第一保健增進福利計劃（Increased Benefits Plan）(管理式保健計劃)
第一保健增進福利計劃(Increased Benefits Plan)除了提供傳統老人醫療保險的福利之外，還另外提供廣泛的福利，包括預防性與全面的牙科、聽覺承保與助聽器、視覺承保、眼鏡或隱形眼鏡、針灸、常規交通、非處方藥(OTC)用款額度、出院後的餐食、SilversSneakers®健身計劃，以及每週七天每天24小時獲取Teladoc(遠程醫療)護理和使用護士協助專線服務。
如果您符合全額額外補助(Extra Help)，又稱為低收入補貼(Low Income Subsidy))與/或老人醫療保險保費減免計劃(Medicare Savings Program，簡稱MSP)的資格，本計劃可能最適合您。如果您符合全額低收入補貼﹐您將符合條件享受$0的每月保費﹐配藥無需支付自付扣除金﹐並且享受較低的處方配藥定額手續費。
您怎樣才能符合資格參加此項計劃？
您享有老人醫療保險A部份與老人醫療保險 B部份
您住在紐約市，或住在拿索郡、羅克蘭、威徹斯特郡、橘郡或沙利文郡
您是美國公民或合法在美國居留者
增進福利計劃計劃重點
點擊此處查看計劃詳情
- 低價或沒有Copay的處方藥
- 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（$200/年）
- 可購買非處方項目的自選藥物與用品（OTC $20/月）福利金
- 免費交通接送看診（40次/年）
- 針灸
- （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
- Coverage for prescription vitamins and $0 for preferred generics
- Simplified eyewear, dental, and hearing benefits
- Reduced specialist copay to $30 (from $40)
- Expanded coverage for worldwide emergent/ urgent care to $200k (from $100k)
- Increased OTC allowance to $20/mo (from $15/mo)
Key benefit and cost-sharing changes
| Increased Benefits Plan | 2021 | 2022 |
| SNF (Skilled Nursing Facility) | $184 each day for days 21-100 | $188 each day for days 21-100 |
| Worldwide Emergency/Urgent Coverage | Worldwide transportation: $225 | Worldwide transportation: $250 |
| Worldwide Emergency/Urgent Maximum Plan Benefit Coverage Limit | Yes $100,000 |
Yes $200,000 |
| Physician Specialist | $40 | $30 |
| Retail Health Clinic | $10 | $10 |
| Medicare Covered X-rays | $15 Separate office visit copay applies |
$25 Separate office visit copay applies |
| Outpatient Diagnostic Radiology Services | $50 Separate office visit copay applies |
$60 Separate office visit copay applies |
| Ground Ambulance | $225 | $250 |
| Air Ambulance | $225 | $250 |
| Supplemental Acupuncture | $0 15 visits every year |
$0 12 visits every year |
| Over the Counter Items | $15/month = $180/year No Rollover | $20/month = $240/year No Rollover |
| 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 |
| Medicare Covered Eye Exams | $40 | $30 |
| Eye Wear | $0 1 every year Medically necessary contact lenses OR Fashion Frames: $0 copay OR Designer Frames: $0 copay OR Premier Frames: $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 lenses for glasses, $0 copay for medically necessary contact lenses OR $200 allowance for non-plan frames and elective contact lenses every year |
| Medicare-Covered Hearing Exams | $40 | $30 |
| Hearing Aids (all types) | $0 Plan covers up to $1000 max ($500 per ear) every 3 years |
Copays per aid by technology level: Entry $0 Basic $175 Prime $475 Preferred $775 Advanced $1075 Premium $1475 Plan covers 2 hearing aids every year |
更多關於“第一保健增進福利計劃”的詳細資訊可查閱以下鏈接：
https://zh.healthfirst.org/increased-benefits-plan/#2022
