Into ekufuneka uyazi ngeCandelo leMedare C

Umxholo

• Yintoni iCandelo leMedicare C?
• Ngaba uyayifuna iMedicare Icandelo C?
• Ngaba ufanelekile kwiCandelo le-Medicare?
• Zeziphi izicwangciso zeCandelo leMedare C ezikhoyo?
• Izicwangciso ze-HMO ze-Medicare
• Izicwangciso ze-Medicare eziluncedo ze-PPO
• Ixabisa malini iCandelo C?
• Ukuba awuyifuni iMedicare yeCandelo C
• Ukuthatha

Yintoni iCandelo leMedicare C?

I-Medicare Icandelo C, ekwabizwa ngokuba yi-Medicare Advantage, lukhetho olongezelelekileyo lwe-inshurensi kubantu abane-Original Medicare.

NgeMedicare yoqobo, ukhuselwe iCandelo A (isibhedlele) kunye neCandelo B (lonyango).

Icandelo le-Medicare Icandelo C libonelela ngamacandelo A no-B kunye neenkonzo ezongezelelweyo, ezinje ngamachiza amiselweyo, amazinyo, umbono kunye nokunye.

Kule nqaku, siza kujonga ukuba yiyiphi i-Medicare Part C ekufuneka ibonelele, ibiza malini, kunye nendlela yokukhetha esona sicwangciso silungileyo kwimeko yakho.

Ngaba uyayifuna iMedicare Icandelo C?

I-Medicare Icandelo C yokugubungela ukongeza ukhuseleko kwi-Medicare enikezelwa ngeenkampani zabucala zeinshurensi. Ngalesi sicwangciso, unokufumana ingxelo ngamayeza amiselweyo, iinkonzo zamazinyo kunye nombono, kunye nezinye iinkonzo ezinxulumene nezempilo.

Ngezibonelelo ezifanelekileyo zeCandelo leMedare C, uya kuba nokugubungela oku kulandelayo:

• Iinkonzo zesibhedlele, ukhathalelo lweziko lokonga, ukhathalelo lwempilo ekhaya, kunye nokunyamekela abaguli
• Iinkonzo zonyango ezinxulumene nokuthintela, ukuxilonga, kunye nokunyanga iimeko
• iinkonzo zempilo yengqondo
• Ukukhutshwa kweziyobisi ngugqirha
• zamazinyo, umbono, kunye neenkonzo zokuva
• Iinkonzo zempilo ezinokuzikhethela, ezinje ngobulungu bokuqina komzimba

Ukuba ufuna ngaphezulu kwesibhedlele esisisiseko kunye neinshurensi yezonyango, iCandelo leMedicare C yindlela ebalulekileyo yokugubungela.

Ngaba ufanelekile kwiCandelo le-Medicare?

Ufanelekile kwi-Medicare Part C ukuba sele unamacandelo e-Medicare A no-B, kwaye ukuba uhlala kwindawo yenkonzo ye-Medicare Part C umboneleli ocinga ngayo.

Ngo-2021, abantu abanesifo sokugqibela se-renal disease (ESRD) banelungelo lokubhalisa kuluhlu olubanzi lwezicwangciso ze-Medicare Advantage ngenxa yomthetho owenziwe yiCongress. Phambi kwalo mthetho, uninzi lweeplani alunakukuvuma okanye lukunciphise kwisiCwangciso seMfuno eziZodwa (SNP) ukuba unesifo se-ESRD.

• Ubhaliso kwi-Medicare luthathelwa ixesha kwaye kufuneka luqaliswe malunga neenyanga ezi-3 ngaphambi kokuba ube neminyaka engama-65. Unokufaka isicelo seMedicare kwinyanga ojika ngayo i-65 kunye neenyanga ezintathu emva kwe-65 yakho.^th usuku lokuzalwa- nangona ingxelo yakho izakulibaziseka.
• Ukuba uphoswa lixesha lokuqala lobhaliso, ubhaliso oluvulekileyo luqala ngo-Okthobha u-15 ukuya ku-Disemba 7 minyaka le.
• Ungayibhalisela iMedicare yoqobo kwi-Intanethi kwiwebhusayithi yoLawulo loKhuseleko loLuntu.
• Unokuthelekisa kunye nokuthenga izicwangciso ze-Medicare Part C kwi-intanethi ngesixhobo sokufumana isicwangciso seMedicare.

Zeziphi izicwangciso zeCandelo leMedare C ezikhoyo?

Eyona ndlela ilula yokufumanisa ukuba zeziphi izicwangciso ze-Medicare Part C ezikhoyo ukusebenzisa isixhobo seMedicare:.

Inkqubo iyakuthatha iimpendulo zakho kwimibuzo ethile kwaye icuthe iinkampani ezibonelela ngezicwangciso zeMedare yeCandelo C ezihambelana neemfuno zakho. Esi sixhobo seMedicare siluncedo ekuthelekiseni izicwangciso kwindawo yakho.

Ukuba sele ufumene ingxelo ngenkampani enkulu yeinshurensi, inokubonelela ngezicwangciso zeCandelo leMedare C. Ezinye zeenkampani ezinkulu zeinshurensi ezibonelela ngeMedicare Icandelo C zezi:

• UAetna
• IBlue Cross Blue Shield
• Cigna
• AbaPhathi beMpilo
• UKaiser Permanente
• KhethaHealth
• Ukhathalelo lweZempilo
• UPMC

Izicwangciso ze-HMO ze-Medicare

Izicwangciso zoMbutho wokulondolozwa kwezeMpilo (HMO) zezona zikhetho zikhethwayo kwabo bafuna ukhuselo olongezelelekileyo olunganikwanga yiMedicare yoqobo. Kwiplani ye-HMO ye-Medicare Advantage, unokufumana ukhathalelo kwisicwangciso sakho kubanikezeli benkonzo zononophelo lwempilo, kodwa kuya kufuneka ufumane ukuhanjiswa ukuze ubone ingcali.

Kukho iindlela ezininzi zokukhetha izicwangciso ze-HMO ze-Medicare Advantage kwilizwe ngalinye, kubandakanywa nezicwangciso kunye neeprimiyamu ezingama- $ 0, akukho mali echithwayo, kunye neentlawulo eziphantsi. Ukubhalisa kwisicwangciso se-HMO seMedicare, kuya kufuneka sele ubhalisile kwi-Medicare yoqobo.

Izicwangciso ze-Medicare eziluncedo ze-PPO

Imibutho yababoneleli abakhethiweyo (ii-PPOs) zezona zikhetho luthathelwa ingqalelo kwezempilo. Olu hlobo lwesicwangciso luvumela inqanaba elikhulu lenkululeko kubathengi.

Ngesicwangciso se-PPO, ungaya koogqirha bakho obukhethileyo, iingcali, kunye namaziko ezempilo, nokuba akukhona kwinethiwekhi yesicwangciso sakho. Nangona kunjalo, iiplani ze-PPO zihlawulisa amaxabiso ahlukeneyo ngokusekwe kuluhlu lwabanikezeli benethiwekhi okanye abangaphandle kwenethiwekhi.

Ii-PPO zikwalungele kuba awudingi ukuthunyelwa ukuze ubone ingcali.

Ixabisa malini iCandelo C?

Kukho iindidi zeendleko ezinxulunyaniswa nesicwangciso seMedicare Part C, oko kuthetha ukuba iindleko zakho zokuphuma epokothweni zingahluka.

Ezinye izicwangciso zeCandelo leMedare C ziya kubandakanya inxenye yepremiyamu yakho yenyanga. Nangona kunjalo, ezinye zezi zicwangciso zikwanazo neprimiyamu yazo kunye nokuncitshiswa.

Ukongeza kwezi ndleko, unokuhlawulwa ngecompayment ngexesha lokufumana iinkonzo.

Eminye imiba ebangela ukuba isicwangciso seMedicare Part C siza kukuhlawula malini:

• uhlobo lwesicwangciso osikhethayo, njenge-HMO, i-PPO, i-PFFS, i-SNP, okanye i-MSA
• umvuzo wakho, onokusetyenziselwa ukumisela ipremiyamu yakho okanye isixa esitsalwayo
• ipesenti yakho yeendleko
• ufuna kangaphi iinkonzo zonyango
• ingaba ufumana iinkonzo zonyango kwinethiwekhi okanye ngaphandle kwenethiwekhi
• ingaba ufumana olunye uncedo lwezemali, njengeMedicaid

Zininzi izibonelelo zokuba neCandelo leMedicare C, kubandakanywa ikepusi yonyaka yokuba uza kuhlawula malini epokothweni. Okwangoku, ezo ndleko zokuqala zinokongeza ngaphezulu kwexesha ngaphambi kokuba ubethe ikepusi, ke kubalulekile ukuba uqwalasele yonke imiba xa ukhetha isicwangciso sakho se-Medicare Part C.

Ukuba awuyifuni iMedicare yeCandelo C

Ukuba wonwabile kukhuseleko lwakho lwangoku lweMedicare kwaye unomdla kuphela ekufumaneni ukugubungela amayeza kagqirha, isicwangciso esizimeleyo seMedicare Part D sisenokuba yeyona ndlela ilungileyo.

Ukuba une-Medicare yokugubungela kodwa ufuna uncedo olongezelelweyo ngeendleko, umgaqo-nkqubo we-inshurensi yokuxhasa iMedare (iMedigap) unokukusebenzela.

Kwabanye abantu, i-Medicare Part C yindleko ezongezelelweyo abangenakukwazi ukuzifikelela - kule meko, ukuthenga ngeengxenye zeCandelo D kunye ne-Medigap kunokunceda ukugcina imali.

Ukunceda ilungu losapho okanye umhlobo ukuba akhethe isicwangciso seMedicare Part C kunokuba yinkqubo enzulu, kodwa akufuneki kube nzima. Nazi izinto ekufuneka ziqwalaselwe xa uphonononga izicwangciso:

• Uhlobo lokugubungela. Ukuba ilungu losapho lwakho linomdla wokhetho lokugubungela ezinganikezelwanga ngamacandelo A no-B, zama ukufumana isicwangciso esigubungela zonke iindawo ezibalulekileyo kubo.
• Uhlobo lwesicwangciso. Ukukhetha uhlobo olufanelekileyo lwesicwangciso seCandelo leMedare ngokuxhomekeke kukhetho lwabo. I-HMO, i-PPO, i-PFFS, i-SNP kunye nezicwangciso zesicwangciso se-MSA kufuneka zonke ziqwalaselwe.
• Iindleko eziphuma epokothweni. Ingeniso ephantsi inokwenza kube nzima ukuhlangabezana neprimiyamu ye-Medicare Part C, yokutsalwa, kunye neendleko zokuphuma epokothweni. Zama ukuthenga ngeerhafu abanokuzifikelela.
• Imeko yezonyango. Wonke umntu unemeko yempilo eyahlukileyo ekufuneka ithathelwe ingqalelo xa uthenga i-Medicare. Cinga ngezinto ezinjengeemeko zempilo, ukuhamba rhoqo, kunye nokukhethwa ngumboneleli.
• Ezinye izinto. Abaxhamli abangaphezu kwama-800,000 bafumanise ukuba izinto ezinje ngesabelo sentengiso sombutho kunye nenqanaba leenkwenkwezi ziye zaqwalaselwa xa kukhethwa isicwangciso seMedare Part C.

Ukuthatha

• Izicwangciso ze-Medicare Part C, ezaziwa ngokuba ziiplani ze-Medicare Advantage, zizicwangciso ze-inshurensi ezinganyanzelekanga ezibonelela ngezibonelelo zoqobo kunye nolongezo lweMedare.
• I-Medicare Icandelo C lukhetho olukhulu kubantu abanomdla wokufumana amayeza amayeza, umbono kunye neenkonzo zamazinyo, kunye nokunye.
• Iindleko zesicwangciso seCandelo C zixhomekeka kwizinto ezahlukeneyo, kubandakanya iindleko zenyanga nezonyaka, iikopayments, kunye neemfuno zakho zonyango.
• Ndwendwela i-Medicare.gov ukufumana isicwangciso seMedicare Part C esikusebenzelayo.

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.

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