Izicwangciso zeMaine Medicare ngo-2021

Umxholo

• Yintoni amayeza?
• Icandelo lezaMayeza A
• Icandelo leMedare B
• Icandelo lonyango Medic C
• Icandelo leMedare D
• Zeziphi izicwangciso ze-Medicare eziluncedo ezifumanekayo eMaine?
• Ngubani ofanelekileyo kwi-Medicare eMaine?
• Ndingabhalisa nini kwizicwangciso zeMedicare Maine?
• Ixesha lokubhalisa lokuqala
• Ubhaliso ngokubanzi: ngoJanuwari 1 ukuya kuMatshi 31
• Ixesha lokubhalisa elivulekileyo: nge-15 ka-Okthobha ukuya kuDisemba 7
• Ixesha elithile lobhaliso
• Iingcebiso zokubhalisa kwi-Medicare eMaine
• Izibonelelo zeMaine Medicare
• Ndifanele ndenze ntoni ngokulandelayo?

Ngokuqhelekileyo unelungelo lokufumana unyango lwe-Medicare xa uneminyaka engama-65 ubudala. I-Medicare yinkqubo ye-inshurensi yezempilo ebonelela ngezicwangciso kwilizwe liphela. I-Medicare Maine ineendlela ezininzi zokukhetha onokukhetha kuzo, ngenxa yoko unokukhetha owona mlinganiso mhle kwiimfuno zakho.

Thatha ixesha lokufumanisa ukufaneleka kwakho, uphando ngezicwangciso ezahlukeneyo, kwaye ufumane okungakumbi malunga nokubhalisa kwizicwangciso zeMedare eMaine.

Yintoni amayeza?

Ekuboneni kokuqala, i-Medicare inokubonakala inzima. Inamalungu amaninzi, iindlela ezahlukeneyo zokugubungela, kunye noluhlu lweeprimiyamu. Ukuqonda iMedicare Maine kuya kukunceda wenze isigqibo esifanelekileyo kuwe.

Icandelo lezaMayeza A

Icandelo A yinxalenye yokuqala yonyango lokuqala. Inika ukhuselo olusisiseko lweMedare, kwaye ukuba ufanelekile ukuba ufumane izibonelelo zoKhuseleko lweNtlalo, uya kufumana iCandelo A simahla.

Icandelo A libandakanya:

• ukhathalelo lwesibhedlele
• ukunqongophala kweenkonzo zononophelo lwezakhono (SNF)
• Ukunqongophala kweenkonzo ezithile zokhathalelo lwempilo okwexeshana
• Unonophelo lwehosisi

Icandelo leMedare B

Icandelo B yinxalenye yesibini yonyango lwantlandlolo. Kuya kufuneka uhlawule iipremiyamu zeCandelo B. Iquka:

• ukuqeshwa koogqirha
• ukhuseleko
• izixhobo ezifana nokuhamba kunye nezitulo ezinamavili
• Unyango lwezonyango
• iimvavanyo zaselebhu kunye neX-reyi
• iinkonzo zempilo yengqondo

Icandelo lonyango Medic C

Izicwangciso zeCandelo C (i-Medicare Advantage) e-Maine zinikezelwa ngabathwali be-inshurensi yempilo yabucala evunyiweyo yi-Medicare. Banikezela:

• isigubungelo esisisiseko njenge-Medicare yoqobo (iinxalenye A no-B)
• Ukukhutshwa kweziyobisi ngugqirha
• iinkonzo ezongeziweyo, ezinje ngombono, amazinyo, okanye iimfuno zokuva

Icandelo leMedare D

Icandelo D kukugubungela amayeza amayeza anikezelwa ngabaphethe i-inshurensi yabucala Inika ingxelo kumayeza akho amiselweyo.

Isicwangciso ngasinye sigubungela uluhlu olwahlukileyo lweziyobisi, ezaziwa njenge-formulary. Ke, ngaphambi kokubhalisa kwisicwangciso seCandelo D, kuyakufuneka uqiniseke ukuba amayeza akho aya kugutyungelwa.

Zeziphi izicwangciso ze-Medicare eziluncedo ezifumanekayo eMaine?

Ukuba ubhalisa kwi-Medicare yoqobo, uya kufumana inkxaso-mali ye-inshurensi yezempilo kuluhlu olusetiweyo lwesibhedlele kunye neenkonzo zonyango.

Izicwangciso ze-Medicare Advantage eMaine, kwelinye icala, zibonelela ngeendlela ezizodwa zokugubungela kunye nenqanaba leprimiyamu, zonke ziyilelwe ukuthelekisa iimfuno zabantu abadala. Abaphethe izicwangciso zeMedare eziluncedo eMaine zezi:

• UAetna
• Impilo ye-AMH
• IHarvard Pilgrim yoKhathalelo lwezeMpilo Inc.
• Humana
• Martin's Point Generations Inzuzo
• Ukhathalelo lweZempilo
• Ukhathalelo

Ngokungafaniyo neMedicare yoqobo, eyinkqubo yesizwe, aba baboneleli ngeinshurensi yabucala bayohluka ukusuka kurhulumente ukuya kurhulumente-naphakathi kwamacandelo. Xa ufuna izicwangciso ze-Medicare Advantage eMaine, qiniseka ukuba uthelekisa kuphela izicwangciso ezibonelela ngogcino lwengingqi yakho.

Ngubani ofanelekileyo kwi-Medicare eMaine?

Njengoko ujonga ukhetho lwakho, kuyanceda ukuba wazi iimfuno zokufaneleka kwizicwangciso zeMedare eMaine. Uya kufaneleka kwi-Medicare Maine ukuba:

• baneminyaka engama-65 okanye ngaphezulu
• bangaphantsi kweminyaka engama-65 kwaye banesifo esinganyangekiyo, esifana nesifo sokugqibela sezintso (ESRD) okanye i-amyotrophic lateral sclerosis (ALS)
• bangaphantsi kweminyaka engama-65 kwaye bafumene izibonelelo zoKhuseleko loLuntu kwiinyanga ezingama-24
• ungummi wase-U.S. okanye umhlali osisigxina

Uya kulungeleka ukufumana icandelo le-A elingena-premium nge-Medicare Maine ukuba:

• uhlawule iirhafu zeMedare iminyaka elishumi yokusebenza kwakho
• Fumana izibonelelo zomhlala-phantsi kuKhuseleko lweNtlalontle okanye kwiBhodi yoMhlala-phantsi yoLoliwe
• wayengumsebenzi waseburhulumenteni

Ndingabhalisa nini kwizicwangciso zeMedicare Maine?

Ixesha lokubhalisa lokuqala

Elona xesha lilungileyo lokubhalisa kwizicwangciso zeMedare eMaine lixesha lakho lokubhalisa. Oku kukuvumela ukuba ufumane ingxelo oyifunayo ukususela kwiminyaka engama-65 ubudala.

Ixesha lakho lokuqala lokubhalisa liwindow leenyanga ezi-7 eliqala iinyanga ezi-3 ezipheleleyo ngaphambi kokuzalwa kwakho kwama-65, kubandakanya inyanga yakho yokuzalwa, kwaye uqhubeke ukongeza iinyanga ezintathu emva kosuku lwakho lokuzalwa.

Ukuba ulungele izibonelelo zoKhuseleko lweNtlalo, uya kubhaliswa ngokuzenzekelayo kwi-Medicare Maine yoqobo.

Ngeli xesha lesakhelo, ungabhalisa kwisicwangciso seCandelo D okanye kwisicwangciso seMedigap.

Ubhaliso ngokubanzi: ngoJanuwari 1 ukuya kuMatshi 31

Ukukhutshwa kwe-Medicare kufuneka kuphononongwe rhoqo ngonyaka njengoko ukhathalelo lwakho lwempilo lutshintsha okanye njengoko izicwangciso ziguqula imigaqo-nkqubo yokugubungela

Ixesha lokubhaliswa ngokubanzi liqala ngoJanuwari 1 ukuya kuMatshi 31. Ikuvumela ukuba ubhalisele i-Medicare yoqobo ukuba awukenzi oko. Unokusebenzisa eli xesha ukubhalisa kwizicwangciso zeMedicare Advantage okanye kwiCandelo D.

Ixesha lokubhalisa elivulekileyo: nge-15 ka-Okthobha ukuya kuDisemba 7

Ixesha lokubhalisa elivulekileyo liqala ukusuka nge-15 ka-Okthobha ukuya kuDisemba 7. lelinye ixesha apho unokutshintsha khona ukugquma.

Ngeli xesha, uya kuba nakho ukutshintsha phakathi kwezicwangciso ze-Medicare Advantage eMaine, ubuyele kwi-Medicare yokuqala, okanye ubhalise kugonyo lweziyobisi.

Ixesha elithile lobhaliso

Ezinye iimeko zikuvumela ukuba ubhalise kwi-Medicare Maine okanye wenze utshintsho kwisicwangciso sakho ngaphandle kwala maxesha obhaliso oluqhelekileyo. Unokulungela ukubhaliswa kangangexesha elithile ukuba:

• ulahlekelwe ngumshuwalense wezempilo
• phuma kwindawo yokugubungela isicwangciso sakho
• ufudukele kwikhaya labalupheleyo

Iingcebiso zokubhalisa kwi-Medicare eMaine

Njengoko ulinganisa ukhetho lwakho kwaye uthelekise izicwangciso zeMedare eMaine, landela ezi ngcebiso:

• Khangela ukuba ukulungele nini ukubhalisa kwaye, ukuba kunokwenzeka, ubhalise ngexesha lakho lokuqala lobhaliso.
• Thetha kwiofisi kagqirha uze ufumane ukuba zeziphi iinethiwekhi. I-Medicare yoqobo igubungela uninzi loogqirha; Nangona kunjalo, ukuqhuba ngasese izicwangciso ze-Medicare Advantage eMaine zisebenza kunye noogqirha abathile benethiwekhi kwindawo nganye. Qinisekisa ukuba ugqirha wakho uthungelwano oluvunyiweyo lwaso nasiphi na isicwangciso ocinga ngaso.
• Ukuba ucinga ngesicwangciso seziyobisi okanye isicwangciso seNzuzo, yenza uluhlu olupheleleyo lwawo onke amayeza akho. Emva koko, thelekisa olu luhlu ngokubhekisele kwingxelo enikezelwa sisicwangciso ngasinye kwifomula yayo ukuqinisekisa ukuba amayeza akho afakiwe.
• Jonga ukuba isicwangciso ngasinye senziwe njani ngokubanzi, kwaye ujonge ukulinganiswa komgangatho okanye inkqubo yokulinganisa iinkwenkwezi. Eli nqanaba libonisa ukuba isicwangciso sibekwe njani kumgangatho wokhathalelo lonyango, ulawulo lwesicwangciso, kunye namava amalungu. Isicwangciso esineenkwenkwezi ezi-5 esenziwe kakuhle kakhulu. Uya kwaneliseka sisicwangciso esinjalo ukuba siyazifezekisa zonke ezinye iimfuno zakho.

Izibonelelo zeMaine Medicare

Le mibutho ilandelayo inokubonelela ngolwazi oluthe kratya malunga nezicwangciso zokuqala zeMedicare kunye neMedicare kwiMaine:

• Imeko yeeNkonzo zokuGuga nokuKhubazeka kweMaine. Tsalela umnxeba ku-888-568-1112 okanye ufumane ulwazi oluthe kratya kwi-intanethi malunga noluntu kunye nenkxaso yasekhaya, ukhathalelo lwexesha elide, kunye neNkqubo yokuNcediswa kweNkqubo ye-Inshurensi yezeMpilo (i-SHIP), kunye nengcebiso malunga neMedicare.
• Iziko le-Inshurensi. Tsalela umnxeba ku-800-300-5000 okanye ujonge iwebhusayithi ukuze ufumane ulwazi oluthe kratya malunga nezibonelelo kunye namaxabiso eMedare.
• Iinkonzo Zomthetho Zabantu Abadala. Ukufumana iingcebiso zomthetho zasimahla malunga neinshurensi yokhathalelo lwempilo, izicwangciso zeMedicare, uKhuseleko lweNtlalo, okanye izibonelelo zepenshini, tsalela umnxeba ku-800-750-535 okanye ujonge kwi-Intanethi.

Ndifanele ndenze ntoni ngokulandelayo?

Njengoko usondela kwiminyaka yakho yokuzalwa engama-65, qalisa ukufumana okungakumbi malunga nezicwangciso zeMedare eMaine uze uqhathanise ukhetho lwakho lokugubungela. Unokufuna ukwenza oku kulandelayo:

• Cinga ngeenkonzo zokhathalelo lwempilo ongathanda ukufikelela kuzo, kwaye ufumane isicwangciso esingahambelani nohlahlo-lwabiwo mali kuphela, kodwa nolondolozo lwempilo lwakho luyafuna.
• Sebenzisa ikhowudi yakho ye-ZIP xa ukhangela izicwangciso zokuqinisekisa ukuba ujonga kuphela ezo zifumanekayo kuwe.
• Tsalela umnxeba kwi-Medicare, okanye isicwangciso se-Advantage okanye umboneleli weCandelo D, ukubuza nayiphi na imibuzo elandelayo kwaye uqalise inkqubo yobhaliso.

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.