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十大正规网赌软件在你的健康计划中吗?


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十大正规网赌软件及其诊所的合同
有二十多个健康计划.


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按此浏览计划一览表*

 

 

解开医疗保险迷宫

VMC's GoldenCare health and wellness program for seniors offers informative seminars to help you select your optimal Medicare plan and supplemental insurance.

Learn about GoldenCare's other valuable benefits and download an application

如果我们和你们的保险公司有合同的话, we will bill you after your insurance company has processed your claim. Our billing statement lists relevant charges and clearly notes any payments we received from your insurance company. 

如果你没有保险, you will need to make financial arrangements prior to receiving services at VMC; Please read about our 财政援助计划选择.

医疗保险受益人通知
To our Medicare population, please review your Medicare benefits carefully. You are responsible to know your Medicare benefits and non-covered services. 您将为任何未涵盖的服务承担经济责任. An example of a Medicare non-covered service would be any self-administered drugs provided to you during a hospital outpatient hospital visit. 如果你有医疗保险补充保险, VMC还将向他们提交所有服务的账单, 包括未支付的医疗保险费用. 如果没有药品保险, or the non-covered services are also denied by your supplemental Medicare plan, payment for those drugs will be your personal financial responsibility.

如需更完整的说明，请参阅传单， “医疗保险——我有保险吗??"

Pre-authorization

Some procedures may require pre-authorization from your insurance company or making other financial arrangements in advance. Please 审核预授权要求 并阅读我们的指南 为您在VMC的住宿做准备.

Billing

 

了解你在余额账单保护法下的权利

This notice applies to commercial plans (fully insured commercial, PEBB, SEBB and opted-in self-funded employer-sponsored) that are enrolled into the Balance Billing Protection Act (BBPA) for specific services.  The BBPA does not apply to Medicare or Medicaid, which have other protections for enrollees. To confirm this notice applies to your health plan please contact your insurance carrier.


Beginning January 1, 2020, Washington state law protects you from ‘surprise billing’ or ‘balance billing’ if you receive emergency care or are treated at an in-network hospital or outpatient surgical facility by an out-of-network provider.

What is ‘surprise billing’ or ‘balance billing’ and when does it happen?
Under your health plan, you’re responsible for certain cost-sharing amounts. 这包括共同付款、共同保险和免赔额. You may have additional costs or be responsible for the entire bill if you see a provider or go to a facility that is not in your plan’s provider network.

Some providers and facilities have not signed a contract with your insurer. 它们被称为“网络外”供应商或设施. They can bill you the difference between what your insurer pays and the amount the provider or facility bills. 这被称为“意外账单”或“余额账单”.’

保险公司必须告诉你, 通过他们的网站或应要求, which providers, 医院和设施都在他们的网络中. And hospitals, surgical facilities and providers must tell you which provider networks they participate in on their website or on request.

当您无法结清账单时:

Emergency Services
The most you can be billed for emergency services is your plan’s in-network cost-sharing amount even if you receive services at an out-of-network hospital in Washington, Oregon or Idaho or from an out-of- network provider that works at the hospital. The provider and facility cannot balance bill you for emergency services.

Certain services at an In-Network Hospital or Outpatient Surgical Facility
当你接受手术时, anesthesia, pathology, radiology, laboratory, or hospitalist services from an out-of-network provider while you are at an in-network hospital or outpatient surgical facility, 你最多可以收取的费用是你的网络费用分摊额. 这些供应商不能平衡账单.

In situations when balance billing is not allowed, the following protections also apply:

  • Your insurer will pay out-of-network providers and facilities directly. 您只负责支付您的网络内费用分摊.
  • Your insurer must:
    • Base your cost-sharing responsibility on what it would pay an in-network provider or facility in your area and show that amount in your explanation of benefits.
    • Count any amount you pay for emergency services or certain out-of-network services (described above) toward your deductible and out-of-pocket limit.
     
  • Your provider, hospital, or facility must refund any amount you overpay within 30 business days.
  • A provider, hospital, or outpatient surgical facility cannot ask you to limit or give up these rights.

如果您从网络外提供商接收服务, 在任何其他情况下的医院或设施, 您可能仍有结余账单, 或者你可能要为整个账单负责.

这项法律并不适用于所有的健康计划. If you get your health insurance from your employer, the law might not protect you. Be sure to check your plan documents or contact your insurer for more information.

如果你认为你被冤枉了， file a complaint with the Washington state Office of the Insurance Commissioner at www.insurance.wa.gov or call 1-800-562-6900.

Please see the column 医疗运营商网络 below to see if Valley is a participating provider with your network in regards to the Balance Billing Protection Act. 

Health Plan 医疗运营商网络 十大正规网赌软件呢
hospital participate?		 十大正规网赌软件呢
诊所网络参与?

 

6 Degrees Health   No - Not Contracted No - Not Contracted

 

Aetna Health (including First Health/Conventry, excluding Aetna Whole Health) Open Choice, Managed Choice, Elect Choice, Aetna Premier Care Network, Aexcel, all w & 无安泰管理药房网络 Yes Yes

 

Centivo 信诺PPO网络，恩布莱特网络 Yes
Yes

 

信诺(包括前Great West和One Health计划) WA ppa - ppa直连网络, WA OAP直接网络, WA PPO-PPA直接网络/国家药房网络, WA OAP直接w/国家药房网络, 信诺WA网络的LocalPlus, 西澳信诺本地Plus /国家药房网络 Yes Yes

 

信诺行为健康服务 EverNorth No No

 

DSHS-Medicaid-Apple健康   Yes Yes

 

仅限家庭计划   Covers only contraception services in clinic; excludes all other medical services; excludes infants. Covers only contraception services in clinic; excludes all other medical services; excludes infants.

 

(DSHS)医疗补助管理医疗计划
      Amerigroup    Yes Yes
      华盛顿社区健康计划   Yes No
      协调护理(百岁)   Yes Yes
      Molina Health Care   Yes Yes
      联合医疗社区
      Health Plan		   Yes Yes

 

Exchange Products
华盛顿的莫利纳医疗公司 Molina Choice, Constant Care and Core Care, Cascade Standard Yes Yes
Premera遗产签名 Preferred, Cascade Yes Yes
布里奇斯潘健康公司 青铜护理按需，青铜基本，青铜HDHP，级联 Yes Yes
United HealthCare 采购产品青铜价值，黄金价值，银优势，级联 Yes Yes
Regence Blue Shield Individual and Family Network, Cascade, Bronze Care on Demand, Bronze Essential, Gold 2000 Yes  Yes
Regence Blue Shield Cascade Care East Side健康网络 No No
太平洋来源(通过首选健康福利获得) Navigator, Cascade Yes Yes
社区健康网络 级联，级联选择 Yes 没有初级护理，有专科护理和转诊
协调护理(Ambetter) 级联选择，级联，清除，基本，安全 No No
凯撒基金会西北健康计划 级联，WA青铜，WA金，WA银 No No

 

联邦雇员:安泰健康, Alliance Health Plan, AWPU Health Plan, 蓝十字和蓝盾, GEHA Benefit Plan, Mail Handlers, and PacifiCare   Yes Yes

 

首选健康网络 首选健康网络 Yes Yes

 

凯撒基金会健康计划  获得PPO和联邦选择计划 Yes      Yes

 

凯撒基金会健康计划  Summit PPO Network Tier 2 Benefit Tier 2 Benefit

 

凯撒基金会健康计划 Core/HMO, Medicare Advantage, Elect PPO, Core Select and Connect/Virtual Plus No No

 

Labor & Industries   Yes Yes

 

March Vision   Yes Yes

 

Medicare   Yes Yes

 

医疗保险管理式医疗计划
      安泰医疗保险优惠   Yes Yes
      Amerigroup Medicare Advantage   Yes Yes
      人性化/荣誉/选择关怀
      PPO/HMO		 人类医疗保险，荣誉/选择护理/PPO/HMO, Optum护理网络 Yes Yes
      莫利纳医疗保险全面保险 Select; D-SNP Yes Yes
      莫利纳医疗保险选择保险   No No
      Premera Medicare Advantage   Yes Yes
      UnitedHealthcare医疗保险
      MedAdvantage		   Yes Yes
      医疗保险管理医疗计划Optum
      Care Network		   Yes Yes
      Regence Blue Advantage HMO   Yes Yes
      摄政医疗保险优势PPO   Yes Yes
      CHPW   Yes No
      PacificSource医疗保险   Yes Yes
      健保医疗保险HMO & PPO   Yes Yes

 

PEBB State of Washington & 其他市政当局及政府机构 Yes Yes

 

Premera Blue Cross Global, Heritage, 传统与牙科选择, Heritage Prime, Heritage Signature, 传统签名和牙科选择, Individual Signature,

人寿保险有限公司.，西澳首选生命健康计划		 Yes Yes

 

Premera Blue Cross      LifeWise初级护理，LifeWise级联护理 No No

 

私人医疗保健系统/多计划   Yes Yes

 

Regence Blue Shield 参与，优先考虑，个人 & Family Network, Real Value, UW Medicine AHN, High Performing Network (HPN) Yes Yes

 

SEBB 全州的学区 Yes Yes

 

Tricare   Yes Yes

 

Triwest   Yes Yes

 

Uniform Medical Plan   Yes Yes

 

联合保健/联合保健网络 包租、选择、选项、签名值、选择 Yes Yes

 

联合保健/联合保健网络      Navigate, Core Yes No


 *以上列出的合同健康计划可能会有变化.

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