I-Medicare i-HMO kunye ne-PPO Umlinganiselo kunye neenketho
Isicwangciso soNcedo lweMagrari sinikwa ngamashishini e-inshurensi yempilo eyimfihlo evunyiweyo yi-Medicare kwaye inesivumelwano sokukunikezela ngeenzuzo ze-Medicare.
Isicwangciso seNgcaciso seMicrosoft?
Ukuba ujoyina iSicwangciso soNcedo lweMida, isicwangciso kufuneka sinikeze yonke iNgxenye A (Intshuwalense Yesibhedlele) kunye neNgxenye B (i-Inshurensi yezoNyango), kuquka nexakeka kwaye unonophelo olungxamisekileyo.
Inzuzo enkulu kuphela engakhange ihlanganiswe kwezi zicwangciso zonyango lokunakekelwa kwezibhedlele - le nzuzo ifunyenwe yi-Medicare yasekuqaleni nangona ukhetha iSicwangciso seNzuzo ye-Medicare.
Amalungiselelo amaninzi e-Medicare Benevantage anikezela ngokukhawuleza, njengombono, ukuva, amazinyo, kunye nokuhlolwa ngokubanzi kunye nezinye iinkqubo zempilo kunye nokuphila. Iiplani ezininzi zentsebenzo zibandakanya i-Medicare yecandelo lokuthengisa iziyobisi ( Medicare Part D ).
Uninzi lwezicwangciso ze-Medicare Benevantage zilawulwa izicwangciso zonyango , ngokuqhelekileyo inhlangano yokugcinwa kwempilo (i-HMO) okanye intlangano yokubonelela ngenkonzo (PPO). Ezi zicwangciso zingadinga ukuba ukhethe ugqirha wezempilo oyintloko (PPP), ufumane ukuhanjiswa kwi-PCP yakho ukuze ubone ingcali, kwaye usebenzise kuphela oogqirha, izibhedlele, kunye nezinye izibonelelo zonyango kunye neenkonzo eziyinxalenye yeso sixhobo somncedisi wezempilo .
Ezinye iinkampani zomshuwalense zempilo zonyango zibonelela ngeCandelo le-Advantage Plan elibizwa ngokuba yi-Private Fee-for-Service (PFFS) Isicwangciso esinokuvumela ukuba ubone nawuphi na ugqirha okanye usebenzise esinye isibhedlele esivunyiweyo.
Nangona kunjalo, ngokungafani ne-Medicare yasekuqaleni, unakho ukufumana ikhoyayari yokutyelela ugqirha kwaye akubona bonke ababoneleli abanokukulungela ukukuphatha. Nangona kunjalo, kwisiCwangciso sePFFS, akumele ukhethe i-PCP kwaye akudingeki ukuba uhanjiswe ukuze ubone ingcali.
IsiCwangciso seNzuzo yeMedirative Cost?
Inyanga nganye, i-Medicare ihlawula isicwangciso sakho sempesheni imali echanekileyo yokubonelela.
Isicwangciso sempiliso ke uxanduva lokuhlawula ugqirha, isibhedlele kunye nabanye ababonelela ngononophelo.
Nangona isicwangciso sakho sengeniso kufuneka silandele imithetho ye-Medicare, inokukuhlawula i- premium kunye nezongezelelo zeendleko ze-pocket , njenge- copayment yokutyelela ugqirha, uqinisekiso lwezinto zokusebenza zonyango ezizinzileyo (njengesihlalo sabakhubazekile), kunye ne-annuable deductible imithi yonyango.
Ukwaxanduva lwakho lwe-premium ye-Medicare Part B yenyanga yeenyanga, ekhutshwe kwi-check your security check.
Umzekelo: uGeorge C. uhlala eMassachusetts kwaye unesicwangciso seMedare Benevantage kwi-Fallon Community Health, esinye sezicwangciso zezempilo eziphakamileyo kakhulu kwilizwe. Unesicwangciso se-HMO kunye nokujongana neziyobisi. Iindleko ze-premium zenyanga zeprogram yi-$ 208.40 (i-Medicare Part B premium ye $ 96.40 kunye ne-$ 112 ehlawulwa ngu-Fallon). Iindleko ze-out-of-pocket ziquka i-copay ye-$ 15 nganye yokutyelela kwe-PCP, i-$ 20 nganye kwintetho yokutyelela, i-10% ye-coinsurance yezixhobo zonyango ezizinzileyo, kunye ne-deductible yonyaka ka-310.
Ndizijoyina njani iSicwangciso soNcedo lweMida?
Ngokuqhelekileyo, unako ukujoyina iSicwangciso seNzuzo yeMedareba ukuba unayo i-Medicare Part A kunye neCandelo B kwaye uhlala kwindawo apho kukho icebo lokufumana amalungu amatsha.
Ezinye izicwangciso zifikelela kuphela kumabhunga athile ngaphakathi kwiphondo kwaye kufuneka uhlale kwenye yezo zibalo apho icebo linikezelwa khona.
Ezinye iziCwangciso zeNzuzo zeMedareya zibambe iisemina zendawo ukuba zizise izicwangciso zazo kwaye ufumane kwaye uzalise isicelo sephepha ngelo xesha. Ungakwazi ukubhalisa ngokubiza isicwangciso, ukutyelela iwebhusayithi ye-plan, okanye kwi-www.medicare.gov. Isayithi le-Medicare likuvumela ukuba uqhathanise izicwangciso kwindawo yakho. Ungakwazi ukujoyina ngokubiza i-Medicare ngo-800-633-4227.
Ukuba uguqula kwisicwangciso esincinci secebo, konke okufuneka uyenze kukujoyina isicwangciso esitsha kwaye uya kuhlengahlengiswa ngokuzenzekelayo kwisicwangciso sakho esidala.
Awuyi kuba naluphi na ukuphela kwenkcazo yakho.
Imida ye-Medicare xa unokujoyina, utshintshe okanye uphononise iSicwangciso seNzuzo ye-Medicare. Unokujoyina isicwangciso xa uqala ukufaneleka kwi-Medicare. Le naliphi ixesha eliqala kwiinyanga ezintathu ngaphambi kwenyanga uvula i-65 kwaye uphelisa inyanga ezintathu emva kwenyanga uvula iminyaka engama-65.
Umzekelo, ukuba uvula iminyaka engama-65 ngo-Apreli wama-28, ixesha lakho lokufaneleka liqala ngoJanuwari 1 kwaye luphela ngo-Julayi 30.
Ukuba ukhubazekile kwaye unesiqinisekiso soKhuseleko lweNtlalontle yeNhlalakahle, unokujoyina iplani yesicwangciso esincinci ngaphambi kweenyanga ezintathu emva kwenyanga yakho yesi-25 yokukhubazeka.
Unokutshintsha okanye uphonononge amathuba akho ngexesha lokubhalisa phakathi koNovemba 15 noDisemba 31 wonyaka ngamnye.
Ukufumana iinkcukacha ezingakumbi kwi-Medicare Advantage Plan yobhaliso, tyelela iwebhusayithi ye-Medicare.
Yintoni Endiyifunayo Ukuba Ndiyazi NgesiCwangciso Sokufumana I-Medicare Benevantage Plan?
Kubalulekile ukuba uqonde ukungafani phakathi kweMveli ye-Medicare ne-Medicare Advantage Plans . Ezinye izinto okumele uzikhumbule malunga nezicwangciso zentengiso zi:
- Kufuneka ulandele imigaqo! Umzekelo, ukuba unesicwangciso se-HMO, kufuneka ukhethe i-PCP kwaye usebenzise kuphela iinkonzo zenethiwekhi.
- Ungakwazi ukudibanisa isicwangciso esincomekayo nangona unayo okanye enye imeko ekhoyo ngaphambili . Akukho xesha lokulinda.
- Ukuba isicwangciso sakho sengenzuzo sinquma ukungabandakanyeki kwi-Medicare, unokujoyina esinye isicwangciso okanye ubuyele kwi-Medicare yaseMveli.
- Ukuba isicwangciso sakho sengeniso asibandakanyi ukukhutshwa kwezidakamizwa, kufuneka ujoyine isicwangciso seMedare yeDesti kwilizwe lakho. Nangona kunjalo, ngokubhekiselele kwi-Medicare: "Ukuba unesicwangciso se-Medicare Benevantage Plan esichaphazelekayo kunye nokujoyina i-Medicare Prescription Drug Plan, uya kuhlengahlengiswa kwi-Medicare Advantage Plan kwaye ubuyele kwi-Medicare yasekuqaleni."
- Ngethuba nje ubhalise kwiSicwangciso soNcedo lwe-Medicare, akufuneki ukuba uthenge umgaqo-nkqubo we-Medicare Supplement Insurance (Medigap). Enyanisweni, akukho mthethweni ukuba umntu athengise umgaqo-nkqubo we-Medigap ukuba uceba kwisicwangciso. Iintlawulo ezinikezelwa ngumgaqo- nkqubo we- Medigap zigqityiwe ngesicwangciso sakho sempatho kwaye isongezelelo asiyihlawuli izicucu zakho, iipayili, okanye i-coinsurance.
IziCwangciso zeeMpilo zeMpilo kunye noTshintsho lwezeMpilo
Izicwangciso ze-Medicare Benevantage zixabisa urhulumente wesigqeba ngaphezu kweMveli yeMveli. Ukususela ngo-2012, i-Medicare iya kuqalisa ukunciphisa inkxaso-mali kwezi zicwangciso.
Ukuba ubhaliswe kwisiCwangciso seNzuzo ye-Medicare, kufuneka uhlawule iphrimiyamu ephezulu okanye uhlangabezane neenzuzo ezincitshisiwe. Nangona kunjalo, ezi zicwangciso azikwazi ukunciphisa naziphi na izibonelelo onokuzifumana ngokuqhelekileyo kwi-Medicare yendabuko.