Kodi Ndi Njira Zotani Zothandizira Medicare Zomwe Zimaperekedwa Kwaulere mu 2021?

Zamkati

• Zosankha za WellCare Medicare Advantage
• WellCare HMO mapulani
• Mapulani a WellCare PPO
• Mapulani a Zosowa Zapadera za WellCare Medicare
• Malipiro a WellCare Private for-Service
• Kodi ndi mayiko ati omwe amapereka mapulani a WellCare Medicare Advantage?
• Kodi mapulani a WellCare Medicare Advantage amaphimba chiyani?
• Kodi mapulani a WellCare Medicare Advantage amawononga ndalama zingati?
• Kodi Medicare Advantage (Medicare Part C) ndi chiyani?
• Kutenga

• WellCare imapereka mapulani a Medicare Advantage m'maiko 27.
• WellCare imapereka mapulani a PPO, HMO, ndi PFFF Medicare Advantage.
• Zolinga zomwe mungapeze zimadalira komwe mukukhala.
• WellCare yapezeka ndi Centene Corporation, yomwe imathandizira mamembala 23 miliyoni m'maiko onse 50.

WellCare Health Plans ndi a Tampa, Florida omwe amapereka inshuwaransi omwe amapereka Medicare Advantage (Gawo C) ndi Medicare Part D (mankhwala osokoneza bongo) akukonzekera omwe adzapindule ndi Medicare m'maiko angapo.

Nkhaniyi ifufuza mitundu yosiyanasiyana ya Medicare Advantage yomwe WellCare imapereka, komanso kupereka zitsanzo za mtengo pansi pamalingaliro osiyanasiyana a WellCare mdziko lonselo.

Zosankha za WellCare Medicare Advantage

Zotsatirazi ndi zitsanzo za mitundu yamadongosolo a Medicare Advantage omwe atha kupezeka mdera la munthu. Mapulani nthawi zambiri amakhala okhudzana ndi dera, ndipo WellCare mwina singapereke mitundu yonse yamadongosolo mdera lina.

WellCare HMO mapulani

WellCare imapereka mapulani a Health Maintenance Organisation (HMO) ngati gawo la zopereka zawo za Medicare Advantage. Nthawi zambiri, dongosolo la WellCare HMO liphatikizira kusankha wopereka chithandizo choyambirira (PCP) yemwe amayang'anira chisamaliro cha munthu. Izi zikutanthauza kuti PCP ipereka mwayi kwa akatswiri azaumoyo omwe ali pa intaneti ya WellCare.

Munthu akakhala membala wa HMO, amatha kulipira ndalama zambiri kapena zokwanira akawona dokotala yemwe sali pa netiweki.

Mapulani a WellCare PPO

WellCare imapereka mapulani a Preferred Provider Organisation (PPO) m'maiko kuphatikiza Florida, Georgia, New York, ndi South Carolina. Mabungwewa amapereka mitengo yocheperako posankha omwe amagwiritsa ntchito ma netiweki, komabe munthu amatha kulandirabe ndalama ngati angawone omwe ali kunja kwa netiweki.

Nthawi zambiri, munthu samayenera kupita kukaonana ndi katswiri. Komabe, pakhoza kukhala nthawi zina pamene kutumizidwa kapena kupeza chilolezo choyambirira cha njira kungalimbikitsidwe, makamaka ngati woperekayo ali kunja kwa netiweki.

Mapulani a Zosowa Zapadera za WellCare Medicare

Mapulani a Zosowa Zapadera (SNPs) ndi mapulani a Medicare Advantage opangidwa kwa iwo omwe ali ndi vuto linalake lachipatala kapena zosowa zachuma.

Nayi mitundu yosiyanasiyana ya SNPS yomwe ikupezeka kwa iwo omwe akwaniritsa izi:

• Mapulani a Zosowa Zapadera (C-SNPs): kwa anthu omwe ali ndi matenda aakulu
• Ndondomeko zapadera za Institutional Special Needs (I-SNPs): kwa anthu omwe amakhala m'malo osungira anthu okalamba kapena m'malo osamalira anthu kwanthawi yayitali
• Ma SNP Oyenerera (D-SNPs): kwa odwala omwe ali oyenera kulandira chithandizo cha Medicare ndi Medicaid

Zolingazi aliyense amapereka kuchipatala, chithandizo chamankhwala, komanso chithandizo chamankhwala koma adalekanitsidwa kutengera odwala omwe amawatumikira.

Malipiro a WellCare Private for-Service

WellCare imapereka mapulani a Private Fee-for-Service (PFFS) m'malo osankhidwa mdziko muno. Ili ndi dongosolo lomwe nthawi zambiri limapereka chiwongola dzanja chazomwe amalipira zipatala ndi madotolo pantchito, ndi copay yosungidwa, kapena chitsimikizo chandalama, woperekayo adzaperekanso ndalama.

Dongosolo la PFFS litha kukhala ndi netiweki yothandizira kapena munthu atha kuwona wowapatsa aliyense amene angasankhe. Wothandizirayo amayenera kulandira gawo kuchokera ku Medicare kapena kuvomereza mfundo za PFFS pazomwe angalipire.

Kodi ndi mayiko ati omwe amapereka mapulani a WellCare Medicare Advantage?

WellCare imapereka mapulani a Medicare Advantage m'maiko angapo. Izi zikuphatikiza:

• Alabama
• Arizona
• Arkansas
• California
• Connecticut
• Florida
• Georgia
• Hawaii
• Illinois
• Indiana
• Kentucky
• Louisiana
• Maine
• Michigan, PA
• Mississippi
• Missouri
• New Hampshire
• New Jersey
• New York
• North Carolina
• Ohio
• Rhode Island
• South Carolina
• Tennessee, PA
• Texas
• Vermont
• Washington

Chiwerengero ndi mtundu wamapulani omwe WellCare amapereka m'maiko awa akhoza kukhala osiyanasiyana.

Kodi mapulani a WellCare Medicare Advantage amaphimba chiyani?

Mapulani a WellCare Medicare Advantage amatha kusiyanasiyana malinga ndi dera komanso dera. Komabe, mapulani ambiri amapereka zotsatirazi kuwonjezera pa gawo la Medicare A ndi B. Izi ndi monga:

• kukhala olimba pachaka
• ntchito zamano, kuphatikiza zodzitetezera ndi chithandizo chamankhwala
• Kuphunzira mankhwala osokoneza bongo
• zoyendera kupita kukaonana ndi dokotala komanso malo ogulitsira mankhwala
• ntchito zowonera ndikuthandizira kulipira magalasi ndi magalasi olumikizirana

Mukasanthula pulani inayake, werengani mosamala malongosoledwe a mapulaniwo kuti muwone mitundu yazithandizo zowonjezera zomwe WellCare imapereka.

Kodi mapulani a WellCare Medicare Advantage amawononga ndalama zingati?

WellCare imapereka mapulani a Medicare Advantage pamtengo wa $ 0. Muyenera kulipira ndalama zanu za Medicare Part B mwezi uliwonse ku Medicare koma mutha kulandira zina zowonjezera popanda kulipira pamwezi kuchokera ku WellCare. Ngakhale mutalipira ndalama zotani, mudzalandira ndalama zochotseredwa, zolipiritsa, kapena chitsimikizo cha ntchito, monga kukhazikitsidwa ndi dongosolo lanu ndi Medicare.

Izi ndi zitsanzo za mapulani a WellCare Medicare Advantage omwe akupezeka mdziko lonselo komanso zomwe mungapereke mu 2021.

Zolinga zomwe zilipo ndi mtengo zimatha kusiyanasiyana chaka ndi chaka. Ngati muli ndi dongosolo linalake la WellCare Medicare Advantage, dongosololi lidzakudziwitsani za kusintha kwa ndalama.

Kodi Medicare Advantage (Medicare Part C) ndi chiyani?

Medicare Advantage (Gawo C) ndi dongosolo lamatenda "lophatikizidwa" komwe kampani yabizinesi ya inshuwaransi ili ndi udindo wopereka chiphaso cha munthu ku Medicare. Medicare Part C nthawi zambiri imaphatikizapo Gawo A (kufotokozera kuchipatala), Gawo B (chithandizo chamankhwala), ndi Gawo D (cholemba mankhwala). Komabe, mapulani ena a WellCare samaphimba Gawo D.

Mukamagula dongosolo la Medicare Advantage, Medicare imalipira kampani yanu ya inshuwaransi yomwe ikufuna kuti ikupatseni thanzi labwino. Kuti mukhalebe olimbirana, mapulani anu a inshuwaransi angakupatseni maubwino owonjezera omwe sapezeka mu Medicare yoyambirira. Izi zikuphatikiza ntchito monga mano, masomphenya, kapena kuphimba kumva.

Makampani omwe amapereka Medicare Advantage nthawi zambiri amapeza mgwirizano ndi madotolo ndi zipatala kuti akambirane ndalama zakuchipatala. Ngati dokotala kapena chipatala avomereza kupereka chithandizo pamlingo winawake ndi kampani ya inshuwaransi, kampaniyo nthawi zambiri imawasankha ngati othandizira "pa intaneti".

Zolinga za Medicare Advantage ndizaboma komanso zigawo makamaka chifukwa cha momwe mapulani amakambirana ndi zipatala ndi madotolo mdera lililonse. Zotsatira zake, si mitundu yonse yamapulani ya WellCare yomwe imapezeka m'maiko onse.

Kutenga

WellCare imapereka malingaliro a Medicare Advantage ndi Medicare Part D m'ma 27, ndi mapulani osiyanasiyana malinga ndi dera. Zolingazi zitha kuphatikizira ma PPO, ma HMO, ndi ma PFFF, ndipo zitha kukuthandizani kuti muzitha kusamalira ndalama zamankhwala ndi mankhwala omwe simukupezeka m'mapulogalamu a Medicare.

Mutha kudziwa ngati WellCare imapereka pulani m'dera lanu posaka Medicare kuti ipeze chida chothandizira.

Nkhaniyi idasinthidwa pa Novembala 20, 2020, kuti iwonetse zambiri za 2021 Medicare.

Zomwe zili patsamba lino zimatha kukuthandizani posankha nokha za inshuwaransi, koma cholinga chake si kupereka upangiri wokhudzana ndi kugula kapena kugwiritsa ntchito inshuwaransi kapena zinthu zilizonse za inshuwaransi. Healthline Media siyigulitsa bizinesi ya inshuwaransi mwanjira iliyonse ndipo siyololedwa kukhala kampani ya inshuwaransi kapena opanga madera aliwonse aku U.S. Healthline Media sivomereza kapena kuvomereza aliyense wachitatu yemwe angachite bizinesi ya inshuwaransi.