Received 2022 humana Annual Notice of Changes

quite surprised that usa news declared SSA, medicare funds shorter and shorter but medicare provider can reduce patients copay such as: Maximum out-of-pocket amount from $2650 down to $2600; in network Specialist visits:$25 down to $20 (included Medicare-covered Vision and dental care)

but Ambulance services from $200 jump to $220; nuclear medicine services at a freestanding radiology facility from $100 jump to $120; Once your total drug costs have reached $4,130 jump to $4430, you will move to the next stage (the Coverage Gap Stage)

As for Medical vision benefits: Refractions not covered same as 2022,

Routine vision benefits: Routine vision includes an eye exam with vision exam changes to Refraction is only covered when billed as part of the routine exam ps NOTE: Eye refractions will not be covered if billed separate from a routine vision exam

--this is the most confused that primary doctor,eye clinic office and insurance company always told no extra charge but copay. it turned out patient is forced to pay Refraction fee. do i understand the clinic billed with Medical vision benefits or Routine vision benefits with part of the routine exam or separate from a routine vision exam? NO. if disputed with insurance company they would tell us the clinic used different code they can't help. this year is the 1st time we were told eye clinic should bill humana and eyemed(for refraction) separately. the eye clinic office is the only one appologied and corrected it. many years spouse can't but pay whatever  clinic Refraction charged until can't endure and for last 5? years won't visit eye doctor at all.

ps spouse fell downhe paied $600 plus  $200 for ambulence; vision routine examined details:

...........................VISION routine examined

Provider    HUMANA VISION EYEMED  Date of service    Jul xx, 2021
Total billed charges     $138.00
Plan exclusion Help    $99.00
Applied to deductible    $0.00  Copay    $0.00 ps already paied $25
Service code Help    S0620
..........................ambulance

Description     Total billed charges     Amount Humana paid     Your share     Payment status
Level 1 emergency ambulance transport-advanced life support     $1,850.00     $270.02     $200.00     Paid

Service date    Apr xx, 2021    Service code Help    A0427
Plan exclusion    $1,379.98   Deductible    $0.00  Copay    $200.00
Message THIS AMOUNT BILLED EXCEEDS NORMAL AMOUNT OF CHARGES FOR THIS TYPE OF SERVICE. YOU ARE NOT RESPONSIBLE FOR EXCESS CHARGES.
Ground mileage, per statute mile     $72.00     $36.62     $0.00     Paid

Service date    Apr xx, 2021    Service code Help    A0425
Plan exclusion    $35.38  Deductible    $0.00   Copay    $0.00
Message THIS AMOUNT BILLED EXCEEDS NORMAL AMOUNT OF CHARGES FOR THIS TYPE OF SERVICE. YOU ARE NOT RESPONSIBLE FOR EXCESS CHARGES.

ps from home to hospital about 3.8 miles by googlemaps, spouse waked up before ambulence arrived

ps in usa when innoncent people were beaten/hurt on the street who dont have insurance would turn down to visit hospital because you can see just ambulence cost $1,850.00 for 3.8 miles. And emergency room any service is very expensive which you cant turn down, spouse 4/19-4/23 charges $78,799.34 because it is medicare so 1st time we ended to pay $200 and $600.
the good thing about medicare is patient is NOT RESPONSIBLE FOR EXCESS CHARGES. and paid A NEGOTIATED RATE which is the 1st time happened to spouse. all the years we are forced to pay whatever charged especially some services are not covered by insurance due to hospital/clinic billed code not in insurance companies listing.................................hospital  from 4/19 in, 4/23 discharged
Total billed charges    $78,799.34
Amount Humana paid Help    $6,016.34   Your share Help    $600.00
Applied to deductible    $0.00   Copay    $600.00

Claim details
Description     Total billed charges     Amount Humana paid     Your share     Payment status
    $21,600.00     $6,016.34     $600.00     Paid

Service date    Apr xx, 2021  
Service code Help  NONE  Deductible    $0.00   Copay    $600.00
Message PAID ACCORDING TO A NEGOTIATED RATE WITH THE PROVIDER'S NETWORK.

(rest of items charged as NEGOTIATED RATE WITH THE PROVIDER'S NETWORK with no code number)
    $1,428.34     $0.00     $0.00     Paid
    $183.00     $0.00     $0.00     Paid
    $1,763.00     $0.00     $0.00     Paid
    $219.00     $0.00     $0.00     Paid
    $128.00     $0.00     $0.00     Paid
    $749.00     $0.00     $0.00     Paid
    $8,665.00     $0.00     $0.00     Paid
    $748.00     $0.00     $0.00     Paid
    $1,210.00     $0.00     $0.00     Paid
    $3,306.00     $0.00     $0.00     Paid
    $3,257.00     $0.00     $0.00     Paid
    $3,356.00     $0.00     $0.00     Paid
    $596.00     $0.00     $0.00     Paid
    $500.00     $0.00     $0.00     Paid
    $596.00     $0.00     $0.00     Paid
    $1,873.00     $0.00     $0.00     Paid
    $1,126.00     $0.00     $0.00     Paid
    $4,725.00     $0.00     $0.00     Paid
    $2,203.00     $0.00     $0.00     Paid
    $4,559.00     $0.00     $0.00     Paid
    $5,782.00     $0.00     $0.00     Paid
    $9,263.00     $0.00     $0.00     Paid
    $964.00     $0.00     $0.00     Paid

ps all copay are not counted as deductible (ie out of pocket).

ps spouse 晕过去 in hospital twice when he went to pea and returned bed, another one during he did LAB test when a liquid medicine added(?). we also noticed the measure blood pressure tool on bed was malfunction andhospital suspect daily medicines he took has side effect so didn't give spouse high blood pressure medicine on 4/19 (not sure 4/20)

ps after discharged spouse got in-home physical theorpy to help walking that he got balance problem in hospital. it's no charge(4/25 to 6/1 total 6? visited)

ps 10/1/2021 colonscopy medicines now became counter top medicines ie patient pays 100% for mag citrate dye free LMN 10oz$3.79, Mirax 14 day 8.3oz $16.99, xxx $1.5(?)