Kutheni kubaluleke kangaka ukufumana oGqirha abamkela iMedicare kufutshane nawe

Umxholo

• Kutheni ugqirha omkhethayo kufuneka athathe i-Medicare
• Ungamfumana njani ugqirha othatha amayeza
• Yintoni uGqirha woKhathalelo oluSisiseko (PCP)?
• Ngaba isicwangciso sakho seMedicare sifuna iPCP?
• Umgca osezantsi

Xa ukhetha isicwangciso seMedicare, enye into ebalulekileyo ekufuneka uyiqwalasele kukufumana oogqirha abamkela i-Medicare kufutshane nawe. Nokuba ukhangela iklinikhi, isibhedlele, ugqirha omtsha, okanye ukuba ufuna nje ukugcina ugqirha obukade umbona, ukufumana ukuba ngubani othatha i-Medicare kubalulekile. Konke kuyehla ekwenzeni uphando oluncinci ngaphambi kokucwangcisa ukuqeshwa kwakho okulandelayo kunye nokubuza imibuzo efanelekileyo kutyelelo lwakho olulandelayo.

Qhubeka ufunda ukuze ufunde ngakumbi malunga nokufumana ugqirha owamkela i-Medicare kufutshane nawe kwaye kutheni kubalulekile.

Kutheni ugqirha omkhethayo kufuneka athathe i-Medicare

Ewe ungabona ugqirha ongayamkeliyo i-Medicare, kodwa unokuhlawuliswa amaxabiso aphezulu kutyelelo lwakho kunye nazo naziphi na iinkonzo ozifumanayo. Oku kuthetha ukuba ukhathalelo lwempilo lwakho lunokubiza kakhulu.

Ngokukhetha ugqirha owamkela i-Medicare, uya kuqinisekisa ukuba uhlawulisiwe umyinge ekuxoxiswene ngawo kunye nowamkelekileyo. Iofisi kagqirha wakho iyakubiza i-Medicare ngotyelelo lwakho. Kwiimeko ezininzi, ugqirha owamkela i-Medicare uya kulinda kwakhona ukuva kwakhona kwi-Medicare ngaphambi kokuba akucele ukuba uhlawule nawuphi na umahluko weendleko ukuba kufanelekile.

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Ungamfumana njani ugqirha othatha amayeza

Kukho iindlela ezimbalwa ezilula zokufumana ugqirha owamkela isicwangciso sakho seMedare:

• Ndwendwela ugqirha Thelekisa: Amaziko e-Medicare kunye neeNkonzo zeMedicaid (i-CMS) inezixhobo ezikuvumela ukuba ujonge oogqirha kufutshane nawe kwaye ubathelekise macala onke.
• Jonga iwebhusayithi ye-Medicare: Iwebhusayithi esemthethweni ye-Medicare inezixhobo ezininzi zokufumana ababoneleli kunye nezixhobo ezamkela iMedicare kufutshane nawe. Umzekelo, unokufumana kwaye uthelekise izibhedlele okanye abanye ababoneleli kwaye ukhangele ukuba zeziphi iinkonzo ezigutyungelwe sisicwangciso sakho seMedicare.
• Jonga uluhlu lwenkampani yakho yeinshurensi: I-Medigap kunye ne-Medicare Advantage zizicwangciso ze-Medicare ezibonelelwa ngeenkampani ze-inshurensi zabucala. Ukufumana oogqirha abazamkelayo ezi ndlela zokugubungela, kuya kufuneka ujonge umboneleli wakho okhethiweyo ukuba adweliswe.
• Jonga inethiwekhi yakho: Ukuba i-inshurensi yakho ye-Medicare ibonelelwa ngumboneleli nge-inshurensi ngenethiwekhi yoogqirha kunye nezibhedlele, jonga kwinkampani ukuze uqiniseke ukuba ugqirha wakho ukwinethiwekhi yabo Oku kunokwenziwa ngokubiza umboneleli wakho weinshurensi okanye ujonge iwebhusayithi yabo.
• Buza abahlobo abathembekileyo kunye namalungu osapho: Ukuba unabahlobo okanye amalungu osapho asebenzisa iMedicare, babuze malunga nabanikezeli babo bezempilo. Unomdla kangakanani ugqirha? Ngaba iofisi izisingatha ngokukhawuleza izicelo zabo? Ngaba baneeyure ezifanelekileyo?

Yintoni uGqirha woKhathalelo oluSisiseko (PCP)?

Ugqirha oQhelekileyo woKhathalelo (PCP) ngugqirha ombona rhoqo. I-PCP yakho ngokubanzi ibonelela ngenqanaba lokuqala lokhathalelo olufumanayo, njengokuhlolwa, ukuqeshwa okungxamisekileyo, kunye noviwo oluqhelekileyo okanye lonyaka.

Abantu abaninzi bakhetha ukuba ne-PCP ezinikeleyo ukuze bahlale besazi ukuba babona bani xa beqeshwa. Ukuba nogqirha osele eyazi imbali yakho kunye neenjongo zempilo kunokwenza ukuba amadinga azive esebenza ngakumbi kwaye anesiqhamo ngelixa esusa uxinzelelo malunga nokumangaliswa.

Ezinye iinkampani zeinshurensi zabucala zinokufuna abathengi ukuba babe nePCP enye ekufuneka ivume kwaye idlulisele kwezinye iingcali okanye iinkqubo zokuqonda isifo kunye novavanyo.

Ngaba isicwangciso sakho seMedicare sifuna iPCP?

Ayizizo zonke izicwangciso zeMedicare ezifuna ukuba ukhethe ugqirha wokhathalelo oluphambili. Ukuba ukhetha ukungazikhawuleli kwiofisi enye kunye nodokotela omnye, unokuqhubeka nokubona abanye oogqirha abamkela iMedicare.

Nangona kunjalo, ukuba ujoyina i-Medicare HMO ngokusebenzisa isicwangciso seMedigap okanye seMedare, unokufuna ukukhetha iPPP. Kungenxa yokuba i-PCP yakho inokuba noxanduva lokukuthumela kwingcali kukhathalelo nge-HMO yakho.

Umgca osezantsi

Kubantu abaninzi, ukuba nogqirha abamthembayo obekwe ngokufanelekileyo yinxalenye ebalulekileyo yokhathalelo lwempilo yabo. Ngelixa inyathelo elongezelelekileyo, kubalulekile ukuba uqinisekise ukuba ugqirha wamkela ukhuselo lweMedare ukuze uqiniseke ukuba ufumana uninzi lwezibonelelo zakho zeMedicare.

Ulwazi olukule webhusayithi lunokukunceda ekwenzeni izigqibo malunga neinshurensi, kodwa ayenzelwanga ukunika iingcebiso malunga nokuthengwa okanye ukusetyenziswa kwayo nayiphi na i-inshurensi okanye iimveliso zeinshurensi. I-Healthline Media ayihambelani neshishini leinshurensi nangayiphi na indlela kwaye ayinayo ilayisensi njengenkampani yeinshurensi okanye umvelisi kulo naliphi na igunya laseMelika. I-Healthline Media ayikhuthazi okanye ixhase nabani na onokuthi enze ishishini leinshurensi.

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