Xa Iinkampani Zomshuwalense ZineSandla Esisentla
Into engenanto ingabonakali, ibe nzima, ibe nzima. "Ukuguqulwa okungahambelani" kwi-Medicare, nangona kunjalo, akukho nto inzima. Lo ngumgaqo-mpikiswano onokubambisa abaxhamli abazibandakanyayo. Abanini-bhankanyi bangebhankini bayabhanka ukuba awuyiqondi inkqubo njengoko bakuchukumisa kwiiplani ze-Medicare Benevantage ezingafunekiyo.
Ukuqonda indlela inkqubo esebenza ngayo, okokuqala kufuneka uqonde ukuba ubhaliso oluzenzekelayo, lufanelekile, kwaye kutheni ufuna ukukhetha isicwangciso seMedare Benevantage kwi-Medicare yaseMveli .
Yazi amalungelo akho uze ufake ukukhetha kwisandla sakho.
Ukwahlukana phakathi kweMveli yeMveli kunye ne-Medicare Benevantage
I-Medicare yasekuqaleni yabizwa ngokuba yi-Medicare eyaqala ukuba khona emva kowe-1965. Oku kubandakanye iCandelo A , umshuwalense webhedlele obandakanya ukwamkelwa kwabagulayo kunye nokunyamekela esibhedlele, kunye neCandelo B , i-inshorensi yonyango ejongene neendleko zakho zokugula kunye nokuhlala ukugcina .
Icandelo C, eyaziwa ngokuba yi-Medicare Benevantage, nangona kunjalo, yinto ehlukile kwi-Medicare yasekuqaleni. Ihlanganisa yonke into eyenziwa yiCandelo A no-B kodwa ingafaka iinkonzo ezongezelelweyo kwimenyu yayo yokubhengezwa yi-Original Medicare ayifihla. Ngokuxhomekeke kwiimfuno zakho zonyango, unokukhetha ukuhamba kwisicwangciso se-Medicare Benevantage endaweni ye-Medicare yaseMveli kodwa gcina ukhumbule ukuba awunakho bobabini.
Iindleko-bulumko, ulindele ukuhlawula ngaphezulu kwi-Medicare Benevantage.
Abaninzi baseMerika bafumana iSahlulo A samahhala. Oko kukuthi, ukuba wena okanye iqabane lakho uye wasebenza ngeekota ezingama-40 kwi-Medicare-taxed-jobed, i-premium ye-A ye-Aim premium iya kukhululeka. Wonke umntu uhlawula iiprimiyamu zeNgxenye B, inani elingu-dollar elihluka ngokusekelwe kwingeniso yakho.
Izicwangciso ze-Medicare Benevantage zineeprimiyamu yazo zonke.
Nangona isicwangciso sakho se-Medicare Benevantage sihlawula iinkonzo zakho zeCandelo B, kufuneka uhlawule iiprayam zenyanga zeNgxenye B.
Ukubhalisa ngokuzenzekelayo kunye noKhuseleko loLuntu
Ukubhalisa ngokuzenzekelayo kwi-Medicare kunye noKhuselo loLuntu kuhamba ngesandla. Abantu abafumana inzuzo yeNtlalo yoKhuselo baya kubhaliswa ngokuzenzekelayo kwi-Original Medicare xa befanelekile. Oku kuya kwenzeka ngexesha lokuQala lokuBhaliswa kokuQala xa uphendukela kwiminyaka engama-65 ubudala okanye emva kokuba ubekho kwi- inshurensi yokukhubazeka kweNtlalo (SSDI) kwiinyanga ezingama-24.
Ukuba ufake isicelo kwiinyanga ezintathu zokuqala zePeriode yokuBhaliswa kokuQala, iintlawulo zakho zeMedare ziya kuqala ngosuku lokuqala lwenyanga yakho yokuzalwa eyi-65. Xa usebenza kwisiqingatha sesibini seNyanga yokuBhaliswa kokuQala, iintlawulo zakho ziya kuqala zingangeenyanga ezi-3 (ngenyanga eyi-1 ukuba usebenza ngenyanga yakho yokuzalwa, kwiinyanga ezi-2 ukuba usebenzise inyanga emva kokuzalwa kwakho ngenyanga okanye kwiinyanga ezintathu ukuba sebenzisa iinyanga ezi-2 ukuya kwezi-3 emva kwenyanga yakho yokuzalwa). Kwimeko ye-SSDI, inzuzo ye-Medicare iza kuqala ngenyanga ye-25 yezibonelelo zakho zokukhubazeka.
Kungakhathaliseki indlela yokubhalisa ngokuzenzekelayo, iindleko zeeprayimari zakho zenyanga zichithwa ngokukhawuleza kwi-check Safety yakho.
Ukuba ufuna isicwangciso se-Medicare Benevantage endaweni yeSifo seMveli, uza kufuneka uthathe inyathelo kwaye ubhalisele isicwangciso.
Ukuba nasiphi na isigqibo unqumle ukuba awufuni ukuthatha inxaxheba kwi-Medicare ngeli xesha lokubhalisa ngokuzenzekelayo, kufuneka uthabathe inyathelo uze uphume. Yilumke kakhulu ekwenzeni esi sigqibo. Ukunciphisa ICandelo Iingeniso ze-A ziphinde ziphelise iintlawulo zakho zeNtlalo.
Abantu abangenako ukufumana iinzuzo zoKhuselo lweNtlalo kufuneka bathathe inyathelo baze babhalise kwi-Medicare ngokwabo. Ubuncinane kwafuneka kufike uguqulelo olungapheliyo.
Ukuguquka kokuguqulwa okungahambi kakuhle
Ukubhalisa ngokuzenzekelayo ngoku kunokuchaphazela abantu abangenakufumana inzuzo yeNtlalo yeNtlalo.
Ukuguqulwa kwamandla angenawo amandla kwiinkampani zomshuwalense yabucala axhasa amacebo e-Medicare Advantage. Ukuba unesicwangciso sezempilo esinikwe enye yeenkampani zomshuwalense ngexesha ufanelekile kwi-Medicare, nokuba ngaba nguNqanaba loNonophelo loNcedo lwezempilo okanye icebo lezempilo elixhaswe ngumqeshi, inkampani inokubhalisela ngokuzenzekelayo kwenye yazo Izicwangciso zeMida.
Ekubonweni kokuqala, oku kungathi ngathi yinto entle. Emva koko, le nkqubo inokunceda umntu ofuna ukuhlala kunye nenkampani efanayo yomshuwalense. Kuya kuba lula ukulawula, ukuphelisa isinyathelo kwinkqubo, kwaye uncede uqhubeke nokuqhubeka nenkampani. Inokuthi ithintele ukuhlawulwa kwezigwebo ezinokuthi zindleko zamakhulu ukuya kumawaka eedola eziphuma kwiindleko zesikhwama kubantu ababhalisa ixesha elide kwi-Medicare.
Kanye njengoko kukho iingenelelo zokuguqulwa okungahambi kakuhle, kukho ukungahleleki.
- Iindleko. I-Medicare yasekuqaleni yindlela encinci yexabiso, kodwa inkampani yomshuwalense yabucala iyicinga ukuba uya kufuna ukuhlawula i-premium eyongezelelweyo nyanga zonke kwiCandelo leNzuzo ye-Medicare.
- Ukhetho. Inkampani ikhetha icebo kuwe. Baya kukhetha icebo elibiza kakhulu ukuqhuba i-profits, kungekhona isicwangciso esona siphumelele kakhulu okanye sinofezekisa iimfuno zakho.
- Umyinge. Ungacingi isicwangciso obenakho ngaphambi kokuba ufanelekile kwi-Medicare yisicwangciso esiza kuqhubeka phantsi kwe-Medicare Benevantage. Unokulahlekelwa ukufikelela kwabanye oogqirha, amanxibelelwano esibhedlele, amayeza, okanye iinkonzo ngokuxhomekeke kwisicwangciso se-Medicare Benevantage esikhethiweyo.
Imisebenzi yokuguqulwa engagqibekanga
Amaziko e-Medicare kunye neeNkonzo zeMedicaid (i-CMS) ifuna iinkampani ze-inshorensi ukuba zifake isicelo semvume yokuthatha inxaxheba ekuguquleni okungagqibekanga. Oku kuvumela urhulumente ukuba aphathe umgaqo-nkqubo kwizinga. Indlela edlala ngayo kwihlabathi lenene, nangona kunjalo, ibonakalise ukuba yingxaki.
Umshuwalense kufuneka anike umzuzwana isaziso esibhaliweyo seentsuku ezingama-60 zobhaliso lwabo kwisicwangciso. Ukuba loo mntu akayi kuphuma, ukuba ukubhalisa kusebenza ngokuzenzekelayo. Ingxaki kukuba i-mailings evela kwinkampani yomshuwalense eyazisa umxhamli wale nyaniso ingangcwatyelwa phakathi kokubethelwa kweefayili evela kwezinye iinkampani zomshuwalense ezikhuthaza izicwangciso zazo. Abantu abadala baye bahlaziywa ngezinto zokuthengisa kwaye badidekile ngamalungelo abo.
Umxhamli angazi ukuba bafumana isicwangciso se-Medicare Benevantage kuze kube yilapho bethola ibhalwa-mali yokunakekelwa okwenziwe ngaphandle kwenethiwekhi okanye bafumana ikariti ye-Medicare Advantage kunye nodokotela ononophelo olusisiseko kulolu hlobo. ukulahleka kokuqhubeka nokunyamekela abaninzi abantu abadala.
Ukubamba kodwa AkunakuMisa ukuguquka
Ingxaki ngokuguqulwa okungagqibekanga kukuba abaxhamli banokukhetha ukuphuma ngaphandle kokungena kwiiplani ze-Medicare Benevantage. Ukubeka nje, ufakwa kwisicwangciso kwaye unyanzelekile ukuwukhansela kunokuba unike inkululeko yokuwukhetha kuqala.
Iindaba ezilungileyo kukuba i-CMS ifake ixeshana kwizicelo ezivela kwizicwangciso ezintsha ze-inshorensi ezifuna ukuthatha inxaxheba ekuguquleni okungagqibekanga. Iindaba ezimbi ukuguqulwa okungagqibekanga kusekho izicwangciso eziye zanikwa imvume.
Yazi amalungelo akho kwaye ugcine iso lokuphuma kwiimeyile ezivela kwinkampani yakho yomshuwalense enokubhekiselele ekuguquleni okungekho nto. Ufanelwe isicwangciso esilungelelanisa imfuno zakho, zombini kunye nemali. Ukuba ukuguqulwa okungagqibekanga kusebenza kuwe, kulungile! Ukuba akunjalo, unganqikazi ukuphuma kwaye ukhethe i-Original Medicare okanye icebo elithile le-Advantage ye-Advantage, kunye nenkampani yakho yangoku okanye enye inkampani.
> Imithombo:
> I-Crochunis, uM. Ukubhaliswa kwabangabikhoyo ngabanye kwi-Initial Eligibility for Medicare. Amasebe e-Medicare ne-Medicaid Services website. https://www.cms.gov/Medicare/Eligibility-and-Enrollment/MedicareMangCareEligEnrol/Downloads/HPMS_Memo_Seamless_Moratorium.pdf. Ipapashwe ngo-Oktobha 21, 2016.
> I- Medicare Manual Managing Care: Isahluko 2 - UkuBhaliswa kweMpilo kunye nokuHlulwa kweMpilo. Amasebe e-Medicare ne-Medicaid Services website. https://www.cms.gov/Medicare/Eligibility-and-Enrollment/MedicareMangCareEligEnrol/Downloads/CY_2016_MA_Enrollment_and_Disenrollment_Guidance_9-14-2015.pdf. Ukuhlaziywa kukaSeptemba 14, 2015.
> Icandelo C-MEDICARE + INKQUBO YENKQUBO: Ukufaneleka, ukhetho, nokuBhalisa. Iwebhusayithi yoLawulo loKhuseleko loLuntu. https://www.ssa.gov/OP_Home/ssact/title18/1851.htm.