Ukuqonda amayeza

I-Medicare yi-inshurensi yezempilo eqhutywa ngurhulumente kubantu abaneminyaka engama-65 okanye ngaphezulu. Abanye abantu banokufumana i-Medicare:

• Abantu abancinci abakhubazekileyo
• Abantu abanomonakalo osisigxina wezintso (isigaba sokugqibela sesifo sezintso) kwaye bafuna i-dialysis okanye ukufakelwa kwezintso

Ukufumana i-Medicare, kufuneka ube ungummi wase-United States okanye umhlali osisigxina osemthethweni ohlala kweli lizwe iminyaka emihlanu ubuncinci.

I-Medicare inamalungu amane. Icandelo A no-B bakwabizwa ngokuba yi "Original Medicare."

• Icandelo A - Ukhathalelo lasesibhedlele
• Icandelo B - Unonophelo lwangaphandle
• Icandelo C - Uncedo lweMedicare
• Icandelo D - isiCwangciso seMithi sokuNyanga amayeza

Uninzi lwabantu lunokukhetha i-Original Medicare (iinxalenye A kunye no-B) okanye i-Medicare Advantage. NgeMedicare yoqobo, unokhetho lokukhetha isiCwangciso D samayeza akho amiselweyo.

Icandelo leMedicare A ligubungela iinkonzo kunye nezinto ezifunekayo ukunyanga isifo okanye iimeko zonyango kwaye zenzeka ngexesha:

• Ukunyamekela esibhedlele.
• Unonophelo lwezakhono zononophelo, xa uthunyelwa ukuba uphinde uchache kwisifo okanye kwinkqubo. (Ukufudukela kumakhaya abalupheleyo xa ungasakwazi ukuhlala ekhaya akuhlawulwa yiMedicare.)
• Ukunyamekela.
• Ukutyelela impilo ekhaya.

Iinkonzo kunye nezinto ezibonelelweyo ngelixa usesibhedlele okanye indawo enokuthi ibandakanywe zezi:

• Unonophelo olunikezelwa ngoogqirha, abongikazi, kunye nabanye ababoneleli ngempilo
• Iziyobisi
• Unonophelo
• Unyango lokunceda ngentetho, ukuginya, ukuhamba, ukuhlamba, ukunxiba njalo njalo
• Uvavanyo lweLebhu kunye nemifanekiso
• Ugqirha kunye neenkqubo
• Izitulo zamavili, abahambahambayo kunye nezinye izixhobo

Uninzi lwabantu aluyihlawuli imali yenyanga kwiCandelo A.

Unonophelo lwangaphandle. Icandelo leMedicare B linceda ukuhlawulela unyango kunye neenkonzo ezinikezelwa njengesigulana esingaphandle. Unonophelo lwabaguli bangaphandle lunokwenzeka kwi:

• Igumbi lexakeka okanye enye indawo yesibhedlele, kodwa xa ungamkelwa
• Iiofisi zomboneleli wezempilo (kubandakanya umongikazi, ugqirha, nabanye)
• Amaziko otyando
• Ilabhoratri okanye iziko lokucinga
• Ikhaya lakho

Iinkonzo kunye nabanye ababoneleli ngezempilo. Ikwahlawulela iinkonzo zononophelo lwempilo, ezinje:

• Ukutyelela impilo kunye nezinye iinkonzo zokukhusela, ezifana nomkhuhlane kunye ne-pneumonia shots kunye ne-mammograms
• Iinkqubo zotyando
• Uvavanyo lweLebhu kunye ne-x-ray
• Iziyobisi kunye namayeza ongenako ukukunika wona, njengamayeza onikwe ngemithambo yakho
• Ukondla iityhubhu
• Utyelelo kunye nomboneleli
• Izitulo zamavili, abahamba ngeenyawo, kunye nezinye izinto
• Kwaye okuninzi

Uninzi lwabantu luhlawula ipremiyamu yenyanga ngeCandelo B. Uhlawula ikhefu elincinci lonyaka. Nje ukuba kufikelelwe kweso sixa, uhlawula ama-20% eendleko kwiinkonzo ezininzi. Oku kubizwa ngokuba yi-coinsurance. Uhlawula ikopi yeendleko zokundwendwela ugqirha. Le yintlawulo encinci, ihlala iphantse ibe yi- $ 25 okanye njalo, kugqirha ngamnye okanye kutyelelo lweengcali.

Ngokuchanekileyo oko kugutyungelweyo kwindawo yakho kuxhomekeke:

• Imithetho yaseburhulumenteni kunye neyaseburhulumenteni
• Oko kwenziwa nguMedare kugqityiwe
• Zeziphi iinkampani zasekhaya ezithatha isigqibo sokugubungela

Kubalulekile ukuba uhlale ujonga ukogquma kwakho ngaphambi kokusebenzisa inkonzo ukufumana ukuba yeyiphi i-Medicare eza kuyihlawulela kwaye ungadinga ukuyihlawulela.

Izicwangciso zoncedo lweMedare (MA) zibonelela ngezibonelelo ezifanayo njengeCandelo A, Icandelo B, kunye nenxalenye D. Oku kuthetha ukuba ukhuselekile kukhathalelo lonyango kunye nasezibhedlele kunye namayeza amiselweyo. Izicwangciso ze-MA zinikezelwa ziinkampani zeinshurensi zabucala ezibonelelweyo ezisebenza kunye neMedicare.

• Uhlawula i-premium yenyanga yolu hlobo lwesicwangciso.
• Ngokwesiqhelo kuya kufuneka usebenzise oogqirha, izibhedlele, kunye nabanye ababoneleli abasebenza nesicwangciso sakho okanye uya kuhlawula imali eninzi.
• Izicwangciso ze-MA zigubungela zonke iinkonzo ezigutyungelwe yi-Original Medicare (icandelo A kunye nenxalenye B).
• Banikezela ngokugubungela okongezelelweyo njengombono, ukuva, amazinyo, kunye nokufakwa kweziyobisi kugqirha. Ngamanye amaxesha, kungafuneka uhlawule ngaphezulu izibonelelo ezithile ezongezelelweyo ezinje ngononophelo lwamazinyo.

Ukuba une-Medicare yoqobo (iinxalenye ze-A kunye ne-B) kwaye ufuna ukugqunywa ngamayeza amiselweyo, kuya kufuneka ukhethe isiCwangciso seMithi yoNyango (isiCwangciso D). Olu khuselo lubonelelwa ziinkampani zeinshurensi zabucala ezivunyiweyo yiMedicare.

Awunakho ukukhetha isiCwangciso D ukuba unesicwangciso seMedicare seNzuzo kuba ukuhanjiswa kweziyobisi kunikezelwa zizicwangciso.

IMedigap yipolisi ye-inshurensi eyongezelelweyo ye-Medicare ethengiswa ziinkampani zabucala. Kuyanceda ukuhlawula iindleko ezinje ngeekopayments, ukuqinisekiswa kweemali, kunye nokuncitshiswa. Ukufumana umgaqo-nkqubo weMedigap kufuneka ube neMedicare yoqobo (icandelo A kunye nenxalenye B). Uhlawula inkampani yeinshurensi yabucala ipremiyamu yenyanga kumgaqo-nkqubo wakho weMedigap ukongeza kwintlawulo yenyanga ye-Part B oyibhatala kwi-Medicare.

Kuya kufuneka ujoyine i-Medicare Part A phakathi kweenyanga ezintathu ngaphambi kwenyanga yakho yokuzalwa (uguqula i-65) kunye neenyanga ezi-3 emva kwenyanga yakho yokuzalwa. Unikwe inyanga ye-7 yokujoyina.

Ukuba awubhaliseli iCandelo A kule festile, uyakuhlawula imali yesohlwayo ukuze ujoyine isicwangciso, kwaye ungahlawula iipremiyamu eziphezulu zenyanga. Nokuba usasebenza kwaye uza kugutyungelwa yi-inshurensi yomsebenzi, kuya kufuneka ubhalisele i-Medicare Part A. Ke sukulinda ukujoyina iMedicare.

Ungabhalisela i-Medicare Icandelo B xa ubhalisela okokuqala icandelo A, okanye ungalinda ude ulufune olo hlobo lokugubungela.

Unokukhetha phakathi kwe-Medicare yoqobo (Icandelo A kunye neCandelo B) okanye isiCwangciso seNzuzo ye-Medicare (Icandelo C). Uninzi lwexesha, ungatshintshela ngapha nangapha phakathi kwezi ntlobo zokugubungela ubuncinci kube kanye ngonyaka.

Thatha isigqibo sokuba uyafuna na ukugqunywa ngamachiza kagqirha okanye iCandelo D. Ukuba ufuna ukunikwa iziyobisi ngugqirha kufuneka uthelekise izicwangciso eziqhutywa ziinkampani zeinshurensi Sukuthelekisa iipremiyamu ngelixa uthelekisa izicwangciso. Qinisekisa ukuba amayeza akho agutyungelwe sisicwangciso ojonge kuso.

Cinga ngezi zinto zingezantsi xa ukhetha isicwangciso sakho:

• Ukubonelela-Isicwangciso sakho kufuneka sigubungele iinkonzo kunye namayeza owafunayo.
• Iindleko-Thelekisa iindleko ekufuneka uzihlawule kwizicwangciso ezahlukeneyo. Thelekisa iindleko zepremiyamu, ezitsalwayo, kunye nezinye iindleko phakathi kokukhetha kwakho.
• Amachiza amiselweyo-Jonga ukuqinisekisa ukuba onke amayeza akho agqunyiwe phantsi kwefomula yesicwangciso.
• Ukhetho lukagqirha nolwesibhedlele-Jonga ukuba ungamsebenzisa na ugqirha kunye nesibhedlele osithandayo.
• Umgangatho wokhathalelo-Jonga uphononongo kunye nokuhlelwa kwezicwangciso kunye neenkonzo ezibonelelwa zizicwangciso kwindawo yakho.
• Ukuhamba -Fumanisa ukuba ngaba isicwangciso siyakugubungela na xa usiya kwelinye ilizwe okanye ngaphandle kwe-United States.

Ukuze ufunde okungakumbi malunga neMedicare, funda malunga nezicwangciso zeMedicare Advantage ezikhoyo kwindawo yakho, kwaye uthelekise oogqirha, izibhedlele, nabanye ababoneleli kwindawo yakho, yiya ku-Medicare.gov - www.medicare.gov

Amaziko eewebhusayithi zeMedicare kunye neMedicaid Services. Yintoni amayeza? www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices/whats-medicare. Kufumaneka ngoFebruwari 2, 2021.

Amaziko eewebhusayithi zeMedicare kunye neeNkonzo zeMedicaid. Zithini izicwangciso zezempilo zeMedicare. www.imedicare.gov/what-medicare-covers/what-medicare-health-plans-cover. Kufumaneka ngoFebruwari 2, 2021.

Amaziko eewebhusayithi zeMedicare kunye neMedicaid Services. Izixhasi kunye nezinye i-inshurensi. www.medicare.gov/supplements-other- inshurensi. Kufumaneka ngoFebruwari 2, 2021.

UStefanacci RG, uCantelmo JL. Unonophelo kubantu abadala baseMelika. Ku: Gcwalisa i-HM, i-Rockwood K, i-Young J, ii-eds. Incwadi ka-Brocklehurst ye-Geriatric Medicine kunye neGerontology. Ngomhla we-8. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 129.

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• Unyango lweziyobisi kwiMedare