Izicwangciso ze-Indiana Medicare ngo-2021

Umxholo

• Yintoni amayeza?
• Icandelo lezaMayeza A
• Icandelo leMedare B
• Icandelo C (Uncedo ngamayeza)
• Icandelo leMedare D
• I-inshurensi yokuncedisa iMedare (iMedigap)
• Zeziphi izicwangciso eziluncedo zeMedicare ezikhoyo eIndiana?
• Ngubani ofanelekileyo kwi-Medicare e-Indiana?
• Ndingabhalisa nini kwizicwangciso zeMedicare Indiana?
• Ixesha lokubhalisa lokuqala
• Ubhaliso ngokubanzi: ngoJanuwari 1 ukuya kuMatshi 31
• Uncedo kwiMedicare ubhaliso oluvulekileyo: ngoJanuwari 1 ukuya ku-Matshi 31
• Amayeza abhalisiweyo avulekileyo: nge-1 ku-Okthobha u-31
• Ixesha elithile lobhaliso
• Iingcebiso zokubhalisa kwi-Medicare e-Indiana
• Izixhobo zaseIndiana Medicare
• Ndifanele ndenze ntoni ngokulandelayo?

I-Medicare yinkqubo ye-inshurensi yezempilo efumanekayo kubantu abaneminyaka engama-65 okanye nangaphezulu, nakwabo bangaphantsi kweminyaka engama-65 ubudala abaneemeko ezithile zezempilo okanye ukukhubazeka.

Yintoni amayeza?

Izicwangciso zeMedicare eIndiana zinamacandelo amane:

• ICandelo A, elisisibhedlele esikhathalelayo
• Icandelo B, olunyango lwangaphandle
• Icandelo C, ekwabizwa ngokuba yi-Medicare Advantage
• Icandelo D, eligubungela iziyobisi

Xa ugqiba iminyaka engama-65 ubudala, ungasayina kwi-Medicare yoqobo (Icandelo A kunye neCandelo B).

Icandelo lezaMayeza A

Uninzi lwabantu luyakufanelekela ukufumana iCandelo A ngaphandle ngaphandle kwepremiyamu yenyanga. Ukuba awufanelanga, ungathenga ukhuselo.

Icandelo A lokugubungela libandakanya:

• yokugubungela xa ungeniswa esibhedlele ukhathalelo lwexeshana
• Ukukhutshwa okungaphelelanga kononophelo lwexeshana lokhathalelo lweziko
• ezinye iinkonzo zononophelo lwempilo ekhaya
• isibhedlele

Icandelo leMedare B

Icandelo B lokugubungela libandakanya:

• utyelelo loogqirha
• Ukuhlolwa kokuthintela kunye nokuhlolwa
• iimvavanyo kunye neelebhu zelebhu
• izixhobo zonyango ezizinzileyo
• Unyango kunye neenkonzo zonyango

Emva kokubhalisela i-Medicare yoqobo, unokuthatha isigqibo sokuba ufuna isicwangciso se-Medicare Advantage (Icandelo C) okanye isicwangciso seMedigap, kunye nokusetyenziswa kweziyobisi.

Icandelo C (Uncedo ngamayeza)

Abaphethe i-inshurensi yabucala babonelela ngezicwangciso zeMedicare zeAdvantage eIndiana ezithi zixhamle izibonelelo zoNyango lokuqala ngokugubungela amayeza amayeza kunye nezinye iinkonzo, ezinje ngamazinyo okanye ukhathalelo lombono. Ukugquma okukhethekileyo kuyahluka ngesicwangciso kunye nomphathi.

Olunye uncedo lwezicwangciso ze-Advantage ngumda wonyaka wokuphuma epokothweni. Emva kokuba ufikelele kumda wonyaka obekwe sisicwangciso, isicwangciso sakho sihlawula zonke iindleko zakho ezivunyiweyo ze-Medicare zokhathalelo lonyaka.

I-Medicare yoqobo, kwelinye icala, ayinayo imida yonyaka. Ngamacandelo A no-B, uhlawula

• uxhuzulelwa ixesha ngalinye ungeniswa esibhedlele
• kutsalwa imali rhoqo ngonyaka kwiCandelo B
• Ipesenti yeendleko zonyango emva kokuhlawula iCandelo B

Icandelo leMedare D

Icandelo D licwangcisa amayeza amayeza kunye nezitofu zokugonya. Olu hlobo lokugubungela luyafuneka, kodwa unokukhetha ezimbalwa:

• uthenge umgaqo-nkqubo weCandelo D ngeMedicare yoqobo
• Bhalisela isicwangciso seNzuzo ye-Medicare equka ukukhutshwa kweCandelo D
• Fumana ingxelo efanayo kwesinye isicwangciso, njengesicwangciso esixhaswe ngumqeshi

Ukuba awunayo i-inshurensi yonyango kwaye ungayibhaliseli ngexesha lokubhalisa okokuqala, uya kuhlawula isohlwayo sobhaliso emva kwexesha.

I-inshurensi yokuncedisa iMedare (iMedigap)

IMedigap inokunceda ukuhlawula iindleko ezipokothweni. Kukho "iiplani" ezili-10 ezibonelela nge-coverage: A, B, C, D, F, G, K, L, M, and N.

Isicwangciso ngasinye sinokugubungela okwahlukileyo, kwaye ayizizo zonke izicwangciso ezithengiswayo kuyo yonke indawo. Cinga ngezidingo zakho xa ujonga izicwangciso zeMedigap, kwaye usebenzise isixhobo sokufumana isicwangciso seMedare ukuze ubone ukuba zeziphi izicwangciso ezithengiswa kwikhowudi yakho ye-ZIP.

Kuxhomekeka kwisicwangciso osikhethayo, iMedigap igubungela ezinye okanye zonke ezi ndleko zeMedare:

• iikopayi
• Uqinisekiso
• utsalo
• Unonophelo lwezakhono zononophelo
• unyango olungxamisekileyo

I-Medigap iyafumaneka ukuze isetyenziswe kuphela kwi-Medicare yoqobo. Ayinakudityaniswa nezicwangciso zeMedicare Advantage (Icandelo C). Awunakho ukubhalisa kuzo zombini iiMedicare Advantage kunye neMedigap.

Zeziphi izicwangciso eziluncedo zeMedicare ezikhoyo eIndiana?

E-Indiana, izicwangciso ze-Medicare Advantage ziwela phantsi kweendidi ezisixhenxe:

• Izicwangciso zoMbutho wezeMpilo (HMO). Kwi-HMO, ukhetha umboneleli wokhathalelo oluphambili (i-PCP) kuthungelwano lwesicwangciso soogqirha. Loo mntu uququzelela ukhathalelo lwakho, kubandakanya ukuhanjiswa kweengcali. Ii-HMOs zibandakanya izibhedlele kunye nezixhobo ngaphakathi kwenethiwekhi ngokunjalo.
• I-HMO enezicwangciso zenkonzo (POS). I-HMO enezicwangciso ze-POS zigubungela ukhathalelo ngaphandle kwenethiwekhi. Ngokuqhelekileyo zibandakanya iindleko ezingaphezulu kwe-epokothweni zokhathalelo lwangaphandle kwenethiwekhi, kodwa ezinye zeendleko ziyagutyungelwa.
• Izicwangciso zoMbutho woMboneleli okhethiweyo (PPO). Izicwangciso ze-PPO zinothungelwano lwababoneleli ngononophelo kunye nezibhedlele kwaye azifuni ukuba ufumane ukuhanjiswa kwePCP ukubona ingcali. Inkathalo ngaphandle kwenethiwekhi inokubiza ngaphezulu okanye ayinakugutyungelwa konke konke.
• Izicwangciso zokhathalelo olulawulwa ngumboneleli (PSO). Kwezi zicwangciso, ababoneleli bathatha umngcipheko wezemali wokhathalelo, ke ukhetha i-PCP kwisicwangciso kwaye uyavuma ukusebenzisa ababoneleli besicwangciso.
• Iiakhawunti zokonga iMedare (MSAs). I-MSA ibandakanya isicwangciso seinshurensi esisuswe kakhulu kunye neakhawunti yokonga yeendleko zonyango ezifanelekileyo. I-Medicare ihlawula iipremiyamu zakho kwaye ifake isixa esithile kwiakhawunti yakho unyaka nonyaka. Unokufuna ukhathalelo kuwo nawuphi na ugqirha.
• Izicwangciso zabucala zeNkonzo-yeNkonzo (PFFS). Ezi zizicwangciso zeinshurensi zabucala ezimisela amaxabiso okubuyiselwa ngokuthe ngqo kunye nababoneleli. Unokukhetha nawuphi na ugqirha okanye indawo eyakwamkela isicwangciso sakho se-PFFS; Nangona kunjalo, ayingabo bonke ababoneleli abaya kuthi.
• Izicwangciso zoMbutho weZibonelelo zoLuntu. Ezi zicwangciso zii-HMOs, ii-HMOs ezinee-POS, ii-PPOs, okanye iiPSO ezenziwe ngumbutho wenkolo okanye wobuzalwana. Ubhaliso lunokulinganiselwa kubantu abakuloo ntlangano.

IziCwangciso zeMfuno eziZodwa (SNPs) zikwakhona ukuba ufuna ukhathalelo olulungelelanisiweyo. Ezi zicwangciso zibonelela ngokugubungela kunye noncedo.

Unokufumana i-SNP ukuba:

• ziyafaneleka zombini iMedicaid kunye neMedicare
• Unemeko enye okanye ezingapheliyo okanye ezikhubazayo
• hlala kwindawo yokhathalelo yexesha elide

Aba bathwali beinshurensi babonelela ngezicwangciso zeMedicare Advantage eIndiana:

• UAetna
• Konke
• Umhobe iBlue Cross kunye neBlue Shield
• Impilo yoMhobe Abagcini
• Inkonzo yoKhathalelo
• Humana
• Izicwangciso zezeMpilo zeYunivesithi yaseIndiana
• Ukhathalelo lwezeMpilo lweLasso
• MyTruAdvantage
• Ukhathalelo lweZempilo
• Impilo yeZing

Izicwangciso ezahlukeneyo ziyafumaneka kwisithili ngasinye saseIndiana, ke ukhetho lwakho luxhomekeke kwindawo ohlala kuyo kunye nekhowudi yakho ye-ZIP. Ayizizo zonke izicwangciso ezikhoyo kuyo yonke indawo.

Ngubani ofanelekileyo kwi-Medicare e-Indiana?

Ukuze ufaneleke kwizicwangciso ze-Medicare Indiana, kufuneka:

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

Unokufanelekela ngaphambi kokuba ube neminyaka engama-65 ukuba:

• Ufumene i-Inshurensi yokuKhubazeka kwezeNtlalontle (i-SSDI) okanye iZibonelelo zoMhlala-phantsi zoLoliwe (RRB) kangangeenyanga ezingama-24
• banesifo sokugqibela sezintso (ESRD) okanye ukufakelwa kwezintso
• bane-amyotrophic lateral sclerosis (ALS), ekwabizwa ngokuba sisifo sikaLou Gehrig

Ndingabhalisa nini kwizicwangciso zeMedicare Indiana?

Abanye abantu babhalise ngokuzenzekelayo kwi-Medicare, kodwa uninzi kufuneka lubhalise ngexesha lokubhalisa elichanekileyo.

Ixesha lokubhalisa lokuqala

Ukuqala iinyanga ezi-3 ngaphambi kwenyanga yokuzalwa kwakho kwama-65, ungabhalisa kwi-Medicare. Izibonelelo zakho ziya kuqala kusuku lokuqala lwenyanga yakho yokuzalwa.

Ukuba uyaliphosa eli xesha lokubhalisa kwangoko, ungasabhalisa ngenyanga yokuzalwa kwakho kunye neenyanga ezi-3 emva koko, kodwa ukugubungela kuya kulibaziseka.

Ngexesha lokuqala lokubhalisa, ungabhalisa kumanqanaba A, B, C, no-D.

Ubhaliso ngokubanzi: ngoJanuwari 1 ukuya kuMatshi 31

Ukuba uliphosile ixesha lakho lokuqala lokubhalisa, ungabhalisa ekuqaleni konyaka ngamnye, kodwa ingxelo yakho ayizukuqala kude kube nguJulayi 1. Ubhaliso lwamva lusenokuthetha ukuba uza kuhlawula isohlwayo nanini na xa ubhalisa.

Emva kokubhaliswa ngokubanzi, ungasayinela i-Medicare Advantage ukususela ngo-Ephreli 1 ukuya ku-Juni 30.

Uncedo kwiMedicare ubhaliso oluvulekileyo: ngoJanuwari 1 ukuya ku-Matshi 31

Ukuba sele ubhalisile kwisicwangciso se-Medicare Advantage, ungatshintsha izicwangciso okanye ubuyele kwi-Medicare yasekuqaleni ngeli xesha.

Amayeza abhalisiweyo avulekileyo: nge-1 ku-Okthobha u-31

Ikwabizwa ngokuba lixesha lobhaliso lonyaka, eli lixesha apho unokuthi:

• tshintsha kwi-Medicare yoqobo uye kwi-Medicare Advantage
• tshintsha kwi-Medicare Advantage uye kwi-Medicare yoqobo
• tshintshela kwesinye isicwangciso seMedicare Advantage uye kwesinye
• tshintsha isicwangciso esinye seMedicare D (iyeza) ukuya kwelinye

Ixesha elithile lobhaliso

Ungabhalisa kwi-Medicare ngaphandle kokulinda ubhaliso oluvulekileyo ngokulungela ixesha elithile lobhaliso. Oku kuyakwenzeka ngesiqhelo ukuba ulahlekelwe kukugubungela phantsi kwesicwangciso esixhaswe ngumqeshi, phuma kwindawo yokugubungela isicwangciso sakho, okanye isicwangciso sakho asisafumaneki ngenxa yesizathu esithile.

Iingcebiso zokubhalisa kwi-Medicare e-Indiana

Kubalulekile ukuvavanya iimfuno zakho zokhathalelo lwempilo kwaye ufunde isicwangciso ngasinye ngocoselelo ukuze ukhethe eyona inika eyona nkxaso ibalaseleyo kwiimfuno zakho. Qwalasela ngononophelo:

• nokuba uyayifuna na iMedicare yoqobo okanye iMedicare Advantage
• ukuba oogqirha bakho obathandayo bakwinethiwekhi yesicwangciso seMedicare
• zithini iipremiyamu, ezitsalwayo, iikopay, ukuqinisekiswa kwemali, kunye neendleko zokuphuma epokothweni kwisicwangciso ngasinye

Ukuthintela isohlwayo sokubhalisa emva kwexesha, sayina kuwo onke amalungu e-Medicare (A, B, kunye no-D) okanye uqiniseke ukuba unayo enye into yokugubungela, njengesicwangciso esixhaswe ngumqeshi xa uneminyaka engama-65.

Izixhobo zaseIndiana Medicare

Ukuba ufuna ulwazi oluthe kratya okanye uncede ukuqonda ukhetho lwakho lweMedicare eIndiana, ezi zixhobo ziyafumaneka:

• Isebe lase-Indiana le-Inshurensi, 800-457-8283, elinikezela ngesishwankathelo seMedare, amakhonkco aluncedo eMedicare, kunye noncedo lokuhlawula iMedicare
• Inkqubo ye-Inshurensi yezeMpilo yase-Indiana State (SHIP), 800-452-4800, apho amavolontiya aphendula imibuzo kwaye akuncede ngokubhaliswa kwe-Medicare
• Medicare.gov, 800-633-4227

Ndifanele ndenze ntoni ngokulandelayo?

Nazi iingcebiso zokukunceda ubhalise kwi-Medicare:

• Ukuqokelela naziphi na iirekhodi okanye ulwazi malunga nemigqaliselo yakho kunye neemeko zonyango.
• Buza ugqirha wakho ukuba zeziphi i-inshurensi okanye izicwangciso zeMedicare abazamkelayo okanye abathatha inxaxheba kuzo.
• Misela ixesha lokubhalisa kwakho kwaye uphawule ikhalenda yakho.
• Bhalisela iCandelo A kunye neCandelo B, emva koko uthathe isigqibo sokuba ungasithanda na isicwangciso seMedicare Advantage.
• Khetha isicwangciso kunye nesigubungelo osifunayo kunye nababoneleli obathandayo.

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.