Izinhlelo ze-Blue Cross Medicare Advantage ngo-2021

-Delile

• Yini ama-Blue Cross Medicare Advantage plans?
• Izinhlelo ze-Blue Cross Medicare Advantage HMO
• Izinhlelo ze-Blue Cross Medicare Advantage PPO
• Izinhlelo zomuthi kadokotela weBlue Cross Medicare
• Izinhlelo zeBlue Cross Medicare Advantage PFFS
• Ama-SNP we-Blue Cross Medicare
• Zibiza malini izinhlelo ze-Blue Cross Medicare Advantage?
• Yini i-Medicare Advantage (Medicare Part C)?
• Ukuthatha

• IBlue Cross inikeza izinhlelo nezinhlobo ezahlukahlukene zeMedicare Advantage ezifundazweni eziningi e-United States.
• Izinhlelo eziningi zifaka ukumbozwa kwezidakamizwa kadokotela, noma ungathenga uhlelo oluhlukile lwengxenye D.
• Izinhlelo eziningi zeBlue Cross Medicare Advantage zinikela ngamaphrimiyamu angama- $ 0 ngenyanga kanye nokusetshenziswa kwezidakamizwa kadokotela.

I-Medicare Advantage ingenye ye-Medicare yasekuqaleni lapho inkampani yangasese yomshuwalense wezempilo inikezela ngezinzuzo zakho ze-Medicare, kanye nezinye izinzuzo zangempela i-Medicare engahlinzeki ngokwesiko. Izibonelo zifaka phakathi umbono, amazinyo, kanye nezinsizakalo zezempilo zokuvikela. IBlue Cross Blue Shield ingenye yalezi zinkampani.

Le ndatshana ikunikeza ukubuka izinhlelo ezitholakalayo zeBlue Cross Medicare Advantage e-United States.

Yini ama-Blue Cross Medicare Advantage plans?

IBlue Cross inikela ngezinhlelo ezahlukahlukene zeMedicare Advantage. Ukutholakala kwazo kungahluka ngesifunda nezwe.

Ake sibuyekeze izinhlobo ezahlukene zezinhlelo ze-tMedicare Advantage ezinikezwa yi-Blue Cross.

Izinhlelo ze-Blue Cross Medicare Advantage HMO

IBlue Cross inikeza izinhlelo ze-Health Maintenance Organisation (HMO) ezifundazweni eziningi, kufaka phakathi i-Arizona, California, Florida, Florida, Massachusetts, nezinye eziningi. Kulolu hlobo lohlelo, uzoba nomhlinzeki wokunakekelwa okuyisisekelo okwangaphakathi kwenethiwekhi (PCP).

Uma ubuzodinga ukunakekelwa okukhethekile, ungaqala ubone i-PCP yakho, khona-ke bazokunikeza ukuthunyelwa ukuze ubone isazi. Uhlelo lwakho lomshuwalense kuzofanele kuqala luvume ukuthunyelwa kodokotela abakhethekile.

Okuhlukile ngeBlue Cross ukuthi abesifazane abaningi ngeke badinge ukuthunyelwa ukuze babone i-in-network OB / GYN yokunakekelwa okujwayelekile kwabesifazane, njengePap smear.

Izinhlelo ze-Blue Cross Medicare Advantage PPO

I-Blue Cross inikeza izinhlelo ze-Preferred Provider Organisation (PPO) ezifundazweni ezibandakanya i-Alabama, Florida, Hawaii, neMontana (ukubala nje ezimbalwa). Njengomthetho ojwayelekile, i-PPO izoba ne-premium ephakeme kancane kune-HMO. Lokhu kungenxa yokuthi akudingeki ukuthi uthole ukuthunyelwa ukuze ubone isazi lapho une-PPO.

Kodwa-ke, ungonga imali ngokukhetha abahlinzeki be-in-network ohlwini lwabanikezeli benkampani yomshuwalense. Ungakhokha ngaphezulu uma ukhetha umhlinzeki ongaphandle kwenethiwekhi.

Izinhlelo zomuthi kadokotela weBlue Cross Medicare

I-Medicare Part D ihlela ukumboza imishanguzo yakho kadokotela. Amanye amaMedicare Advantage ahlela ngeBlue Cross anikezela ngemithi kadokotela. Kodwa-ke, uma uhlelo lungahlinzeki ngokumbozwa, ungakhetha uhlelo lwezidakamizwa oluzimele.

IBlue Cross inikela ngezinhlelo “eziyisisekelo” “nezithuthukisiwe” esigabeni semithi kadokotela kanye ne-Standard, Plus, Enhanced, Preferred, Premium, Select, kanye nezinye izinketho zenqubomgomo yezidakamizwa. Ngayinye izofaka i-formulary, noma uhlu lwemithi uhlelo oluhlanganayo kanye nezindleko ezahlukahlukene. Ungahlola lolu hlu noma amafomula ukuze uqiniseke ukuthi noma yiluphi uhlelo olucabangayo lubandakanya nemithi oyiphuzayo.

Izinhlelo zeBlue Cross Medicare Advantage PFFS

Uhlelo lwe-Private Fee For Service (PFFS) luhlelo lweMedicare Advantage olunikezwa yiBlue Cross e-Arkansas kuphela. Lolu hlobo lohlelo aludingi ukuthi usebenzise i-PCP ethile, abahlinzeki abakwi-network, noma uthole ukuhanjiswa. Esikhundleni salokho, uhlelo lubeka ukuthi luzobuyisela malini udokotela futhi unesibopho sokukhokha imali esele yomhlinzeki.

Kwesinye isikhathi, abahlinzeki bazokwenza isivumelwano necebo le-PFFS lokuhlinzeka ngezinsizakalo. Ngokungafani nezinye izinhlelo zeMedicare, umhlinzeki wohlelo lwePFFS akudingeki akunikeze izinsizakalo ngoba nje amukela iMedicare. Bangakhetha ukuthi bazohlinzeka insizakalo ngezinga lembuyiselo yeMedicare noma cha.

Ama-SNP we-Blue Cross Medicare

Uhlelo Olukhethekile Lwezidingo (SNP) uhlelo lweMedicare Advantage olunikezelwe kulabo abanesimo esithile noma isici esithile. Ngokufanelekile, uhlelo luhlinzeka ngezici zokumboza ezinkulu umuntu angazidinga. I-Medicare idinga ukuthi wonke ama-SNP ahlinzeke ngemithi kadokotela.

Izibonelo ze-Blue Cross SNPs zifaka:

• Zibiza malini izinhlelo ze-Blue Cross Medicare Advantage?

  Imakethe yeMedicare Advantage iyanda ngokuncintisana. Uma uhlala esifundeni sedolobha elikhulu, kungahle kube nezinhlelo eziningi ongakhetha kuzo.

  Okulandelayo ezinye zezibonelo zezinhlelo zeBlue Cross Medicare Advantage ezindaweni ezahlukahlukene ngamaphrimiyamu abo wanyanga zonke nezinye izindleko.Lezi zinhlelo azibandakanyi izindleko zeprimiyamu yakho yanyanga zonke yePart B.

  Idolobha / uhlelo	Isilinganiso senkanyezi	Iphrimiyamu yanyanga zonke	Impilo idonswa, isidakamizwa ebanjwayo	In-network out-of-pocket max	I-PCP copay ngokuvakasha ngakunye	Uchwepheshe we-copay ngokuvakasha ngakunye
  ILos Angeles, CA: I-Anthem MediBlue StartSmart Plus (HMO)	3.5	$0	$0, $0	$3,000	$5	$0–$20
  IPhoenix, AZ: I-BluePathway Plan 1 (HMO)	Akutholakali	$0	$0, $0	$2,900	$0	$20
  I-Cleveland, OH: I-Anthem MediBlue Access Core (i-Regional PPO)	3.5	$0 (akubandakanyi ukufakwa kwezidakamizwa)	$ 0, akufakiwe	$4,900	$0	$30
  IHouston, TX: IBlue Cross Medicare Advantage Basic (HMO)	3	$0	$0, $0	$3,400	$0	$30
  I-Trenton, NJ: I-Horizon Medicare Blue Advantage (HMO)	4	$31	$0, $250	$6,700	$10	$25

  Lezi yizibonelo ezimbalwa zezinhlelo ezitholakalayo zeBlue Cross Advantage ezivela kuwebhusayithi ye-Medicare.gov yokuthola uhlelo. Kungaba nezinye izinketho eziningi endaweni yekhodi le-ZIP.

  Yini i-Medicare Advantage (Medicare Part C)?

  Ukuba ne-Medicare Advantage (Ingxenye C) kusho ukuthi inkampani yomshuwalense enikeza uhlelo lwakho izohlinzeka ngokutholakala kwe-Medicare Part A (ukumbozwa kwesibhedlela), i-Medicare Part B (ukumbozwa kwezokwelapha). Ezinye izinhlelo zinikeza nokusetshenziswa kwezidakamizwa kadokotela. Izinhlelo ze-Medicare Advantage ziyahlukahluka ezindlekweni zazo ezingaphandle kwezikhwama kanye nokufakwa, kufaka phakathi ama-copayments kanye nemali yemali.

  Izikhathi zokugcina zokubhalisa noma zokushintsha uhlelo lwakho lwe-Medicare Advantage

  Lezi ezilandelayo izinsuku ezibalulekile zokubhalisa noma zokushintsha uhlelo lwakho lwe-Medicare Advantage:

  • Isikhathi sokuqala sokubhalisa. Izinyanga ezi-3 zokuqala ngaphambi kosuku lwakho lokuzalwa lwama-65, inyanga yakho yokuzalwa, nezinyanga ezi-3 ngemuva kosuku lwakho lokuzalwa lwama-65.
  • Isikhathi sokubhalisa esivulekile. Okthoba 15 kuya kuDisemba 7 yisikhathi sokubhalisa esivulekile seMedicare Advantage. Izinhlelo ezintsha ziqala ukusebenza ngoJanuwari 1.
  • Ukubhaliswa okuvulekile kweMedicare Advantage. Ngalesi sikhathi, umuntu angashintshela kolunye uhlelo lweMedicare Advantage uma esenayo iMedicare Advantage.
  • Isikhathi sokubhaliswa esikhethekile seMedicare. Isikhathi sesikhathi lapho ungashintsha khona uhlelo lwakho lwe-Advantage ngenxa yezimo ezikhethekile njengokuhamba noma uhlelo oludonswe endaweni yakho.

  Ukuthatha

  IBlue Cross ingenye yezinkampani eziningi zomshuwalense ezinikela ngezinhlelo zeMedicare Advantage. Ungathola amapulani atholakalayo ngokusesha emakethe yeMedicare.gov noma ngewebhusayithi yeBlue Cross. Gcina izinsuku ezisemqoka engqondweni lapho unquma ukuthi uzobhalisa nini ohlelweni lweMedicare Advantage.

  Lo mbhalo uvuselelwe ngoNovemba 19, 2020, ukukhombisa imininingwane ye-2021 Medicare.

  

  Imininingwane ekule webhusayithi ingakusiza ekwenzeni izinqumo eziphathelene nomshuwalense, kepha ayihloselwe ukunikeza iseluleko maqondana nokuthengwa noma ukusetshenziswa kwanoma imuphi umshwalense noma imikhiqizo yomshuwalense. I-Healthline Media ayisebenzisi ibhizinisi lomshwalense nganoma iyiphi indlela futhi ayinamalayisensi njengenkampani yomshuwalense noma umkhiqizi kunoma iyiphi indawo yase-U.S. I-Healthline Media ayincomi noma ivumele noma yiziphi izinkampani zangaphandle ezingase zenze ibhizinisi lomshwalense.