Zifunyanwa Njani IziCwangciso zezeMveliso zeMedare?

Umxholo

• Zeziphi izinto ezichaphazela iindleko zakho kwisicwangciso seMedical Advantage?
• Zithini izicwangciso zokunceda amayeza?
• Ngaba ndifanelekile kwizicwangciso ze-Medicare Advantage?
• Yise kude

Izicwangciso ze-Medicare ze-Advantage zizonke iindlela ezizezinye kwi-Medicare yoqobo enikezelwa ziinkampani zabucala. Baxhaswa ngemali yiMedicare nangabantu ababhalisela isicwangciso esithile.

Qhubeka ufunda ukuze ufunde okungakumbi malunga nezicwangciso ze-Medicare Advantage kunye neendleko zokuphuma epokothweni kwezi zicwangciso.

Zeziphi izinto ezichaphazela iindleko zakho kwisicwangciso seMedical Advantage?

Imali oyihlawulayo kwi-Medicare Advantage isekelwe kwinani lezinto, kubandakanywa:

• Iipremiyamu zarhoqo ngenyanga. Ezinye izicwangciso azinayo iipremiyamu.
• Iiprimiyamu zanyanga zonke ze-Medicare Part B. Ezinye izicwangciso zihlawula zonke okanye inxalenye yePrimiyamu yesiGaba B.
• Ukutsalwa konyaka. Ingabandakanya ukuncitshiswa konyaka okanye ezinye ezinciphisiweyo.
• Indlela yokuhlawula. I-coinsurance okanye intlawulo oyibhatalayo kwinkonzo nganye okanye undwendwele.
• Uhlobo kunye nobuninzi. Uhlobo lweenkonzo ozifunayo kwaye zinikezelwa kangaphi.
• Ukwamkela ugqirha / umthengisi. Ichaphazela iindleko ukuba ukwisicwangciso se-PPO, i-PFFS, okanye i-MSA, okanye uphuma-kwenethiwekhi.
• Imigaqo. Ngokusekwe kwimithetho yakho yesicwangciso, njengokusebenzisa abathengisi benethiwekhi.
• Izibonelelo ezongezelelweyo. Yintoni oyifunayo kunye nento ehlawulwa sisicwangciso.
• Umda wonyaka. Iindleko zakho zokuphuma epokothweni zazo zonke iinkonzo zonyango.
• Unyango. Ukuba unayo.
• Xela urhulumente. Ukuba uyayifumana.

Ezi zinto zitshintsha minyaka le ngokwe:

• iipremiyamu
• utsalo
• iinkonzo

Iinkampani ezibonelela ngezicwangciso, hayi i-Medicare, zichonga ukuba ubhatala malini kwiinkonzo ezigutyungelweyo.

Zithini izicwangciso zokunceda amayeza?

Ngamanye amaxesha kubhekiswa kuzo njengezicwangciso ze-MA okanye iCandelo C, izicwangciso ze-Medicare Advantage zinikezelwa ziinkampani zabucala ezivunyiweyo yiMedicare. Ezi nkampani zityikitya neMedare ukuba zidibanise ezi nkonzo zeMedare:

• Unyango lwe-Medicare Icandelo A: ukuhlala esibhedlele kwizibhedlele ezinganyangekiyo, ukhathalelo lwe-hospice, ukhathalelo kwiziko labongikazi abanezakhono, kunye nolondolozo lwempilo ekhaya
• I-Medicare Icandelo B: iinkonzo ezithile zikagqirha, ukhathalelo lwezigulana ezingalaliswayo, izinto zonyango kunye neenkonzo zokuthintela
• Icandelo leMedicare D (ngesiqhelo): amayeza amiselweyo

Ezinye izicwangciso ze-Medicare Advantage zinika inkxaso eyongezelelweyo, njenge:

• zamazinyo
• umbono
• ukuva

Izicwangciso eziqhelekileyo ze-Medicare Advantage zi:

• Izicwangciso ze-HMO (umbutho wolondolozo lwempilo)
• Izicwangciso ze-PPO (umbutho womboneleli okhethiweyo)
• Izicwangciso ze-PFFS (umrhumo wenkonzo yabucala)
• I-SNP (izicwangciso zemfuno ezizodwa)

Izicwangciso ezincinci eziqhelekileyo zeMedicare ziquka:

• Izicwangciso zeakhawunti yokonga amayeza (iMSA)
• Izicwangciso ze-HMOPOS (indawo yenkonzo ye-HMO)

Ngaba ndifanelekile kwizicwangciso ze-Medicare Advantage?

Unokuhlala ujoyina uninzi lwezicwangciso ze-Medicare Advantage ukuba:

• uneMedicare Icandelo A kunye neCandelo B
• uhlala kwindawo yezicwangciso zenkonzo
• abanaso isiphelo sesifo sezintso (ESRD)

Yise kude

Izicwangciso ze-Medicare Advantage - ekwabizwa ngokuba ziiPlani ze-MA okanye iCandelo C - zinikezelwa ziinkampani zabucala kwaye zihlawulelwa yiMedicare nangabantu abafanelekileyo beMedicare ababhalisela esi sicwangciso.

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.