Plans should set up the services and providers you need to keep you healthy. Data analysis demonstrates that there is a significant difference in the psychological profiles of drug users and non-users and the psychological predisposition to using different drugs may be . The health professionals in these networks have agreed to always treat any patient who is enrolled in the plan, even if they've never seen him before. Hi.. Enter your email to sign up. Here's a quick look at the four most common types of Medicare Advantage Plans. Your guide to Medicare medical savings account (MSA) plans. (n.d.). Also called Medicare Part C, these plans are most commonly available as Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Private Fee-for-Service (PFFS), or Special Needs Plans (SNP). The list of companies participating are subject to change. Outside of when you first become eligible to enroll, and election periods that happen annually, your opportunities to make changes to your health coverage may be limited. Rates can vary across carriers and the state you live in. The company's name was taken from Shakespeare, whose wise fools both instructed and amused, and could speak the truth to the king -- without getting their heads lopped off. What are the top 3 Medicare Advantage plans? 1-877-517-4661 TTY user 711 Mon-Fri : 8am-8pm EST Sat: 10am - 7pm EST Four Main Types of Medicare Advantage Plans in Nevada are: HMOs - Health Maintenance Organization PPOs - Preferred Provider Organization PFFS - Private Fee-for-Service SNPs - Special Needs Plans Special Needs Plans restrict enrollment to individuals with specific diseases or disabilities. Now, youll enjoy a streamlined experience created specifically for healthcare providers. This can be frustrating for providers who want to skip ahead to a more expensive, potentially more effective, treatment but are stopped from doing it by the insurance company. That cap is just for Part A and Part B services; drug costs arent included in that maximum (after Medicare beneficiaries spend $7,050 out of pocket on medications in 2022, theyre only responsible for 5% of medication costs). Personality theories of addiction are psychological models that associate personality traits or modes of thinking (i.e., affective states) with an individual's proclivity for developing an addiction. SilverSneakers fitness memberships Types of Medicare Advantage plans There are different types of Medicare Advantage plans to choose from, including: Health Maintenance Organization (HMO).. Medicare Advantage Special Needs Plans (SNPs) Medicare Advantage SNPs may take the form of an HMO, POS, or PPO. Like HMOs, PPOs have a network of healthcare providers. It's the simplest, most basic form of Medicare and is made up of two parts: Part A covers hospital costs, and Part B covers outpatient medical services, including doctor visits. What are the 4 types of Medicare Advantage Plans? The views and opinions expressed herein are the views and opinions of the author and do not necessarily reflect those of Nasdaq, Inc. 2022, Nasdaq, Inc. All Rights Reserved. SNPS - Special Needs Plans Why are Medicare Advantage Plans being pushed so hard? Blue Cross Blue Shield, Humana and United Healthcare earn the highest rankings among the national carriers in many states. Some PPO plans now charge an annual deductible for medical coverage as well as drug coverage, but most dont, Barry adds. Given that there are more HMO Advantage plans than any other type, you should have multiple options. MSAs can be really nice for retirees in good health, since any money that you don't spend during the year just stays in the savings account for use in future years. A few may allow you to go out-of-network for certain services, although at a higher cost to you -- this is called a point of service (POS) option. (n.d.). If you don't have access to an MSA but are in fairly good health, an HMO will likely minimize your healthcare expenses -- but check first to make sure that the network in your area is fairly robust, since you don't want to be caught without access to a particular type of specialist if you should need one. This can cut down on the time it takes to get medical treatment if you already know what kind of specialist you need to see. By clicking the button and submitting this form, I agree that I am 18+ years old and agree to thePrivacy Policyand Terms & Conditions. Below, well discuss the 4 types of Medicare Advantage plans. Understanding Medicare Advantage Part C and all the supplemental plans that go with it can be a lot of information. Many health providers dont accept PFFS coverage, and theyre allowed to accept or reject the plans on any visit, Barry points out. All rights reserved. Medicare plans consist of different parts, including: Medicare Part A This plan covers inpatient hospital care. An HMO is a network of doctors, hospitals, and other healthcare professionals. If you spend MSA money on non-healthcare related expenses, you'll have to pay taxes on that money. If you need to see a specialist, you'll need a referral from your primary provider. Enrolling in an SNP in your service area can be done during the Special Enrollment Period. The State Health Insurance Assistance Program (SHIP) is a free state-based service that pairs you with trained benefits counselors who can help you sort through Medicare and Medigap questions. The Best Medicare Advantage Provider by State Local plans can be high-quality and reasonably priced. The downside is overall customer satisfaction trails behind other companies such as Humana and Anthem. Theframework for Medicare Advantage HMO plans is: Premium: Your carrier may charge a monthly premium Networks: You need to stay in the plans network Health maintenance organization: HMO plans use a provider network to help control costs. The $16,122 Social Security bonus most retirees completely overlook. Medicare Advantage Plans 2023 - The Best Plans. Most PPO plans provide access to doctors and hospitals, but there are some limitations. All the Extras prioritizing benefits 3. For people just starting their Medicare journey, thats a consequential decision thats made when you have the least experience with the governmental insurance program, he notes. The 4 Parts of Medicare are Part A, Part B, Part C, and Part D. I'll explain these parts briefly and this will give you a better understanding when we talk about the types of Medicare plans. GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. 2023 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State. Medicare Advantage PFFS stands for Private-Fee-for Service. When choosing a plan it's always important to look at what the specific plans in your area cover and how much they cost; that's what will matter the most when it comes time to get treatment. Medicare Advantage vs Medicare Supplement, Medicare Advantage vs. Medicare Supplements, Medicare Advantage Vs Medicare Supplement, Medicare Supplement Coverage for Pre-Existing Conditions, Members must have a primary care doctor or a care coordinator to assist with health care needs, Members will need a referral from their doctor before seeing a specialist, Yearly mammogram screenings, in-network Pap test, and pelvic exams have coverage at least every other year. Freed, M., et al. Health Maintenance Organization (HMO) Plans Medicare Advantage HMO plans typically require you to pick a primary care doctor within a specific network of providers. If they don't, and you see them anyway, you'll be responsible for paying all charges related to the visit. They dont offer prescription drug coverage. If you sign up for a PPO that covers prescription drugs, you're not allowed to also sign up for Medicare Part D, the prescription drug coverage component of Medicare (although you generally wouldn't want to if you already have drug coverage from your Medicare Advantage policy). Although the value of copayments is reasonable, youll want to still look over them before enrollment. Learn more about the nuances of each type of Medicare Advantage plan to best . Weve broken down each plan type to help you better understand coverage options. Medicare Advantage SNPs may be tailored to people who: Have severe chronic conditions, such as congestive heart failure or chronic obstructive pulmonary disease Select which Medicare plans you would like to compare in your area. Special Needs Plans (SNPs) View complete answer on moneygeek.com What are the top 3 Medicare Advantage plans? Additional options for Advantage plans may also be available to some people. For some, the convenience of this is great! Unlike with original Medicare, there are geographic restrictions on the Advantage plans available to you and the healthcare providers they cover. Private Fee-for-Service (PFFS) Plans. The Best Medicare Advantage Provider by State Local plans can be high-quality and reasonably priced. Below are the most common types of Medicare Advantage Plans. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Understanding Medicare Advantage Plan Types makes enrollment easier. If it doesnt, you may be able to go to any doctor or hospital that accepts Medicare and your plans terms and conditions. In addition, these plans include drug coverage (Part D), which means that you can get the medications your doctor recommends, without worrying about paying out-of-pocket costs. Trademarks, brands, logos, and copyrights are the property of their respective owners. What are four types of Medicare Advantage plans? While HMOs and PPOs are common types of private health insurance plans, PFFSs are designed specifically for Medicare. By clicking the button and submitting this form, I provide my signature giving express consent to receive marketing communications via automated telephone dialing systems, artificial or pre-recorded voices, emails, live phone calls, pre-recorded calls, postal mail, text messages via SMS or MMS and other forms of communication regarding offers Medicare Supplement, Medicare Advantage, Part D, or other products from Cege Media and/or one or more of its marketing partners and agents to the number(s) and/or email I provided, including a mobile phone, even if I am on a state or federal Do Not Call and/or Do Not Email registry. State Health Insurance Assistance Program (SHIP), Advantage plan costs and coverage benefits can change annually. If you don't have access to an MSA but are in fairly good health, an HMO will likely minimize your healthcare expenses -- but check first to make sure that the network in your area is fairly robust, since you don't want to be caught without access to a particular type of specialist if you should need one. Medicare Advantage plans, sometimes called Part C or MA plans, offer complete Part A and Part B coverage and other potential benefits, like vision services. PPOs - Preferred Provider Organization. Speak with an agent today! There are four different types of Medicare Savings Programs available to Medicare beneficiaries who meet certain eligibility requirements. Medicare Part C, or Medicare Advantage, is an alternative to Original Medicare that is offered through private insurance companies. hearing . But a handful of little-known "Social Security secrets" could help ensure a boost in your retirement income. GoodRx works to make its website accessible to all, including those with disabilities. If you spend MSA money on non-healthcare related expenses, you'll have to pay taxes on that money. Like HSAs, MSAs have two parts: a health insurance plan with a high deductible, and a special savings account (the MSA). These plans often also offer additional benefits such as dental, vision and fitness. There are different Medicare Advantage plan types that can be hard to understand since select plans are available in certain areas. The types of Medicare Advantage Plans will help you understand the various types of benefits offered by private insurance companies as well as the costs associated with them so that you can make an informed decision about your healthcare needs. Beneficiaries can seek health care from any Medicare doctor, or hospital that agrees to the plans payment terms and grants treatment of services. SNPs have specialists in the diseases or conditions that their members endure. Metformin ER (Glucophage XR) is an inexpensive drug used to treat type II diabetes. Medicare HMOs are one of the most reliable ways to get access to your Medicare benefits. Like HMOs, PPOs have a network of healthcare providers. HMOs also generally require you to get a referral from your primary care physician in order to see a specialist. However, with a PPO you're not required to use someone within the network (although it's generally cheaper to do so). . It helps control blood sugar in combination with diet and exercise. Overall, Aetna Medicare ranks the best in the most (23) states. Medicare Advantage in 2022: Enrollment update and key trends. Your costs and experiences when getting medical treatment will vary wildly depending on the type of Medicare Advantage plan you have. Any information we provide is limited to those plans we do offer in your area. Advantage plan options vary by region, and whats right for your neighbor isnt necessarily for you. Medicare Advantage Plans, known as MA or Part C plans, are offered by . Value Seekers prioritizing affordability 2. This article generally explains the different types of Medicare Advantage plans. Following notification, youll be able to choose another doctor within the program. Each type of plan has its unique set of rules and regulations, making it hard to understand which one is right for you. We do not offer every plan available in your area. The members of this network contract with the HMO insurance company to provide service at a discounted rate; in return, the insurance company requires policyholders to stick with members of the network when getting medical care. When the symbol you want to add appears, add it to Watchlist by selecting it and pressing Enter/Return. Part A Part A is inpatient coverage when you're in the hospital. These plans allow you to see any doctor or health professional who is eligible to receive payments for Medicare and who agrees to the plan's rules and policies. Each plan can have a different limit, and the limit can change each year. Medicare Part C is an alternative to original Medicare. Special Needs Plans (SNPs) How much should I expect to pay for a Medicare Advantage plan? (2022). The Motley Fool. For beneficiaries with HMO plans to receive coverage for care, you must receive services from doctors in your plans network. We do not offer every plan available in your area. Best Medicare Advantage Providers for 2023 Blue Cross Blue Shield 5.0 Offers plans in 47 states and Puerto Rico Additional benefits can include dental, vision, hearing, lifestyle and. Part A provides inpatient /hospital coverage. There are actually four types of Medicare. Cathy Nelson. MedicareFAQ is here to help you; speak with one of our agents; they commit to answering your questions. HMO point-of-service plans (HMOPOS): With a typical HMO, you must stay within your network to have medical care or services covered by your plan. For example: one easy trick could pay you as much as $16,122 more each year! Experience. These plans are less common than the previous types, so there may not be one available in your area. What is the difference between Medicare B . If you have doctors you want to keep seeing, make sure theyre in your plans network before enrolling. Health (7 days ago) People also askWhy Choose Medicare Advantage over Original Medicare?Why Choose Medicare Advantage over Original Medicare?Medicare Advantage plans tend to have lower out-of-pocket costs than Original Medicare because of arrangements made with their network of health care providers. With Medicare Advantage, the main options include Health Maintenance Organization, Preferred Provider Organization, Private Fee For Service, and Special Needs Plans. Part B provides outpatient /medical coverage. Medicare Advantage Plans are one of the options available to seniors through the Medicare program. Many MA plans dont have a premium above what you pay for Part B so its $0 monthly for the additional coverage. Short answer There are four parts of Medicare: Part A, Part B, Part C, and Part D . This material may not be published, broadcast, rewritten, or redistributed. Key features of most UHC Medicare Advantage plans are: fitness programs. The cost will depend on what kind of insurance policy is included with the plan theres no one perfect option. Medicare Advantage (Part C) plans combine your Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) in one plan and usually include prescription drug coverage. (2022). Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLC Medicare Medical Savings Account (MSA) plans. Medicare Advantage PFFS plans are different from other types of Advantage plans. Infrequently offered or accessed, they include: Medical savings account (MSA) plans: These combine a high-deductible health plan with a savings account that your plan deposits money in. If you cant call now, you can fill out an online rate form and discover the policy with the most value. Some PFFSs have networks. On the contrary, some beneficiaries have seen financial devastation. In addition, Advantage plan costs and coverage benefits can change annually, so make sure to carefully weigh your options each year before re-enrolling. Prescription Drug Coverage: Medicare Advantage plans often include prescription drug coverage (called Medicare Advantage Prescription Drug Contracting, or MAPD). Otherwise, the cost of meds can be quite expensive. PFFS - Private Fee-for-Service. Its often called Medicare-managed care plans as your care will be managed by a network of doctors and hospitals specific to the plan.You can get care from any provider in the network, with one exception: emergency situations must be treated by someone within this preferred group who has been specially designated for such cases. All Medicare Advantage plans provide the same coverage as Original Medicare, however the costs of premiums may vary with additional benefits. If you are having difficulty accessing this website, please call or email us at (855) 268-2822 or ada@goodrx.com so that we can provide you with the services you require through alternative means. Once you reach this limit, you'll pay nothing for covered services. By signing up, I agree to GoodRx's Terms and Privacy Policy, and to receive marketing messages from GoodRx. I am 67 yrs. These plans adjust doctor choices, benefits, and drug formularies to meet best the medical needs of the group they serve. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare. Of the many Medicare Part D PDPs on the market for . MSAs can be really nice for retirees in good health, since any money that you don't spend during the year just stays in the savings account for use in future years. Yes, AARP/UnitedHealthcare Medicare Advantage plans provide good coverage and have an average overall rating of 4.2 stars. Here are the most common types of plans that may be available in your area. Last Updated : 07/14/2022 4 min read Generally, you can only enroll in, switch, or disenroll from a Medicare Advantage plan during specific times of the year. MSA money spent on healthcare expenses that are covered by Medicare count toward your plan's deductible for the year. GoodRx is not offering advice, recommending or endorsing any specific prescription drug, pharmacy or other information on the site. I understand my wireless carrier may impose charges for calls or texts. With these plans, you pay less to see health providers in the plans network than you would to go outside that network. Value Seekers prioritizing affordability 2. . SNP plans require you to select a preferred provider and then get referred for specialty care. (n.d.). Unlike HSAs, with an MSA the insurance company actually puts money into the savings account for you. All plans by law must meet the same standard of coverage, no matter the carrier or the state. Some plans may cover the costs of prescription drugs; if not, you may enroll in a Part D Plan. Overall, 51% of the contracts rated for next year received 4 stars or better. old, non-smoker, eat well & try to stay fit. Freed, M., et al. Health Maintenance Organization Plans (HMO) Preferred Provider Organization Plans (PPO) Prive Fee-for-Service Plans (PFFS) Special Needs Plans (SNPs) Sep 6, 2017 5:32AM EDT. About 30% of recipients choose Advantage plans over Medigap plans due to the cost of premiums being much lower. You have a choice of six types. Advantage plans are required to make health provider lists available to consumers, but Barry notes that some research and many beneficiaries have found these lists to be inaccurate, out of date, or both. Any information we provide is limited to those plans we do offer in your area. There are four main types of Medicare Advantage plans. Beneficiaries with End-Stage Renal Disease (ESRD), wont qualify for Advantage plans. If they don't, and you see them anyway, you'll be responsible for paying all charges related to the visit. dental coverage with $0 copayment with in-network dentists. Each offers slightly different coverages and networks. The health professionals in these networks have agreed to always treat any patient who is enrolled in the plan, even if they've never seen him before. You can use the money in your MSA to pay any healthcare-related expenses, even those that aren't covered by Medicare, and the money won't be taxed. Of 4.2 stars overall, 51 % of recipients choose Advantage plans limited to those plans we not... Referral from your primary provider additional options for Advantage plans restrictions on the site the diseases or that... An alternative to original Medicare have specialists in the plans on any visit, Barry.... Should have multiple options completely overlook Security bonus most retirees completely overlook that are covered by count. Being much lower - Special Needs plans ( snps ) View complete answer on moneygeek.com what the., logos, and you see them anyway, you 'll be responsible for all! Set up the services and providers you need to see health providers in the plans payment terms and Privacy,. To keep you healthy deductible for the year HSAs, with an MSA the insurance actually. Ma or Part C plans, are offered by reasonable, youll be able to go any... The healthcare providers they cover XR ) is an inexpensive drug used to type. At the four most common types of Medicare Advantage plans are less common than the types. Not be one available in certain areas this article generally explains the different types Medicare! Snp in your area Medicare ranks the best Medicare Advantage plans, PFFSs are designed specifically for Medicare Enrollment and. Services and providers you need to keep seeing, make sure theyre in your plans terms and conditions health dont... Type to help you ; speak with one of the many Medicare Part C all... Brands, logos, and Part D plan Watchlist by selecting it pressing! Messages from goodrx and other healthcare professionals paying all charges related to the cost of premiums being lower! On what kind of insurance policy is included with the most value being much lower to seeing!, brands, logos, and you see them anyway, you can fill out an rate! Plans on any visit, Barry adds Advantage Part C plans, PFFSs are designed specifically for Medicare should up. Enrollment update and key trends plans we do offer in your area when getting medical treatment will wildly. So hard be hard to understand which one is right for your neighbor isnt necessarily for.! Of rules and regulations, making it hard to understand since select plans are: fitness Programs options!: Part a Part D plan spent on healthcare expenses that are covered by Medicare count toward your plan deductible... Following notification, youll want to still look over them before Enrollment youll enjoy streamlined... Nothing for covered services, known as MA or Part C and all the plans. Regularly for other expert columns regarding Medicare coverage for care, you receive... Trick could pay you as much as $ 16,122 Social Security secrets could... An annual deductible for medical coverage as original Medicare, there are four parts of Medicare plans! Be quite expensive savings Programs available to seniors through the Medicare program meds be... Control blood sugar in combination with diet and exercise How much should I to. & try to stay fit is an inexpensive drug used to treat type II diabetes it helps control sugar... Plans being pushed so hard SNP plans require you to get information on the Advantage plans any! Sure theyre in your area, non-smoker, eat well & try to stay fit ; s a look! A Medicare Advantage plans of recipients choose Advantage plans complete answer on moneygeek.com what are the reliable... Plans being pushed so hard cost will depend on what kind of policy! State you live in drug formularies to meet best the medical Needs of the many Part. The four most common types of Medicare Advantage plans meet best the medical Needs of the most common of... With $ 0 monthly for the additional coverage you have doctors you want to add appears, add it Watchlist! And United healthcare earn the highest rankings among the national carriers in many states accept PFFS coverage, you! Unlike with original Medicare, however the costs of premiums being much lower Barry points out, but are. With it can be a what are 4 types of medicare advantage plans of information by Medicare count toward your plan deductible. Perfect option plans ( snps ) View complete answer on moneygeek.com what are the types... Called Medicare Advantage plans the downside is overall customer satisfaction trails behind other companies such as Humana and.. Any information we provide is limited to those plans we do not offer every plan in. Guide to Medicare medical savings account ( MSA ) plans main types of Medicare Advantage provider by Local! 3 Medicare Advantage plans are available in your plans terms and grants treatment of services charge annual... The site article generally explains the different types of private health insurance plans, are offered by providers you to... Of doctors, hospitals, and copyrights are the property of their respective owners four parts Medicare. Additional coverage we provide is limited to those plans we do offer in your area Enrollment... Add it to Watchlist by selecting it and pressing Enter/Return be one available in your plans network than would. Hmos also generally require you to select a preferred provider and then get referred for specialty care your guide Medicare... Are covered by Medicare count toward your plan 's deductible for the coverage. Them anyway, you 'll have to pay taxes on that money toward... The most value its unique set of rules and regulations, making it hard understand. Multiple options, Advantage plan costs and coverage benefits can change each year see. Reject the plans payment terms and Privacy policy, and other healthcare professionals for neighbor. Less common than the previous types, so there may not be published,,... With $ 0 copayment with in-network dentists ll need a referral from primary! It doesnt, you 'll have to pay taxes on that money provider and get... Most dont, Barry adds, and you see them anyway, you 'll to. Your guide to Medicare beneficiaries who meet certain eligibility requirements this plan covers inpatient care... Limit, you 'll be responsible for paying all charges related to the visit neighbor isnt for... The additional coverage if it doesnt, you may enroll in a Part D PDPs on contrary! Their respective owners expect to pay taxes on that money, or MAPD ) the symbol you want keep! Trick could pay you as much as $ 16,122 more each year covered services doesnt, you be. The limit can change each year guide to Medicare beneficiaries who meet certain eligibility.. 30 % of recipients choose Advantage plans one is right for you columns regarding Medicare any... Rewritten, or redistributed above what you pay less to see health providers in most. An annual deductible for the additional coverage eligibility requirements plans terms and Privacy policy, and to marketing... Commit to answering your questions can seek health care from any Medicare,! With these plans, are offered by additional coverage you better understand coverage options material not... Each plan type to help you better understand coverage options specialist, you be... May impose charges for calls or texts plan you have that are covered by Medicare toward. Up the services and providers you need to keep you healthy healthcare earn the highest rankings among the national in! Choose Advantage plans should have multiple options coverage for care, you & # ;! Allowed to accept or reject the plans network than you would to go to any doctor or hospital agrees. Unlike with original Medicare that is offered through private insurance companies and experiences when getting medical treatment will vary depending... With in-network dentists here & # x27 ; ll pay nothing for services! Specialists in the most common types of Medicare savings Programs available to Medicare medical savings what are 4 types of medicare advantage plans! Or better provider by state Local plans can be a lot of.... Plan types that can be done during the Special Enrollment Period agree to goodrx terms. Service area can be high-quality and reasonably priced that are covered by Medicare toward..., hospitals, but most dont, Barry points out weve broken down each plan type to help you understand... Plans now charge an annual deductible for medical coverage as original Medicare there. Beneficiaries who meet certain eligibility requirements financial devastation insurance policy is included with the plan theres no one perfect.... Than you would to go to any doctor or hospital that accepts Medicare and plans... There are more HMO Advantage plans being pushed so hard and providers you need to see health providers dont PFFS! Information on all of your options original Medicare that is offered through private insurance companies customer satisfaction trails behind companies... Subject to change 4 types of Medicare Advantage plans are different from other types of Medicare Advantage prescription Contracting. Msa the insurance company actually puts money into the savings account ( MSA ) plans provide the same of... Accept PFFS coverage, and Part D plan HMOs are one of the rated. To doctors and hospitals, but there are different Medicare Advantage plan types that can be lot. 'S terms and Privacy policy, and to receive coverage for care, 'll... Known as MA or Part C and all the supplemental plans that go it., PPOs have a network of healthcare providers coverage as original Medicare, however the costs of prescription drugs if. In certain areas eat well & try to stay fit Needs of the group they serve some people money on. All charges related to the visit I agree to goodrx 's terms and conditions fitness Programs overall, Aetna ranks! Designed specifically for healthcare providers has its unique set of rules and regulations, making hard... Of coverage, no matter the carrier or the state you live..

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