Izicwangciso zentsebenzo zonyango ziza kwiintlobo ezine ezisisiseko
I-Medicare Benevantages Plans, okanye i-Medicare Part C, inikezela abaxhamli beMedare ngenye indlela kwi-Medicare yendabuko. Ezi zicwangciso zivumela izigulane ukuba zikhethe isicwangciso esinokubonelela ukuguquguquka okufunekayo ukuze zihambelane neemfuno zabo ezithile. Oku kunokubangela ukuba abaninzi abaxhamli beMicrosoft bafumane imali engenayo.
IziCwangciso zeNzuzo zeMagqirha
Iinkampani zeeMpilo zeNkqubo zeMpilo kufuneka zilandele isethi efanayo yemithetho elawula inkqubo ye-Medicare. Izivumelwano zeMedare kunye nemibutho karhulumente okanye yabucala ukubonelela ngeendlela ezahlukeneyo zempilo ezijongene neenzuzo ezifanayo ze-Medicare Part A kunye neNgxenye B.
- I-Medicare Icandelo A libizwa ngokuba yi-inshurensi yesibhedlele kuba inceda ukuhlawula ukunyamekela isigulane esifumene nesilwanyana esibhedlele esibhedlele, isibhedlele esifikeleleko esibalulekileyo, isibonelelo soononophelo lwezakhono (SNF), ukunakekelwa kwezibhedlele kunye nokunakekelwa kwempilo ekhaya.
- I-Medicare Ingxenye B yinxalenye ye-Medicare ebizwa ngokuba yi-inshurensi yonyango. Le nxalenye ye-Medicare ikhethela izigulane xa zifikelela kwiminyaka engama-65 ubudala, kwaye zihlawulwa i-premium yenyanga. Icandelo B libandakanya iinkonzo ezininzi ezingakhange zifakwe kwiCandelo A.
Iintlobo zeeNkqubo zeMicrosoft Benefits Plans - Icandelo C
Kukho iintlobo ezine ezahlukileyo zeMicrosoft Benefits Plans abaxhamli abangakhetha kuzo. Ezi ziyahlukahluka ngendlela ababoneleli abahlawulwa ngayo, kunye neepayili kunye nezinye iimfuno zezigulane.
1. Umbutho wezeMpilo okanye i-HMO Plans
I-Medicare i-HMO izicwangciso zisebenza ngendlela efanayo nokunyamekelwa kwe-HMO. Isiqalo esibonakala sisona sininzi nesicwangciso se-HMO yindlela yayo yokuhlawula. Iofisi yezobugqirha ifumana inkokhelo ehleliweyo, yenyanga ngenyanga. Eli nani lihlala lifana naluphi na ukutyelelwa kwesigulane, iindleko zeendleko ezifakwe kwintlawulo, okanye nangona bengenakunyamekelwa nonke. Ezinye iimpawu ze-HMO zi:
- Akuncinci kubaboneleli bee-network ngaphandle koxakeka
- Ukudluliselwa okufunekayo kubone ingcali
- Ugunyaziso oluphambili lufunekayo kwiinkonzo ezithile
- Amalungu akanayo ama-copay amancinci kunye namancinci
2. Umbutho woMboneleli okhethiweyo okanye iiPPO
Izicwangciso zeMParelo zePPO zifana neenkqubo zokunyamekela iPPO. IipPOs zihlawula ngeendlela zokufumana imali-yeenkonzo. Ukutyelela i-Ofisi, iimvavanyo zelabhu, ii-X ray, okanye ezinye iinkonzo zihlawulwa ngokwemiqathango yeshedyuli. Le ndlela yokuhlawula ivumela iofisi yezobugqirha ukuba ifumane ukuhlawulelwa okuphezulu kwiqendu ngalinye lokunyamekela. Ezinye iimpawu zi:
- Abanikezeli benethiwekhi kunye nabaxhasi be-intanethi bavunyelwe, kodwa izigulane zihlawula ngaphantsi xa abanikezeli benethwekhi basebenzisa
- Akukho zithunyelwayo ezifunekayo ukuze zibone ingcali
- Ugunyaziso oluphambili lufunekayo kwiinkonzo ezithile
- Amalungu angaba noxanduva lokuncitshiswa, i-copays kunye ne-coinsurance
- Unika izibonelelo ezongezelelweyo eziqhathaniswa neMedare yeMveli, ngeendleko ezongezelelweyo
- Kuquka i-out-of-pocket maximum year
3. I-Private Fee-For-Service okanye i-PFFS Plans
Into ebalulekileyo yokwazi malunga nezicwangciso ze-Medicare ze-PFFS kukuba zivumela ababoneleli ukuba "balinganise ibhilikhwe" ukuya kuma-15 ekhulwini kwixabiso lexabiso lokuhlawula inkonzo. Izicwangciso ze-PFFS zisebenza ngokufanayo kwizicwangciso zenkxaso.
Izicwangciso ze-inshorensi yokuzihlawula zenza iintlawulo kwiofisi yezobugcisa ngokusekelwe kumzekelo wemali-yeenkonzo. Ngomrhumo-wenkonzo, iofisi yezobugcisa ihlawulwa isamba esisetyenzisiweyo nganye kwifom okanye iseyunithi yenkonzo enikwe. Ukutyelela i-Ofisi, iimvavanyo zelabhu, ii-X ray, okanye ezinye iinkonzo zihlawulwa ngokwemiqathango yeshedyuli. Le ndlela yokuhlawula ivumela iofisi yezobugqirha ukuba ifumane ukuhlawulelwa okuphezulu kwiqendu ngalinye lokunyamekela.
IziCwangciso zeeMfuno eziZodwa okanye iSNP
IziCwangciso zeMfuno eziZodwa zeMedare zijoliswe kubaxhamli abahlala nezimo ezithile ezingapheliyo, izifo okanye izifo. Iinzuzo zikhawulelwe kwizigulane ezi:
- Unesimo esithile esingapheliyo okanye sokukhubazeka njengengculazi / iAIDS, isifo sikashukela, imeko zezempilo, ukungaphumeleli kwentliziyo (CHF), nje ukubiza ezimbalwa
- Hlala kwikhaya lokunakekelwa okanye unyamekele ekhaya
- Fumana ii-Medicare kunye neMedicaid inzuzo
Abathwali
Izicwangciso ze-Medicare Izibonelelo ngamanye amaxesha zidibaniswa kunye nezicwangciso zokunyamekela eziphathiswe ngabasebenzi bezezifo zonyango. Zininzi zezi zicwangciso zinikezwa ngeenkampani ezinkulu zekhoshurensi zempilo ezifana:
- Aetna
- AARP
- Ukunakekelwa kweMpilo eManyeneyo
- Blue Cross Blue Shield
- I-WellCare
Kubalulekile ukuba uqaphele izicwangciso ze-Medicare Benevantage kwindawo yakho kunye nendlela yokufaka ibango ukuze ukhusele iintlawulo ezilibazisekile.