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UHC Important CSNP Consumer FYI

It is very important for consumers enrolling in a CSNP to know the following about accessing providers: Some CSNPs are Preferred Provider Organization (PPO) or Point of Service (POS) Plans that allow members to see out-of-network providers for covered services, generally with higher cost sharing.   Mrs. Walters is entitled to Part A and has … Read more

UHC-Event-Sam

On October 1, Sam reported the formal marketing/sales event he has scheduled for 9 a.m. on November 19. Luckily, before he had flyers printed, he remembered he has an 8 a.m. dentist appointment November 19. Just to make sure he can get to his event on time, he advertises the event to start at 9:30 … Read more

UHC Health Assessment

How is a CSNP or DSNP member’s care management health risk levels determined initially? The member completes a Health Assessment that asks a series of questions about their health status and assistance they may need with activities of daily living.   Mrs. Lyons is in good health, uses a single prescription, and lives independently in … Read more

UHC-DSNP-Lose

When does the Special Election Period for Dual/LIS Change in Status begin for DSNP members that lose Medicaid eligibility? Six months after they have been disenrolled from the DSNP   Mrs. Walters is entitled to Part A and has medical coverage without drug coverage through an employer retiree plan. She is not enrolled in Part … Read more

UHC – Sales Event What type of event must an agent conduct when she wants to be able to collect consumer information, schedule future appointments, and accept enrollment applications?

What type of event must an agent conduct when she wants to be able to collect consumer information, schedule future appointments, and accept enrollment applications? Marketing/sales event Mr. Block is currently enrolled in a Medicare Advantage plan that includes drug coverage. He found a stand-alone Medicare prescription drug plan in his area that offers better … Read more

MA (Part C) Plans are health plan options approved by Medicare and offered by private insurance companies.

Which of the following consumers would be eligible for Medicare? Consumers age 65 or older, consumers under 65 years of age with certain disabilities for more than 24 months and consumers of all ages with ESRD or ALS Which of the following defines a Medicare Advantage (MA) Plan? MA Plans are health plan options approved … Read more

什麼是美國公共負擔?

  特朗普4日簽署公告,要求申請美國簽證的移民必須證明足以負擔醫療照護費用,或「得到批准的」醫療保險,否則可能遭拒絕入境。 白宮4日宣布,新規定11月3日生效,針對新申請者,不溯及既往,不影響持有綠卡的永久居民,也不適用尋求庇護的難民或兒童。 不過,這項規定適用美國公民的配偶及雙親,可能影響試圖讓家屬依親的美國居民。 限制移民 白宮再推一項公共政策 「點看」紅藍卡F計劃與C部分的對比 這項公告指出,移民將被禁止入境,除非他們能負擔入境30天內的醫療保險,或在成為永久居民後,仍有充足資金來源支付任何醫療費用。 川普政府試圖改變對家庭友善的移民政策,轉為基於價值的體系,此公告成為限制移民的另一項公共政策。 華府當局今年初迅速改變規範,撤銷利用公共福利移民的綠卡資格;白宮指示官員恢復以收入為基礎的福利方案,提案要求審查申請公共住宅補貼之移民的身分。 23%合法非老年移民 可能沒有保險 官員引述非營利公衛政策智庫「凱瑟家庭基金會」(Kaiser Family Foundation)的報告指出,在非老年人口中,23%合法移民可能沒有保險,而8%美國公民無保險。 必要保險可由個人購買或由雇主提供,可為短期或針對災難;醫療補助計畫(Medicaid)不算,但移民若在買保險時使用聯邦政府埋單的「可負擔健保」(ACA)的補貼,則無法取得簽證。 太多非公民 濫用「慷慨公共健康計畫」 凱瑟家庭基金會的健康照護執行副總裁李維特(Larry Leavitt)推文寫道,「合法移民縱然適用ACA補助,卻礙於文告規範左右為難。」 白宮表示,太多非公民濫用「慷慨公共健康計畫」,造成「無法補償的健康照護負擔」。 「點看」紅藍卡自費陷阱!哪些項目是紅藍卡不包的呢? 無黨派智庫「移民政策研究所」(Migration Policy Institute) 表示,57%移民自2017年起有私人健保,美國人的比率則為69%;與此同期,30%移民為公衛保險被保人,而美國人僅36%。 移民政策研究所指出,ACA上路後,移民的未保險比率從2013年的32%降至2017年的20%。 移民公司:此禁令無恥地令人驚駭 每年約有110萬人取得綠卡;在前總統歐巴馬任內協助施行H-4工作許可,之後共同創辦協助家庭移民科技公司「無限移民」(Boundless Immigration)的藍德(Doug Rand)形容,「此移民禁令無恥地令人驚駭,混亂實施,保證會拆散公民和他們的合法移民配偶等近親。」 公共負擔新規 (白卡/半白卡轉換身份?) 2020:2月24日起實施 美國公民及移民服務局(USCIS)30日晚宣布,全美除了伊利諾州外,將於2月24日起執行「基於公共負擔理由不予受理的最終規則」(Inadmissibility on Public Charge Grounds final rule);USCIS會根據新規對綠卡申請者的年齡、健康情況、收入、教育和技能等因素進行審查,來判斷其未來是否會成為「公共負擔」,以決定是否通過綠卡申請。 「點看」紅藍卡的承保內容、費用和重點? USCIS指出,該最終規則不僅適用於判斷綠卡申請者未來是否會成為公共負擔,也適用於身分轉換申請者;若想延期或轉換非移民身分,要證明自己自獲得非移民身分起未接收過公共福利。 伊利諾州「移難民權益聯盟」(ICIRR) 向芝加哥聯邦法庭提告,要求禁止新法在伊州執行,去年10月獲法院判決勝訴,聯邦法庭1月30日仍做出維持此前否決「公共負擔」新規的決定,暫時免除在外。 除伊州外,USCIS將對在2月24日後申請的移民執行最終規則,日期以紙質遞件UPS、FedEx和DHL的郵戳日期為準,電子件以及寄送日期為準。 USCIS代理局長古辛納利(Ken Cuccinelli)表示,「自給自足」是美國價值觀的核心,也是百年來移民法的重要組成部分,通過要求試圖留在美國的移民依靠自己的資源、家庭和社區,USCIS鼓勵自給自足,促進移民獲得成功,同時也保護美國納稅人   公共負擔新規何時生效? 公共負擔新規從2020年2月24日開始實施。 什麼是美國公共負擔? 這個所謂 “公共負擔規則” 在美國移民法律已經存在很久了。現在,這個公共負擔規說某些人不是美國公民, … Read more