Morero oa Medicare Advantage o fana ka WellCare ka 2021?

Litaba

• Morero oa likhetho tsa WellCare Medicare Advantage
• Meralo ea HMO ea WellCare
• Meralo ea WellCare PPO
• Merero ea litlhoko tse khethehileng tsa WellCare Medicare
• Merero ea WellCare ea Tefiso ea Botho ea Ts'ebeletso
• Ke linaha life tse fanang ka merero ea WellCare Medicare Advantage?
• Merero ea WellCare Medicare Advantage e koahela eng?
• Merero ea WellCare Medicare Advantage e bokae?
• Medicare Advantage (Medicare Part C) ke eng?
• Tsela

• WellCare e fana ka merero ea Medicare Advantage libakeng tse 27.
• WellCare e fana ka merero ea PPO, HMO, le PFFF Medicare Advantage.
• Merero e ikhethang eo u ka e fumanang e tla itšetleha ka hore na u lula hokae.
• WellCare e fumanoe ke Centene Corporation, e sebeletsang litho tse limilione tse 23 liprofinseng tsohle tse 50.

Merero ea WellCare Health ke mofani oa inshorense ea Tampa, Florida ea fanang ka Medicare Advantage (Karolo ea C) le Medicare Part D (moriana o fanoang ke ngaka) ba rerang ho bajalefa ba Medicare libakeng tse 'maloa.

Sengoliloeng sena se tla hlahloba mefuta e fapaneng ea meralo ea Medicare Advantage eo WellCare e fanang ka eona, hape e fane ka mehlala ea litšenyehelo tlasa meralo e fapaneng ea WellCare naheng ka bophara.

Morero oa likhetho tsa WellCare Medicare Advantage

Tse latelang ke mehlala ea mefuta ea merero ea Medicare Advantage e ka fumanehang sebakeng sa tšireletso sa motho. Merero hangata e khethehile haholo tikolohong, mme WellCare e kanna ea se fane ka mefuta eohle ea meralo sebakeng se itseng.

Meralo ea HMO ea WellCare

WellCare e fana ka merero ea Health Maintenance Organisation (HMO) e le karolo ea linyehelo tsa bona tsa Medicare Advantage. Ka tloaelo, moralo oa WellCare HMO o tla kenyelletsa ho khetha mofani oa tlhokomelo ea mantlha (PCP) ea tsamaisang tlhokomelo ea motho. Sena se bolela hore PCP e tla fetisetsa ho litsebi tsa tlhokomelo ea bophelo bo botle ba leng marang-rang bakeng sa WellCare.

Ha motho e le setho sa HMO, ba ka lefa litšenyehelo tse phahameng kapa tse felletseng haeba ba bona ngaka e kantle ho marang-rang.

Meralo ea WellCare PPO

WellCare e fana ka merero ea Mokhatlo oa Bafani ba Khethiloeng (PPO) libakeng tse kenyeletsang Florida, Georgia, New York le South Carolina. Mekhatlo ena e fana ka litefiso tse fokotsehileng bakeng sa ho khetha bafani ba inthanete, leha ho le joalo motho a ntse a ka fumana puseletso haeba a bona bafani ba kantle ho marang-rang.

Ka tloaelo, motho ha a na ho tlameha ho fumana phetisetso ho bona setsebi. Leha ho le joalo, ho kanna ha ba le maemo ao ho ona ho ka romelloang phetisetso kapa ho fumana tumello ea pele bakeng sa ts'ebetso, haholo haeba mofani oa thepa e le ea kantle ho marang-rang.

Merero ea litlhoko tse khethehileng tsa WellCare Medicare

Merero e khethehileng ea Litlhoko (SNPs) ke merero ea Medicare Advantage e etselitsoeng ba nang le boemo bo itseng ba bongaka kapa tlhoko ea lichelete.

Mona ke mefuta e fapaneng ea SNPS e fumanehang bakeng sa ba fihlelang litekanyetso:

• Moralo oa litlhoko tse khethehileng tsa maemo a sa foleng (C-SNPs): bakeng sa batho ba nang le maemo a sa foleng a bophelo bo botle
• Morero oa Litlhoko tsa Mekhoa e Ikhethileng ea Setheo (I-SNPs): bakeng sa batho ba lulang mahaeng a maqheku kapa litsing tsa tlhokomelo ea nako e telele
• Li-SNP tse Kopaneng tse Tšoanelehang (D-SNPs): bakeng sa bakuli ba tšoanelehang bakeng sa tšireletso ea Medicare le Medicaid

Merero ena ka 'ngoe e fana ka sepetlele se felletseng, litšebeletso tsa bongaka le ho fana ka litaba tsa ngaka empa li arotsoe ho latela bakuli bao ba ba sebeletsang.

Merero ea WellCare ea Tefiso ea Botho ea Ts'ebeletso

WellCare e fana ka merero ea poraefete ea tefiso ea tšebeletso (PFFS) libakeng tse khethiloeng tsa naha. Ona ke moralo o atisang ho fana ka sekhahla se behiloeng sa seo o tla se lefa lipetlele le lingaka bakeng sa litšebeletso, ka seteishene sa copay, kapa ts'ehetso ea lichelete, mong'a leano le eena o tla lefa.

Morero oa PFFS o kanna oa ba le marang-rang a mofani kapa motho a ka khona ho bona mofani ofe kapa ofe eo ba mo khethang. Mofani oa thepa o tlameha ho amohela kabelo ho tsoa ho Medicare kapa ho amohela lipehelo tsa moralo oa PFFS hore na o tla lefa eng.

Ke linaha life tse fanang ka merero ea WellCare Medicare Advantage?

WellCare e fana ka merero ea Medicare Advantage libakeng tse 'maloa. Tsena li kenyelletsa:

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

Palo le mofuta oa merero eo WellCare e fanang ka eona libakeng tsena e ka fapana.

Merero ea WellCare Medicare Advantage e koahela eng?

Merero ea WellCare Medicare Advantage e ka fapana ho ea ka libaka le libaka. Leha ho le joalo, merero e mengata e fana ka melemo e latelang ho kenyelletsa likarolo tsa Medicare A le B. Tsena li kenyelletsa:

• litho tsa selemo le selemo tsa boikoetliso
• Litšebeletso tsa meno, ho kenyeletsoa ts'ireletso ea kalafo le kalafo
• Ho koaheloa ke lithethefatsi
• lipalangoang ho etela ngaka le li-pharmacy
• lits'ebeletso tsa pono le ho thusa ho lefella likhalase le lilense tsa puisano

Ha u ntse u lekola moralo o itseng, bala ka hloko litlhaloso tsa moralo oa melemo e le hore u bone mefuta ea litšebeletso tse ling tse fanoang ke WellCare.

Merero ea WellCare Medicare Advantage e bokae?

WellCare e fana ka merero ea Medicare Advantage ka $ 0 premium. U ntse u tlameha ho lefa premium ea hau ea Medicare Part B khoeli le khoeli ho Medicare empa u ka fumana lits'ebeletso tse ling ntle le tefo ea khoeli le khoeli ho tsoa WellCare. Ho sa tsotelehe hore na o lefa bokae, o tla theoleloa chelete, likoloto, kapa ts'episo ea lichelete bakeng sa lits'ebeletso, joalo ka ha ho behiloe ke moralo oa hau le Medicare.

Tse latelang ke mehlala ea merero ea WellCare Medicare Advantage e fumanehang naheng ka bophara le seo u ka se lefang ka 2021.

Merero le litefiso tse fumanehang li ka fapana selemo le selemo. Haeba u na le moralo o itseng oa WellCare Medicare Advantage, moralo o tla u tsebisa nakong ea ho oa ha liphetoho tsa litšenyehelo.

Medicare Advantage (Medicare Part C) ke eng?

Medicare Advantage (Karolo C) ke "moralo" oa bophelo bo botle moo k'hamphani ea inshorense e ikemetseng e ikarabellang bakeng sa ho fana ka tšireletso ea motho ea Medicare. Medicare Karolo ea C hangata e kenyelletsa Karolo ea A (tšireletso ea sepetlele), Karolo ea B (tšireletso ea bongaka), le Karolo ea D (tšireletso ea lithethefatsi e fanoang ke ngaka). Leha ho le joalo, merero e meng ea WellCare ha e koahele Karolo ea D.

Ha u reka moralo oa Medicare Advantage, Medicare e lefa k'hamphani ea hau ea inshorense eo e ikhethelang ho u fa melemo ea bophelo bo botle. E le hore u lule u tlholisano, leano la hau la inshorense le ka u fa melemo e meng e sa fumaneheng ho Medicare ea mantlha. Tsena li kenyelletsa lits'ebeletso tse kang meno, pono, kapa tšireletso ea kutlo.

Likhamphani tse fanang ka Medicare Advantage hangata li etsa konteraka le lingaka le lipetlele ho buisana ka litšenyehelo tsa lits'ebeletso tsa bongaka. Haeba ngaka kapa sepetlele se lumela ho fana ka lits'ebeletso ka tekanyo e itseng le k'hamphani ea inshorense, hangata k'hamphani e tla ba khetha e le mofani oa "in-network".

Merero ea Medicare Advantage e maemong a mmuso le libaka ka ho khetheha ka lebaka la tsela eo leano le buisanang le lipetlele le lingaka sebakeng ka seng. Ka lebaka leo, ha se mefuta eohle ea merero ea WellCare e fumanehang libakeng tsohle.

Tsela

WellCare e fana ka merero ea Medicare Advantage le Medicare Part D libakeng tse 27, ka merero e fapaneng ka libaka. Merero ena e ka kenyelletsa li-PPO, li-HMO, le li-PFFF, 'me li ka u thusa ho laola litšebeletso tsa bophelo bo botle le litheko tsa meriana e sa koaeloang tlasa mananeo a tloaelehileng a Medicare.

U ka fumana hore na WellCare e fana ka moralo sebakeng sa heno ka ho batlisisa Medicare's fumana sesebelisoa sa moralo.

Sengoliloeng sena se ntlafalitsoe ka la 20 Pulungoana 2020 ho bonts'a tlhaiso-leseling ea 2021 ea Medicare.

Tlhahisoleseling e fumanehang webosaeteng ena e ka u thusa ho iketsetsa liqeto ka inshorense, empa ha ea etsetsoa ho fana ka likeletso mabapi le ho reka kapa ho sebelisa inshorense kapa lihlahisoa tsa inshorense. Healthline Media ha e sebetse khoebong ea inshorense ka tsela efe kapa efe ebile ha e na laesense ea ho ba k'hamphani ea inshorense kapa moetsi oa matla afe kapa afe a U.S. Healthline Media ha e khothaletse kapa ho ts'ehetsa batho ba boraro ba ka etsang khoebo ea inshorense.