14 Imibuzo ebuzwa rhoqo kwiMedicare iyaphendulwa

Umxholo

• 1. Igquma ngantoni iMedicare?
• Amayeza okuqala
• Icandelo lezaMayeza A
• Icandelo leMedare B
• Icandelo leMedicare C (Uncedo lweMedicare)
• Icandelo leMedare D
• Unyango lweMedare (iMedigap)
• 2. Ngaba amayeza amiselweyo agqunywe yiMedicare?
• Icandelo D
• Icandelo C
• 3.Ndilifanele nini unyango?
• 4. Ndingabhalisa nini kwiMedare?
• 5. Ngaba iMedicare isimahla?
• 6. Ixabisa malini i-Medicare ngo-2021?
• Icandelo A
• Icandelo B
• Icandelo C
• Icandelo D
• IMedigap
• 7.Yintoni i-Medicare etsalelwayo?
• 8. Yintoni ipremiyamu yonyango?
• 9. Yintoni i-Medicare copay?
• 10. Yintoni isiqinisekiso seMedicare?
• 11. Yintoni i-Medicare ephezulu epokothweni ephezulu?
• 12. Ndingayisebenzisa iMedicare xa ndingaphandle kwesimo sam?
• 13. Ndingazitshintsha nini izicwangciso zeMedare?
• 14. Ndenza ntoni xa ndilahla ikhadi lam leMedare?
• Ukuthatha

Ukuba wena okanye umntu obathandayo kutshanje ubhalisele i-Medicare okanye uceba ukubhalisa kungekudala, unokuba nemibuzo ethile. Le mibuzo inokubandakanya: Yintoni egqunywa nguMedare? Sisiphi isicwangciso seMedicare esiya kugubungela amayeza am amiselweyo? Ziza kuba ngakanani iindleko zam zenyanga zonyango?

Kweli nqaku, siza kuphonononga izihloko ezinje ngokugubungela, iindleko, kunye nokunye ukunceda ukuphendula eminye yemibuzo ebuzwa rhoqo ye-Medicare.

1. Igquma ngantoni iMedicare?

I-Medicare iqulathe icandelo A, Icandelo B, Icandelo C (iAdvantage), Icandelo D, kunye neMedigap- zonke ezi zibonelela ngezidingo zakho ezisisiseko zonyango.

Amayeza okuqala

Icandelo leMedicare A kunye neCandelo B liyaziwa ngokudibeneyo njengeMedicare yoqobo. Njengoko uza kufunda, i-Medicare yoqobo igubungela kuphela iimfuno zesibhedlele kunye nezo ziyimfuneko kwezonyango okanye kuthintelo. Ayigubungeli amayeza amiselweyo, ukuhlolwa kwamazinyo minyaka le okanye ukujonga umbono, okanye ezinye iindleko ezinxulumene nonyango lwakho.

Icandelo lezaMayeza A

Icandelo A ligubungela ezi nkonzo zilandelayo zezibhedlele:

• Ukunyamekela esibhedlele
• ukhathalelo lokunyanga ngaphakathi
• ukhathalelo olunobuchule kwiziko lokonga
• ukhathalelo lwamakhaya abalupheleyo (hayi ixesha elide)
• ukhathalelo lwempilo ekhaya
• Unonophelo lwehosisi

Icandelo leMedare B

Icandelo B ligubungela iinkonzo zonyango kubandakanya:

• unyango lwezonyango
• ukhathalelo lonyango
• Unyango lweemeko zonyango
• izixhobo zonyango ezizinzileyo
• iinkonzo zempilo yengqondo
• amayeza athile amayeza angalaliswayo
• iinkonzo zetelehealth (njengenxalenye yempendulo yangoku kuqhambuko lwe-COVID-19)

Icandelo leMedicare C (Uncedo lweMedicare)

Uncedo lweMedicare lukhetho lweMedare olunikezelwa ziinkampani zeinshurensi zabucala. Ezi zicwangciso zigubungela iinkonzo zentsusa zeCandelo le-A kunye ne-B. Uninzi lukwahambisa ukugubungela amayeza amiselweyo; zamazinyo, umbono kunye neenkonzo zokuva; iinkonzo zempilo; kunye nokuninzi.

Icandelo leMedare D

Icandelo leMedicare D linceda ukuhlawula iindleko zamachiza amiselweyo. Izicwangciso zeMedicare zeCandelo D zithengiswa ziinkampani zeinshurensi zabucala kwaye zinokongezwa kwiMedicare yoqobo.

Unyango lweMedare (iMedigap)

Izicwangciso zeMedigap zinceda ekuhlawuleni iindleko ezinxulumene neMedicare yoqobo. Oku kunokubandakanya ukuncitshiswa, ukuqinisekiswa kwemali, kunye nokuhlawulwa kwemali. Ezinye izicwangciso zeMedigap zikwanceda ukuhlawula iindleko zonyango onokuthi uzenze xa usiya ngaphandle kwelizwe.

2. Ngaba amayeza amiselweyo agqunywe yiMedicare?

I-Medicare yoqobo igubungela amayeza athile. Umzekelo:

• Icandelo leMedicare A ligubungela amayeza asetyenziselwa unyango lwakho xa usesibhedlele. Ikwaquka amanye amayeza asetyenziswa ngexesha lempilo yasekhaya okanye ukhathalelo lwe-hospice.
• Icandelo leMedicare B ligubungela amayeza athile alawulwa ngaphandle, njengeofisi kagqirha. Icandelo B likwaquka nezitofu zokugonya.

Ukufumana ukugubungela amayeza apheleleyo amayeza kunye neMedicare, kuya kufuneka ubhalise kwiCandelo leMedicare D okanye kwisicwangciso seCandelo leMedicare C esigubungela iziyobisi.

Icandelo D

Icandelo leMedicare D linokongezwa kwi-Medicare yoqobo ukunceda ukuhlawula iindleko zamachiza amiselweyo. Isicwangciso ngasinye seCandelo D sine-formulary, elu luhlu lwamayeza amiselweyo aya kuwagubungela. La mayeza amiselweyo awela kumanqanaba athile, ahlala ehlulwe ngokwexabiso kunye nophawu. Zonke izicwangciso ze-Medicare Part D kufuneka zigubungele ubuncinci iziyobisi ezibini kwizigaba eziphambili zamachiza.

Icandelo C

Uninzi lwezicwangciso ze-Medicare Advantage zikwabonelela ngogonyo lweziyobisi. NjengeCandelo leMedicare D, isicwangciso ngasinye seNzuzo siya kuba nemithetho yenkqubo yokugubungela. Gcina nje ukhumbula ukuba ezinye ze-Medicare Health Maintenance Organisation (HMO) kunye noMbutho woMboneleli oKhethiweyo (PPO) unokuhlawulisa ngaphezulu kwimigqaliselo yakho ukuba usebenzisa iikhemesti ezingaphandle kwenethiwekhi.

3.Ndilifanele nini unyango?

Abantu baseMelika abaneminyaka engama-65 nangaphezulu banelungelo lokubhalisa kwi-Medicare. Abanye abantu abangaphantsi kweminyaka engama-65 abanokukhubazeka ixesha elide nabo kufanelekile. Nantsi indlela efanelekileyo yokufaneleka kweMedicare:

• Ukuba uguqula iminyaka engama-65 ubudala, uvumelekile ukuba ubhalise kwi-Medicare kwiinyanga ezintathu ngaphambi kokuzalwa kwakho kwama-65 ukuya kwiinyanga ezi-3 emva koko.
• Ukuba ufumana izibonelelo zokukhubazeka inyanga nenyanga ngokusebenzisa uLawulo loKhuseleko loLuntu okanye iBhodi yoMhlala-phantsi yoLoliwe, uyafaneleka kwiMedicare emva kweenyanga ezingama-24.
• Ukuba une-amyotrophic lateral sclerosis (ALS) kwaye ufumana izibonelelo zenyanga zokukhubazeka, uyakufanelekela ukufumana unyango kwangoko.
• Ukuba ufunyaniswe unesifo se-renal (i-ESRD) kwaye uye wafakelwa izintso okanye ufuna i-dialysis, uvumelekile ukubhalisa kwi-Medicare.

4. Ndingabhalisa nini kwiMedare?

Kukho amaxesha amaninzi obhaliso kwi-Medicare. Nje ukuba uhlangane neemfuno zokufaneleka, ungabhalisa ngala maxesha alandelayo.

Ngamanye amaxesha, ukubhaliswa kweMedicare kuyazenzekela. Umzekelo, uya kubhaliswa ngokuzenzekelayo kwi-Medicare yoqobo ukuba ufumana iintlawulo zokukhubazeka kwaye:

• Uguqula iminyaka engama-65 kwiinyanga ezi-4 ezizayo.
• Ufumene iintlawulo zokukhubazeka iinyanga ezingama-24.
• Ufumaniswe ukuba une-ALS.

5. Ngaba iMedicare isimahla?

Ezinye izicwangciso ze-Medicare Advantage zipapashwa njengezicwangciso "zamahhala". Ngelixa ezi zicwangciso zingenakho ukuhlawulwa ngaphandle kwepremiyamu, azikhululekanga ngokupheleleyo: Kuya kufuneka uhlawule iindleko ezithile eziphuma epokothweni.

6. Ixabisa malini i-Medicare ngo-2021?

Inxalenye nganye ye-Medicare oyibhalayo ineendleko ezinxulumene nayo, kubandakanya iipremiyamu, iimali ezixhuzuliweyo, ii-copayments kunye ne-coinsurance.

Icandelo A

Iindleko zeCandelo leMedicare A zibandakanya:

• ipremiyamu naphi na ukusuka kwi- $ 0 ukuya kwi- $ 471 ngenyanga, kuxhomekeke kumvuzo wakho
• Ukutsalwa kwe-1,484 yeedola ngexesha lezibonelelo
• isiqinisekiso semali esiyi- $ 0 kwiintsuku zokuqala ezingama-60 zokuhlala ngaphakathi, ukuya kuthi ga kwiindleko ezipheleleyo zeenkonzo kuxhomekeke ekubeni wamkelwe ixesha elingakanani

Icandelo B

Iindleko zeCandelo leMedare B zibandakanya:

• i-premium ye- $ 148.50 okanye ngaphezulu ngenyanga, kuxhomekeke kumvuzo wakho
• itsaliwe $ 203
• ukuqinisekiswa kwemali yeepesenti ezingama-20 zexabiso lemali yakho evunyiweyo ye-Medicare yeenkonzo
• intlawulo egqithileyo ukuya kuthi ga kwipesenti ezili-15 ukuba iindleko zeenkonzo zakho zingaphezulu kwesixa esivunyiweyo

Icandelo C

Iindleko zeCandelo leMedare C ziyahluka ngokuxhomekeka kwindawo okuyo, umboneleli wakho, kunye nohlobo lokugubungela isicwangciso sakho.

Iindleko zeCandelo leMedare C zibandakanya:

• Icandelo A iindleko
• Iindleko zeCandelo B
• Intlawulo yenyanga ngenyanga yesicwangciso seCandelo C.
• kutsalwa unyaka nonyaka kwisicwangciso seCandelo C.
• isicwangciso sesiyobisi esitsalwayo (ukuba isicwangciso sakho sibandakanya ukugqunywa ngamachiza amiselweyo)
• isiqinisekiso semali okanye intlawulo ekhutshelweyo kutyelelo ngalunye lukagqirha, utyelelo lweengcali, okanye ukugcwaliswa kwesiyobisi ngugqirha

Icandelo D

Iindleko zeCandelo leMedare D zibandakanya:

• intlawulo yanyanga le
• Ukutsalwa konyaka kwe-445 yeedola okanye ngaphantsi
• isiqinisekiso semali okanye imali oyikhuphelayo yokuhlawula iziyobisi

IMedigap

Izicwangciso zeMedigap zibiza i-premium yenyanga eyahlukileyo nefuthe kwisicwangciso sakho seMedigap, indawo okuyo, inani labantu ababhalise kwisicwangciso, kunye nokunye. Kodwa izicwangciso zeMedigap zikwanceda ukuhlawula ezinye zeendleko zonyango lokuqala.

7.Yintoni i-Medicare etsalelwayo?

Unciphiso lweMedicare lixabiso lemali olichitha epokothweni unyaka nonyaka (okanye ixesha) kwiinkonzo zakho ngaphambi kokugubungela ukukhutshwa kweMedare. Amayeza e-Medicare A, B, C, no-D onke anezinto ezitsalwayo.

8. Yintoni ipremiyamu yonyango?

I-premium ye-Medicare yimalini oyihlawulayo ukuze ubhalise kwisicwangciso seMedicare. Icandelo A, Icandelo B, Icandelo C, Icandelo D, kunye neMedigap zonke zihlawulisa iipremiyamu zenyanga.

9. Yintoni i-Medicare copay?

I-Medicare copayment, okanye i-copay, lixabiso ekufuneka uhlawule ngalo epokothweni ngalo lonke ixesha ufumana iinkonzo okanye ugcwalisa iyeza likagqirha.

Uncedo lweMedicare (Icandelo C) libiza imali eyahlukeneyo kutyelelo lukagqirha kunye neengcali. Ezinye izicwangciso zibiza iintlawulo eziphezulu zeenkonzo ezingaphandle kwenethiwekhi.

Izicwangciso zeziyobisi ze-Medicare zibiza intlawulo eyahlukeneyo yamachiza ngokusekwe kwisicwangciso sefomula kunye nenqanaba lamayeza owathathayo. Umzekelo, iziyobisi ezikwinqanaba 1 zihlala zenziwe ngokwesiqhelo kwaye zibiza kakhulu.

Iikopi zakho ezithile ziya kuxhomekeka kwinzuzo okanye kwiCandelo D lesicwangciso osikhethileyo.

10. Yintoni isiqinisekiso seMedicare?

I-Medicare ye-coinsurance yipesenti ohlawula ngayo epokothweni ngeendleko zeenkonzo zakho ezivunyiweyo ze-Medicare.

Icandelo lamaMedicare A lihlawulisa isiqinisekiso semali esiphezulu xa uhlala esibhedlele. Ngo-2021, iCandelo A i-coinsurance yi- $ 371 kwiintsuku zesibhedlele ezingama-60 ukuya kuma-90 kunye ne-742 zama-dollar iintsuku ezingama-91 ukuya phezulu.

Icandelo leMedicare B lihlawulisa isixa semali esiqinisekisiweyo sama-20 epesenti.

I-Medicare Icandelo D liceba ukuhlawulisa i-coinsurance yemali ngendlela efanayo neekopayments, zihlala zikwinqanaba eliphezulu, amayeza egama-kwaye ziya kuhlala zikuhlawulisa nokuba kukwipopay okanye kwi-coinsurance kodwa hayi zombini.

11. Yintoni i-Medicare ephezulu epokothweni ephezulu?

Ubungakanani be-Medicare ngaphandle kwe-pocket ngumda wokuba uza kuhlawula malini epokothweni kuzo zonke iindleko zakho ze-Medicare ngonyaka omnye. Akukho mda kwiindleko zokuphuma epokothweni kwi-Medicare yoqobo.

Zonke izicwangciso ze-Medicare Advantage zinemali engaphezulu kwe-epokothweni minyaka le, eyahluka ngokuxhomekeke kwisicwangciso obhalise kuso. Ukubhalisa kwisicwangciso seMedigap kunokunceda ekunciphiseni iindleko zokuphuma epokothweni ngonyaka.

12. Ndingayisebenzisa iMedicare xa ndingaphandle kwesimo sam?

I-Medicare yoqobo ibonelela ngogcino kwilizwe lonke kubo bonke abaxhamli. Oku kuthetha ukuba ukhuselekile kukhathalelo lonyango lwangaphandle.

Izicwangciso ze-Medicare Advantage, kwelinye icala, zibonelela ngogcino kuphela kwilizwe ohlala kulo, nangona abanye benokunikezela ngeenkonzo zenethiwekhi ngaphandle kwelizwe.

Nokuba unayo i-Medicare yoqobo okanye i-Medicare Advantage, kuya kufuneka usoloko uqinisekisa ukuba umboneleli omtyelelayo wamkela isabelo se-Medicare.

13. Ndingazitshintsha nini izicwangciso zeMedare?

Ukuba ubhalisile kwisicwangciso seMedare kwaye ufuna ukutshintsha isicwangciso sakho, ungakwenza oko ngexesha lokubhalisa elivulekileyo, eliqala Oktobha 15 ukuya kuDisemba 7 ngonyaka nganye.

14. Ndenza ntoni xa ndilahla ikhadi lam leMedare?

Ukuba ulahlekelwe likhadi lakho le-Medicare, unoku-odola indawo evela kwiwebhusayithi yoKhuseleko lweNtlalo. Ngena ngokulula kwiakhawunti yakho kwaye ucele ukutshintshwa phantsi kwethebhu "yokuBuyiselwa kwamaXwebhu". Unokucela ikhadi elitshintshayo ngokubiza i-800-MEDICARE.

Kungathatha malunga neentsuku ezingama-30 ukufumana ikhadi lakho lokutshintsha iMedare. Ukuba ufuna ikhadi lakho ukuze uqeshwe ngaphambi koko, unokuprinta ikopi yayo ngokungena kwiakhawunti yam yeMicrosoft.

Ukuthatha

Ukuqonda i-Medicare kunokuziva kunzima, kodwa kukho izixhobo ezininzi onazo. Ukuba ufuna uncedo olongezelelekileyo ubhalisela i-Medicare okanye usenemibuzo engaphendulwanga, nazi ezinye izixhobo ezinokunceda:

• I-Medicare.gov inolwazi malunga nabanikezeli bendawo, iifom ezibalulekileyo, iincwadana ezinokukhutshelwa, kunye nokunye.
• I-CMS.gov inolwazi oluhlaziyiweyo malunga notshintsho olusemthethweni lomthetho kunye nohlaziyo kwinkqubo ye-Medicare.
• I-SSA.gov ikuvumela ukuba ufikelele kwiakhawunti yakho ye-Medicare kunye nolunye ukhuseleko lwezeNtlalontle kunye nezixhobo zeMedicare.

Eli nqaku lahlaziywa ngo-Novemba 19, 2020, ukubonisa ulwazi ngo-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.