas ua tau raws li cov qauv:
- Kev Mob Nkeeg Xav Tau Muaj Kev Mob Hlob Ntu (C-SNPs): rau cov neeg muaj kab mob kev nkeeg
- Cov phiaj xwm Kev Xav Tau Hauv Tuam Tsev (I-SNPs): rau cov neeg nyob hauv tsev laus lossis cov tsev tu neeg mus ib lub sij hawm ntev
- Cov Muaj Cai Tau Txais SNPs Ob (D-SNPs): rau cov neeg mob uas tsim nyog rau ob qho kev pab them nqi kho mob Medicare thiab Medicaid
Cov phiaj xwm no tau muab txhua txoj kev pw hauv tsev kho mob, kev pab kho mob, thiab cov ntawv kho mob tab sis tau sib cais raws cov neeg mob uas lawv muab kev pab.
WellCare Txoj Kev Npaj Them Nqi rau Cov Kev Npaj
WellCare muaj cov Kev Npaj Ua Tus Kheej (Fee-for-Service) (PFFS) cov phiaj xwm hauv cheeb tsam xaiv hauv lub tebchaws. Nov yog txoj kev npaj uas feem ntau muab cov kev teev tus nqi rau dab tsi nws yuav them cov tsev kho mob thiab cov kws kho mob rau cov kev pabcuam, nrog rau them nyiaj nqi, lossis npib nyiaj them nqi, tus neeg tuav txoj cai yuav them ib yam nkaus.
Cov phiaj xwm PFFS yuav muaj cov koom haum muab kev koom tes lossis ib tus neeg tuaj yeem pom tus neeg muab kev pab cuam lawv xaiv. Tus kws kho mob yuav tsum lees txais chaw ua haujlwm los ntawm Medicare lossis lees txais PFFS cov phiaj xwm cov ntsiab lus uas nws yuav tau them.
Cov xeev twg muab WellCare Medicare Advantage cov phiaj xwm?
WellCare muaj Medicare Advantage cov phiaj xwm hauv ntau lub xeev. Cov no suav nrog:
- Alabama
- Arizona
- Arkansas
- California
- Txuas Txuas
- Florida
- Georgia
- Hawaii
- Lub xeev Illinois
- Indiana
- Kauj Ruam
- Louisiana
- Maine
- Michigan
- Mississippi
- Missouri
- Tshiab Hampshire
- New Jersey
- New York
- North Carolina
- Ohio
- Rhode Island
- South Carolina
- Lub Tebchaws Tennessee
- Texas
- Vermont
- Washington
Tus naj npawb thiab hom phiaj xwm txheej uas WellCare muab rau hauv cov xeev no yuav txawv.
WellCare Medicare Advantage cov phiaj xwm duav tau dab tsi?
WellCare Medicare Advantage cov kev pab them nqi tuaj yeem sib txawv raws xeev thiab cheeb tsam. Txawm li cas los xij, ntau lub phiaj xwm muab cov kev pab nram qab no ntxiv rau Medicare seem A thiab B. Cov no suav nrog:
- kev ua tub qoj ib xyoos ib zaug
- kev pab kho kaus hniav, suav nrog kev tiv thaiv thiab kho mob
- Kev pab them tshuaj
- kev thauj mus los ntawm kws kho mob mus ntsib thiab chaw muag tshuaj
- pab cuam kho qhov muag thiab pab them rau tsom iav thiab iav ntsiab muag
Thaum koj tab tom ntsuas ib qho phiaj xwm twg, ua tib zoo nyeem daim phiaj xwm piav qhia cov txiaj ntsig kom koj thiaj pom cov hom kev pab cuam uas WellCare muaj.
WellCare Medicare Advantage cov phiaj xwm them nqi ntau npaum li cas?
WellCare muaj qee qhov phiaj xwm Medicare Advantage ntawm tus nqi $ 0. Koj tseem yuav tsum them koj qhov Medicare Tshooj B hwm txhua lub hlis rau Medicare tab sis tuaj yeem tau txais kev pabcuam ntxiv yam tsis muaj nqi them los ntawm WellCare. Tsis muaj nqi dab tsi uas koj them, koj yuav tau txiav tawm, them nqi, lossis them rau qhov kev pabcuam, raws li koj cov phiaj xwm thiab Medicare.
Cov hauv qab no yog qee cov piv txwv ntawm WellCare Medicare Advantage cov phiaj xwm muaj nyob thoob plaws teb chaws thiab seb koj yuav them nyob rau xyoo 2021.
| Lub nroog / txoj kev npaj | Lub Hnub Qub kev ntsuas | Tus nqi txhua hli | Kev noj qab haus huv txiav tawm / tshuaj txiav tawm | Kev tawm ntawm hnab ris ntau | Thawj tus kws kho mob them nyiaj / cov nyiaj them nqi sib ntsib ib zaug | Kws tshaj lij cov nqi them / cov nyiaj tau zoo nyob rau ib zaug |
|---|---|---|---|---|---|---|
| Cleveland, OH: WellCare Dividend (HMO) | 3.5 | $0 | $0; $0 | $3,450 hauv kev koom tes | 20% | 20% |
| Pob zeb me, AK: WellCare Nyiam (HMO) | 3 | $0 | $0; $0 | $6,000 hauv kev koom tes | $0 | $35 |
| Portland, KUV: WellCare Hnub Xaiv Tawm Ntawm Qhov Zoo Ntxiv Ntxiv 550B (PPO) | 3.5 | $0 | $0; $0 | $5,900 hauv kev koom tes | $5 hauv network; $ 25 tsis muaj koom nrog | $ 30 hauv network |
| Caij nplooj ntoos hlav, MO: WellCare Premier (PPO) | Tsis muaj | $0 | $0; $0 | $5,900 hauv kev koom tes; $10,900 tawm ntawm lub network | $ 0 hauv network; 40% tawm ntawm lub network | $ 35 hauv network; 40% tawm ntawm kev sib koom tes nrog kev pom zoo |
| Trenton, NJ: WellCare Tus Nqi (HMO-POS) | 3.5 | $0 | $0; $0 | $7,500 hauv thiab tawm ntawm network | $ 5 hauv kev sib txuas; 40% tawm ntawm lub network | $ 30 hauv network; 40% tawm ntawm kev sib koom tes nrog kev pom zoo |
Muaj cov phiaj xwm thiab cov nqi tuaj yeem sib txawv ntawm lub xyoo. Yog tias koj muaj phiaj xwm WellCare Medicare Advantage tshwj xeeb, txoj kev npaj yuav ceeb toom rau koj thaum lub sij hawm hloov pauv cov nqi.
Medicare Advantage (Medicare Tshooj C) yog dab tsi?
Medicare Advantage (Tshooj C) yog "them" txoj kev pab them nqi kho mob uas cov tuam txhab tuav pov hwm ntiag tug muaj lub luag haujlwm los muab kev tuav pov hwm rau Medicare rau ib tug neeg. Medicare Tshooj C feem ntau suav nrog Ntu A (kev fajseeb khomob hauv tsev khomob), Tshooj B (kev khomob), thiab Tshooj D (kev fajseeb khomob tshuaj). Li cas los xij, qee qhov phiaj xwm WellCare tsis them rau Ntu D.
Thaum koj mus yuav ib qho Medicare Advantage txoj kev pab them nqi, Medicare them koj lub tuam txhab kev pov hwm kev xaiv uas muab rau koj cov txiaj ntsig kev noj qab haus huv. Yuav kom muaj kev sib tw, koj qhov kev fajseeb khomob yuav muab cov kev pab ntxiv rau koj uas tsis muaj nyob hauv daim Medicare qub. Cov no suav nrog cov kev pabcuam xws li kev kho hniav, kho qhov muag, lossis kev hnov lus.
Cov tuam txhab uas muab Medicare Advantage feem ntau ua ntawv cog lus nrog cov kws kho mob thiab tsev kho mob los sib tham txog tus nqi rau cov kev pab kho mob. Yog tias tus kws kho mob lossis tsev kho mob pom zoo muab kev pabcuam rau qee tus nqi nrog lub tuam txhab kev pov hwm, lub tuam txhab feem ntau yuav xaiv lawv ua "kev sib koom tes".
Cov ntawv faj seeb Medicare Advantage yog cov kev qhia meej hauv xeev thiab cheeb tsam vim tias txoj kev npaj sib tham nrog tsev kho mob thiab kws kho mob hauv txhua cheeb tsam. Raws li qhov tshwm sim, tsis yog txhua hom phiaj xwm phiaj xwm WellCare muaj nyob rau txhua lub xeev.
Cov nqa mus
WellCare muaj Medicare Advantage thiab Medicare Part D cov phiaj xwm hauv 27 lub xeev, nrog cov phiaj xwm sib txawv raws cheeb tsam. Cov phiaj xwm no yuav suav nrog PPOs, HMOs, thiab PFFFs, thiab tuaj yeem pab koj tswj cov nqi kho mob thiab cov tshuaj uas tsis muaj nyob hauv Medicare cov qauv pab cuam.
Koj tuaj yeem nrhiav pom tias WellCare muaj phiaj xwm nyob hauv koj thaj tsam los ntawm kev tshawb nrhiav Medicare qhov nrhiav cov phiaj xwm phiaj xwm.
Kab lus no tau raug hloov kho thaum Lub Kaum Ib Hlis 20, 2020, kom pom zoo 2021 Cov ntaub ntawv Medicare.
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.
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