Izicwangciso zeNevada Medicare ngo-2021

Umxholo

• Yintoni amayeza?
• Icandelo A
• Icandelo B
• Icandelo C (Uncedo ngamayeza)
• Icandelo D
• I-inshurensi yonyango (iMedigap)
• Zeziphi izicwangciso eziluncedo kuMayeza ezifumaneka eNevada?
• Ngubani ofanelekileyo kwiMedicare eNevada?
• Ndingabhalisa nini kwizicwangciso zeMedicare Nevada?
• Ixesha lokubhalisa lokuqala (IEP)
• Ixesha lokubhalisa ngokubanzi
• Uncedo lweMedicare lubhaliso oluvulekileyo
• Ixesha lokubhalisa elivulekileyo
• Amaxesha obhaliso olukhethekileyo (SEPs)
• Iingcebiso zokubhalisa kwiMedicare eNevada
• Izixhobo zeNevada Medicare
• Ndifanele ndenze ntoni ngokulandelayo?

Ukuba uhlala eNevada kwaye uneminyaka engama-65 ubudala okanye ngaphezulu, unokufanelekela kwi-Medicare. I-Medicare yi-inshurensi yezempilo ngurhulumente womanyano. Unokufaneleka ukuba ungaphantsi kweminyaka engama-65 kwaye uhlangabezana neemfuno ezithile zonyango.

Funda ngokufunda malunga nokukhetha kwakho i-Medicare e-Nevada, nini kunye nendlela yokubhalisa, kunye namanyathelo alandelayo.

Yintoni amayeza?

• Amayeza okuqala: igubungela ukuhlala esibhedlele kunye nokunyamekela abagulayo ngaphandle kwecandelo A no-B
• Uncedo lwamayeza: Izicwangciso zeinshurensi yezempilo yabucala eqokelela izibonelelo ezifanayo neMedicare yoqobo kwaye inokunikezela ngokhetho olongezelelekileyo lokugubungela
• Icandelo le-Medicare Icandelo D: ezi zicwangciso zeinshurensi zabucala zigubungela iindleko zamayeza amiselweyo
• I-inshurensi yonyango (iMedigap): Izicwangciso zibonelela ngenkxaso yokunceda ekuhlawuleni imali, ii-copays, i-coinsurance, kunye nezinye iindleko ze-Medicare ezingaphandle kweepokotho

Icandelo A

Icandelo A ligubungela ukhathalelo esibhedlele, isibhedlele esibalulekileyo, okanye ixesha elilinganiselweyo kwiziko labongikazi abanezakhono.

Ukuba uvumelekile ukuba ungafumana iCandelo A le-premium, akukho zindleko zenyanga zokugubungela. Uya kuba netyala lokutsalwa nanini na xa ungeniswa kukhathalelo.

Ukuba awulungelanga icandelo A ngaphandle kwepremiyamu, usenakho ukufumana iCandelo A kodwa kuya kufuneka uhlawule ipremiyamu.

Icandelo B

Icandelo B ligubungela olunye unyango ngaphandle kwesibhedlele, kubandakanya:

• utyelelo kugqirha wakho
• ukhuseleko
• Uvavanyo lweelebhu, ukuvavanywa kovavanyo kunye nokucinga
• izixhobo zonyango ezizinzileyo

Iipremiyamu zanyanga zonke zezicwangciso zeCandelo B ziyaguquka minyaka le.

Icandelo C (Uncedo ngamayeza)

I-inshurensi yabucala ikwabonelela ngezicwangciso zeMedicare Advantage (Icandelo C). Izicwangciso ze-Medicare Advantage zibonelela ngezibonelelo ezifanayo njengamacandelo A kunye no-B kwi-Medicare yoqobo kodwa bahlala benokhuselo olongezelelekileyo (kunye nepremiyamu eyongezelelweyo) enokubandakanya:

• wamazinyo, umbono, kunye nokhathalelo lokuva
• Iirampu zabakhubazekile
• ukuhanjiswa kokutya ekhaya
• ukuthuthwa okuyimfuneko

Kusafuneka ubhalise kwicandelo A kunye neCandelo B kwaye uhlawule iprimiyamu yeCandelo B xa ubhalisa kwisicwangciso seMedicare Advantage.

Icandelo D

Wonke umntu kwi-Medicare unelungelo lokufumana iziyobisi ngugqirha (Icandelo D), kodwa linikezelwa kuphela ngomshuwalense wabucala. Kubalulekile ukuthelekisa izicwangciso kuba iindleko kunye nokugubungela kuyahluka.

I-inshurensi yonyango (iMedigap)

I-inshurensi yokuncedisa iMedare (iMedigap) inceda ekuhlawuleni iindleko eziphuma epokothweni kumacandelo A no-B. Ezi zicwangciso zinikezelwa ngababoneleli ngeinshurensi yabucala.

Izicwangciso zeMedigap zinokulingana ngokufanelekileyo ukuba uneendleko zokhathalelo lwempilo oluphezulu kuba i-Medicare yoqobo ayinayo umda wenkcitho ongaphandle epokothweni yonyaka. Izicwangciso zeMedigap zinokunceda ekunciphiseni uxinzelelo malunga neendleko zokhathalelo lwempilo olungaziwayo ukuba ukhetha enye enepokotho ephezulu.

Zeziphi izicwangciso eziluncedo kuMayeza ezifumaneka eNevada?

Izicwangciso zeMedare eziluncedo kwiNevada ziwela ngokwendidi ezine:

Umbutho woLondolozo lwezeMpilo (HMO). Nge-HMO, ukhathalelo lwakho luququzelelwa ngugqirha oyintloko (PCP) kwinethiwekhi yesicwangciso ekubhekisa kwiingcali njengoko kufuneka. Ukuba uphuma kwinethiwekhi ngayo nayiphi na into ngaphandle kononophelo olungxamisekileyo okanye idialysis, ngekhe igqunywe. Kubalulekile ukufunda nokulandela yonke imigaqo yesicwangciso.

IpheImibutho yoMboneleli ehanjisiweyo (I-PPO). Izicwangciso ze-PPO zinothungelwano loogqirha kunye nezixhobo ezibonelela ngeenkonzo ezifakwe kwisicwangciso sakho. Awudingi ukuthunyelwa ukuze ubone ingcali, kodwa usenokufuna ukuba nePCP yokulungelelanisa inkathalo yakho. Ukunyamekela ngaphandle kwenethiwekhi kuya kubiza ngaphezulu.

Imali yabucala-yeNkonzo(PFFS). Nge-PFFS, ungaya kulo naliphi na ugqirha okanye indawo evunyiweyo ye-Medicare, kodwa bayaxoxa ngeerhafu zabo. Asingabo bonke ababoneleli abazamkelayo ezi zicwangciso, ke jonga ukuba oogqirha bakho obathandayo bathatha inxaxheba ngaphambi kokuba ukhethe olu khetho.

ISicwangciso seeMfuno eziZodwa (SNP). I-SNP ziyafumaneka kubantu abafuna inqanaba eliphezulu lolawulo lwenkqubela kunye nokulungelelanisa. Unokufanelekela i-SNP ukuba:

• uneemeko ezithile zempilo, ezinjengesifo sokugqibela sezintso (i-ESRD), isifo seswekile, okanye iimeko zentliziyo ezingapheliyo
• bafanelekele zombini i-Medicare kunye neMedicaid (ezimbini ezifanelekileyo)
• hlala kwikhaya labalupheleyo

Izicwangciso ze-Medicare zeNzuzo kwiNevada zibonelelwa zezi zilandelayo:

• I-Aetna Medicare
• Ukulungelelaniswa kweSicwangciso seMpilo
• Konke
• Umhobe iBlue Cross kunye neBlue Shield
• Humana
• Iinkampani ze-Imperial Insurance, Inc.
• Ukhathalelo lwezeMpilo lweLasso
• Isicwangciso seMpilo esiPhakamileyo
• KhethaHealth
• Unonophelo lwaBadala kunye
• Ukhathalelo lweZempilo

Ayizizo zonke izinto ezihambisa izithuthi kuzo zonke izithili zeNevada, ke ukhetho lwakho luya kwahluka ngokusekwe kwikhowudi yakho ye-ZIP.

Ngubani ofanelekileyo kwiMedicare eNevada?

Ufanelekile kwi-Medicare ukuba uneminyaka engama-65 okanye ngaphezulu kwaye ungummi okanye umhlali wase-United States kule minyaka mi-5 idlulileyo okanye nangaphezulu.

Ukuba ungaphantsi kweminyaka engama-65 ubudala, unokufanelekela ukuba:

• bafumane izibonelelo zokukhubazeka kwiBhodi yoMhlala-phantsi yoLoliwe okanye koKhuseleko lweNtlalo
• bane-ESRD okanye ngabamkeli ukufakelwa kwezintso
• ndine-amyotrophic lateral sclerosis (ALS)

Ukufumana icandelo leMedicare A ngaphandle kwepremiyamu yenyanga, wena okanye iqabane lakho kufuneka nihlangabezane neemfuno ngokusebenza emsebenzini apho nihlawule irhafu yeMedare iminyaka eli-10 okanye nangaphezulu.

Ungasebenzisa isixhobo seMedicare sokufaneleka kwi-Intanethi ukumisela ukufaneleka kwakho.

Ndingabhalisa nini kwizicwangciso zeMedicare Nevada?

I-Medicare yoqobo, i-Medicare Advantage, kunye nezicwangciso zeMedigap zibeke amaxesha apho ungabhalisa okanye utshintshe izicwangciso kunye nokugubungela. Ukuba uphoswa lixesha lokubhalisa, kuya kufuneka uhlawule isohlwayo kamva.

Ixesha lokubhalisa lokuqala (IEP)

Ifestile yoqobo yokubhalisa kuxa uneminyaka yobudala engama-65. Ungabhalisa nanini na kwiinyanga ezi-3 ezingaphambi kwenyanga, okanye kwiinyanga ezi-3 emva kosuku lwakho lokuzalwa lwama-65.

Ukuba ubhalisa ngaphambi kwenyanga yakho yokuzalwa, ukogquma kwakho kuya kuqala kwinyanga oba nayo i-65. Ukuba ulinda de ibe yinyanga yakho yokuzalwa okanye kamva, kuyakubakho ukulibaziseka kweenyanga ezi-2 okanye ezi-3 ngaphambi kokuba kuqalwe ukhuseleko.

Ngexesha le-IEP yakho uyakwazi ukubhalisela iinxalenye A, B, kunye no-D.

Ixesha lokubhalisa ngokubanzi

Ukuba ulahlekelwe yi-IEP yakho kwaye kufuneka ubhalisele i-Medicare yasekuqaleni okanye utshintshe iindlela zokukhetha, ungakwenza oku ngexesha lokubhalisa ngokubanzi. Ixesha lokubhalisa ngokubanzi livela qho ngonyaka phakathi NgoJanuwari 1 noMatshi 31, kodwa ingxelo yakho ayizukuqala kude kube nguJulayi 1.

Uyakwazi ukubhalisela iinxalenye A kunye no-B okanye utshintshe kwi-Medicare yoqobo uye kwi-Medicare Advantage ngexesha lokubhalisa ngokubanzi.

Uncedo lweMedicare lubhaliso oluvulekileyo

Ungatshintsha usuke kwisicwangciso esinye se-Medicare Advantage uye kwesinye okanye utshintshele kwi-Medicare yoqobo ngexesha lobhaliso oluvulekileyo lwe-Medicare. Uncedo kwiMedicare ubhaliso oluvulekileyo lwenzeka rhoqo ngonyaka phakathi NgoJanuwari 1 noMatshi 31.

Ixesha lokubhalisa elivulekileyo

Ngexesha lokubhalisa okuvulekileyo, ungabhalisa kwicandelo C (isibonelelo seMedicare) okokuqala okanye ubhalise kwiCandelo D ukuba awuzange uyenze ngexesha le-IEP.

Ubhaliso oluvulekileyo lwenzeka rhoqo ngonyaka phakathi Oktobha 15 noDisemba 7.

Amaxesha obhaliso olukhethekileyo (SEPs)

I-SEP zikuvumela ukuba ubhalise ngaphandle kwexesha lokubhalisa eliqhelekileyo ngenxa yezizathu ezithile, njengokulahleka kwesicwangciso esixhaswe ngumqeshi, okanye ukuphuma kwindawo yesevisi yesicwangciso sakho. Ngale ndlela, akukho mfuneko yokuba ulinde ukubhaliswa okuvulekileyo.

Iingcebiso zokubhalisa kwiMedicare eNevada

Ngeendlela ezininzi ezikhoyo, kubalulekile ukuba uqwalasele iindleko zonyango kunye neemfuno zakho kunyaka ngamnye ukumisela esona sicwangciso silungileyo.

Ukuba ulindele iindleko zokhathalelo lwempilo kulo nyaka uzayo, unokufuna isicwangciso seMedicare seNzuzo ukuze iindleko zigutyungelwe emva kokuba ufike ngaphandle kwepokotho. Isicwangciso seMedigap sinokunceda kwiindleko zonyango oluphezulu.

Ezinye izinto ekufuneka ziqwalaselwe zezi:

• Iindleko zenyanga zepremiyamu
• Ukutsalwa kwemali, ii-copays kunye nokuqinisekiswa kwemali
• ababoneleli kwinethiwekhi yesicwangciso

Ungalujonga kwakhona umlinganiso weenkwenkwezi we-CMS ukubona ukuba izicwangciso ezithile zinamanqaku kangakanani kumgangatho kunye nokwoneliseka kwezigulana.

Izixhobo zeNevada Medicare

Ngolwazi oluthe kratya malunga nezicwangciso zeMedicare eNevada, fikelela kwezi zixhobo zilandelayo:

• Inkqubo ye-Inshurensi yezeMpilo kaRhulumente (SHIP): 800-307-4444
• I-SeniorRx ngoncedo lokuhlawula amayeza amiselweyo: 866-303-6323
• Ulwazi kwizicwangciso zeMedigap kunye nee-MA
• Isixhobo sokulinganisa inqanaba lokunyanga
• I-Medicare: fowunela i-800-MEDICARE (800-633-4227) okanye uye kwi-Medicare.gov

Ndifanele ndenze ntoni ngokulandelayo?

Ukufumana nokubhalisa kwiMedicare eNevada:

• Chonga iimfuno zakho zempilo kunye neendleko zokhathalelo lwempilo unyaka nonyaka ukuze ukhethe isicwangciso esifanelekileyo, kubandakanya ukuxhaswa okanye iCandelo D.
• Izicwangciso zophando ziyafumaneka kubaphathi kwindawo yakho.
• Phawula ikhalenda yakho ngexesha elifanelekileyo lobhaliso ukuze ungaphoswa kukubhalisa.

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.