第一保健生活改善計劃（Life Improvement Plan） (管理式保健計劃 雙重資格特殊需要計劃)
第一保健生活改善計劃（Healthfirst Life Improvement Plan）是一種老人醫療保險Medicare Advantage符合雙重資格的特殊需要計劃，為會員提供傳統老人醫療保險的福利，外加例如處方藥承保、OTC Plus卡、牙科、聽力、視覺、交通、SilverSneakers®健身計劃，以及每週七天、每天24小時透過電話或視頻獲得醫療護理服務及護士協助專線等福利。
此外，您無需轉介便可以看網絡內專科醫生。這個計劃專門針對擁有老人醫療保險（Medicare）及輔助計劃的人士提供。
生活改善計劃計劃重點
點擊此處查看計劃詳情
- OTC Plus卡用於自選藥物與用品（OTC $158/月）和與健康相關項目、健康食品、健身器材及活動追蹤器、助聽器定額手續費、個人緊急應變系統（PERS）以及家庭網路服務（2022計劃特色）
- 處方藥承保
- 綜合牙科（無上限）
- 聽力檢查及助聽器（一對助聽器，每隻耳朵高達$1,475/年）
- 視力檢查及眼鏡（$358補助/年）
- SilverSneakers®健身計劃
- 針灸（20次普通針灸+20次背部針灸）
- 免費交通接送看診（28次/年）
- （如住院2天或以上 出院後）可獲高達28天84次的送餐到家服務
2022 Enhancements
- $0 preferred generic drugs
- Enhanced member choice for OTC
- Simplified and enhanced eyewear benefit
- Reduced cost-sharing to improve hearing aid affordability
- Simplified prior-authorization criteria for comprehensive dental services
- No maximum benefit limit on worldwide emergent/ urgent care
Key benefit and cost-sharing changes
| Life Improvement Plan | 2021 | 2022 |
| Worldwide Emergency/Urgent Maximum Plan Benefit Coverage Limit | $100,000 | Unlimited |
| Supplemental Acupuncture | 30 visits every year | 20 visits every year |
| OTC Plus Card | $145/month = $1,740/yr No rollover Includes OTC healthy food & produce |
$158/month = $1,896/yr No rollover Includes OTC healthy foods, internet service, PERS, exercise equipment, fitness trackers, and cost-sharing for hearing aids |
| Health Education | $0 | Not covered |
| Supplemental Comprehensive Dental | Dentures, Root canals, crowns & extractions covered based on medical necessity | Medical necessity criteria removed for dentures, root canals, crowns and extractions |
| Prosthodontics, Other Oral/Maxillofacial Surgery/Other services | Implants covered | Implants no longer covered |
| Eye Wear | $0 1 every year Medically Necessary contact lenses OR Fashion Frames at $0 copay OR Designer Frames at $0 copay OR Premier Frames at $20 copay OR Non-Plan Frames: $175 benefit allowance OR Elective Contact Lenses: $175 benefit allowance(1 every year) |
$0 Copay for plan frames (fashion, designer or premier), $0 copay for single vision, bifocal, trifocal, standard anti-reflective coating or standard progressive lenses for glasses, $0 copay for medically necessary contact lenses OR $350 allowance for non-plan frames and elective contact lenses every year |
| Hearing Aids (all types) | $0 Plan covers up to $1,000 max ($500 per ear) every 3 years |
Copays per aid by technology level: Entry $0 Basic $50 Prime $75 Preferred $500 Advanced $1075 Premium $1475 Plan covers 2 aids every year |
更多關於“第一保健生活改善計劃”的詳細資訊可查閱以下鏈接：
