Ukuqonda Umgaqo-nkqubo weMedigap kunye neNkxaso-mali yeNcediso
I-Medicare yasekuqaleni (ebandakanya iNgxenye ye-A ye-Inshurensi yebhedlele kunye neCandelo B I-inshurensi yonyango ) ihlawulela ezininzi, kodwa kungekhona zonke, iinkonzo ezinxulumene nempilo kunye neenkonzo zempilo. Unokuthenga umgaqo-nkqubo we-inshurensi ukufihla "ikhefu" ezingakhokhelwa yi-Medicare, njengemali yokubhalwa kwemali, i-coinsurance, kunye neengxowa-mali. Ezi ziyakongeza kwiinkcitho ezininzi ezingaphandle, ngokukodwa xa ukhulelwe esibhedlele okanye ufuna iinkonzo zasekhaya ezinonophala.
Ezinye iinkqubo zeMedigap nazo ziya kuhlawula iinkonzo ezithile zezempilo ngaphandle kwe-United States kunye neenkonzo zokukhusela ezongezelelweyo ezingagqithwanga yi-Medicare.
Intshuwalense yaseMedigap (eyaziwa ngokuba yi-Medicare Supplement Insurance) ngokuzithandela kwaye unembopheleleko ye-premium yenyanga okanye yekota. I-Medicare ayiyi kuhlawula nayiphi na iindleko zakho ukuthenga umgaqo-Medigap.
Iipolisi zeMigigap zisebenza njani?
Ukuba ukhona kwi-Original Medicare (Ingxenye A no-B) kwaye unemigaqo-nkqubo ye-Medigap, u-Medicare wokuqala uhlawula isabelo saso semali evunyiweyo ye-Medicare kwiindleko zakho zokunakekelwa kwempilo. Emva koko umgaqo wakho weMedigap uhlawula isabelo sawo seendleko.
Umzekelo: U-Alice G unesifo sikashukela se-2 kunye nokutyelela ugqirha wakhe wokunyamekela okokuqala kwinyanga ezintathu ukuya kwezine ekunyamekelweni. Umgaqo wakhe we-Medigap uquka isiCwangciso seB burance , kodwa akusiyo iSicwangciso B sakhe esingenakunikwa. Ekuqaleni konyaka, uhlawula i-$ 155 yokuqala yeendleko zakhe zokundwendwela. Emva koko, i-Medicare ihlawula i-80% yemali evunyiweyo ye-Medicare yokutyelela kwakhe ugqirha kunye nomgaqo-nkqubo wakhe we-Medigap uhlawula i-20% esele - ekubeni u-Medicare uvuma ukuvakasha i-ofisi eyi-$ 65, i-Medicare ihlawula i-$ 52 kwaye i-Medigap ihlawula i-$ 13.
Iipolisi zeMedigap zithengiswa ngama-inshurensi yabucala. Le nkqubo imele ichongwe ngokucacileyo njenge- Medicare Supplement Insurance . Yaye, ngamnye umgaqo-nkqubo kufuneka ulandele imithetho yaseburhulumenteni kunye neyelizwe eyenzelwe ukukhusela abathengi.
Iinkampani zomshuwalense yaseMedigap ziyakuthengisa kuphela umgaqo-nkqubo oqhelekileyo weMedigap ochongwe ngamagama A ngeL.
Isicwangciso ngasinye seMedigap kufuneka sinikele ngeenzuzo ezifanayo eziphambili, kungakhathaliseki ukuba yiphi inkampani yomshuwalense eyithengisayo. Ngoko, i-Medigap Isicwangciso F inesiseko esinye seenzuzo kungakhathaliseki ukuba yinkampani yomshuwalense okanye indawo.
Intonga yaseMedigap esuka kuDkt Mike: Azikho zonke izicwangciso ezikhoyo kuzo zonke iindawo. Kwaye, abathathu bathi - eMassachusetts, eMinnesota naseWisconsin - banemigaqo-nkqubo yabo ye-Medigap eyahlukileyo kwiiplani ze-Medigap eziqhelekileyo.
Ingakanani iMigigap Inkokhelo Yomshuwalense?
Ingakanani uhlawula ngayo umgaqo we-Medigap kuxhomekeke kwisicwangciso okhethayo kunye nenkampani yomshuwalense oyisebenzisayo.
I ngasinye sezicwangciso (A ngeL) sinikeza iintlobo ezahlukeneyo zeenzuzo kunye neendleko ziyahluka kunye nenani le-coverage. Ngokubanzi, iSicwangciso esingu-A, esibonelela ngezona zibonelelo ezincinci kuneeprayimari eziphantsi. Izicwangciso zeMedigap ezinikezela ngeenzuzo ezininzi, ezifana neCwangciso J, zihlala zifumana i-premium ephezulu. Ngokwe-Medicare Rights Centre, iiplani ezidume kakhulu zeMedigap zi-C no-F, kuba zibandakanya iingeniso ezinkulu kwaye zibiza kakhulu kunezinye iinjongo ezininzi.
Nangona i-Medicare ichaza ukuba isicwangciso ngasinye seMedigap sinikeza, asiyikulawula oko inkampani yomshuwalense inokuyihlawula. Iinkampani ze-inshorensi ezizimeleyo zingahlawulisa iiprayimari ezahlukileyo ngokufanayo kwi-Medigap.
Umzekelo: KwiSixeko saseNew York, ngoDisemba ka-2009, i-premium yenyanga ye-Medigap Plan C isuka kwi-low-dollar 232 ukuya kuma-337 aphezulu. Oku kuya kuba ngumlinganiselo wonyaka we $ 1260!
Nguwuphi uhlobo lweeNzuzo ezenza iMigigad Policies Offer?
Izicwangciso ze-Medigap A ngeJ kufuneka zibandakanye ezi zibonelelo ezilandelayo:
- Ukunakekelwa kweZibhedlele ezingapheliyo: Ugalelo lweCandelo le-Medicare I-A ye-coinsurance (kodwa kungeyiyo iSahlulo se-A deductible ngonyaka) kunye ne-coverage engaphezulu kweentsuku ezingama-365 emva kokugqitywa kweeMedike.
- Iindleko zezoNyango: Ugaqambisa i-Medicare Part B coinsurance (kodwa kungeyiyo iNgxenye B yonyaka echithwayo) okanye iikhowyenti zeenkonzo zonyango zezigulane. Icandelo B coinsurance ngokuqhelekileyo ngu-20% wexabiso elivunyiweyo le-Medicare ngenkonzo.
- Igazi: Ugalela iipilisi ezintathu zokuqala zegazi ozifunayo ngonyaka.
Ngokuxhomekeke kwiplani ye-Medigap oyikhethayo, unokufumana iindleko zeendleko ezongezelelweyo kunye neenzuzo I-Medicare ayifihla, kuquka:
- Isibhedlele esichithwa ngonyaka (izicwangciso B ukuya kuL)
- Isiqinisekiso soqeqesho lwezonyango (izicwangciso C ukuya kuL)
- Icandelo B elichithwe ngonyaka (izicwangciso C, F kunye noJ)
- Unonophelo olungxamisekileyo ngexesha lokuhamba kwamanye amazwe (izicwangciso C ukuya kuJ)
- Ukunakekelwa kokubuya ekhaya (izicwangciso D, G, I noJ)
- Ukunyamekela okukhuselekileyo kungagqithwanga yi-Medicare (izicwangciso E kunye noJ)
- I-Medicare Part B ngaphezulu kweerhafu zamatyala (izicwangciso F, G, I kunye noJ) - inkokhelo engaphezu kwemali ingaphezulu kwe-Medicare-evunyelwe ukuba ugqirha ongenathatha inxaxheba kwiprogram ye-Medicare angahlawulisa.
Inyaniso ye-Medigap evela kuDkt Mike: iMigigap Plans L ne-K zinikezela nge-Medicare Part A ezidityanisiweyo kunye ne-coinsurance, igazi, kunye ne-coinsurance okanye i-copayments kwi-Medicare Part B, ukunakekelwa kwezibhedlele, ii-nursing ezikhuselekileyo. Ezi zicwangciso zineemfuneko ezahlukileyo zokwabelana ngeendleko kunezicwangciso ze-A ukuya kwiJ kwaye kufuneka udibanise umyinge ongaphandle kwe-pocket ngonyaka ongadlula i-$ 4500.
Ukuqala ngoJuni 1, 2010, iintlobo zezicwangciso zeMedigap ongayithenga ziya kutshintsha. Izicwangciso E, H, I, kunye noJ ziyi kuphinda zithengiswe (ukuba sele sele ubhalisile kwenye yezi zicwangciso, unokugcina isicwangciso sakho). Izicwangciso ezimbini ezintsha zeMigigap (M neN) ziya kunikwa.
Ngaba Ndiyifuna Imigaqo-nkqubo ye-Medigap ukuba ndibhaliswe kwisiCwangciso seNzuzo yeMagare?
Ngethuba nje ukuba ubhalise kwiCwangciso soNcedo lweMida , awuyidingi ukuthenga umgaqo-Medigap. Enyanisweni, akukho mthethweni ukuba umntu athengise umgaqo-nkqubo we-Medigap ukuba uceba kwisicwangciso. Iintlawulo ezinikezelwa ngumgaqo-nkqubo we-Medigap zigqityiwe ngesicwangciso sakho sempatho kunye ne-Supplementary Medigap ayihlawuli i-deductibles plan you benefit, i-copayments, okanye i-coinsurance.
Ndingafunda phi ngakumbi malunga ne-Medigap Coverage?
Ngaphambi kokuthenga isicwangciso seMedigap, kubalulekile ukuba uqonde imigaqo ye-Medicare ye-Medigap, amalungelo akho, kwakunye neendlela zokwaMedigap ezikhoyo kwimeko yakho. Ezi zixhobo zilandelayo ziindawo ezilungileyo zokuqala:
- Ukukhetha i-Poligap Policy: Isikhokelo esivela kwi-Medicare
- I-inshurensi eyongezelelweyo ye-Medicare yasekuqaleni: I-resource resource interactive malunga ne-Medigap evela kwiCentral Rights Rights Centre
- Inkqubo yoNcedo lwe-Intsholongwane yezeMpilo: inkqubo eyenza ukunikwa ngcebiso kunye nokuncedisa kubantu abane-Medicare