Izicwangciso zoNyango lweMedare: Into ekufuneka uyazi ngeMedigap

Umxholo

• Isicwangciso sokongeza isicwangciso sonyango
• Ukubonelelwa kwepremiyamu yesiGaba B
• Ishedyuli yokuthelekisa isicwangciso sonyango
• Isicwangciso sonyango songeza iindleko
• Izibonelelo zokukhetha isicwangciso seMedigap
• Ukungancedi ekukhetheni isicwangciso seMedigap
• IMedigap ngokuchasene neNcedo lweMedicare
• Ngaba ndifanelekile kwisicwangciso sokongeza iMedare?
• Ndibhalisa njani?
• Ukuthatha

Izicwangciso zokuncedisa kwi-Medicare zizicwangciso ze-inshurensi zabucala eziyilelwe ukuzalisa ezinye zezikhewu kwi-Medicare. Ngesi sizathu, abantu bakwabiza le nkqubo njengeMedigap. I-inshurensi yokuxhasa i-inshurensi yokunyanga izinto ezinje ngokutsalwa kunye nokuhlawulwa kwemali.

Ukuba usebenzisa iinkonzo zonyango xa unayo i-inshurensi yokuncedisa i-Medicare, i-Medicare ihlawula isahlulo sayo kuqala, emva koko isicwangciso sakho sonyango se-Medicare siza kuhlawula naziphi na iindleko eziseleyo.

Zininzi izinto ekufuneka ziqwalaselwe xa ukhetha isicwangciso sokongeza iMedare. Funda malunga neengcebiso zokuthatha isigqibo sokuba ufuna isicwangciso seMedigap kunye nothelekiso lokukhetha.

Isicwangciso sokongeza isicwangciso sonyango

Kukho izicwangciso ezili-10 ze-inshurensi zokuncedisa i-inshurensi ezikhoyo. Nangona kunjalo, ezinye izicwangciso azisafumaneki kubhaliso olutsha. I-Medicare isebenzisa oonobumba abakhulu ukubhekisa kwezi zicwangciso, kodwa azihambelani nendawo zeMedicare.

Umzekelo, Icandelo leMedicare A luhlobo olwahlukileyo lokugubungela kuneSicwangciso seMedigap A. Kulula ukudideka xa kuthelekiswa iinxalenye kunye nezicwangciso. Izicwangciso ezili-10 zeMedigap zibandakanya izicwangciso A, B, C, D, F, G, K, L, M, kunye no-N.

Izicwangciso zokuncedisa kwiMedare zifakwe kumanqanaba amaninzi. Oku kuthetha ukuba umgaqo-nkqubo owuthengayo kufuneka unikezele ngezibonelelo ezifanayo nokuba yeyiphi na inkampani oyithenga kwi-inshurensi.

Ngaphandle kwemigaqo-nkqubo yeMedigap eMassachusetts, Minnesota naseWisconsin. Ezi zicwangciso zinokuba nezibonelelo ezahlukileyo ezisemgangathweni ngokusekwe kwiimfuno zomthetho ezikwelo lizwe.

Ukuba inkampani yeinshurensi ithengisa isicwangciso sokuncedisa kwi-Medicare, kufuneka inike okungenani isiCwangciso seMedigap A kunye nesiCwangciso C okanye isiCwangciso F. Nangona kunjalo, urhulumente akafuni ukuba inkampani yeinshurensi ibonelele ngesicwangciso ngasinye.

Inkampani yeinshurensi ayinakukuthengisela wena okanye umntu omthandayo isicwangciso seinshurensi yokuncedisa iMedare ukuba sele une-inshurensi ngeMedicaid okanye kwiMedicare Advantage. Kwakhona, izicwangciso zokuncedisa kwi-Medicare zigubungela umntu omnye-hayi isibini esitshatileyo.

Ukubonelelwa kwepremiyamu yesiGaba B

Ukuba uvumelekile ngomhla okanye emva kukaJanuwari 1, 2020, awunakho ukuthenga isicwangciso esigubungela ipremiyamu yesiGaba B. Oku kubandakanya isiCwangciso seMedigap C kunye nesiCwangciso F.

Nangona kunjalo, ukuba sele unesinye sezicwangciso, unokuzigcina. Ukongeza, ukuba ubulungele i-Medicare ngaphambi kukaJanuwari 1, 2020, unokukwazi ukuthenga iSicwangciso C okanye isiCwangciso F ngokunjalo.

Ishedyuli yokuthelekisa isicwangciso sonyango

Isicwangciso ngasinye seMedigap sigubungela ezinye zeendleko zakho kwiCandelo A, kubandakanya ukuqinisekiswa kwemali, iindleko zesibhedlele ezandisiweyo, kunye nokunakekelwa kwe-hospice okanye i-copayments.

Zonke izicwangciso zeMedigap zikwahlawula ezinye zeendleko zakho zeCandelo B, njengesiqinisekiso semali okanye iicopayments, ezitsalwayo, kunye neepilisi zakho zokuqala ezi-3 zegazi ukuba ufuna ukutofelwa.

Ishati engezantsi ithelekisa ukugubungela uhlobo ngalunye lwesicwangciso seMedigap:

Isicwangciso sonyango songeza iindleko

Nangona iiplani zokuncedisa i-Medicare ziqhelekileyo ngokwemimiselo yezibonelelo abazibonelelayo, ziyahlukahluka kwixabiso ngokusekelwe kwinkampani yomshuwalense ezithengisayo.

Kufana nokuthenga kwintengiso: Ngamanye amaxesha, isicwangciso osifunayo sibiza imali encinci kwivenkile enye nangaphezulu kwenye, kodwa ikwayimveliso enye.

Iinkampani zeinshurensi zihlala zixabisa imigaqo-nkqubo yeMedigap ngenye yeendlela ezintathu:

• Uluntu lukaliwe. Uninzi lwabantu luhlawula ngokulinganayo, nokuba ubudala okanye isini. Oku kuthetha ukuba ipremiyamu yomntu yeinshurensi inyuka, isigqibo sokuyonyusa sinxulumene kakhulu noqoqosho kunempilo yomntu.
• Iminyaka yobudala ikaliwe. Le premium inxulumene nobudala bomntu xa beyithengile. Njengomgaqo jikelele, abantu abancinci bahlawula kancinci kwaye abantu abadala bahlawula ngaphezulu. I-premium yomntu inokunyuka njengoko ikhula ngenxa yokunyuka kwamaxabiso, kodwa kungenxa yokuba ikhula.
• Ubudala obufikelelweyo bulinganisiwe. Le premium iphantsi kubantu abancinci kwaye inyuka njengoko umntu esiya esiba mdala. Ingabiza ixabiso eliphantsi njengokuba umntu eqala ukuyithenga, kodwa inokuba yeyona ibiza kakhulu njengoko bekhula.

Ngamanye amaxesha, iinkampani zeinshurensi ziya kubonelela ngezaphulelo zokuqwalaselwa okuthile. Oku kubandakanya izaphulelo kubantu abangatshayiyo, abasetyhini (abahlala benendleko eziphantsi zokhathalelo lwempilo), kwaye ukuba umntu ubhatala kwangaphambili ngonyaka.

Izibonelelo zokukhetha isicwangciso seMedigap

• Izicwangciso ze-inshurensi zokuncedisa i-Medicare zinokukunceda ukuhlawula iindleko ezinje ngeemali ezitshixwayo, ukuqinisekiswa kwemali kunye neepawotsheni.
• Ezinye izicwangciso zeMedigap zinokuphelisa iindleko zomntu eziphuma epokothweni.
• Ukuba ubhalisa kwixesha lokubhalisa elivulekileyo emva kokuba ugqiba iminyaka engama-65, iinkampani zeinshurensi azinakukukhetha ngaphandle kweemeko zempilo.
• Izicwangciso zeMedigap ziya kubandakanya iipesenti ezingama-80 zeenkonzo zakho zononophelo lwempilo xa uhamba ngaphandle kweUnited States.
• Uninzi lwezicwangciso onokukhetha kuzo ukuze ulungele iimfuno zakho zokhathalelo lwempilo.

Ukungancedi ekukhetheni isicwangciso seMedigap

• Ngelixa umgaqo-nkqubo weMedigap unokukunceda ukuhlawula ezinye zeendleko zakho zeMedicare, ayigubungeli iyeza likagqirha, umbono, amazinyo, ukuva, okanye naziphi na ezinye izinto zempilo ezinje ngobulungu bokuqina okanye ukuthuthwa.
• Ukufumana ukhuseleko kwiinkonzo zonyango ezidweliswe ngasentla, kuya kufuneka ungeze umgaqo-nkqubo we-Medicare Part D okanye ukhethe isicwangciso se-Medicare Advantage (Icandelo C).
• Imigaqo-nkqubo yokulinganiswa kweminyaka yobudala ihlawulisa iipremiyamu eziphezulu njengoko uneminyaka yobudala.
• Ayizizo zonke izicwangciso ezibonelela ngesibonelelo seziko labongikazi abanezakhono okanye ukhathalelo lwehosisi, jonga izibonelelo zesicwangciso sakho ukuba unokufuna ezi nkonzo.

IMedigap ngokuchasene neNcedo lweMedicare

Uncedo lweMedicare (Icandelo C) sisicwangciso seinshurensi esihlangeneyo. Ibandakanya iCandelo A kunye neCandelo B, kunye neCandelo D kwiimeko ezininzi.

Izicwangciso ze-Medicare ze-Advantage zingabizi kakhulu kune-Medicare yoqobo kwabanye abantu. Izicwangciso ze-Medicare Advantage zinokubonelela ngezibonelelo ezongezelelweyo, ezinjengamazinyo, ukuva, okanye umbono.

Nanku ukujonga ngokukhawuleza kwinto omele uyazi malunga ne-Medicare Advantage kunye neMedigap:

• Zombini ezi zicwangciso zibandakanya ukugubungela icandelo le-Medicare Icandelo A (ukhuseleko esibhedlele) kunye neCandelo B (iindleko zeinshurensi yezonyango).
• Uninzi lwezicwangciso ze-Medicare Advantage zibandakanya iCandelo D (ukugubungela amayeza amayeza). IMedigap ayinakho ukuhlawula iindleko zonyango.
• Ukuba unayo i-Medicare Advantage, awukwazi ukuthenga isicwangciso seMedigap. Ngabantu abane-Medicare yoqobo kuphela abanelungelo lokufumana ezi zicwangciso.

Rhoqo, isigqibo siyehla kwiimfuno zempilo nganye kunye nokuba isicwangciso ngasinye sixabisa malini. Izicwangciso zokuncedisa i-Medicare zingabiza ngaphezu kwe-Medicare Advantage, kodwa nazo zingahlawula ezinye ezinxulumene nokuncitshiswa kunye neendleko ze-inshurensi.

Kuya kufuneka uthengise ujonge ukuba zeziphi izicwangciso onokuzifumana okanye umntu omthandayo ukuze akuncede wenze olona khetho lulungileyo.

Ngaba ndifanelekile kwisicwangciso sokongeza iMedare?

Uvumelekile ukuba ubhalise kwisicwangciso sokuncedisa kwi-Medicare ngexesha lokubhalisa kwaseMedigap. Eli xesha liinyanga ezi-3 ngaphambi kokuba ujike iminyaka engama-65 kwaye ubhalisele iCandelo B, ukuya kwiinyanga ezi-3 emva kosuku lwakho lokuzalwa. Ngeli xesha, unelungelo eliqinisekileyo lokuthenga isicwangciso sokuncedisa i-Medicare.

Ukuba uhlala ubhalisile kwaye uhlawula ipremiyamu yakho, inkampani yeinshurensi ayinakho ukurhoxisa isicwangciso. Nangona kunjalo, ukuba sele unayo i-Medicare, inkampani ye-inshurensi inokuphika ukuthengisa umgaqo-nkqubo wokuncedisa kwi-Medicare ngokusekelwe kwimpilo yakho.

Ndibhalisa njani?

Ukuthenga isicwangciso sokuncedisa i-Medicare kunokuthatha ixesha kunye nomzamo, kodwa kufanelekile. Kungenxa yokuba uninzi lwabantu lugcina imigaqo-nkqubo yabo yeMedigap ubomi babo bonke.

Ukuqala ngomgaqo-nkqubo olunge ngakumbi kwiimfuno zakho okanye zomntu omthandayo kunokunceda ukugcina uxinzelelo kunye nokuhlala imali kwixesha elizayo.

Nanga amanyathelo asisiseko okuthenga umgaqo-nkqubo weMedigap:

• Vavanya ukuba zeziphi izibonelelo ezibaluleke ngakumbi kuwe. Ngaba uzimisele ukuhlawula ezinye zeededuza, okanye ngaba ufuna ukugubungela okupheleleyo? Ngaba ulindele ukuba ufuna unyango kwelinye ilizwe okanye hayi? (Oku kuluncedo ukuba uhamba kakhulu.) Jonga itshathi yethu yeMedigap ukumisela ukuba zeziphi izicwangciso ezikunika ezona zibonelelo zibalaseleyo ebomini bakho, kwezezimali nakwimpilo yakho.
• Khangela iinkampani ezibonelela ngezicwangciso zokuncedisa kwiMedare ngokusebenzisa isixhobo sokukhangela seMedigap esivela kwiMedicare. Le webhusayithi inika ulwazi ngemigaqo-nkqubo kunye nokugubungela kunye neenkampani zeinshurensi kwindawo yakho ezithengisa imigaqo-nkqubo.
• Tsalela umnxeba kwi-800-MEDICARE (800-633-4227) ukuba awunakho ukufikelela kwi-intanethi. Abameli abasebenza kweli ziko banokunceda ukubonelela ngolwazi oludingayo.
• Nxibelelana neenkampani zeinshurensi ezibonelela ngemigaqo-nkqubo kwindawo yakho. Nangona kuthatha ixesha, ungabizi inkampani enye. Iirhafu ziyahluka ngokwenkampani, ke kungcono uthelekise. Ixabiso alikho yonke into, nangona kunjalo. I-inshurensi yesebe lakho kunye neenkonzo ezifana ne-eweissratings.com zinokukunceda ufumanise ukuba ngaba inkampani inezikhalazo ezininzi ngayo.
• Yazi ukuba inkampani yeinshurensi mayingaze ikucinezele ukuba uthenge ipolisi. Kananjalo akufuneki babange ukuba basebenzela i-Medicare okanye babange ukuba umgaqo-nkqubo wabo uyinxalenye ye-Medicare. Imigaqo-nkqubo yeMedigap yabucala hayi i-inshurensi karhulumente.
• Khetha isicwangciso. Nje ukuba ujonge lonke ulwazi, ungathatha isigqibo malunga nomgaqo-nkqubo kwaye ufake isicelo.

Izicwangciso zokuncedisa kwiMedare zinokuba nzima ukuhamba. Ukuba unombuzo othile, ungatsalela umnxeba iNkqubo ye-Inshurensi yezeMpilo kaRhulumente (i-SHIP). Ezi arhente zikarhulumente ezifumana inkxaso-mali ezibonelela ngengcebiso yasimahla kubantu abanemibuzo malunga neMedicare kunye nezicwangciso zokuncedisa.

Ukuba unceda umntu omthandayo ukuba abhalise kwi-Medicare, cinga ngezi ngcebiso:

• Qinisekisa ukuba bayabhalisa kwixesha elabiweyo. Ngaphandle koko, banokujongana neendleko ezinkulu kunye nezohlwayo zokubhalisa kade.
• Buza ukuba inkampani yeinshurensi iyithenga njani imigaqo-nkqubo yayo, efana "nokukhupha iminyaka" okanye "ukufikelela kubudala." Oku kunokukunceda uqikelele ukuba umgaqo-nkqubo womntu omthandayo unokunyuka njani kwixabiso.
• Buza ukuba ingaba umgaqo-nkqubo okanye imigaqo-nkqubo oyivandlakanya ngokusondeleyo inyuke njani kule minyaka imbalwa idlulileyo. Oku kunokukunceda uvavanye ukuba umntu omthandayo unemali eyoneleyo yokuhlawula iindleko.
• Qinisekisa ukuba umntu omthandayo unendlela ekhuselekileyo yokuhlawula ipolisi. Eminye imigaqo-nkqubo ihlawulwa ngetsheki rhoqo ngenyanga, ngelixa eminye iyilwa kwiakhawunti yebhanki.

Ukuthatha

Imigaqo-nkqubo ye-inshurensi yokuncedisa iMedicare inokuba yindlela yokunciphisa uloyiko lokungaqiniseki, ngokweendleko zokhathalelo lwempilo. Banokunceda ekuhlawuleni iindleko ezingaphandle kweepokotho ezinokuthi zingagutyungelwa yiMedicare.

Sebenzisa izibonelelo zikarhulumente zasimahla, ezinje ngesebe le-inshurensi yelizwe lakho, kunokukunceda okanye umntu omthandayo enze esona sigqibo sihle malunga nokugubungela.

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.