I-Medicare eCalifornia: Into ekufuneka uyazi

Umxholo

• Icandelo lezaMayeza A
• Icandelo leMedare B
• Icandelo leMedicare C (Uncedo lweMedicare)
• Icandelo leMedare D
• I-inshurensi yokuncedisa iMedare (iMedigap)
• Yeyiphi imihla ebekiweyo yokubhaliswa kwamacandelo e-Medicare kunye nezicwangciso?
• Ukuthatha

I-Medicare yinkqubo yokhathalelo lwempilo esetyenziswa ikakhulu ngabantu abaneminyaka engama-65 nangaphezulu. Abantu bayo nayiphi na iminyaka yokukhubazeka kunye nabo banesifo sokugqibela se-renal disease (ESRD) okanye i-amyotrophic lateral sclerosis (ALS) bayakwazi ukufumana iMedicare.

Ukuba uhlala eCalifornia kwaye uhlangabezana neemfuno zeMedicare, uyakufanelekela ukufumana iMedicare yoqobo (icandelo A no-B) kunye neMedicare Part D, nokuba uhlala kweliphi ilizwe. Ukufumaneka kweCandelo le-Medicare Icandelo C (i-Medicare Advantage) kwahlukile kwezinye iindawo zaseCalifornia kunakwamanye amazwe.

Ukufaneleka kweCandelo le-Medicare kwiCalifornia kusekwe kwikhowudi kunye nekhowudi ye-ZIP yendawo ohlala kuyo ephambili.

Icandelo lezaMayeza A

Icandelo leMedicare A likwabizwa ngokuba yi-inshurensi yesibhedlele. Icandelo A ligubungela ukhathalelo lwezigulana ezilaliswayo esibhedlele, ukhathalelo lwehosisi, ezinye iinkonzo zempilo yasekhaya, kunye nokuhlala kunye neenkonzo ezinqunyelwe kwiziko labongikazi abanezakhono.

Ukuba wena okanye iqabane lakho nisebenze kwaye nihlawule irhafu ye-Medicare iminyaka eli-10 ubuncinci, uya kufaneleka ukuba ungafumani siqendu se-premium ngaphandle kweendleko zenyanga. Nokuba awulungelanga ukufumana icandelo A lesimahla, unokukwazi ukuthenga iCandelo A (iPrimiyamu yeA).

Icandelo leMedare B

Icandelo leMedicare B ligubungela iinkonzo eziyimfuneko, ezinje ngokuqeshwa kukagqirha kunye neenkonzo zeenqwelo zezigulana. Ikwaquka nokhathalelo lokuthintela, njengamayeza amaninzi okugonya. Kanye kunye neCandelo A, i-Medicare Icandelo B lenza i-Medicare yasekuqaleni. Uya kufuneka uhlawule i-premium yenyanga kwi-Medicare Part B.

Icandelo leMedicare C (Uncedo lweMedicare)

Icandelo leMedicare C lithengwa ngeinshurensi zabucala ezivunyiweyo yiMedicare. Ngokomthetho, isicwangciso seCandelo leMedicare C kufuneka sigubungele ubuncinci ubuncinci njengamacandelo okuqala e-Medicare A no-B. Uninzi lwezicwangciso zeCandelo C zigubungela iinkonzo ezininzi kunokuba iMedicare ibonelela, kodwa ihlala ifuna ukuba usebenzise uthungelwano oluthile loogqirha. Ezinye izicwangciso zeCandelo leMedare C zibandakanya ukumiselwa kweziyobisi, kodwa ezinye azenzi.

Icandelo leMedicare C alifumaneki kuyo yonke indawo eCalifornia. Ezinye izithili zinokufikelela kwizicwangciso ezininzi. Ezinye izithili zinokufikelela ezimbalwa kuphela. Amanqanaba angama-115 eCalifornia, njengeCalaveras County, enza hayi unokufikelela kuzo naziphi na izicwangciso zeMedicare Advantage.

Ngenisa ikhowudi yakho ye-ZIP apha ukuze ubone izicwangciso zeMedare ezikhoyo kwindawo yakho.

Iinkampani ezininzi zibonelela ngemigaqo-nkqubo yokuNceda kwiindawo ezithile eCalifornia. Ziquka:

• I-Aetna Medicare
• Ukulungelelaniswa kweSicwangciso seMpilo
• Umhobe iBlue Cross
• IBlue Cross yaseCalifornia
• Usuku olutsha khaca
• Isicwangciso soNyango lwezeMpilo
• Isicwangciso seMpilo yoKhathalelo
• Urhulumente weGolide
• Health Health Community Solutions, Inc. zitshintshi e zeedola imbali yamanani, ishati ukususela ekuqaleni kokuthengisa
• Impilo yeNet yaseCalifornia
• Humana
• IsiCwangciso sezeMpilo seCalifornia, Inc.
• UKaiser Permanente
• Skena iSicwangciso seMpilo
• Ukhathalelo lweZempilo
• Ukhathalelo

Uninzi lwezicwangciso ezinikezelwayo zizicwangciso zoMbutho wezeMpilo (HMO) oqala kwi- $ 0 yenyanga yenyanga. Amaxabiso aphezulu aphuma epokothweni ekufuneka uwahlawule minyaka le anokuhluka kakhulu kwezi zicwangciso. Izicwangciso ze-HMO zihlala zifuna ukuba uhlawule ikopi xa undwendwela ugqirha ngamnye.

Ezinye iintlobo zezicwangciso ze-Medicare Advantage zibandakanya izicwangciso zoMbutho woMboneleli okhethiweyo (PPO). Ezinye zazo zinokuba neepremiyamu eziphezulu zenyanga kunee-HMOs ukongeza kwiindleko ezingaphandle kweepokotho kunye nee-copays. Kubalulekile ukuphonononga izicwangciso oziqwalaselayo, njengoko zahluka kungekuphela kwiindleko kodwa nakwiinkonzo kunye nokugubungela okunikiweyo.

Icandelo leMedare D

I-Medicare Icandelo D yinxalenye ye-Medicare egubungela amayeza amiselweyo. Yenzelwe ukuba isetyenziswe kwi-Medicare yoqobo (iinxalenye A kunye no-B). Ukuba unesicwangciso seNzuzo esiquka amayeza, awuyi kufuna ukuthenga isicwangciso seCandelo D ngokunjalo.

Ukuba awunayo i-inshurensi yokugubungela amayeza ngomnye umthombo, njenge-inshurensi yezempilo oyifumana emsebenzini, kubalulekile ukuba ubhalise kwi-Medicare Part D xa uqala ukufumana iMedicare. Ukuba awukwenzi oko, kuya kufuneka uhlawule amaxabiso aphezulu ngendlela yesohlwayo senyanga ngalo lonke ixesha lokugubungela iCandelo D.

Icandelo leMedicare D linikezelwa ziinkampani zeinshurensi zabucala. Kukho izicwangciso zeCandelo D ezikhoyo kulo lonke ilizwe laseCalifornia. Ezi zicwangciso ziyahluka ngokwamayeza abawagubungelayo, kunye nexabiso labo.

Ngeendlela ezininzi, ukubhalisa kwi-Medicare kunokudideka. Le mibutho inokubonelela ngolwazi oludingayo lokukhetha kwaye ubhalise kwesona sicwangciso sonyango siphezulu kuwe ukuba uhlala eCalifornia.

• Isebe laseKalifornia lokuGuga
• ISebe lase-California le-Inshurensi
• I-HICAP (Inkqubo yeNgcebiso nge-Inshurensi yezeMpilo kunye neNkqubo yoLuleko)
• Iinkqubo Zoncedo lwe-Inshurensi yezeMpilo kaRhulumente (SHIP)

I-inshurensi yokuncedisa iMedare (iMedigap)

I-inshurensi yokuncedisa iMedare okanye iMedigap yenzelwe ukukunceda uhlawulele izinto ezingagutyungelwanga yiMedicare yoqobo. Ezi ndleko zibandakanya ukukopishwa, ukuqinisekiswa kweemali, kunye nokuncitshiswa. ECarlifonia, uyakwazi ukuthenga enye yeendlela ezili-10 zezicwangciso ezisemgangathweni ezifumanekayo kulo lonke ilizwe.

Ezi zicwangciso zibekiweyo zichongiwe ngoonobumba abangoonobumba: A, B, C, D, F, G, K, L, M, no-N. Isicwangciso ngasinye siyahluka ngokokutsalwa, iindleko kunye nokugubungela. ECarlifonia, baninzi i-inshurensi egubungela ezinye okanye zonke ezi zicwangciso. Iindleko zabo ngaphakathi kwezicwangciso zihlala zifana okanye zifana kakhulu.

Ezinye iinkampani ezibonelela ngeMedigap eCalifornia zibandakanya:

• UAetna
• Umhobe iBlue Cross - California
• IBlue Shield yaseCalifornia
• Cigna
• Inkampani ye-Inshurensi edibeneyo yaseMelika
• Umbutho weEverence Inc.
• KwiSithili saseGadi
• Inkampani ye-Inshurensi yoBomi beGlobe
• Impilo yeNet
• Humana
• Ukudibana kwe-Omaha
• UMgcini weSizwe
• Inkampani ye-Inshurensi yezeMpilo yeSizwe
• IOxford
• Ukhuseleko lweSentinel
• Ifama yaseburhulumenteni
• Ukuphumelela kwezeMali kubantu baseLuterans
• I-USAA
• Umanyano lweMelika
• Ukhathalelo lweZempilo

Ezinye izicwangciso zifuna ukuba uhlawule ipesenti yeendleko zeenkonzo ezifakwe phantsi kweCandelo B, kunye neCandelo A elichithwayo.

Kukho iinyanga ezi-6 zokubhalisa ezivulekileyo xa unokufumana iMedigap. Eli xesha liqala ngomhla wokuzalwa kwakho wama-65 kwaye lihambelana nokubhaliswa kwakho kwi-Medicare Part B.

Uninzi lwelizwe, eli lelona xesha kuphela lokuba ubhalise kwisicwangciso seMedigap kwaye uqiniseke ngokufumana, nokuba loluphi uhlobo lwemicimbi yezempilo onayo.

Nangona kunjalo, eCarlifonia, uvunyelwe ukutshintshela kwisicwangciso esahlukileyo seMedigap ngomcimbi oqinisekisiweyo ngeentsuku ezingama-30 emva kosuku lwakho lokuzalwa unyaka nonyaka, ukuba isicwangciso esitsha sikunika ukulingana okanye ukuhlawulwa okuncinci kunesicwangciso sakho sangoku seMedigap.

Yeyiphi imihla ebekiweyo yokubhaliswa kwamacandelo e-Medicare kunye nezicwangciso?

Imihla ebekiweyo yobhaliso lweMedicare eCarlifonia iyafana nakwilizwe liphela, ngaphandle kweMedigap, enamaxesha ongezelelweyo obhaliso.

Ukuthatha

I-Medicare yinkqubo ye-inshurensi yomdibaniso efumaneka eCalifornia kwabo kufanelekileyo. Uncedo lweMedicare (Icandelo leCandelo leMedicare C) alifumaneki kuzo zonke iikhowudi zikarhulumente. Nangona kunjalo, i-Medicare yoqobo (iinxalenye ze-A kunye ne-B), kunye ne-Medicare Icandelo D kunye neMedigap ziyafumaneka kuwo onke amazwe kunye nekhowudi ye-ZIP.

Eli nqaku lahlaziywa ngo-Okthobha u-6, 2020 ukubonisa ulwazi lwe-2021 ye-Medicare.

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.