Izicwangciso zeMpilo
I-Ambetter inikezela ngeendlela ezintathu zokunakekelwa kwezempilo, i- Gold , iSiliva neBronze . Ukukhetha isicwangciso sobhedu kuya kukunika iintlawulo eziphantsi kweenyanga kodwa kuya kubiza ngaphezulu kwiindleko ze-pocket. Isicwangciso seGolide sihlawulela unonophelo lwakho kwindleko, kodwa siza neendleko eziphezulu ze-premium. Isicwangciso seSiliva sinikeza umlinganiselo phakathi kweendleko ze-premium zindleko kunye neendleko zephandle. Izibonelelo eziyimfuneko ezibalulekileyo zezempilo ezihlanganiswe zizicwangciso ziquka:
- IiNkonzo Eziphuthumayo:
- Bhedlele
- Izigulane okanye iiNkonzo ezixhasayo
- Ukunyamekela nokuKhathalela
- Ukunakekelwa koMama noNtsana
- IiNkonzo zeMatriki
- Iinkonzo ezahlukeneyo zonyango (u-Ex.
- Iziyobisi
- IiNkonzo zeLebhu
- IiMpilo zeMental kunye neNkonzo zoThatshulwa kweziyobisi
Ukubonelela ngokubonakalayo kwimbono kufumaneka ngezinye iiplani (ukukhutshwa kwabantwana kwimeko yokuhlolwa kweziliso, imiliselo yezilwanyana.
Unokukhangela iincwadana ngokukhetha iindlela ezahlukeneyo.
Kukho iindlela ezininzi ezahlukileyo ezikhoyo kuwe kwaye unokukhetha ukhetho olusezantsi kwinqanaba lehlwempu, iintlawulo ezichithwayo, iindleko ze-pocket, kunye nexabiso lemali. Umncedisi wencwadi uya kunceda ufumane umboneleli kwindawo yakho.
Nasi umzekelo weCwangciso soPhulo lweNqanaba leGold :
- IiNkonzo Eziphuthumayo: Akukho ntlawulo
- Ukuthutha ngokukhawulezileyo / i-Ambulance (uMoya okanye iGround): Akukho ntlawulo
- Unonophelo olukhawulezileyo: Akukho ntlawulo kubaboneleli bee-network
- Ukutyelela ngokufanelekileyo / ngonyaka / ukuhlolwa / ukugonywa / kakuhle umntwana: Akukho ntlawulo
- Ukunyamekela okuphambili kwipilisi okanye ukulimala kunye nokuhanjiswa kwabazali: Akukho ntlawulo
- Ukutyelela okhethekileyo (i-cardiology, i-podiatry, i-chiropractic): Akukho ntlawulo
- Ukucinga (CT / PET / MRI): Akukho ntlawulo
- X-ray (Ukuchonga / Ukufanekisa): Akukho ntlawulo
- Imali yoNcedo lweZifo: Akukho ntlawulo
- Isibhedlele esingenasifo sePhysical Services and Surgical Services: Akukho ntlawulo
- Ugqirha oPhezulu lweMpilo Ugqirha / IiNkonzo zokuPhepha: Akukho ntlawulo
- ILebhu yokuPhalalisa kunye neenkonzo zoBugcisa: Akukho ntlawulo
- Impilo yengqondo / yokuziphatha nempilo yokusetyenziswa kwezidakamizwa ezingaphandle kwezibonelelo: Akukho ntlawulo
- Ukuhlolwa kwesiso sokubuyiselwa (i-1 ukutyelelwa ngonyaka): i-100 yepesenti
- Iiglasi (iisakhelo 1 ngonyaka): iipesenti eziyi-100 zokukhawuleza
- IiLense (ngebini): iipesenti eziyi-100 zokunika ingxelo
- Imirhumo yesigqirha: Akukho mrhumo kwii-generics, ezikhethiweyo iziyobisi zonyango, izidakamizwa ezingezizo ezikhethiweyo okanye izidakamizwa ezikhethekileyo.
Izinzuzo zeLungu
- Inkqubo Yemivuzo: Unako ukufikelela kuma-$ 250 ngonyaka ukwenzela ukuthintela ukunyamekela.
- Umbuzo we-24/7 Umncedisi wamaNesi: Umongikazi obhalisiweyo uyatholakala 24/7 ukuphendula imibuzo kwaye unike iingcebiso zonyango.
- Ulawulo loKhathalelo: Le nkqubo yenkxaso yokunceda abo baneemeko zokuziphatha okanye izimo zonyango ezinzima.
- Iinkqubo zoLawulo lwezeMpilo: Inkxaso kubantu abanempilo engapheliyo
- Inkxaso yokukhulelwa kwabaseTyhini nabantwana: Ukuxhaswa ngokukhethekileyo koomama abakhulelweyo kunye neentsana.
- Ilayibrari yevidiyo IiVideos zifumaneka kwintlawulo yebhilikhi yokuzenzekelayo, apho uhamba khona ukunakekelwa, i-akhawunti ilungu elikhuselekileyo, iinkonzo zokunakekela ukhuseleko kunye nendlela yokufumana umboneleli wakho oyintloko.
Indlela yokuBhalisa
Ukuba unomdla wokubhalisa u-Ambetter, uza kuqala uhlinzeke ngolwazi oluyisiseko (ubungakanani bentsapho, ingeniso, njl.) Ukufumanisa ukuba zeziphi izicwangciso ezifanelekileyo kwaye ukuba unako ukufumana inkxaso-mali. Uya kuthi ke unikezwe uluhlu lwezinketho zesicwangciso. Emva kokuthelekisa unako ukubhalisela ukufikelela. Uya kufumana ipakethe evumelekileyo kunye nekhadi le-ID yomshuwalense kwi-imeyile.
Ukunikwa kwabaSebenzi boMthengi / iimpendulo
U-Ambetter unomlinganiselo we "B-" kunye neBusiness Business Bureau esekelwe kwizikhalazo zabaxumi ezingama-33 kunye nokuphononongwa kwabathengi aba-15. Ngokubanzi, u-Ambetter ufumene isilinganiselo seBBB esiyi-2.56 kwiinkwenkwezi ezi-5. I-Ambetter ayiyi-BBB evunyelweyo. Nangona iinkampani zingekho phantsi kwembopheleleko yokufuna ukuqinisekiswa kweBBB, ivumela abathengi ukuba babone indlela inkampani ilawula ngayo kwaye ixazulule izikhalazo zabathengi.
Kukho umxube wezinto ezilungileyo nokubi ukujonga ifom ye-intanethi ye-Ambetter. Ezinye izigulane zikhalaza ngenkampani inqaba iinkqubo ngaphandle kwengcaciso efanelekileyo. Ukuhlaziywa okulungileyo kubandakanya ukhetho lokukhokha kwi-intanethi kunye nenkonzo efanelekileyo yokuthengwa ngomnxeba.
Isishwankathelo
I-Ambetter esuka kwi-Care Coordinated ine-amava angama-30 anamava anikezela ngoncedo lwezempilo. Kukho izicwangciso ezininzi zokunceda ukukhetha ukuba ulungele naluphi na uhlahlo lwabiwo-mali kunye neemeko zonyango. Ukuze ufumane ezinye iinkcukacha malunga nezicwangciso zempilo ozifumanayo, unokutyelela iwebhusayithi ye-Ambetter okanye uqhagamshelane nommeli wenkampani ngo-1-877-687-1197 (TTY / TDD 1-877-941-9238).