Zeziphi izicwangciso eziLuncedo zeMedare ezibonelelwa nguHumana ngo-2021?

Umxholo

• Izicwangciso zeHumana Medicare eziluncedo zeHMO
• Iindleko
• Ukufunda
• Izicwangciso zeHumana Medicare eziluncedo zePSO
• Iindleko
• Ukufunda
• Izicwangciso zeHumana Medicare Advantage PFFS
• Iindleko
• Ukufunda
• IHumana Medicare yeNzuzo yeNSP
• Iindleko
• Ukufunda
• Yintoni i-Medicare Advantage?
• Ukuthatha

• UHumana yinkampani yeinshurensi yabucala ebonelela ngezicwangciso zeMedicare Advantage (Icandelo C).
• IHumana ibonelela nge-HMO, i-PPO, i-PFFS, kunye neenketho zesicwangciso se-SNP.
• Ayizizo zonke izicwangciso zeHumana Medicare eziluncedo ezinokuthi zifumaneke kwindawo yakho.

Ukuba sele wenze isigqibo sokuhamba ngesicwangciso seMedicare Advantage (Medicare Part C), usenazo izigqibo ekufuneka uzenzile. Omnye wabo ngumboneleli weinshurensi oya kuthi abonelele ngesimbozo sakho.

UHumana yinkampani yeinshurensi yezempilo efumana inzuzo e-Kentucky kwaye yamkelwe yi-Medicare ukuthengisa izicwangciso zeCandelo C. Siza kuthetha ngezicwangciso ezibonelelwa nguHumana, iindleko zabo, izinto abazigubungelayo, kunye nokunye.

Izicwangciso zeHumana Medicare eziluncedo zeHMO

Iindleko

Izicwangciso zoMbutho weSondlo sezeMpilo (HMO) zinomtsalane kubantu abaninzi ngenxa yokufikeleleka kwazo. Kwiikhowudi ezininzi ze-ZIP, kukho izicwangciso ezikhoyo ze- $ 0 yenyanga yenyanga.

Kuya kufuneka iikopi zexabiso eliphantsi xa ubona ababoneleli, ezinje ngeengcali. Ezi ntlawulo ziyahluka, ngokusekwe kwindawo, kodwa ziqala malunga ne- $ 0 ukuya kwi- $ 50 kwiindawo ezininzi. Kwiimeko ezininzi, ugqirha wakho wokukhathalela oyintloko ngekhe afune ikopi.

Ukuxhuzulwa konyaka kwizicwangciso zeHumana HMO ziyahluka ukusuka kwi- $ 0 ukuya kuthi ga kwi-800 yeedola, ngokusekwe kwindawo yakho kunye nesicwangciso osikhethayo.

Kunokubakho ukuncitshiswa minyaka le ngenxa yokugubungela amayeza amayeza nawo. Oku kwahluka ukusuka kwi- $ 0 ukuya kwi- $ 445, ngokusekwe kwindawo okuyo kunye nesicwangciso osikhethayo.

Iindleko zakho zonyaka eziphuma ngaphandle kweepokotho ziya kwahluka ngokusekwe kwisicwangciso osikhethileyo, kodwa ubuninzi bayo nayiphi na isicwangciso seMedicare Advantage yi- $ 7,550 ngo-2021.

Ukufunda

Zifunwa ngumthetho, ezi zicwangciso zigubungela ubuncinci njenge-Medicare yoqobo, ukuze uqiniseke ngokufumana ukogcinwa esibhedlele, ukhuseleko lwezonyango, kunye nokhathalelo lothintelo, kubandakanya ukuqeshwa konyaka kunye nokugonya.

Njengayo nayiphi na i-HMO, kuya kufuneka ukhethe oogqirha bakho, kubandakanya ugqirha wakho wokukhathalela oyintloko (PCP), ngaphakathi kothungelwano lomboneleli wesicwangciso. I-Humana ibonelela ngesicwangciso sePoint-of-Service (HMO-POS) esikuvumela ukuba ukhethe ngaphandle kwabanikezeli benethiwekhi kwiimeko ezithile.

Uya kudinga ukuthunyelwa kwi-PCP yakho ukuze ubone iingcali kunye nabanye ababoneleli.

IiHMO zeHumana zigubungela ukhathalelo lonyango olungxamisekileyo ngaphandle kweMelika.

Ezinye ze-HMO ze-Humana zikwabandakanya ukugubungela iziyobisi ngokulinganayo okanye okungcono kunezicwangciso ezizimeleyo ze-Medicare Part D.

Uninzi lwezi zicwangciso lubandakanya ubulungu basimahla kwiijimi ezininzi zasekuhlaleni kunye neeklabhu zempilo. Ayizizo zonke izibonelelo zomzimba ezifakiwe kolu luhlu.

Izicwangciso zeHumana Medicare eziluncedo zePSO

Iindleko

Izicwangciso zoMbutho woMboneleli okhethiweyo (PPO) zikunika inkululeko yokukhetha naliphi na ugqirha ovunyiweyo weMedicare onqwenela ukuwabona. Nangona kunjalo, ababoneleli abangaphandle kwesicwangciso baya kuba neendleko ngaphezulu kwimeko ezininzi.

Iipremiyamu zesicwangciso sakho senyanga nenyanga kunye neepopay zingangaphezulu kunee-HMOs kwezinye iikhowudi ze-ZIP kodwa zisabiza. Iikopi zeengcali ziqala ukusuka kwi-20 ukuya kwi-40 yeedola kwiimeko ezininzi.

Uninzi lokuvavanywa kuthintelo lonyaka lunokufunyanwa ngaphandle kweendleko.

Kwakhona, iindleko zakho zonyaka eziphuma ngaphandle kwe-epokothweni ziya kwahluka ngokusekwe kwisicwangciso osikhethileyo kodwa asinakudlula kwi- $ 7,550.

Ukufunda

Njengoko kufunwa ngumthetho, ezi zicwangciso zigubungela ubuncinci njengonyango lwantlandlolo, ukuze uqiniseke ngokufumana ukulaliswa esibhedlele kunye nonyango lwangaphandle.

Uza ku hayi Ufuna ukuthunyelwa ukuze ubone umntu oyingcali.

Ezi zicwangciso zibonelela ngononophelo lwempilo ekhaya. Banikezela ngokongeza okongezayo, njengombono, amazinyo, ukugubungela iziyobisi, kunye neenkqubo zokomelela komzimba.

Unonophelo olungxamisekileyo ngaphandle kwe-United States lolunye uncedo olongeziweyo.

Izicwangciso zeHumana Medicare Advantage PFFS

Iindleko

Umrhumo wabucala wenkonzo (PFFS) awufumaneki kuyo yonke indawo.

Ngesicwangciso se-PFFS, ungabona nawuphi na ugqirha ovunyiweyo we-Medicare, ngokuxhomekeke ekubeni bayamkele imiqathango yenkonzo ye-Humana's PFFS kunye neemeko zokuhlawula.

Izicwangciso zeHumana PFFS zahlukile kwi-Medicare yoqobo kunye nakwezinye izicwangciso zokuxhasa. Njengoko i-inshurensi, i-Humana, hayi i-Medicare, eya kuthi ichonge ukuba bahlawula ntoni na ababoneleli bezempilo kunye nezibhedlele kunye nokuba kufuneka uhlawule malini ngenkathalo yakho.

Ngesicwangciso se-PFFS, awunyanzelekanga ukuba ukhethe ugqirha wokhathalelo oluphambili. Awuyi kufuna ukuthunyelwa ukuze ubone ingcali.

Uninzi lokuvavanywa kuthintelo lonyaka lunokufunyanwa ngaphandle kweendleko.

Kubaluleke kakhulu ukuqinisekisa ukuba ugqirha wakho unesivumelwano esiqhubekayo nenethiwekhi yeHumana PFFS ngaphambi kokufumana iinkonzo. Ngaphandle kokuba ufuna iinkonzo zongxamiseko, awuyi kuqinisekiswa ukuba ugqirha ombonayo uya kukunyanga okanye amkele intlawulo kwisicwangciso sakho.

Iindleko zakho zinokwahluka ngokwesicwangciso osikhethayo. Uya kuthi uhlawule iindleko zokwabelana ngeendleko ezimiselwe sisicwangciso sakho, ezinje ngokuseta iikopayments kunye nokuqinisekiswa kwemali. Unokucelwa ukuba uhlawule ityala lomboneleli ukongeza kwezi ntlawulo zibekiweyo.

Ukufunda

Ngokomthetho, ezi zicwangciso zigubungela ubuncinci njengeMedicare yoqobo, ukuze uqiniseke ukuba uyakufumana isibhedlele kunye neenkonzo zonyango ezingalaliswayo.

Ukugqunywa kwesiyobisi ngugqirha kufakiwe kuninzi, kodwa ayizizo zonke, izicwangciso ze-PFFS.

Unonophelo olungxamisekileyo ngaphandle kwe-United States luyagutyungelwa.

Kuba oogqirha abangasebenziyo benethiwekhi banokukhetha ukwamkela intlawulo ngesicwangciso se-PFFS esekwe kwinkonzo enikiweyo okanye kwimeko nganye, awunakuqiniseka ukuba ugqirha uya kukunyanga, nokuba banyange esinye isigulana Isicwangciso esifanayo se-PFFS osenzayo.

IHumana Medicare yeNzuzo yeNSP

Iindleko

IziCwangciso zeMfuno eziZodwa (ii-SNPs) zihlala zikhululekile kwaye azidingi zikopi, iipremiyamu okanye isiqinisekiso semali.

I-SNPs zifumaneka kuphela xa uhlangabezana neekhrayitheriya ezithile, ezinje:

• Ukuhlala kwiindidi ezithile zezigulana ezingalaliswanga, ezinje ngekhaya labongikazi
• unesifo esinganyangekiyo esivunywa yiMedicare kwi-SNP
• ukufaneleka kweMedicare kunye neMedicaid

I-Humana ibonelela ngeentlobo ezimbini ze-SNP ezifumaneka malunga nama-20. Olunye uhlobo lolwabo bantu banelungelo lokufumana iMedicaid kunye neMedicare. Olunye uhlobo lolwabo baneemeko ezithile zempilo ezingapheliyo, ezinje:

• isifo sentliziyo
• isifo sentliziyo esinganyangekiyo
• isifo esinganyangekiyo semiphunga
• isifo seswekile
• Isifo sokugqibela sezintso (ESRD)

Ukufunda

Ukuba ukulungele ukufumana i-Humana SNP, uya kufumana zonke izibonelelo zeMedicare yoqobo kunye neMedicare Icandelo D.

Iinkqubo zempilo kunye nokuba sempilweni nazo zinokubandakanywa kwiimeko ezinje ngeswekile kunye nokhathalelo lokuthintela. I-SNP yakho inokugubungela ukhathalelo lwamazinyo oluqhelekileyo, ukhathalelo lombono, ukhathalelo lokuva, kunye neenkonzo zokuhambisa zonyango ezingxamisekileyo. Isibonelelo esingaphezulu kwekhawuntareni (OTC) sihlala sibandakanyiwe kwisixa esimiselweyo.

Yintoni i-Medicare Advantage?

Uncedo lweMedicare (Icandelo C) zizicwangciso ezibonelela ngogqithiso olongezelelekileyo malunga noko kubonelelwa yiMedicare yoqobo. Iindleko zesicwangciso ngasinye ziyahluka ngokusekwe kwinqanaba lokugubungela okhetha ukungena kulo, kunye nendawo okuyo.

Izicwangciso zeMedare eziluncedo kufuneka zigubungele ngokusemthethweni ubuncinci njengeMedicare yoqobo. Iinkonzo ezongezelelweyo abazibonelelayo zibandakanya ukogquma amazinyo, umbono, ukuva, kunye neziyobisi.

Ayizizo zonke iintlobo zezicwangciso ezikhoyo kuzo zonke iidolophu. I-Medicare's ifumana isixhobo sesicwangciso inokukunceda uphonononge izicwangciso zeMedicare ezikhoyo kwindawo yakho. Uya kudinga ukufaka ikhowudi yakho ye-ZIP.

Ukuthatha

I-Humana inikeza uluhlu olubanzi lwezicwangciso ze-Medicare Advantage kulo lonke ilizwe. Ezi zicwangciso ziyafunwa ngumthetho ukubonelela ubuncinci ngokugubungela i-Medicare yoqobo.

Uninzi lwezicwangciso zibonelela ngeendlela ezininzi zokugubungela, ezinje ngombono, amazinyo, kunye neziyobisi. Isicwangciso okwaziyo ukukhetha kufuneka sisebenzise ikhowudi yakho ye-ZIP. Iindleko ziyahluka ngokwesicwangciso.

Eli nqaku lahlaziywa ngo-Novemba 13, 2020 ukubonisa ulwazi lwango-2021 lonyango.

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.