Ngaba Unyango loMzimba luGqityiwe nguMedare?

Umxholo

• Ngaba i-Medicare igubungela nini unyango lomzimba?
• Ukufunda kunye neentlawulo
• Ngawaphi amalungu e-Medicare agubungela unyango lomzimba?
• Icandelo A
• Icandelo B
• Icandelo C
• Icandelo D
• IMedigap
• Yimalini unyango lomzimba?
• Ukulinganisa iindleko zakho zokuphuma epokothweni
• Zeziphi izicwangciso zeMedicare ezinokuba ngcono ukuba uyazi ukuba ufuna unyango lomzimba?
• Umgca wezantsi

I-Medicare inokunceda ukuhlawulela unyango ngokwasemzimbeni (i-PT) ethathelwa ingqalelo njengeyimfuneko kwezonyango. Emva kokudibana neCandelo B elichithwayo, eliyi- $ 198 ngo-2020, i-Medicare iya kuhlawula iipesenti ezingama-80 zeendleko zakho ze-PT.

I-PT inokuba yinto ebalulekileyo kunyango okanye ekubuyiseleni iimeko ezahlukeneyo. Ijolise ekubuyiseleni ukusebenza, ukunciphisa iintlungu, kunye nokukhuthaza ukunyuka kokuhamba.

Abanyangi ngokwasemzimbeni basebenza ngokusondeleyo kunye nawe ukuphatha okanye ukulawula iimeko ezahlukeneyo, kubandakanya kodwa kungaphelelwanga kukonzakala kwemisipha, ukubetha, kunye nesifo sikaParkinson.

Qhubeka ufunda ukuze ufumanise ukuba ngawaphi amalungu e-Medicare agubungela i-PT kwaye nini.

Ngaba i-Medicare igubungela nini unyango lomzimba?

Icandelo le-Medicare Icandelo B liya kunceda ukuhlawulela i-PT yezigulana ezingalaliswayo eziyimfuneko kwezonyango. Inkonzo ithathwa njengeyimfuneko kwezonyango xa kufuneka ichonge ngokufanelekileyo okanye inyange imeko okanye isigulo. I-PT inokuthi ithathelwe ingqalelo njengefanelekileyo:

• phucula imeko yakho yangoku
• gcina imeko okuyo ngoku
• ucothe ukonakala ngakumbi kwemeko yakho

Ukuze i-PT igqunywe, kufuneka ibandakanye iinkonzo ezinezakhono ezivela kubuchwephesha obufanelekileyo njengonyango okanye ugqirha. Umzekelo, into efana nokubonelela ngokuzivocavoca ngokubanzi komzimba wonke ayizukugutyungelwa njenge-PT phantsi kwe-Medicare.

Umgqirha wakho womzimba kufuneka akunike isaziso esibhaliweyo ngaphambi kokukunika nayiphi na inkonzo engayi kugqitywa phantsi kweMedare. Ungakhetha ke ukuba uyafuna na ezi nkonzo.

Ukufunda kunye neentlawulo

Emva kokuba udibene neCandelo B elincitshisiweyo, eliyi- $ 198 ngo-2020, i-Medicare iya kuhlawula iipesenti ezingama-80 zeendleko zakho ze-PT. Uya kuba noxanduva lokuhlawula iipesenti ezingama-20 eziseleyo. Akusekho cap kwiindleko ze-PT eziza kuhlawulwa yi-Medicare.

Emva kokuba iindleko zakho ze-PT zizonke zidlula umqobo othile, ugqirha wakho wenyama uyacelwa ukuba aqinisekise ukuba iinkonzo ezibonelelweyo zihlala ziyimfuneko kwezempilo kwimeko yakho. Kwi-2020, lo mqobo ngu- $ 2,080.

Umgqirha wakho uya kusebenzisa amaxwebhu ukubonisa ukuba unyango lwakho luyimfuneko. Oku kubandakanya ukuvavanywa kwemeko yakho kunye nenkqubela phambili kunye nesicwangciso sonyango ngolwazi olulandelayo:

• ukuxilonga
• uhlobo oluthile lwe-PT oya kufumana
• iinjongo zexesha elide zonyango lwakho lwe-PT
• Inani leeseshoni ze-PT oya kuzifumana ngosuku olunye okanye ngeveki enye
• Inani elipheleleyo leeseshoni ze-PT ezifunekayo

Xa iindleko ze-PT zizonke zingaphezulu kwe- $ 3,000, uphononongo lonyango ekujoliswe kulo lunokwenziwa. Nangona kunjalo, ayingawo onke amabango aphantsi kwale nkqubo yoqwalaselo.

Ngawaphi amalungu e-Medicare agubungela unyango lomzimba?

Makhe siqhubeke ngokwaphula iinxalenye ezahlukeneyo zeMedicare kunye nendlela ingxelo ebonelelweyo enxulumene ngayo ne-PT.

Icandelo A

Icandelo leMedicare A yinshurensi yesibhedlele. Ibandakanya izinto ezinje:

• Ukuhlala ngaphakathi kwizibonelelo ezifana nezibhedlele, amaziko empilo yengqondo, amaziko okubuyisela imeko esiqhelweni, okanye amaziko ononophelo anobuchule
• Unonophelo lwehosisi
• ukhathalelo lwempilo ekhaya

Icandelo A linokugubungela ukubuyisela kwimeko yesiqhelo izigulana kunye neenkonzo ze-PT xa zithathwa njengemfuneko yonyango ukuphucula imeko yakho emva kokulaliswa esibhedlele.

Icandelo B

Icandelo leMedicare B yinshurensi yezonyango. Ibandakanya iinkonzo zonyango ezingxamisekileyo eziyimfuneko. ICandelo B linokubandakanya ezinye iinkonzo zothintelo.

Icandelo leMedicare B ligubungela i-PT eyimfuneko kwezonyango. Oku kubandakanya zombini isifo kunye nonyango lweemeko okanye izigulo ezichaphazela amandla akho okusebenza.

Unokulufumana olu hlobo lokhathalelo kwezi ntlobo zilandelayo zoncedo:

• iiofisi zonyango
• Ukunyanga ngasese kunyango
• Amasebe angalalisanga esibhedlele
• amaziko okunyanga ngaphandle
• izibonelelo zokonga (xa iCandelo leMedicare lingasebenzi)
• ekhaya (usebenzisa umboneleli ovunyiweyo we-Medicare)

Icandelo C

Izicwangciso zeMedicare Part C zikwabizwa ngokuba zizicwangciso zeMedicare Advantage. Ngokungafaniyo namacandelo A kunye no-B, zinikezelwa ziinkampani zabucala ezivunyiweyo yiMedicare.

Izicwangciso zeCandelo C zibandakanya ukhuselo olunikezelwa ngamacandelo A no-B. Oku kubandakanya unyango oluyimfuneko lwe-PT. Ukuba unesicwangciso seCandelo C, kuya kufuneka ujonge ulwazi malunga nayo nayiphi na imigaqo-nkqubo ekhethekileyo yeenkonzo zonyango.

Izicwangciso zeCandelo C zinokubandakanya ezinye iinkonzo ezingafakwanga kwicandelo A no-B, ezinje ngamazinyo, umbono, kunye nokugubungela amayeza kagqirha (Icandelo D). Okubandakanyiweyo kwisicwangciso seCandelo C kungohluka.

Icandelo D

Icandelo lonyango i-Medicare Icandelo D kukugubungela amayeza. Ngokufana neCandelo C, iinkampani zabucala ezivunyiweyo yiMedicare zibonelela ngezicwangciso zeCandelo D. Amayeza agutyungelweyo ayahluka ngokwesicwangciso.

Izicwangciso zeCandelo D azigubungeli i-PT. Nangona kunjalo, ukuba amayeza amiselweyo ayinxalenye yonyango okanye isicwangciso sokubuyisa, iCandelo D linokuwagubungela.

IMedigap

I-Medigap ikwabizwa ngokuba yi-Medicare yokuxhasa i-inshurensi. Le migaqo-nkqubo ithengiswa ziinkampani zabucala kwaye inokuhlawula ezinye iindleko ezingagutyungelwanga ngamacandelo A no-B. Oku kunokubandakanya:

• utsalo
• iikopayi
• Uqinisekiso
• Unonophelo lwezonyango xa usiya ngaphandle kweUnited States

Nangona iMedigap isenokungayigubungeli i-PT, eminye imigaqo-nkqubo inokunceda ekugubungeleni ii-copayments okanye izinto ezitsalwayo.

Yimalini unyango lomzimba?

Iindleko ze-PT zinokwahluka kakhulu kwaye izinto ezininzi zinokuchaphazela iindleko, kubandakanya:

• isicwangciso sakho seinshurensi
• uhlobo oluthile lweenkonzo ze-PT ozifunayo
• ubude bexesha okanye inani leeseshoni ezichaphazelekayo kunyango lwe-PT
• yimalini ingcali yonyango lwakho ehlawulisayo
• indawo okuyo
• uhlobo lwesibonelelo osisebenzisayo

ICopay inokuba yinto enkulu kwiindleko ze-PT. Ngamanye amaxesha, ikopi yeseshoni enye inokuba njalo. Ukuba ufuna ukuba neeseshoni ezininzi ze-PT, ezi ndleko zingadibanisa ngokukhawuleza.

Isifundo esivela kwi-2019 sifumanise ukuba inkcitho ye-PT yomthathi-nxaxheba yayiyi- $ 1,488 ngonyaka. Oku kwahluka ngokuxilongwa, kunye neemeko zemithambo-luvo kunye nenkcitho edibeneyo yokutshintsha endaweni ephezulu ngelixa iimeko ze-genitourinary kunye ne-vertigo bezisezantsi.

Ukulinganisa iindleko zakho zokuphuma epokothweni

Nangona usenokungazi ncam ukuba ingakanani indleko ye-PT eya kukuhlawula, kunokwenzeka ukuba uze noqikelelo. Zama oku kulandelayo:

1. Thetha nonyango lwakho lomzimba ukuze ufumane umbono wokuba luza kuba malini unyango lwakho.
2. Jonga ngesicwangciso sakho seinshurensi ukufumanisa ukuba zingakanani ezi ndleko ziya kuhlawulwa.
3. Thelekisa la manani mabini ukuze uqikelele imali oza kuyidinga ukuyihlawula. Khumbula ukufaka izinto ezinje ngee-copays kunye nezinto ezitsaliweyo kuqikelelo lwakho.

Zeziphi izicwangciso zeMedicare ezinokuba ngcono ukuba uyazi ukuba ufuna unyango lomzimba?

Amalungu e-Medicare A no-B (i-Medicare yoqobo) agubungela i-PT eyimfuneko kwezonyango. Ukuba uyazi ukuba uya kudinga unyango lomzimba kunyaka ozayo, ukuba nezi ndawo zinokuhlangabezana neemfuno zakho.

Ukuba unenkxalabo malunga neendleko ezongezelelweyo ezingagqitywanga ngamacandelo A no-B, unokufuna ukucinga malunga nokongeza isicwangciso seMedigap. Oku kunokunceda ukuhlawulela izinto ezinjengee-copays, ezinokongeza ngexesha le-PT.

Izicwangciso zeCandelo C zibandakanya okugutyungelweyo kumacandelo A naku-B. Nangona kunjalo, banokugubungela iinkonzo ezingagutyungelwanga zezi ndawo. Ukuba uya kufuna ukugubungela amazinyo, umbono, okanye iinkqubo zokomelela komzimba ukongeza kwi-PT, jonga isicwangciso seCandelo C.

Icandelo D libandakanya ukugubungela iziyobisi. Inokongezwa kumacandelo A kunye no-B kwaye ihlala ibandakanywa kwizicwangciso zeCandelo C. Ukuba sele uthabathe amayeza kagqirha okanye uyazi ukuba angayinxalenye yesicwangciso sakho sonyango, jonga kwisicwangciso seCandelo D.

Umgca wezantsi

Icandelo leMedicare B ligubungela i-PT yezigulana ezingalaliswayo xa kunyanzelekile. Imfuneko yonyango kuthetha ukuba i-PT oyifumanayo iyafuneka ukuba ichonge ngokufanelekileyo okanye inyange imeko yakho.

Akukho cap kwiindleko ze-PT eziza kuhlawulwa yi-Medicare. Nangona kunjalo, emva kokubambeka okuthile ugqirha wakho ngokwasemzimbeni uya kudinga ukuqinisekisa ukuba iinkonzo ozifumanayo ziyimfuneko kwezonyango.

Ezinye izicwangciso zeMedare, ezinje ngeCandelo C kunye neMedigap, zinokuhlawula iindleko ezinxulumene ne-PT. Ukuba ujonge enye yezi, khumbula ukuthelekisa izicwangciso ezininzi ngaphambi kokukhetha enye kuba ukogquma kungohluka ngesicwangciso.

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.