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第一保健生活改善計劃(Life Improvement Plan)

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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: