Izicwangciso zeDelaware Medicare ngo-2021

Umxholo

• Yintoni amayeza?
• Oko ikugubungelayo
• Iindleko zonyango
• Zeziphi izicwangciso eziluncedo kuMayeza ezifumaneka eDelaware?
• Umbutho woLondolozo lwezeMpilo (HMO)
• Umbutho woMboneleli okhethiweyo (PPO)
• Iakhawunti yokonga unyango (MSA)
• Intlawulo yabucala yeNkonzo (PFFS)
• ISicwangciso seeMfuno eziZodwa (SNP)
• Izicwangciso ezikhoyo eDelaware
• Ngubani ofanelekileyo kwiMedicare eDelaware?
• Ndingabhalisa nini kwizicwangciso zeMedicare Delaware?
• Ubhaliso lomnyhadala
• Ubhaliso lonyaka
• Iingcebiso zokubhalisa kwiMedicare eDelaware
• Izibonelelo zeDelaware Medicare
• IZiko loNcedo lweDelaware Medicare (800-336-9500)
• I-Medicare.gov (800-633-4227)
• Ndifanele ndenze ntoni ngokulandelayo?

I-Medicare yi-inshurensi yezempilo elawulwa ngurhulumente onokuyifumana xa uneminyaka engama-65 ubudala. I-Medicare eDelaware ikwafumaneka nakubantu abangaphantsi kweminyaka engama-65 abahlangabezana neendlela ezithile.

Yintoni amayeza?

I-Medicare ibandakanya iindawo ezine eziphambili:

• Icandelo A: ukunakekelwa esibhedlele
• Icandelo B: unyango lwangaphandle
• Icandelo C: Uncedo lweMedicare
• Icandelo D: amayeza amiselweyo

Oko ikugubungelayo

Icandelo ngalinye leMedicare ligubungela izinto ezahlukeneyo:

• Icandelo A ligubungela inkathalo oyifumanayo njengomguli ongalaliswanga esibhedlele kwaye likwabandakanya ukhathalelo lwehosisi, ukunqongophala kokukhathalelwa kononophelo lwexeshana (SNF), kunye nezinye iinkonzo zokhathalelo lwempilo lwexeshana.
• Icandelo B ligubungela ukhathalelo lwezigulana ezingalaliswayo, ezinjengokutyelelwa ngugqirha, ukhuseleko, kunye nezinye izixhobo zonyango ezizinzileyo.
• Icandelo C ligubungela ukugubungela iCandelo A kunye neCandelo B kwisicwangciso esinye esinokubandakanya ezinye izibonelelo, ezinje ngamazinyo okanye umbono. Ezi zicwangciso zihlala zibandakanya ukugubungela amayeza amayeza ngokunjalo.
• Icandelo D ligubungela ezinye okanye zonke iindleko zamayeza amiselweyo ngaphandle kwesibhedlele (amayeza owafumana ngexesha lokuhlala esibhedlele agqunywe phantsi kweCandelo A).

Ukongeza kumacandelo amane aphambili, kukwakho nezicwangciso zeinshurensi yokuxhasa iMedicare. Amaxesha amaninzi abizwa ngokuba yiMedigap, ezi zicwangciso zigubungela iindleko eziphuma epokothweni ezinje ngee-copays kunye ne-coinsurance yokuba izicwangciso zokuqala zeMedare azifumaneki kubathwali beinshurensi yabucala.

Awunakho ukuthenga zombini iCandelo C kunye neMedigap. Kuya kufuneka ukhethe uhlobo olunye okanye olunye.

Iindleko zonyango

Izicwangciso zeMedicare eDelaware zineendleko ezithile ozihlawulela ukugubungela kunye nokhathalelo.

Icandelo A iyafumaneka ngaphandle kwepremiyamu yenyanga nje ukuba wena okanye iqabane lakho lisebenze iminyaka eli-10 okanye nangaphezulu emsebenzini kwaye nihlawule irhafu ye-Medicare. Unako kwakhona ukuthenga isigubungelo ukuba awuhlangabezani neemfuno zokufaneleka.Ezinye iindleko zibandakanya:

• uxhuzulelwa ixesha ngalinye ungeniswa esibhedlele
• iindleko ezongezelelweyo ukuba isibhedlele okanye i-SNF ihlala ixesha elide kunexesha elimiselweyo

Icandelo B unemirhumo neendleko ezininzi, kubandakanya:

• intlawulo yanyanga le
• utsalo lwarhoqo ngonyaka
• Iipopay kunye neepesenti ezingama-20 zemali-mali emva kokuhlawulwa kwemali yakho

Icandelo C Izicwangciso zinokuba nepremiyamu yezibonelelo ezongezelelweyo ezifumaneka kwisicwangciso. Ukwahlawula ipremiyamu yesiGaba B.

Icandelo D Iindleko zesicwangciso ziyahluka ngokusekwe kwinkcazo.

IMedigap Iindleko zesicwangciso ziyahluka ngokuxhomekeke kwisicwangciso osikhethayo.

Zeziphi izicwangciso eziluncedo kuMayeza ezifumaneka eDelaware?

Izicwangciso ze-Medicare Advantage zivunyiwe ngamaZiko ee-Medicare kunye neeNkonzo zeMedicaid (CMS) kwaye ziyafumaneka kwiinkampani zeinshurensi zabucala. Izibonelelo zibandakanya:

• Zonke izibonelelo zakho ezivela kwicandelo ngalinye le-Medicare zigutyungelwe phantsi kwesicwangciso esinye
• ezinye izibonelelo ezingabandakanyi i-Medicare yoqobo, ezinje ngamazinyo, umbono, ukuva, ukuthuthwa ukuya kwiindawo zonyango, okanye ukuhanjiswa kokutya ekhaya
• ngaphandle kwee-pocket maximum ze $ 7,550 (okanye ngaphantsi)

Zintlanu iindidi zezicwangciso zeMedarea eziluncedo eDelaware. Makhe sijonge kuhlobo ngalunye olulandelayo.

Umbutho woLondolozo lwezeMpilo (HMO)

• Ukhetha umboneleli ngenkathalo oyintloko (PCP) olungelelanisa ukhathalelo lwakho.
• Kuya kufuneka usebenzise ababoneleli kunye nezixhobo ngaphakathi kwenethiwekhi ye-HMO.
• Ngokwesiqhelo ufuna ukuthunyelwa kumboneleli wakho wokuqala wokhathalelo (PCP) ukubona ingcali.
• Inkathalo ngaphandle kwenethiwekhi ihlala ingagutyungelwanga ngaphandle kwexesha likaxakeka.

Umbutho woMboneleli okhethiweyo (PPO)

• Inkathalo evela koogqirha okanye kumaziko ngaphakathi kwenethiwekhi ye-PPO yenethiwekhi iyagutyungelwa.
• Inkathalo ngaphandle kwenethiwekhi inokubiza ngaphezulu, okanye ayinakugutyungelwa.
• Awudingi ukuthunyelwa ukuze ubone ingcali.

Iakhawunti yokonga unyango (MSA)

• Ezi zicwangciso zidibanisa isicwangciso sezempilo esitsalwayo kunye neakhawunti yokonga.
• I-Medicare igalela isixa esithile semali minyaka le ukuhlawula iindleko (ungongeza ngaphezulu).
• Ii-MSAs zinokusetyenziselwa kuphela iindleko zonyango ezifanelekileyo.
• Ukonga kweMSA akukho rhafu (kwiindleko zonyango ezifanelekileyo) kwaye ufumana inzala ngaphandle kweerhafu.

Intlawulo yabucala yeNkonzo (PFFS)

• I-PFFS zizicwangciso ngaphandle kothungelwano loogqirha okanye izibhedlele; ungakhetha ukuya naphi na elamkela icebo lakho.
• Bathetha-thethana ngqo nababoneleli kwaye babone ukuba unetyala elingakanani ngeenkonzo.
• Ayingabo bonke oogqirha okanye amaziko azamkelayo ezi zicwangciso.

ISicwangciso seeMfuno eziZodwa (SNP)

• I-SNPs zenzelwe abantu abafuna ukhathalelo olulungelelanisiweyo ngakumbi kwaye bahlangabezana neziqinisekiso ezithile.
• Kuya kufuneka ulungelelene kabini kwi-Medicare kunye neMedicaid, ubenemeko enye okanye nangaphezulu yezempilo, kunye / okanye uhlala kwikhaya labongikazi.

Izicwangciso ezikhoyo eDelaware

Ezi nkampani zibonelela ngezicwangciso kwiindawo ezininzi eDelaware:

• I-Aetna Medicare
• Cigna
• Humana
• Ukhathalelo lwezeMpilo lweLasso
• Ukhathalelo lweZempilo

Isibonelelo seMedicare sokunikezelwa kwesicwangciso siyahluka ngokommandla, ke ngenisa ikhowudi yakho ye-ZIP xa ufuna izicwangciso apho uhlala khona.

Ngubani ofanelekileyo kwiMedicare eDelaware?

Ukuze ufaneleke kwi-Medicare, kufuneka ube:

• Iminyaka engama-65 okanye ngaphezulu
• ngummi wase-U.S okanye umhlali ngokwasemthethweni kangangeminyaka emi-5 okanye nangaphezulu

Ukuba umncinci kuneminyaka engama-65, unokufumana izicwangciso zeMedicare eDelaware ukuba:

• ukufakelwa kwezintso okanye ukuphela kwesifo sezintso (ESRD)
• ndine-amyotrophic lateral sclerosis (ALS)
• Bebesoloko befumana izibonelelo zoKhuseleko lweNtlalontle okanye iBhodi yoMhlala-phantsi yoLoliwe kwiinyanga ezingama-24

Ungasebenzisa isixhobo seMedicare ukubona ukuba uyafaneleka na.

Ndingabhalisa nini kwizicwangciso zeMedicare Delaware?

Ukufumana i-Medicare okanye i-Medicare Advantage kufuneka ubhalise ngexesha elichanekileyo.

Ubhaliso lomnyhadala

• Ixesha lokubhalisa lokuqala (IEP) yifestile yeenyanga ezi-7 ejikeleze usuku lwakho lokuzalwa lwama-65, ukuqala kwiinyanga ezi-3 ngaphambili kwaye uqhubeke kwiinyanga ezi-3 emva komhla wokuzalwa kwakho. Ukuba ubhalisa ngaphambi kokuba ube neminyaka engama-65 ubudala, ukhuselo lwakho luqala ngenyanga yakho yokuzalwa. Ukubhalisa emva kweli xesha kuya kuthetha ukulibaziseka ekugubungelweni.
• Amaxesha obhaliso olukhethekileyo (SEPs) Ngamaxesha amiselweyo apho ungabhalisela ngaphandle kobhaliso oluvulekileyo ukuba ulahlekelwa kukugubungela izizathu ezahlukeneyo, kubandakanya ukuphulukana nesicwangciso esixhaswe ngumqeshi okanye ukuhamba ngaphandle kwendawo yokugubungela isicwangciso sakho.

Ubhaliso lonyaka

• Ubhaliso ngokubanzi(Januwari 1 ukuya kuMatshi 31): Ukuba awuzange ubhalisele i-Medicare ngexesha le-IEP yakho, ungabhalisa kwiCandelo A, kwiCandelo B, kwiCandelo C, nakwizicwangciso zeCandelo D. Unokuhlawula isohlwayo ngokusayina emva kwexesha.
• Uncedo kwiMedicare ubhaliso oluvulekileyo (nge-1 kaJanuwari ukuya kuMatshi 31): Ungatshintshela kwisicwangciso esitsha ukuba sele ukhona kwi-Medicare Advantage okanye ungaqhubeka nge-Medicare yoqobo.
• Ubhaliso oluvulekileyo(Oktobha 15 ukuya kuDisemba 7): Ungatshintsha phakathi kwe-Medicare yasekuqaleni kunye ne-Medicare Advantage, okanye ubhalisele iCandelo D ukuba awuzange ubhalise ngexesha le-IEP yakho.

Iingcebiso zokubhalisa kwiMedicare eDelaware

Ukukhetha isicwangciso esifanelekileyo kuxhomekeke kwezi zinto zilandelayo:

• iimfuno zakho zokhathalelo lwempilo
• Iindleko eziqikelelweyo
• Ngabaphi oogqirha (okanye izibhedlele) ofuna ukuzibona ngononophelo

Izibonelelo zeDelaware Medicare

Unokufumana iimpendulo kwimibuzo yakho ye-Medicare Delaware kule mibutho:

IZiko loNcedo lweDelaware Medicare (800-336-9500)

• iNkqubo yoNcedo lwe-Inshurensi yezeMpilo kaRhulumente (SHIP), eyayisaziwa njenge-ELDERulwazi
• ingcebiso yasimahla kubantu abaneMedicare
• Iindawo zokucebisa zengingqi kuyo yonke iDelaware (tsalela umnxeba kwi-302-674-7364 ukufumana eyakho)
• Uncedo lwezezimali ukunceda ukuhlawulela i-Medicare

I-Medicare.gov (800-633-4227)

• isebenza njengendawo esemthethweni ye-Medicare
• uqeqeshe abasebenzi kwiminxeba yokunceda ukuphendula imibuzo yakho ye-Medicare
• inecebo lokufumana isicwangciso sokukunceda ufumane i-Medicare Advantage, Icandelo D, kunye neeplani zeMedigap kwindawo yakho

Ndifanele ndenze ntoni ngokulandelayo?

Nanga amanyathelo akho alandelayo okufumana eyona inshurensi yeMedicare yokuhlangabezana neemfuno zakho:

• Qinisekisa ukuba ufuna i-Medicare yasekuqaleni okanye i-Medicare Advantage.
• Khetha i-Medicare Inzuzo okanye umgaqo-nkqubo weMedigap, ukuba uyasebenza.
• Chonga ixesha lobhaliso kunye nexesha elibekiweyo.
• Qokelela amaxwebhu afana noluhlu lwamayeza amayeza owathathayo kunye nayo nayiphi na imeko yonyango onayo.
• Buza ugqirha wakho ukuba bayayamkela na iMedicare, kwaye yeyiphi inethiwekhi eyiMedicare Advantage.

Eli nqaku lahlaziywa ngo-Novemba 10, 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.