Ziba malini izicwangciso zeMedigap kwi2021?
Umxholo
- Yintoni iMedigap?
- Zibiza malini izicwangciso zeMedigap?
- Iipremiyamu zarhoqo ngenyanga
- Ukutsalwa
- Coinsurance kunye neepopays
- Umda wokuphuma epokothweni
- Iindleko eziphuma epokothweni
- Isicwangciso seMedigap sithelekisa iindleko
- Ngaba ndivumelekile kwiMedigap?
- Imihla ebalulekileyo yobhaliso eMedigap
- Ixesha lokubhaliswa kweMedigap
- Amanye amaxesha okubhaliswa kwamayeza
- Ukuthatha
- IMedigap inceda ukuhlawulela ezinye zeendleko zokhathalelo lwempilo ezingagutyungelwanga yiMedicare yoqobo.
- Iindleko oza kuzihlawula kwiMedigap zixhomekeke kwisicwangciso osikhethayo, indawo okuyo, kunye nezinye izinto ezimbalwa.
- I-Medigap ihlala ine-premium yenyanga, kwaye kuya kufuneka uhlawule ii-copays, i-coinsurance, kunye ne-deductibles.
I-Medicare yinkqubo yeinshurensi yezempilo ebonelelwa ngurhulumente wabantu abaneminyaka engama-65 nangaphezulu, kunye namanye amaqela athile. Kuqikelelwa ukuba i-Medicare yoqobo (iinxalenye A no-B) zigubungela malunga neendleko zonyango zomntu.
I-inshurensi yokuncedisa iMedare (iMedigap) inceda ukuhlawula ezinye zeendleko zokhathalelo lwempilo ezingagutyungelwanga yiMedicare yoqobo. Malunga nabantu abaneMedicare yoqobo banesicwangciso seMedigap.
Iindleko zesicwangciso seMedigap zinokwahluka ngenxa yezinto ezininzi, kubandakanya nohlobo lwesicwangciso osibhalisileyo, apho uhlala khona, kunye nenkampani ethengisa isicwangciso.
Apha ngezantsi, siza kuvavanya ngakumbi malunga neendleko zezicwangciso zeMedigap kwi2021.
Yintoni iMedigap?
I-Medigap yi-inshurensi eyongezelelweyo onokuyithenga ukunceda ukuhlawulela izinto ezingagutyungelwanga yiCandelo leMedicare A kunye neMedicare Icandelo B. Eminye imizekelo yeendleko ezinokuthi zigutyungelwe yiMedigap zibandakanya:
- Ukutsalwa kweenxalenye A kunye no-B
- ukuqinisekiswa kwemali okanye ukukopishwa kwamacandelo A no-B
- iindleko ezigqithisileyo zeCandelo B
- iindleko zonyango ngexesha lokuhamba kwamanye amazwe
- igazi (iipunipoli zokuqala ezi-3)
Izinto ezithile ezigutyungelweyo zixhomekeke kwisicwangciso seMedigap osithengayo. Kukho iintlobo ezili-10 ezahlukeneyo zeeplani zeMedigap, nganye nganye ichongwe ngoonobumba: A, B, C, D, F, G, K, L, M, no-N.Isicwangciso ngasinye sinezinga elahlukileyo lokugubungela.
Iinkampani zeinshurensi zabucala zithengisa imigaqo-nkqubo yeMedigap. Isicwangciso ngasinye simiselwe ngokomgangatho, oko kuthetha ukuba kufuneka sinikeze inqanaba elisisiseko lokugubungela. Umzekelo, umgaqo-nkqubo weSicwangciso G ugubungela iseti efanayo yezibonelelo, ngaphandle kwendleko zayo okanye inkampani eyithengisayo.
Imigaqo-nkqubo yeMedigap ikwaqinisekisiwe ukuba iya kuhlaziywa ukuba nje uhlawula iipremiyamu zakho zenyanga. Oku kuthetha ukuba inkampani yeinshurensi oyithengileyo isicwangciso sakho ayinakho ukurhoxisa isicwangciso sakho, nokuba uneemeko zempilo ezintsha okanye eziba mandundu.
Zibiza malini izicwangciso zeMedigap?
Ke zithini iindleko zokwenyani ezinxulunyaniswa nezicwangciso zeMedigap? Makhe sihlolisise iindleko ezinokubakho ngokweenkcukacha.
Iipremiyamu zarhoqo ngenyanga
Umgaqo-nkqubo ngamnye weMedigap uneprimiyamu yenyanga. Inani elichanekileyo linokwahluka ngokomgaqo-nkqubo ngamnye. Iinkampani zeinshurensi zinokubeka iipremiyamu zenyanga ngenyanga kwimigaqo-nkqubo yazo ngeendlela ezintathu ezahlukeneyo:
- Uluntu lukaliwe. Wonke umntu othenga ipolisi uhlawula ipremiyamu efanayo yenyanga ngaphandle kweminyaka.
- Iminyaka yobudala ikaliwe. Iipremiyamu zanyanga zonke zibotshelelwa kwiminyaka oqale ngayo ukuthenga umgaqo-nkqubo, abathengi abancinci benamaqonga aphantsi. Iipremiyamu azinyuki njengokuba usiya ukhula.
- Ubudala obufikelelweyo bulinganisiwe. Iipremiyamu zanyanga zonke zibotshelelwe kwiminyaka yakho yangoku. Oko kuthetha ukuba i-premium yakho iya kunyuka ngokuya usiba mdala.
Ukuba ungathanda ukubhalisa kwisicwangciso seMedigap, kubalulekile ukuthelekisa imigaqo-nkqubo emininzi enikezelwa kwindawo yakho. Oku kunokukunceda ubone ukuba iipremiyamu zibekwa njani kwaye ungalindela ukuhlawula malini ngenyanga.
I-premium yeMedigap yenyanga ihlawulwa ukongeza kwezinye iipremiyamu zenyanga ezinxulumene neMedicare. Oku kunokubandakanya iipremiyamu ze:
- I-Medicare Icandelo A (i-inshurensi yesibhedlele), ukuba ikhona
- Icandelo le-Medicare Icandelo B (i-inshurensi yonyango)
- Icandelo le-Medicare Icandelo D (ukugubungela amayeza amayeza)
Ukutsalwa
I-Medigap ngokwayo ayihambelani ngokuqhelekileyo kwi-deductible. Nangona kunjalo, ukuba isicwangciso sakho seMedigap asigubungeli iCandelo A okanye iCandelo B litsale, usenoxanduva lokuhlawula ezo zinto.
Isicwangciso seMedigap F kunye nesiCwangciso G sinokukhetha okunokutsalwa okuphezulu. Iipremiyamu zenyanga zezi zicwangciso zihlala ziphantsi, kodwa kuya kufuneka uhlangane notsalo ngaphambi kokuba aqale ukugubungela iindleko. Ngowama-2021, i-deductible yi- $ 2,370 kwezi zicwangciso.
Coinsurance kunye neepopays
Njengokuncitshiswayo, iMedigap ngokwayo ayihambelani ne-coinsurance okanye ii-copays. Kusenokufuneka uhlawule i-coinsurance ethile okanye ii-copays ezinxulumene neMedicare yoqobo ukuba umgaqo-nkqubo wakho weMedigap awuzikhuselanga.
Umda wokuphuma epokothweni
Isicwangciso seMedigap K kunye noCwangciso L banemida engaphandle. Eli lelona xabiso liphezulu ekuya kufuneka uhlawule ngalo epokothweni.
Ngo-2021, iSicwangciso K kunye neSicwangciso L semida engaphandle kweedola zii-6,220 zamaRandi kunye ne-3,110 yeedola ngokwahlukeneyo. Emva kokudibana nomda, isicwangciso sihlawula iipesenti ezili-100 zeenkonzo ezigutyungelweyo unyaka wonke.
Iindleko eziphuma epokothweni
Kukho iinkonzo ezinxulumene nempilo ezingagqitywanga nguMedigap. Ukuba ufuna ukusebenzisa ezi nkonzo, kuya kufuneka uzihlawulele epokothweni. Oku kunokubandakanya:
- zamazinyo
- umbono, kubandakanya iiglasi zamehlo
- izixhobo zokuva
- Ukukhutshwa kweziyobisi ngugqirha
- Unonophelo lwexesha elide
- ukhathalelo lwabucala
Isicwangciso seMedigap sithelekisa iindleko
Itheyibhile elandelayo ibonisa ukuthelekiswa kweendleko zepremiyamu yenyanga nganye kwizicwangciso ezahlukeneyo zeMedigap kwizixeko ezine zesampulu eMelika.
| IWashington, D.C. | IDes Moines, IA | IAurora, CO | ISan Francisco, CA | |
|---|---|---|---|---|
| Cwangcisa uA | $72–$1,024 | $78–$273 | $90–$379 | $83–$215 |
| Cwangcisa B | $98–$282 | $112–$331 | $122–$288 | $123–$262 |
| Isicwangciso C | $124–$335 | $134–$386 | $159–$406 | $146–$311 |
| Cwangcisa uD | $118–$209 | $103–$322 | $137–$259 | $126–$219 |
| Isicwangciso F | $125–$338 | $121–$387 | $157–$464 | $146–$312 |
| Isicwangciso F (ukuncitshiswa okuphezulu) | $27–$86 | $27–$76 | $32–$96 | $28–$84 |
| Cwangcisa uG | $104–$321 | $97–$363 | $125–$432 | $115–$248 |
| Isicwangciso G (ukuncitshiswa okuphezulu) | $26–$53 | $32–$72 | $37–$71 | $38–$61 |
| Cwangcisa uK | $40–$121 | $41–$113 | $41–$164 | $45–$123 |
| Cwangcisa uL | $68–$201 | $69–$237 | $80–$190 | $81–$175 |
| Cwangcisa uM | $145–$309 | $98–$214 | $128–$181 | $134–$186 |
| Cwangcisa uN | $83–$279 | $80–$273 | $99–$310 | $93–$210 |
Amaxabiso aboniswe ngentla asekwe kwindoda eneminyaka engama-65 engasebenzisi icuba. Ukufumana amaxabiso athile kwimeko yakho, faka ikhowudi yakho ye-ZIP kwisixhobo sokufumana isicwangciso seMedigap seMedigap.
Ngaba ndivumelekile kwiMedigap?
Kukho imigaqo ethile ehambelana nokuthenga umgaqo-nkqubo weMedigap. Oku kubandakanya:
- Kuya kufuneka ube unayo iMedicare yentsusa (icandelo A no-B). Wena ayikwazi uneMedigap kunye neMedicare Advantage.
- Isicwangciso seMedigap sigubungela umntu omnye kuphela. Oku kuthetha ukuba amaqabane aya kufuna ukuthenga imigaqo-nkqubo eyahlukileyo.
- Ngokomthetho wobumbano, iinkampani zeinshurensi azifuneki ukuba zithengise imigaqo-nkqubo yeMedigap kubantu abangaphantsi kweminyaka engama-65. Ukuba ungaphantsi kweminyaka engama-65 kwaye uneMedicare yoqobo, usenokungakwazi ukuthenga umgaqo-nkqubo owufunayo.
Ukongeza, ezinye izicwangciso zeMedigap azisafumaneki kwabo batsha kwiMedicare. Nangona kunjalo, abantu abasele bebhalisile kwezi zicwangciso banokuzigcina. Ezi zicwangciso zibandakanya:
- Isicwangciso C
- Cwangcisa u-E
- Isicwangciso F
- Cwangcisa uH
- Cwangcisa mna
- Cwangcisa uJ
Imihla ebalulekileyo yobhaliso eMedigap
Apha ngezantsi kukho imihla ebalulekileyo yokubhalisa kwisicwangciso seMedigap.
Ixesha lokubhaliswa kweMedigap
Eli xesha liqala lixesha leenyanga ezi-6 eziqala xa uneminyaka engama-65 kwaye ubhalise kwiCandelo leMedicare B. Ukuba ubhalisa emva kweli xesha, iinkampani zeinshurensi zinokunyusa iipremiyamu zenyanga ngenxa yokubhalwa phantsi kwezonyango.
Ukubhalwa kwezonyango yinkqubo esetyenziswa ziinkampani zeinshurensi ukwenza izigqibo malunga nokugubungela isekwe kwimbali yakho yezonyango. Ukubhalwa kwezonyango akuvumelekanga ngexesha lokubhaliswa kokuqala kweMedigap.
Amanye amaxesha okubhaliswa kwamayeza
Usengathenga isicwangciso seMedigap ngaphandle kwexesha lakho lokuqala lokubhalisa. Nanga amanye amaxesha apho ungabhalisa kwisicwangciso seMedigap unyaka wonke:
- Ubhaliso ngokubanzi (ngoJanuwari 1 – Matshi 31). Ungatshintsha ukusuka kwelinye icebo le-Medicare Advantage uye kwelinye, okanye ungashiya isicwangciso se-Medicare Advantage, ubuyele kwi-Medicare yoqobo, kwaye ufake isicelo se-Medigap.
- Ubhaliso ngokuvulekileyo ngo-Okthobha 15-Disemba 7). Ungabhalisa kuso nasiphi na isicwangciso seMedicare, kubandakanya nesicwangciso seMedigap, ngeli xesha.
Ukuthatha
IMedigap luhlobo lweinshurensi eyongezelelweyo onokuyithenga ukunceda ukuhlawulela iindleko ezinxulumene nezempilo ezingagutyungelwanga yiMedicare yoqobo. Kukho iintlobo ezili-10 ezahlukeneyo zesicwangciso esimiselweyo seMedigap.
Iindleko zesicwangciso seMedigap zixhomekeke kwisicwangciso osikhethayo, apho uhlala khona, nakwinkampani othenga kuyo ipolisi yakho. Uya kuhlawula ipremiyamu yenyanga ngesicwangciso sakho kwaye unokuba noxanduva lwezinto ezithile ezikhutshiweyo, ukuqinisekiswa kwemali kunye neepopay.
Ungaqala ubhalise kwisicwangciso seMedigap ngexesha lokubhalisa kwaseMedigap. Ngeli xesha ugqiba iminyaka engama-65 kwaye ubhalise kwi-Medicare Part B. Ukuba awubhalisi ngeli xesha, ngekhe ube nakho ukubhalisa kwisicwangciso osifunayo okanye kungabiza ngaphezulu.
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.
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