Izicwangciso zeOregon Medicare ngo-2021

Umxholo

• Yintoni amayeza?
• Izicwangciso zokuncedisa kwiMedare
• Izicwangciso zamachiza amiselweyo
• Uncedo lweMedicare (Icandelo C)
• Zeziphi izicwangciso ze-Medicare eziluncedo ezikhoyo e-Oregon?
• Ngubani ofanelekileyo kwi-Medicare e-Oregon?
• Ndingabhalisa nini kwizicwangciso zeMedicare Oregon?
• Iingcebiso zokubhalisa kwi-Medicare e-Oregon
• Izibonelelo zonyango zeOregon
• Ndifanele ndenze ntoni ngokulandelayo?

Nokuba uthengela izicwangciso ze-Medicare e-Oregon okokuqala okanye ucinga ngokutshintsha i-Medicare yakho yangoku, kubalulekile ukuba uqale uqonde zonke iinketho zakho.

Funda ngokufunda malunga nezicwangciso ezahlukeneyo zeMedare ezifumaneka eOregon, amaxesha obhaliso, kunye nokunye.

Yintoni amayeza?

I-Medicare yinkqubo ye-inshurensi yezempilo yesizwe elawulwa ngurhulumente womanyano. Iyafumaneka kubantu abaneminyaka engama-65 nangaphezulu, kunye nakwabo nabuphi na ubudala abanokukhubazeka okuthile okanye iimeko zempilo.

Icandelo A kunye no-B benza i-Medicare yoqobo onokuyifumana kurhulumente. Kule minyaka, inkqubo yoqobo ye-Medicare iye yanda ukubandakanya izicwangciso onokuzithenga kwii-inshurensi zabucala. Ezi zicwangciso zinokongeza okanye zithathe indawo yokugubungela oyifumana phantsi kweMedicare yoqobo.

Icandelo A yi-inshurensi yesibhedlele. Kuyanceda ukuhlawula iindleko ze:

• Iinkonzo zononophelo lwempilo ezilaliswayo ezifunyanwa esibhedlele
• ukuhlala ixesha elincinci kwiziko labongikazi elinobuchule
• Unonophelo lwehosisi
• ezinye iinkonzo zempilo ekhaya

Ukuba wena okanye iqabane lakho nihlawule irhafu yonyango ngexesha lokusebenza, ngekhe uhlawule ipremiyamu kwiCandelo A.

Icandelo B linceda ukuhlawula iindleko zonyango lwangaphandle, njengeenkonzo okanye izinto ozifumanayo kugqirha wakho oyintloko okanye ingcali, kubandakanya ukhuseleko. Uhlawula ipremiyamu yeCandelo B. Ela mali lixhomekeke kwizinto ezahlukeneyo, kubandakanya nomvuzo wakho.

Icandelo A kunye no-B bagubungela iinkonzo ezininzi, kodwa kuninzi okungafakwanga yi-Medicare yoqobo. Akukho kugubungela amayeza amiselweyo, ukhathalelo lwexesha elide, okanye amazinyo, umbono, okanye iinkonzo zokuva.

Nokuba iinkonzo zihlawulwa yi-Medicare, i-inshurensi ayisiyi-100 yeepesenti. Kuya kufuneka uhlawule imali ebonakalayo epokothweni xa ubona ugqirha, njengee-copays, i-coinsurance, kunye ne-deductibles.

Unokwandisa ikhava yakho ngokuthenga iiplani ezinikezelwa ngeinshurensi zabucala. Oku kubandakanya isongezelelo seMedare, amayeza amiselweyo, kunye nezicwangciso zeMedicare Advantage.

Izicwangciso zokuncedisa kwiMedare

Izicwangciso zokuncedisa kwiMedare, ngamanye amaxesha zibizwa ngokuba yiMedigap, zongeza ukogquma kwiMedicare yakho yoqobo. Banokukunceda ukuthoba isixa osibhatalayo epokothweni xa ufuna ukhathalelo. Banokongeza amazinyo, umbono, ukhathalelo lwexesha elide, okanye olunye ukhuseleko.

Izicwangciso zamachiza amiselweyo

Izicwangciso zeCandelo D zizicwangciso zamachiza amiselweyo. Bajolise kuphela ekuncedeni ukuhlawula iindleko zamayeza.

Uncedo lweMedicare (Icandelo C)

I-Medicare Advantage (Icandelo C) izicwangciso zibonelela ngokutshintshwa "konke-in-one" kwi-Medicare yoqobo kunye nokugubungela ukongeza. Endaweni yokuba nokudityaniswa kwezicwangciso zikawonke-wonke nezabucala, unokufumana isicwangciso seMedicare Advantage esibandakanya iseti ebanzi yezibonelelo, kubandakanya ukugubungela amayeza amiselweyo, umbono kunye namazinyo, ukhathalelo lwexesha elide, ukuva, kunye nokunye.

Kwaye izicwangciso ze-Medicare Advantage zihlala zibandakanya uninzi lokongezwa, njengezaphulelo kunye neenkqubo zempilo kunye nokuba sempilweni.

Zeziphi izicwangciso ze-Medicare eziluncedo ezikhoyo e-Oregon?

Ezi nkampani zilandelayo ze-inshurensi zabucala zibonelela ngezicwangciso ze-Medicare Advantage e-Oregon:

• I-Aetna Medicare
• Izicwangciso zezeMpilo zeAtrio
• Impilo yeNet
• Humana
• UKaiser Permanente
• Ukhathalelo lwezeMpilo lweLasso
• Isicwangciso sezeMpilo seModa, Inc.
• Unyango lwePacificSource
• IziCwangciso zeNkxaso yeMedicare
• Ukuhlaziya iBlueCross BlueShield yaseOregon
• Ukhathalelo lweZempilo

Ukucwangciswa kokunikezelwa kuyahluka ngokommandla, ke ukhetho lwakho luya kuxhomekeka kwinto ekhoyo kwingingqi ohlala kuyo.

Ngubani ofanelekileyo kwi-Medicare e-Oregon?

Ukufaneleka kwamayeza kuxhomekeke kubudala bakho okanye imeko yezempilo. Uvumelekile ukubhalisa ukuba:

• ndineminyaka engama-65 okanye ngaphezulu
• Ngaphantsi kweminyaka yobudala engama-65 kwaye unokukhubazeka okufanelekileyo
• nawuphi na ubudala kwaye unesifo sokugqibela sesifo se-renal (ESRD) okanye i-amyotrophic lateral sclerosis (ALS)

Ndingabhalisa nini kwizicwangciso zeMedicare Oregon?

Ukuba ukufaneleka kwakho kwe-Medicare kusekwe kubudala, ungaqala inkqubo yobhaliso kwiinyanga ezintathu ngaphambi kwenyanga yokuzalwa kwakho kwama-65. Eli lixesha lakho lokuqala lokubhalisa. Ihlala iinyanga ezi-3 emva kwenyanga apho uza kugqiba iminyaka engama-65 ubudala.

Kuhlala kusengqiqweni ukubhalisa ubuncinci kwiCandelo A ngexesha lokubhalisa okokuqala, kuba kufanelekile ukufumana izibonelelo zeCandelo A ngaphandle kokuhlawula ipremiyamu.

Ukuba wena okanye iqabane lakho likhetha ukuqhubeka nokusebenza kwaye niqhubeke nokufanelekela ukuxhaswa ngemali ngumqeshi, unokufuna ukuyeka ukubhalisa kwiCandelo B okanye nakuphi na ukhuselo olongezelelekileyo. Kwiimeko ezinjalo, uya kulungela ixesha elithile lobhaliso kamva.

Unokwenza utshintsho kwisicwangciso esele sikhona se-Medicare okanye ubhalise okokuqala kwi-Medicare ngexesha lokubhalisa elivulekileyo ukusuka ngo-Okthobha u-15 ukuya ku-Disemba 7.

Kukho ithuba lokubhalisa elivulekileyo leMedicare unyaka nonyaka. Ngeli xesha, unokutshintsha ukogquma ukusuka kwi-Medicare yoqobo ukuya kwisicwangciso se-Medicare Advantage. Ixesha lokubhalisa elivulekileyo kwizicwangciso ze-Medicare Advantage zivela ngoJanuwari 1 ukuya ku-Matshi 31.

Iingcebiso zokubhalisa kwi-Medicare e-Oregon

Xa uthenga izicwangciso ze-Medicare e-Oregon, uya kufuna ukugcina engqondweni ukuba iinkampani ze-inshurensi zabucala zinokuguquguquka ngakumbi, ukuze bakwazi ukwenza izicwangciso zabo ngeendlela ezahlukeneyo.

Ngokomzekelo, ezinye izicwangciso ze-Medicare Advantage zingaba zicwangciso zoLondolozo lwezeMpilo (HMO), ezifuna ukuba ukhethe ugqirha oyintloko ojongene nokunyamekela kwakho kwaye kufuneka akunike ukuthunyelwa ukuba ufuna ukubona iingcali.

Abanye banokuba zizicwangciso zoMboneleli oKhethiweyo (PPO) ezikunika ukufikelela kubanikezeli benethiwekhi bazo zonke izinto ezizodwa ngaphandle kwesidingo sokuthunyelwa.

Loluphi uhlobo lwesicwangciso olusengqiqweni kuwe? Oko kuxhomekeke kwiimeko zakho ezizodwa kunye nokukhetha kwakho. Unokufuna ukuqwalasela le mibuzo ilandelayo xa ujonga ukhetho lwakho:

• Liza kundibiza malini eli cebo? Zingakanani iipremiyamu? Ngaba kukho iindleko eziphuma epokothweni xa ndibona ugqirha okanye ndigcwalisa amayeza?
• Ngaba ndiza kuba nakho ukufikelela koogqirha nezibhedlele ezilungele mna? Ngaba inethiwekhi ibandakanya ababoneleli esele ndibenobudlelwane nabo? Ngaba ndiza ku-inshorwa xa ndifuna ukhathalelo xa ndihamba?
• Zeziphi iintlobo zeenkqubo ezibandakanyiweyo? Ngaba ezi nkqubo zingaluncedo kum?

Izibonelelo zonyango zeOregon

Ezi zixhobo zinokuba luncedo ukuba ungathanda ukufunda ngakumbi malunga nezicwangciso zeMedicare eOregon:

• Uncedo lweeinshurensi zezeMpilo eziPhezulu, ngeOregonHealthCare.gov
• Medicare.gov, iwebhusayithi esemthethweni ye-Medicare
• Ulawulo loKhuseleko loLuntu

Ndifanele ndenze ntoni ngokulandelayo?

Xa ulungele ukuthatha inyathelo elilandelayo ekubhaliseni kwi-Medicare, jonga ezi zenzo:

• Yenza olunye uphando malunga nezicwangciso zakho ezizodwa. Uluhlu olungentla apha lunokuba sisiqalo esiluncedo ekujongeni kwizicwangciso zeMedare e-Oregon. Kwakhona kunokuba luncedo ukunxibelelana nommeli weinshurensi onokunika isikhokelo esenzelwe umntu ngakumbi.
• Ukuba okwangoku ukulungele ukubhalisa, ungaqala inkqubo ngokugcwalisa isicelo se-Intanethi kwiwebhusayithi ye-SSA. Indawo ibandakanya noluhlu lokutshekisha oluneenkcukacha oza kuyidinga ukufaka isicelo.

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.