Zeziphi izicwangciso zokuLungiselela iMedicare ezibonelelwa yi-WellCare ngo-2021?

Umxholo

• Isicwangciso se-WellCare Medicare sokukhetha isicwangciso
• Izicwangciso zeHMO ze-WellCare
• Izicwangciso ze-WellCare PPO
• Izicwangciso zeemfuno ezizodwa ze-WellCare Medicare
• Izicwangciso ze-WellCare zaBucala-zeeNkonzo
• Zeziphi izinto ezibonelela ngezicwangciso ze-WellCare Medicare Advantage?
• Zithini iiplani ze-WellCare Medicare Advantage?
• Zingakanani iiplani ze-WellCare Medicare Advantage cost?
• Yintoni i-Medicare Advantage (Medicare Part C)?
• Ukuthatha

• I-WellCare ibonelela ngezicwangciso ze-Medicare Advantage kumazwe angama-27.
• I-WellCare ibonelela ngezicwangciso ze-PPO, i-HMO, kunye ne-PFFF ye-Medicare.
• Izicwangciso ezithile ezifumanekayo kuwe ziya kuxhomekeka apho uhlala khona.
• I-WellCare ifunyenwe yiCentene Corporation, ethi ibonelele ngamalungu angama-23 ezigidi kuwo onke ama-50.

Izicwangciso zeMpilo ye-WellCare yiTampa, eFlorida esekwe kumboneleli ngeinshurensi ebonelela ngeMedicare Advantage (Icandelo C) kunye neMedicare Icandelo D (iyeza elicetyiweyo) icebo labaxhamli beMedicare kumazwe aliqela.

Eli nqaku liza kuphonononga iintlobo ezahlukeneyo zesicwangciso seMedicare Advantage ezinikezelwa yi-WellCare, kunye nokubonelela ngemizekelo yeendleko phantsi kwezicwangciso ezahlukeneyo ze-WellCare kwilizwe liphela.

Isicwangciso se-WellCare Medicare sokukhetha isicwangciso

Le ilandelayo yimizekelo yeentlobo zezicwangciso zeMedicare Advantage ezinokuthi zifumaneke kwindawo yokugubungela umntu. Izicwangciso zihlala zijolise ngqo kwingingqi, kwaye i-WellCare ayinakho ukubonelela ngazo zonke iintlobo zesicwangciso kwindawo ethile.

Izicwangciso zeHMO ze-WellCare

I-WellCare ibonelela ngezicwangciso zoMbutho wezeMpilo yoLondolozo lwezeMpilo (HMO) njengenxalenye yesibonelelo seMedicare. Ngokwesiqhelo, isicwangciso se-HCM ye-WellCare iya kubandakanya ukukhetha umboneleli wokhathalelo oluphambili (PCP) olawula ukhathalelo lomntu. Oku kuthetha ukuba i-PCP iya kwenza ukuthunyelwa kwiingcali zononophelo lwempilo ezikwinethiwekhi ye-WellCare.

Xa umntu eyilungu le-HMO, banokuhlawula iindleko eziphezulu okanye ezigcweleyo xa bebona ugqirha ongaphandle kwenethiwekhi.

Izicwangciso ze-WellCare PPO

I-WellCare ibonelela ngezicwangciso zoMbutho woMboneleli oKhethiweyo (PPO) kumazwe kubandakanya iFlorida, Georgia, New York, kunye neSouth Carolina. Le mibutho ibonelela ngamaxabiso ancitshisiweyo ekukhetheni ababoneleli benethiwekhi, ukanti umntu usenokufumana imbuyekezo xa ebona ababoneleli abangaphandle kwenethiwekhi.

Ngokwesiqhelo, umntu akunyanzelekanga ukuba afumane ukuthunyelwa ukuze abone ingcali. Nangona kunjalo, kunokubakho iimeko apho ukufumana ukuthunyelwa okanye ukufumana ukugunyaziswa kwangaphambili kwenkqubo kunokukhuthazwa, ngakumbi ukuba umboneleli ngumntu ongaphandle kwenethiwekhi.

Izicwangciso zeemfuno ezizodwa ze-WellCare Medicare

Izicwangciso zeMfuno eziZodwa (ii-SNPs) zizicwangciso ze-Medicare zeNzuzo ezijolise kwabo banesimo esithile sezonyango okanye iimfuno zemali.

Nazi iintlobo ezahlukeneyo ze-SNPS ezifumanekayo kwabo bahlangabezana neenqobo zokugweba:

• Izicwangciso zeMeko eYodwa yeZicwangciso eziZodwa (C-SNPs): kubantu abaneemeko zempilo ezingapheliyo
• Izicwangciso zemfuno ezizodwa zamaziko (I-SNPs): Kubantu abahlala kumakhaya abalupheleyo okanye kwiindawo zononophelo lwexesha elide
• Ii-SNP ezifanelekileyo (i-D-SNPs): kwizigulana ezikulungeleyo ukugubungela iMedicare kunye neMedicaid

Ezi zicwangciso zibonelela ngokulaliswa esibhedlele ngokubanzi, inkonzo yezonyango, kunye nokukhutshwa ngugqirha kodwa zahlulwe ngokusekwe kwizigulana abazisebenzisayo.

Izicwangciso ze-WellCare zaBucala-zeeNkonzo

I-WellCare ibonelela ngezicwangciso zabucala zeNkonzo-yeNkonzo (PFFS) kwiindawo ezikhethiweyo zelizwe. Esi sisicwangciso esihlala sinika umyinge wento eza kuhlawula ngayo izibhedlele kunye noogqirha ngeenkonzo, nge-copay ebekiweyo, okanye i-coinsurance, umnini-polisi uya kuhlawula ngokunjalo.

Isicwangciso se-PFFS sinokuba nenethiwekhi yomboneleli okanye umntu angakwazi ukubona nawuphi na umboneleli abamkhethayo. Umboneleli kufuneka aqhele ukwamkela isabelo esivela kwiMedicare okanye amkele imigaqo yesicwangciso sePFFS malunga nento eza kuyihlawula.

Zeziphi izinto ezibonelela ngezicwangciso ze-WellCare Medicare Advantage?

I-WellCare ibonelela ngezicwangciso ze-Medicare Advantage kwiindawo ezininzi. Oku kubandakanya:

• IAlabama
• IArizona
• IArkansas
• California
• Unxibelelwano
• IFlorida
• Jojiya
• IHawaii
• I-Illinois
• Indiana
• EKentucky
• ELouisiana
• Maine
• EMichigan
• Nguyen
• EMissouri
• ENew Hampshire
• Enew Jersey
• Inew York
• North Carolina
• IOhio
• IRhode Island
• EMzantsi Carolina
• ETennessee
• ETexas
• IVermont
• EWashington

Inani kunye nohlobo lwezicwangciso ezibonelelwa yi-WellCare kwezi meko zinokwahluka.

Zithini iiplani ze-WellCare Medicare Advantage?

Izicwangciso ze-WellCare Medicare eziluncedo zinokwahluka ngommandla nakwingingqi. Nangona kunjalo, uninzi lwezicwangciso zibonelela ngezi zibonelelo zilandelayo ukongeza kumacandelo e-Medicare A kunye no-B. Oku kubandakanya:

• ubulungu bokomelela ngonyaka
• Iinkonzo zamazinyo, kubandakanya ukukhusela kunye nokunyanga
• Ukukhutshwa kweziyobisi ngugqirha
• ukuthuthwa kutyelelo logqirha nakwiikhemesti
• iinkonzo zombono kunye noncedo lokuhlawulela iiglasi kunye neelensi zonxibelelwano

Xa uvavanya isicwangciso esithile, funda ngononophelo inkcazo yesicwangciso seenzuzo ukuze ubone iintlobo zeenkonzo ezongezelelweyo ezinikezelwa yi-WellCare.

Zingakanani iiplani ze-WellCare Medicare Advantage cost?

I-WellCare ibonelela ngezicwangciso ezithile ze-Medicare Advantage kwi- $ 0 premium. Kuya kufuneka uhlawule i-premium yakho ye-Medicare Part B inyanga nenyanga kwi-Medicare kodwa unokufumana iinkonzo ezongezelelweyo ngaphandle kwepremiyamu yenyanga evela kwi-WellCare. Nokuba yeyiphi na intlawulo oyibhatalayo, uya kuba nokutsalwa, ukukhutshwa kwemali, okanye ukuqinisekiswa kwemali kwiinkonzo, njengoko kumiselwe sisicwangciso sakho kunye neMedicare.

Oku kulandelayo yimizekelo yezicwangciso ze-WellCare Medicare Advantage ezikhoyo kwilizwe liphela kunye nento onokuyihlawula ngo-2021.

Izicwangciso ezikhoyo kunye neendleko ziyahluka unyaka nonyaka. Ukuba unesicwangciso esithile se-WellCare Medicare Advantage, esi sicwangciso siya kukwazisa ekwindla ngalo naluphi na utshintsho kwiindleko.

Yintoni i-Medicare Advantage (Medicare Part C)?

Uncedo lweMedicare (Icandelo C) sisicwangciso sempilo "esihlanganisiweyo" apho inkampani yeinshurensi yabucala inoxanduva lokubonelela ngomntu nge-Medicare. Icandelo le-Medicare Icandelo C lidla ngokubandakanya iCandelo A (ukhuseleko esibhedlele), iCandelo B (ukhuseleko), kunye neCandelo D (ukugubungela amayeza amayeza). Nangona kunjalo, ezinye izicwangciso ze-WellCare azigubungeli iCandelo D.

Xa uthenga isicwangciso se-Medicare Advantage, i-Medicare ihlawula inkampani yakho ye-inshurensi ukuba ikunike izibonelelo zempilo. Ukuhlala ukhuphisana, isicwangciso sakho seinshurensi sinokukunika izibonelelo ezongezelelweyo ezingafumanekiyo kwiMedicare yoqobo. Oku kubandakanya iinkonzo ezinje ngamazinyo, umbono, okanye ukugubungela ukuva.

Iinkampani ezibonelela ngeMedicare Advantage zihlala zisebenza kunye noogqirha kunye nezibhedlele ukuze baxoxe ngeendleko zeenkonzo zonyango. Ukuba ugqirha okanye isibhedlele siyavuma ukubonelela ngeenkonzo kwinqanaba elithile kwinkampani yeinshurensi, inkampani iya kuthi ibachonge njengomboneleli "othungelwano".

Izicwangciso ze-Medicare ze-Advantage zikarhulumente kunye nemimandla ethile ngenxa yendlela isicwangciso esithetha ngayo nezibhedlele kunye noogqirha kwindawo nganye. Ngenxa yoko, ayizizo zonke iintlobo zesicwangciso se-WellCare ezifumanekayo kuwo onke amazwe.

Ukuthatha

I-WellCare ibonelela ngeNzuzo ye-Medicare kunye ne-Medicare Icandelo D kwizicwangciso ezingama-27, ngezicwangciso ezahluka ngokwengingqi. Ezi zicwangciso zinokubandakanya ii-PPOs, ii-HMOs, kunye nee-PFFF, kwaye zinokukunceda ekulawuleni ukhathalelo lwempilo kunye neendleko zamachiza amiselweyo angakhankanywanga phantsi kweenkqubo eziqhelekileyo zeMedare.

Unokufumana ukuba i-WellCare ibonelela ngesicwangciso kwindawo yakho ngokukhangela kwi-Medicare ufumane isixhobo sesicwangciso.

Eli nqaku lahlaziywa ngo-Novemba 20, 2020 ukubonisa ulwazi lwango-2021 lonyango.

Ulwazi olukule webhusayithi lunokukunceda ekwenzeni izigqibo malunga neinshurensi, kodwa ayenzelwanga ukunika iingcebiso malunga nokuthengwa okanye ukusetyenziswa kwayo nayiphi na i-inshurensi okanye iimveliso zeinshurensi. I-Healthline Media ayihambelani neshishini leinshurensi nangayiphi na indlela kwaye ayinayo ilayisensi njengenkampani yeinshurensi okanye umvelisi kulo naliphi na igunya laseMelika. I-Healthline Media ayikhuthazi okanye ixhase nabani na onokuthi enze ishishini leinshurensi.