Qorshayaasha Faa'iidada Macaashka ee 'Blue Cross Medicare' sanadka 2021

Qanacsan

• Waa maxay qorshooyinka Faa'iidada Macaashka ee 'Blue Cross Medicare'?
• Qorshooyinka HMO ee Faa'iidada Blue Cross
• Qorshayaasha PPO ee 'Blue Cross Medicare Advantage'
• Qorshayaasha dawada dhakhtarku qoro ee Blue Cross Medicare
• Qorshooyinka 'PFFS' ee 'Blue Cross Medicare Advantage'
• Blue Cross Medicare SNP-yada
• Waa imisa qiimaha qorshooyinka Faa'iidada Bukaan-socodka ee Blue Cross?
• Waa maxay Medicare Advantage (Medicare Qaybta C)?
• Qaadashada

• Blue Cross waxay bixisaa noocyo kala duwan oo ah Medicare Advantage qorshayaal iyo noocyo inta badan gobolada dalka Mareykanka.
• Qorshayaal badan waxaa ka mid ah caymiska dawada dhakhtarku qoro, ama waxaad iibsan kartaa qorshe Qaybta D kale ah.
• Qaar badan oo ka mid ah qorshooyinka Faa'iidada Daryeelka ee 'Blue Cross Medicare' ayaa bixiya $ 0 khidmadaha bilaha ah oo ay weheliso caymiska dawada ee la qoro

Faa'iidada Medicare waa beddelka Medicare-ka asalka ah halkaasoo shirkad caymis caafimaad oo gaar loo leeyahay ay ku siiso waxtarkaaga Medicare, oo lagu daro faa'iidooyinka kale ee asalka ah ee Medicare dhaqan ahaan ma bixiso. Tusaalooyinka waxaa ka mid ah aragga, ilkaha, iyo adeegyada caafimaadka ka hortagga ah. Blue Cross Blue Shield waa mid ka mid ah shirkadahaas.

Maqaalkani wuxuu ku siinayaa fiirinta qorshooyinka Faa'iidada Faa'iidada ee Blue Cross ee laga heli karo Maraykanka.

Waa maxay qorshooyinka Faa'iidada Macaashka ee 'Blue Cross Medicare'?

Blue Cross waxay bixisaa qorshayaal Medicare Advantage kala duwan. Helitaankoodu wuu ku kala duwanaan karaa gobol iyo gobol.

Aynu dib u eegno noocyada kala duwan ee qorshooyinka Faa'iidada tMedicare ee Blue Cross ay bixiso.

Qorshooyinka HMO ee Faa'iidada Blue Cross

Blue Cross waxay bixisaa qorshayaal Ururka Dayactirka Caafimaadka (HMO) qorshayaal dhowr gobol ah, oo ay kujiraan Arizona, California, Florida, Massachusetts, iyo kuwa kaloo badan. Noocan qorshahan ah, waxaad kuheli lahayd adeeg bixiye daryeel aasaasi ah oo kujira shabakadda (PCP).

Haddii aad u baahato daryeel gaar ah, waxaad marka hore arki laheyd takhtarkaaga (PCP), kadib waxay ku siin doonaan gudbin si aad ugu tagto takhasusle. Qorshahaaga caymiska marka hore waa inuu oggolaadaa gudbinta takhtarka takhasuska leh.

Marka laga reebo Blue Cross ayaa ah in dumarka badankood aysan u baahnaan doonin gudbin si ay u arkaan shabakad isku xirta OB / GYN oo loogu talagalay daryeelka dumarka ee joogtada ah, sida Pap smear.

Qorshayaasha PPO ee 'Blue Cross Medicare Advantage'

Blue Cross waxay bixisaa qorshayaal bixiyaha la doorbiday (PPO) qorshayaal ka socda gobolada oo ay kujiraan Alabama, Florida, Hawaii, iyo Montana (inyar uun magacow). Sida caadiga ah, PPO wuxuu yeelan doonaa qiimo kayar kan HMO. Tani waa sababta oo ah badanaa uma baahnid inaad hesho tixraac si aad u aragto takhasusle markaad leedahay PPO.

Si kastaba ha noqotee, waad badbaadin kartaa lacag adoo ka dooranaya bixiyeyaasha shabakadda liiska bixiyaha shirkadda caymiska. Waad bixin kartaa wax intaa ka badan haddii aad doorato bixiye ka baxsan shabakadda.

Qorshayaasha dawada dhakhtarku qoro ee Blue Cross Medicare

Qorshayaasha Medicare Qaybta D waxay daboolayaan daawooyinka laguu qoray. Qaar ka mid ah qorshayaasha Medicare Advantage iyada oo loo marayo Blue Cross ayaa bixiya caymiska dawada ee la qoro. Si kastaba ha noqotee, haddii qorshuhu uusan bixinaynin caymis, waxaad dooran kartaa qorshe dawooyin dhakhtar qoro oo keli ah.

Blue Cross waxay bixisaa qorshayaal "aasaasi ah" iyo "la xoojiyay" oo ku saabsan qeybta daawada laguu qoro iyo sidoo kale Standard, Plus, Enhanced, Preferred, Premium, Select, iyo fursado badan oo ku saabsan siyaasada daawada laguu qoro Mid waliba wuxuu soo bandhigi doonaa liiska, ama liiska daawooyinka qorshuhu daboolayo iyo kharashyada kala duwan. Waad hubin kartaa liisaskan ama qaacidooyinka si aad u hubiso in qorshe kasta oo aad tixgeliso ay ku jiraan dawooyinka aad qaadato.

Qorshooyinka 'PFFS' ee 'Blue Cross Medicare Advantage'

Khidmadda Adeegga Gaarka ah ee Adeegga (PFFS) waa qorshe Faa'iido Medicare oo Blue Cross ay ku bixiso Arkansas oo keliya. Nooca qorshahan uma baahnid inaad isticmaasho takhtarka PCP gaar ah, bixiyeyaasha shabakadda, ama aad hesho tixraacyo. Taabadalkeed, qorshuhu wuxuu dejiyaa inta ay dib u bixinayso dhakhtar adiguna waxaad mas'uul ka tahay bixinta inta ka hartay magdhowga bixiyaha.

Mararka qaarkood, bixiyeyaashu waxay qandaraas la geli doonaan qorshaha PFFS si ay u bixiyaan adeegyo. Si ka duwan qorshayaasha kale ee Medicare, bixiyaha qorshaha PFFS maahan inuu ku siiyo adeegyo sababtoo ah waxay aqbalaan Medicare. Iyaga ayaa dooran kara haddii ay adeeg ku bixinayaan heerka lacag-celinta Medicare iyo in kale.

Blue Cross Medicare SNP-yada

Qorshaha Baahiyaha Gaarka ah (SNP) waa qorshaha Faa'iidada Medicare ee loogu talagalay kuwa qaba xaalad ama dabeecad gaar ah. Fikrad ahaan, qorshuhu wuxuu bixiyaa dhinacyo badan oo daboolis ah oo qofku u baahan karo. Medicare waxay ubaahantahay in dhamaan SNPs ay bixiyaan caymiska dawada dhakhtarku qoro.

Tusaalooyinka Blue Cross SNPs waxaa ka mid ah:

• Waa imisa qiimaha qorshooyinka Faa'iidada Bukaan-socodka ee Blue Cross?

  Suuqa Medicare Advantage waa mid si isa soo taraysa u tartamaya. Haddii aad ku nooshahay magaalo-weynta weyn, waxaa jiri kara tobannaan qorshooyin oo aad kala dooran karto.

  Tusaalooyinka soo socda ayaa ah qaar ka mid ah qorshooyinka Faa'iidada Macaashka ee 'Blue Cross Medicare' ee meelo kala duwan leh bil kasta iyo khidmadahooda kale. Qorshayaashani kuma jiraan kharashka biilkaaga billaha ah ee Qaybta B.

  Magaalada / qorshaha	Qiimeynta Xiddigaha	Lacagta billaha ah	Caafimaadka laga jari karo, daroogada laga jari karo	In-network-ka jeebka jeebka max	Lacag bixinta PCP booqashokiiba	Kharashka takhasuska gaarka ah booqashokiiba
  Los Angeles, CA: Heesta MediBlue StartSmart Plus (HMO)	3.5	$0	$0, $0	$3,000	$5	$0–$20
  Phoenix, AZ: Qorshaha BluePathway 1 (HMO)	Lama heli karo	$0	$0, $0	$2,900	$0	$20
  Cleveland, OH: Astaanta MediBlue Access Core (Regional PPO)	3.5	$0 (kuma jiraan caymiska dawada)	$ 0, kuma jiraan	$4,900	$0	$30
  Houston, TX: Blue Cross Medicare Faa'iidada Aasaasiga ah (HMO)	3	$0	$0, $0	$3,400	$0	$30
  Trenton, NJ: Horizon Medicare Faa'iidada Buluuga (HMO)	4	$31	$0, $250	$6,700	$10	$25

  Kuwani waa tusaalooyin yar oo ka mid ah qorshooyinka Faa'iidada Blue Cross ee laga heli karo bogga raadiyaha qorshaha Medicare.gov. Waxaa jiri kara ikhtiyaarro kale oo badan aagga summada ZIP-ka.

  Waa maxay Medicare Advantage (Medicare Qaybta C)?

  Haysashada Faa'iidada Medicare (Qaybta C) macnaheedu waa in shirkadda caymiska ee bixisa qorshahaaga ay bixin doonto caymiska Medicare Qaybta A (caymiska isbitaalka), Medicare Qaybta B (caymiska caafimaadka). Qorshayaasha qaarkood ayaa sidoo kale bixiya caymiska daawada laguu qoro. Qorshayaasha Medicare Advantage waxay ku kala duwan yihiin kharashyada jeebkooda iyo caynsanaantooda, oo ay ku jiraan lacag-bixinta iyo lacag-bixinta.

  Wakhtiyada kama dambaysta ah ee isqorista ama beddelka qorshahaaga Faa'iidada Medicare

  Kuwa soo socdaa waa taariikhaha muhiimka ah ee isqorista ama beddelka qorshahaaga Faa'idada Medicare:

  • Mudada isdiiwaangalinta hore. 3da bilood ee ugu horeeya kahor dhalashadaada 65aad, bisha dhalashadaada, iyo 3 bilood kadib dhalashadaada 65aad.
  • Muddada isqorista furan. Oktoobar 15 illaa Diseembar 7 waa xilliga diiwaangelinta furan ee Macaashka Medicare. Qorshayaal cusub ayaa dhaqan galaya 1-da Janaayo.
  • Diiwaangelinta furan ee Medicare Advantage Inta lagu jiro muddadan, qofku wuxuu u wareegi karaa qorshe kale oo ah 'Medicare Advantage' haddii uu hore u lahaa Medicare Advantage.
  • Muddada isqorista gaarka ah ee Medicare Advantage. Waqtiga waqtiga aad ku beddeli karto qorshahaaga Faa'iidada duruuf gaar ah sida dhaqaaq ama qorshe lagu tuuray aaggaaga.

  Qaadashada

  Blue Cross waa mid ka mid ah dhowr shirkado caymis oo bixiya qorshayaasha Faa'iidada Medicare. Waxaad ka heli kartaa qorshooyinka la heli karo adoo ka baaraya suuqa Medicare.gov ama bogga internetka ee loo yaqaan 'Blue Cross'. Maskaxda ku hay taariikhaha muhiimka ah markaad go aansaneysid goorta laqoroo qorshaha Medicare Advantage.

  Maqaalkani waxaa la cusbooneysiiyay Nofeembar 19, 2020, si loo muujiyo macluumaadka 2021 ee Medicare.

  

  Macluumaadka ku jira websaydhkan ayaa kaa caawin kara inaad go'aanno shaqsiyeed ka gaarto caymiska, laakiin looguma talagalin inay bixiso talo ku saabsan soo iibsiga ama adeegsiga wixii caymis ama alaab caymis ah. Healthline Media kama wareejiso ganacsiga caymiska si kasta oo aan loo sharciyeynin shirkad caymis ama soo saare sharci kasta oo Mareykan ah. Healthline Media ma kugula talinayso ama taageereyso dhinac saddexaad oo badali kara ganacsiga caymiska.