Izicwangciso zeIdaho Medicare ngo-2021

Umxholo

• Yintoni amayeza?
• Icandelo A
• Icandelo B
• Icandelo C
• Icandelo D
• IMedigap
• Iakhawunti yokonga iMedare
• Zeziphi izicwangciso eziluncedo kuMayeza ezifumaneka eIdaho?
• Ngubani ofanelekileyo kwi-Medicare e-Idaho?
• Ndingabhalisa nini kwizicwangciso zeMedicare Idaho?
• Iingcebiso zokubhalisa kwiMedicare eIdaho
• Izixhobo zeIdaho Medicare
• Ndifanele ndenze ntoni ngokulandelayo?

Izicwangciso zeMedicare eIdaho zibonelela nge-inshurensi yezempilo kubantu abaneminyaka engama-65 nangaphezulu, nangabanye abantu abangaphantsi kweminyaka engama-65 abahlangabezana neziqinisekiso ezithile. Kukho iindawo ezininzi kwi-Medicare, kubandakanya:

• i-Medicare yoqobo (Icandelo A kunye neCandelo B)
• Uncedo lweMedicare (Icandelo C)
• Izicwangciso zamachiza amayeza (Icandelo D)
• I-inshurensi yonyango (iMedigap)
• Iakhawunti yokonga iMedare (MSA)

I-Medicare yoqobo inikezelwa ngurhulumente womanyano. Uncedo lweMedicare, izicwangciso zamachiza amiselweyo, kunye neinshurensi yeMedigap zonke zinikezelwa ngabaphethe i-inshurensi yabucala.

Funda ukuze ufunde ngakumbi malunga nokukhetha kwakho i-Medicare e-Idaho.

Yintoni amayeza?

Wonke umntu obhalisa kwi-Medicare, kubandakanya nezicwangciso ze-Medicare Advantage, kufuneka abhalise kuqala kwi-Part A kunye ne-Part B.

Icandelo A

ICandelo A alinayo i-premium yenyanga kubantu abaninzi. Uya kuhlawula imali exhuzulwayo ngalo lonke ixesha ungeniswa esibhedlele. Ibandakanya:

• Ukunyamekela esibhedlele
• Unonophelo olunqongopheleyo kwizibonelelo zabongikazi
• Unonophelo lwehosisi
• Olunye ukhathalelo lwempilo ekhaya

Icandelo B

Icandelo B linepremiyamu yenyanga kunye nokutsalwa konyaka. Nje ukuba uhlangane nokuncitshiswa, uhlawula iipesenti ezingama-20 zokuqinisekisa malunga naluphi na ukhathalelo lwentsalela yonyaka. Ibandakanya:

• Unonophelo lwangaphandle lwezonyango
• ukuqeshwa kukagqirha
• ukhathalelo lothintelo, njengokuhlolwa kunye nokutyelelwa qete ngonyaka
• iimvavanyo zelebhu kunye nokucinga, njengeX-reyi

Icandelo C

Izicwangciso zeMedicare Advantage (Icandelo C) ziyafumaneka kubathwali beinshurensi babucala abazaqokelela iinxalenye A kunye no-B, kwaye bahlala befumana izibonelelo zeCandelo D kunye nezinye iintlobo zokugubungela.

Icandelo D

Icandelo D lihlawula iindleko zamachiza amiselweyo kwaye kufuneka zithengwe ngesicwangciso se-inshurensi yabucala. Izicwangciso ezininzi ze-Medicare Advantage zibandakanya iCandelo D lokugubungela.

IMedigap

Izicwangciso zeMedigap ziyafumaneka kubathwali beinshurensi yabucala ukunceda ekuhlawuleni ezinye iindleko zokhathalelo lwakho, kuba iMedicare yoqobo ayinayo imida yokuphuma epokothweni. Ezi zicwangciso zifumaneka kuphela ngeMedicare yoqobo.

Iakhawunti yokonga iMedare

Iiakhawunti zokonga i-Medicare (ii-MSAs) ziyafana neeakhawunti zokonga impilo ezinedipozithi ezinokutsalwa zerhafu ezinokusetyenziselwa iindleko zonyango ezifanelekileyo, kubandakanya iiprimiyamu zesicwangciso seMedicare kunye nokhathalelo lwexesha elide. Ezi zahlulwe kwiakhawunti yokonga iMedare, kwaye unemithetho ethile yerhafu yokujonga kwakhona nokuqonda ngaphambi kokuba ubhalise.

Zeziphi izicwangciso eziluncedo kuMayeza ezifumaneka eIdaho?

Abaphethe i-inshurensi ababonelela ngesivumelwano se-Medicare Advantage kunye namaziko ee-Medicare kunye neeNkonzo zeMedicaid (i-CMS) kwaye banikezela nge-inshurensi efanayo ne-Medicare yoqobo. Uninzi lwezi zicwangciso lukwanendawo yokugubungela izinto ezinje:

• zamazinyo
• umbono
• ukuva
• ukuthuthwa kwabaqeshwa bezonyango
• ukuhanjiswa kokutya ekhaya

Olunye uncedo lwezicwangciso ze-Medicare Advantage ngumda wonyaka ophuma epokothweni wenkcitho ye- $ 6,700 - ezinye izicwangciso zinemida ephantsi. Emva kokuba ufikelele kumda, isicwangciso sakho sihlawula iipesenti ezili-100 zeendleko zokugutyungelwa unyaka wonke.

Izicwangciso zeMedicare eziluncedo eIdaho zibandakanya:

• Umbutho woLondolozo lwezeMpilo (HMO). Ugqirha wokhathalelo oluphambili (i-PCP) omkhethileyo kwinethiwekhi yababoneleli uya kulungelelanisa ukhathalelo lwakho. Udinga ukuthunyelwa kwi-PCP yakho ukuze ubone ingcali. Ii-HMO zinemithetho enje ngababoneleli kunye namancedo ekufuneka uwasebenzisile ngaphakathi kwenethiwekhi, kunye neemfuno zokuvunywa kwangaphambili, ke funda kwaye ulandele imigaqo ngononophelo ukuze uqiniseke ukuba awuchaphazeleki ngeendleko ezingalindelekanga.
• Inqaku leNkonzo ye-HMO (HMO-POS). I-HMO enenqaku lenkonzo (i-POS) inokuvumela ukuba ufumane ukhathalelo ngaphandle kwenethiwekhi kwizinto ezithile. Kukho iifizi ezongezelelweyo zokhathalelo lwe-POS lwangaphandle kwenethiwekhi. Izicwangciso zifumaneka kuphela kwezinye iidolophu zeIdaho.
• Umbutho woMboneleli okhethiweyo (PPO). Nge-PPO, unokufumana ukhathalelo kuye nawuphi na umboneleli okanye indawo kwinethiwekhi ye-PPO.Awudingi ukuhanjiswa okuvela kwi-PCP ukubona iingcali, kodwa isengumbono olungileyo ukuba ube nogqirha oyintloko. Ukhathalelo ngaphandle kwenethiwekhi lunokubiza kakhulu okanye alunakugutyungelwa.
• Imali yabucala yeNkonzo yeNkonzo (PFFS). Izicwangciso ze-PFFS zithetha-thethana ngqo nababoneleli kunye nezixhobo ukumisela ukuba unetyala lantoni kunyango. Abanye banonxibelelwano lwabanikezeli, kodwa uninzi lukuvumela ukuba uye nakowuphi na ugqirha okanye isibhedlele esiya kuthi samkele isicwangciso. Izicwangciso ze-PFFS azamkelekanga kuyo yonke indawo.
• Izicwangciso zemfuno ezizodwa (SNPs). Ii-SNP e-Idaho zibonelelwa kwiidolophu ezithile kwaye ziyafumaneka kuphela ukuba ufanelekile kuzo zombini iiMedicare neMedicaid (ezimbini ezifanelekileyo).

Unokukhetha izicwangciso ze-Medicare Advantage e-Idaho ukusuka:

• I-Aetna Medicare
• Umnqamlezo oluhlaza okwesibhakabhaka waseIdaho
• Humana
• MediGold
• Ukhathalelo lwempilo lweMolina e-Utah naseIdaho
• Unyango lwePacificSource
• Regence BlueShield yeIdaho
• KhethaHealth
• Ukhathalelo lweZempilo

Izicwangciso ezikhoyo ziya kwahluka ngokuxhomekeka kwindawo ohlala kuyo.

Ngubani ofanelekileyo kwi-Medicare e-Idaho?

I-Medicare e-Idaho iyafumaneka kubemi base-US (okanye abahlali bezomthetho kangangeminyaka emi-5 okanye nangaphezulu) abaneminyaka engama-65 nangaphezulu. Ukuba ungaphantsi kweminyaka engama-65 ubudala, usenokukwazi ukufumana i-Medicare ukuba:

• Ufumene intlawulo yokukhubazeka kweBhodi yoLuntu okanye yeBhodi yoLondolozo loLoliwe kwiinyanga ezingama-24
• Unesifo sezintso (ESRD)
• ndine-amyotrophic lateral sclerosis (ALS)

Ndingabhalisa nini kwizicwangciso zeMedicare Idaho?

Kukho amaxesha athile onyaka apho ungabhalisa okanye utshintshe izicwangciso zeMedare kunye neMedicare.

• Ixesha lokubhalisa lokuqala (IEP). Kwiinyanga ezintathu ngaphambi kokuba ube neminyaka engama-65, ungabhalisa kwi-Medicare yokufumana ingxelo eqala ngenyanga yakho yokuzalwa. Ukuba uyiphose loo festile, usengabhalisa ngethuba lokuzalwa kwenyanga yakho okanye kwiinyanga ezi-3 emva koko, kodwa kukho ukulibaziseka ngaphambi kokuba kuqalwe nge-inshurensi.
• Ubhaliso ngokubanzi (ngoJanuwari 1 – Matshi 31). Ungabhalisela iinxalenye A, B, okanye D ngexesha lokubhalisa ngokubanzi ukuba uphoswe yi-IEP kwaye awufanelanga ixesha lokubhalisa elikhethekileyo. Ukuba awunayo enye ingxelo kwaye awuzange ubhalise ngexesha le-IEP yakho, unokuhlawula isohlwayo sokubhalisa emva kwexesha kwiCandelo B kunye neCandelo D.
• Ubhaliso oluvulelekileyo (nge-15 ka-Okthobha-kaDisemba 7). Ukuba sele ubhalisele i-Medicare, ungatshintsha iindlela zokukhetha ngexesha lokubhaliswa konyaka.
• Uncedo lweMedicare lubhaliso oluvulekileyo (nge-1 kaJanuwari-Matshi 31). Ngexesha lobhaliso oluvulekileyo, unokutshintsha izicwangciso zeMedicare Advantage okanye utshintshele kwiMedicare yoqobo.
• Ixesha elithile lobhaliso (SEP). Ungabhalisela i-Medicare ngexesha le-SEP ukuba ulahlekelwe kukugubungela ngesizathu esifanelekileyo, njengokuhamba ushiye indawo yenethiwekhi yesicwangciso sakho okanye ukuphulukana nesicwangciso esixhaswe ngumqeshi emva kokuthatha umhlala-phantsi. Awunyanzelekanga ukuba ulinde ukubhaliswa konyaka.

Iingcebiso zokubhalisa kwiMedicare eIdaho

Ngeendlela ezininzi ezikhoyo, kubalulekile ukuba uqwalasele ngononophelo iimfuno zakho zokhathalelo lwempilo ukufumanisa ukuba ngaba yinyani na iMedicare okanye iMedicare Advantage lolona khetho lufanelekileyo kunye nokuba unokufuna ukhuselo olongezelelekileyo.

Khetha isicwangciso:

• unabo oogqirha obathandayo kunye namaziko alungele indawo okuyo
• igubungela iinkonzo ozifunayo
• ibonelela ngendawo efikelelekayo
• Inenqanaba eliphezulu leenkwenkwezi kumgangatho kunye nokwoneliseka kwesigulana kwiCMS

Izixhobo zeIdaho Medicare

Fumana iimpendulo kwimibuzo kwaye ufumane uncedo ngezicwangciso zeMedicare Idaho kwezi zixhobo zilandelayo:

• Abacebisi abaPhezulu be-Inshurensi yezeMpilo (SHIBA) (800-247-4422). I-SHIBA ibonelela ngoncedo simahla kubantu abadala baseIdaho ngemibuzo malunga neMedicare.
• Idaho Isebe le-Inshurensi (800-247-4422). Oovimba abanika ulwazi ngoNcedo olongezelelekileyo kunye neNkqubo yoLondolozo lweMedare ngoncedo lokuhlawulela i-Medicare ukuba awukwazi ukuyifumana.
• Phila ngokungcono Idaho (877-456-1233). Obu budlelwane babucala babucala kunye nolwazi kunye nezixhobo malunga neMedare kunye nezinye iinkonzo zabahlali baseIdaho.
• Inkqubo ye-Idaho AIDS yoNcedo lweziyobisi (IDAGAP) (800-926-2588). Lo mbutho unikezela ngoncedo lwezezimali kwi-Medicare Part D yokugubungela ukuba une-HIV.

• Ndifanele ndenze ntoni ngokulandelayo?

  Xa ulungele ukubhalisa kwi-Medicare:

  • Thatha isigqibo sokuba ufuna ukhuselo olongezelelweyo kunye nezibonelelo zesicwangciso seMedicare Advantage (Icandelo C).
  • Ukuphonononga izicwangciso ezikhoyo kwingingqi yakho kunye nokuba zeziphi iingxelo abazibonelelayo.
  • Phawula ikhalenda yakho kwi-IEP yakho okanye ubhaliso oluvulekileyo ukuze wazi ukuba ungasayina nini.

  Eli nqaku lahlaziywa ngo-Okthobha u-5, 2020 ukubonisa ulwazi nge-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.