Ngaba isiCwangciso seMedigap C sahamba ngo-2020?

Umxholo

• Ngaba isicwangciso seMedigap C sihambile?
• Kuthekani ukuba sele ndinesicwangciso seMedigap C okanye ndifuna ukubhalisela enye?
• Ngaba zikhona ezinye iindlela ezifanayo zesicwangciso ezikhoyo?
• Yintoni etyhilwa sisiCwangciso seMedigap C?
• Zeziphi ezinye izicwangciso ezibanzi ezikhoyo?
• Ngaba kukho umahluko weendleko phakathi kwezicwangciso?
• Ndikhetha njani isicwangciso esifanelekileyo kum?
• Imisebenzi yeMedigap:
• Umxhasi weMedigap:
• Ukuthatha

• Isicwangciso seMedigap C sisicwangciso esongezelelekileyo sokugubungela i-inshurensi, kodwa asifani neCandelo leMedicare C.
• Isicwangciso seMedigap C sigubungela uluhlu lweendleko zeMedare, kubandakanya neCandelo B elincitshisiweyo.
• Ukusukela nge-1 kaJanuwari 2020, isiCwangciso C asisafumaneki kubhaliso olutsha lweMedare.
• Ungasigcina isicwangciso sakho ukuba ubusele unesicwangciso C okanye ukuba ubulungele i-Medicare ngaphambi ko-2020.

Ungazi ukuba bekukho utshintsho kwizicwangciso zeMedigap eziqala ngo-2020, kubandakanya ne-Medigap Plan C. Ukuqala ngoJanuwari 1, 2020, isiCwangciso C sayeka. Ukuba unayo i-Medicare kunye nesicwangciso sokuncedisa iMedigap okanye ulungele ukubhalisa, usenokuzibuza ukuba olu tshintsho lukuchaphazela njani.

Into yokuqala omele uyazi kukuba iSicwangciso C asifani ne-Medicare Icandelo C. Zivakala zifana, kodwa iCandelo C, elikwabizwa ngokuba yi-Medicare Advantage, yinkqubo eyahluke ngokupheleleyo kwi-Medigap Plan C.

Isicwangciso C sisicwangciso esithandwayo seMedigap kuba sibonelela ngenkxaso kwiindleko ezininzi ezinxulunyaniswa neMedare, kubandakanya neCandelo B elitsalelweyo. Ngaphantsi kwemithetho emitsha ka-2020, ukuba ubusele ubhalisile kwiSicwangciso C, unokugcina le ngxelo.

Nangona kunjalo, ukuba umtsha kwi-Medicare kwaye ucinga ngeCwangciso C, ngekhe ukwazi ukuyithenga. Iindaba ezimnandi zininzi ezinye izicwangciso zeMedigap ezikhoyo.

Kule nqaku, siza kuthetha malunga nokuba kutheni iSicwangciso C simkile kwaye zeziphi ezinye izicwangciso ezinokuba zilungele wena endaweni yoko.

Ngaba isicwangciso seMedigap C sihambile?

Ngo-2015, iCongress yadlulisa umthetho obizwa ngokuba yi-Medicare Access kunye ne-CHIP Reauthorization Act ka-2015 (MACRA). Olunye lotshintsho olwenziwe ngulo mgaqo yayikukuba izicwangciso zeMedigap azivumelekanga ukubonelela ngesahlulo seCandelo B. Lo mthetho uqale ukusebenza ngoJanuwari 1, 2020.

Olu tshintsho lwenzelwa ukudimaza abantu ekutyeleleni i-ofisi kagqirha okanye isibhedlele xa bekungekho mfuneko. Ngokufuna ukuba wonke umntu ahlawule epokothweni kwiCandelo B elitsalwayo, iCongress inethemba lokunciphisa ukutyelelwa kwezifo ezincinci ezinokuphathwa ekhaya.

Isicwangciso C sesinye seendlela ezimbini zeMedigap ezikhethileyo ezigubungele iCandelo B elitsalwayo (elinye yayiliCwangciso F). Oku kuthetha ukuba ayinakuphinda ithengiswe kubhaliso olutsha ngenxa yomgaqo omtsha we-MACRA.

Kuthekani ukuba sele ndinesicwangciso seMedigap C okanye ndifuna ukubhalisela enye?

Ungasigcina isicwangciso sakho C ukuba sele unaso. Logama nje ubhalisile ngaphambi kukaDisemba 31, 2019, unokuqhubeka nokusebenzisa isicwangciso sakho.

Ngaphandle kokuba inkampani uthathe isigqibo sokungasiniki isicwangciso sakho, unokuxhoma kuso ixesha elide ukuba iyavakala kuwe. Ukongeza, ukuba ufanelekile kwi-Medicare ngomhla okanye ngaphambi kuka-Disemba 31, 2019, usengabhalisa kwiSicwangciso C.

Imigaqo efanayo iyasebenza kwiSicwangciso F. Ukuba ubunayo, okanye sele ubhalisile kwi-Medicare ngaphambi ko-2020, iSicwangciso F siya kufumaneka kuwe.

Ngaba zikhona ezinye iindlela ezifanayo zesicwangciso ezikhoyo?

Isicwangciso C asizukufumaneka kuwe ukuba usandula ukufumana iMedicare ngo-2021. Usenokuninzi okunokukhethwa kwizicwangciso zeMedigap ezigubungela uninzi lweendleko zakho zeMedicare. Nangona kunjalo, ezo zicwangciso azinakugubungela iindleko zeNxalenye B ezitsalwayo, ngokomgaqo omtsha.

Yintoni etyhilwa sisiCwangciso seMedigap C?

Isicwangciso C sithandwa kakhulu ngenxa yendlela ebanzi ngayo. Uninzi lwemirhumo yokwabelana ngeendleko zeMedicare zigutyungelwe phantsi kwesicwangciso. Ukongeza kwi-Part B yokutsalwa, iSicwangciso C siquka:

• Icandelo le-Medicare A litsaliwe
• Icandelo le-Medicare Icandelo leendleko zokuqinisekisa
• Icandelo leMedicare B iindleko zokuqinisekisa
• Uqinisekiso lwemali esibhedlele ukuya kwiintsuku ezingama-365
• Iipunipoyi zokuqala ezi-3 zegazi ezifunekayo kwinkqubo
• indawo yokuhlala yabongikazi
• Ukuqinisekiswa kwemali ye-hospice
• ingxelo engxamisekileyo kwilizwe langaphandle

Njengoko ubona, phantse zonke iindleko eziwela kubaxhamli be-Medicare zigutyungelwe sisiCwangciso C. Iindleko ekukuphela kwazo ezingagutyungelwanga siCwangciso C zezinto ezaziwa njengeCandelo B "iindleko ezingaphezulu." Iindleko ezingaphezulu kwesixa-mali singaphezulu kweendleko ezivunyiweyo ze-Medicare ezihlawulwa ngumboneleli ngenkonzo yezempilo ngenkonzo. Imirhumo egqithileyo ayivunyelwanga kwamanye amazwe, isenza isicwangciso C sibe lukhetho olukhulu.

Zeziphi ezinye izicwangciso ezibanzi ezikhoyo?

Kukho iintlobo ngeentlobo zezicwangciso zeMedigap ezikhoyo, kubandakanya isiCwangciso C kunye nesiCwangciso F. Ukuba awukwazi ukubhalisa nakwezinye kwezo zinto kuba wawungafanelekanga kwi-Medicare ngaphambi ko-2020, unokhetho oluninzi lokugubungela okufanayo.

Ukhetho oludumileyo lubandakanya iZicwangciso D, G, kunye noN. Zonke zinikezela ngokugubungela okufanayo kwiZicwangciso C no-F, umahluko ophambili:

• Isicwangciso D. Esi sicwangciso sinikezela konke ukugubungela iSicwangciso C ngaphandle kweCandelo B elitsalelweyo.

• Ngaba kukho umahluko weendleko phakathi kwezicwangciso?

  Iiprimiyamu zeSicwangciso C zihlala ziphakamile kancinci kuneepremiyamu zenyanga zeZicwangciso D, G, okanye uN. Iindleko zakho ziya kuxhomekeka kwindawo ohlala kuyo, kodwa ungajonga ezinye zeesampulu zeendleko ezivela kwilizwe lonke kwitshathi engezantsi:

  Isixeko	Isicwangciso C	Cwangcisa uD	Cwangcisa uG	Cwangcisa uN
  IPhiladelphia, PA	$151–$895	$138–$576	$128–$891	$88–$715
  ISan Antonio, TX	$120–$601	$127–$529	$88–$833	$70–$599
  IColumbus, OH	$125–$746	$106–$591	$101–$857	$79–$681
  KwiDenver, CO	$152–$1,156	$125–$693	$110–$1,036	$86–$722

  Kuxhomekeke kwisimo sakho, unokuba ngaphezulu kwesicwangciso esinye seG. Amanye amazwe anikezela ngesicwangciso esiphakamileyo sokutsalwa kweSicwangciso G. Iindleko zakho zepremiyamu ziya kuba sezantsi ngesicwangciso esitsalwe ngaphezulu, kodwa ukuncitshiswa kwakho kungaphakama njengamawaka ambalwa eedola ngaphambi kokuba ukugubungela kwakho iMedigap kukhabe.

  Ndikhetha njani isicwangciso esifanelekileyo kum?

  Izicwangciso zeMedigap zinokukunceda uhlawule iindleko ezinxulumene neMedicare. Kukho izicwangciso ezili-10 ezikhoyo, kwaye i-Medicare ifuna ukuba zibekwe mgangathweni nokuba yeyiphi na inkampani ebabonelelayo. Ngaphandle kwalo mgaqo zizicwangciso ezinikezelwa kubahlali baseMassachusetts, Minnesota, okanye eWisconsin. La mazwe anemithetho eyahlukeneyo yezicwangciso zeMedigap.

  Nangona kunjalo, izicwangciso zeMedigap azenzi ngqondo kuye wonke umntu. Kuxhomekeke kuhlahlo-lwabiwo mali kunye neemfuno zokhathalelo lwempilo, ukuhlawula imali eyongeziweyo enokutsalwa kunokuba kungafanelekanga ngezibonelelo.

  Kwakhona, izicwangciso zeMedigap aziboneleli ngamayeza amiselweyo kunye nokunye ukugubungela. Umzekelo, ukuba unesifo esinganyangekiyo esifuna ugqirha, ungangcono kwisicwangciso seMedicare Advantage okanye isicwangciso seMedicare Part D.

  Kwelinye icala, ukuba ugqirha wakho ukhuthaze inkqubo eza kufuna ukuhlala esibhedlele, isicwangciso seMedigap esigubungela iCandelo A elincitshisiweyo kunye nesibhedlele esiqinisekisiweyo kunokuba sisenzo esihle.

  Imisebenzi yeMedigap:

  • Ukugubungela kwilizwe liphela
  • Ukuhlawula iindleko ezininzi zamayeza
  • ukongezwa kweentsuku ezingama-365 zokugubungela isibhedlele
  • ezinye izicwangciso zibonelela ngokugubungela ngelixa usiya phesheya
  • ezinye izicwangciso zigubungela ezongezelelweyo njengeenkqubo zokomelela komzimba
  • Uluhlu olubanzi lwezicwangciso onokukhetha kuzo
  

  Umxhasi weMedigap:

  • Iindleko zepremiyamu zinokuphakama
  • Ukufakwa kweziyobisi kugqirha akubandakanywanga
  • amazinyo, umbono, kunye nokunye ukugubungela okungafakwanga
  

  Ungazithengela izicwangciso zeMedigap kwindawo yakho usebenzisa isixhobo kwiwebhusayithi yeMedicare. Esi sixhobo siza kukubonisa izicwangciso ezikhoyo kwindawo yakho kunye namaxabiso abo. Ungasisebenzisa eso sixhobo ukwenza isigqibo sokuba ngaba kukho isicwangciso esihlangabezana neemfuno zakho kunye nohlahlo-lwabiwo mali.

  Ngoncedo oluthe kratya, ungaqhagamshelana neNkqubo ye-Inshurensi yezeMpilo kaRhulumente (i-SHIP) ukufumana ingcebiso malunga nokukhetha isicwangciso kwilizwe lakho. Unokuqhagamshelana noMedare ngqo kwiimpendulo zemibuzo yakho.

  Ukuthatha

  Isicwangciso seMedigap C yindlela yokuncedisa eyaziwayo kuba igubungela uninzi lweendleko zokuphuma epokothweni ezinxulumene neMedicare.

  • Ukususela ngoJanuwari 1, 2020, iSicwangciso C sayeka.
  • Ungasigcina iSicwangciso C ukuba sele unaso.
  • Usengabhalisa kwiSicwangciso C ukuba ubulungele i-Medicare ngomhla okanye phambi kukaDisemba 31, 2019.
  • ICongress igwebe ukuba isiCwangciso B esitsalwayo asinakuphinda sigqitywe ngezicwangciso zeMedigap.
  • Unokuthenga izicwangciso ezifanayo ngaphandle kwesiCwangciso B sokutsalwa kwemali.
  • Izicwangciso ezifanayo zibandakanya izicwangciso zeMedigap D, G, kunye no-N.

  Eli nqaku lahlaziywa ngo-Novemba 20, 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.