Yonke into ekufuneka uyazi ukuba ufuna ukutshintsha iziCwangciso eziNcedisayo zeMedare
Umxholo
- Ndizitshintsha njani izicwangciso zeMedicare?
- Ndingasitshintsha nini isicwangciso seMedicare?
- Ixesha lokubhalisa lokuqala
- Uncedo lweMedicare lubhaliso oluvulekileyo
- Ixesha lokubhalisa elivulekileyo
- Amaxesha obhaliso olulodwa
- Ngubani ofanelekileyo kwi-Medicare Advantage?
- Zithini izicwangciso zokunceda amayeza?
- Ukuthatha
- Unamathuba amaninzi okutshintsha isicwangciso sakho seNzuzo ye-Medicare unyaka wonke.
- Ungasitshintsha isicwangciso sakho se-Medicare Advantage kunye ne-Medicare yokugubungela iziyobisi ngexesha lokubhaliswa kwe-Medicare okanye ixesha lokubhalisa elivulekileyo le-Medicare.
- Ungasitshintsha kwakhona isicwangciso sakho seNzuzo ye-Medicare ngexesha lokubhaliswa okukhethekileyo okubangelwa lutshintsho olukhulu ebomini bakho.
Ukuba iimeko zakho zitshintshile okoko wabhalisa kwisicwangciso seMedarement Advantage, ngoku usenokuba ujonge isicwangciso esahlukileyo esihlangabezana ngcono neemfuno zakho. Kodwa ngaba ungalahla elinye icebo kwaye utshintshele kwelinye?
Impendulo emfutshane, ewe. Impendulo ende: Ungasitshintsha isicwangciso sakho se-Medicare Advantage kodwa kuphela ngexesha lokubhalisa ngexesha lonyaka. Akunzima, kodwa kubalulekile ukwenza ngexesha elifanelekileyo. Ngaphandle koko, unokuphulukana nokugubungela okanye wenze izithuba kugubungela lwakho.
Nantsi into ekufuneka uyazi malunga nexesha kunye nendlela yokutshintsha isicwangciso sakho se-Medicare Advantage.
Ndizitshintsha njani izicwangciso zeMedicare?
Isibonelelo seMedicare (Icandelo C) senziwa ziinkampani zeinshurensi zabucala. Ukuba unesicwangciso seMedicare Advantage, unga:
- tshintshela kwisicwangciso esahlukileyo seMedicare esiBonelela ngeziyobisi
- tshintshela kwisicwangciso esahlukileyo seMedicare Advantage esinganikeliyo ngeziyobisi
- tshintshela kwi-Medicare yoqobo (icandelo A no-B) kunye neCandelo D (isicwangciso sonyango)
- tshintshela kwi-Medicare yoqobo ngaphandle kokongeza isicwangciso seCandelo D
Unokwenza utshintsho olunye kuphela kwisicwangciso sakho ngexesha lokubhaliswa kwe-Medicare Advantage.
Ukutshintsha izicwangciso, nxibelelana nomboneleli weinshurensi yesicwangciso osithandayo kwaye ufake isicelo sokugubungela. Ukuba awuqinisekanga ukuba unxibelelana njani nomboneleli, isixhobo sokufumana isicwangciso seMedicare kunokuba luncedo. Uya kukhutshwa kwisicwangciso sakho sangaphambili nje ukuba isicwangciso sakho esitsha siqale ukusebenza.
Ukuba utshintsha isicwangciso se-Medicare Advantage uye kwi-Medicare yoqobo, ungabiza isicwangciso sakho sangaphambili okanye ubhalise kwi-Medicare ngokubiza i-800-MEDICARE.
Ndingasitshintsha nini isicwangciso seMedicare?
Ungatshintsha izicwangciso ze-Medicare ze-Advantage ngexesha lokuseta amaxesha amisiweyo unyaka nonyaka kwisithuba sexesha elichaziweyo emva kweziganeko ezithile zobomi. Nayi imihla ethile kunye nemigaqo xa unokutshintsha izicwangciso ze-Medicare Advantage.
Ixesha lokubhalisa lokuqala
Ungasitshintsha isicwangciso sakho se-Medicare Advantage nangaliphi na ixesha ngexesha lokubhalisa kwakho kokuqala.
Ukuba ulungele ukufumana i-Medicare ngokusekwe kubudala bakho, ukubhaliswa kwakho okokuqala kuqala kwiinyanga ezintathu ngaphambi kwenyanga yokuzalwa kwakho kwama-65, kubandakanya inyanga yakho yokuzalwa, kwaye kuyaqhubeka kangangeenyanga ezintathu emva koko. Lilonke, ixesha lokubhalisa lokuqala lihlala iinyanga ezisi-7.
Ukuba ufanelekile kwi-Medicare ngokusekelwe kukukhubazeka, ixesha lakho lokuqala lokubhalisa liqala kwiinyanga ezi-3 ngaphambi kwenyanga yakho yama-25 yokufumana i-Inshurensi yokuKhubazeka kwezeNtlalontle okanye iBhodi yeRetire Retirement Board, kubandakanya inyanga yakho yama-25, kwaye iyaqhubeka kangangeenyanga ezintathu emva koko.
Uncedo lweMedicare lubhaliso oluvulekileyo
Unokwenza utshintsho kwisicwangciso sakho nanini na ngexesha le-Medicare Advantage evulekileyo yokubhalisa ukususela ngoJanuwari 1 ukuya ku-Matshi 31 minyaka yonke. Eli ikwaxesha lokubhaliswa ngokubanzi kweMedicare.
Utshintsho olwenzayo luya kusebenza ngosuku lokuqala lwenyanga elandelayo kwinyanga oyitshintshe ngayo.
Ixesha lokubhalisa elivulekileyo
Unokwenza utshintsho kwisicwangciso sakho se-Medicare Advantage nangaliphi na ixesha ngexesha lonyulo lonyaka, olubizwa ngokuba lubhaliso oluvulekileyo. Oku kuhlala ngo-Okthobha u-15 ukuya ku-Disemba 7 ngonyaka. Utshintsho olwenzayo luya kuqala ngoJanuwari 1 wonyaka olandelayo.
Amaxesha obhaliso olulodwa
Iziganeko ezithile zobomi zinokubangela ithuba lokutshintsha isicwangciso sakho seMedicare. Ukuba ufudukela kwindawo entsha, ukhetho lwakho lokugubungela luyatshintsha, okanye uhlangabezana nezinye iimeko zobomi, i-Medicare inokukunika ixesha lokubhalisa elikhethekileyo.
Nasi isishwankathelo salo msitho kunye nezinto onokukhetha kuzo:
| Ukuba oku kuyenzeka… | Ndinga… | Kudala ndinalo ndenza utshintsho… |
|---|---|---|
| Ndiyaphuma kwindawo yam yenkonzo yesicwangciso | tshintshela kwi-Medicare Advantage okanye kwiCandelo D lesicwangciso | Iinyanga ezi-2 * |
| Ndihamba kwaye iiplani ezintsha ziyafumaneka apho ndihlala khona | tshintshela kwi-Medicare Advantage okanye kwiCandelo D lesicwangciso | Iinyanga ezi-2 * |
| Ndibuyela eUnited States | Joyina i-Medicare Advantage okanye isicwangciso seCandelo D | Iinyanga ezi-2 * |
| Ndiyaphuma okanye ndiye kwiziko lokonga okanye kwiziko lokhathalelo lwexesha elide | ujoyine i-Medicare Advantage okanye isicwangciso seCandelo D, tshintsha izicwangciso ze-Medicare Advantage, okanye lahla i-Medicare yeNzuzo kwaye utshintshele kwi-Medicare yoqobo | okoko uhlala kwiziko kunye neenyanga ezi-2 emva kokuba uphumile |
| Ndiye ndakhululwa ejele | Joyina i-Medicare Advantage okanye isicwangciso seCandelo D | Iinyanga ezi-2 * |
| Andifanelekanga kwiMedicaid kwakhona | ujoyine i-Medicare Advantage okanye isicwangciso seCandelo D, tshintsha izicwangciso zeMedicare, okanye yeka i-Medicare yeNzuzo kwaye utshintshele kwi-Medicare yoqobo | Iinyanga ezintathu * |
| Andinayo i-inshurensi yezempilo evela kumqeshi okanye kwimanyano yam kwakhona | Joyina i-Medicare Advantage okanye isicwangciso seCandelo D | Iinyanga ezi-2 * |
| Ndibhalisa kwisicwangciso sePACE | yeka i-Medicare Inzuzo okanye isicwangciso seCandelo D | nanini na |
| Unyango lwezonyango luceba isicwangciso sam | tshintsha izicwangciso zeMedicare | ityala elichongiweyo ityala |
| Amayeza aphelisa icebo lam | tshintsha izicwangciso zeMedicare | ukusuka kwiinyanga ezi-2 ngaphambi kokuba iplani iphele kude kube yinyanga enye emva kokuba iphelile |
| I-Medicare ayilihlaziyi icebo lam | tshintsha izicwangciso zeMedicare | ukusukela nge-8 kaDisemba ukuya kumhla wokugqibela ngoFebruwari |
| Ndilungele iMedicare kunye neMedicaid | Joyina, tshintsha, okanye ulahle izicwangciso zeMedicare | kanye ngexesha likaJan – Mar, Apr-Jun, noJul – Sep |
| Ndibhalisa kwisicwangciso sokuNceda amayeza kaRhulumente (okanye ndilahlekelwe sisicwangciso) | Joyina isicwangciso se-Medicare seNzuzo kunye neCandelo D | kanye ngonyaka |
| Ndilahla umgaqo-nkqubo wam weMedigap xa ndijoyina isicwangciso seMedicare Advantage | yeka i-Medicare yeNzuzo kwaye ujoyine iMedicare yoqobo | Kwiinyanga ezili-12 emva kokuba uqale ukujoyina isicwangciso se-Medicare Advantage |
| NdineSicwangciso seMfuno eziZodwa kodwa andisenayo imfuno ekhethekileyo | tshintshela kwi-Medicare Advantage okanye kwiCandelo D icebo | Kwiinyanga ezi-3 emva kokuba ixesha lobabalo liphelile |
| Ndijoyina isicwangciso esingalunganga ngenxa yempazamo yomsebenzi womdibaniso | ujoyine i-Medicare Advantage okanye isicwangciso seCandelo D, tshintsha izicwangciso ze-Medicare Advantage, okanye ulahle i-Medicare Advantage kwaye utshintshele kwi-Medicare yoqobo | Iinyanga ezi-2 * |
| I-Medicare inika umlinganiso weenkwenkwezi ezi-5 kwisicwangciso kwindawo yam | tshintshela kwisicwangciso se-5 se-Medicare Advantage | kanye phakathi kukaDisemba 8 noNovemba 30 |
*Qhagamshelana Unyango.gov ngeenkcukacha ukuba iwotshi iqala nini ukukhawuleza.
Ngubani ofanelekileyo kwi-Medicare Advantage?
Ukuze ufaneleke kwisicwangciso se-Medicare Advantage, kufuneka ubhalise kwi-Medicare yasekuqaleni (Icandelo A kunye neCandelo B). Uyakufuna kwakhona ukuhlala kwindawo egutyungelwe ngumboneleli ngeinshurensi enikezela ngezicwangciso zeMedicare Advantage kubaxhamli abatsha.
Ukuze ufaneleke kwi-Medicare yasekuqaleni, kufuneka ube ngummi wase-US okanye umhlali ngokusisigxina osemthethweni iminyaka emi-5 ubuncinci kwaye ulingane enye okanye nangaphezulu kwezi ndidi:
- baneminyaka engama-65 okanye ngaphezulu
- unokukhubazeka
- ndine-amyotrophic lateral sclerosis (ALS)
- Unesifo sezintso (ESRD)
Zithini izicwangciso zokunceda amayeza?
Uncedo lweMedicare (Icandelo C) zizicwangciso zeinshurensi yezempilo ezithengiswa ziinkampani zeinshurensi zabucala. Banikezela ngokugubungela okufanayo ne-Medicare yoqobo (Icandelo A kunye neCandelo B), kunye nezibonelelo ezongezelelweyo.
Kuxhomekeke kwisicwangciso, ezinye zezo zibonelelo zingabandakanya amazinyo, ukuva, umbono, kunye nokugubungela amayeza amayeza. Unokuqhathanisa izicwangciso ngokusebenzisa isixhobo sokufumana isicwangciso seMedare. Oku kuyakuvumela ukuba ubone ukugubungela kunye namaxabiso afumanekayo kufutshane nawe.
Ukuthatha
Unokwenza utshintsho kwisicwangciso sakho se-Medicare Advantage ngo:
- nokongeza okanye ukulahla ukugubungela iziyobisi
- ukutshintshela kwisicwangciso esahlukileyo seMedicare
- ukubuyela kwi-Medicare yoqobo, kunye okanye ngaphandle kwesicwangciso samachiza
Into ebalulekileyo ekufuneka uyiqaphele kukuba ungasitshintsha isicwangciso sakho ngamaxesha athile kuphela enyakeni. Ungatshintsha nangaliphi na ixesha ngexesha lakho lokubhalisa kwiinyanga ezi-7 zokuqala. Unokutshintsha ngexesha lokubhalisa elivulekileyo ukuwa ngakunye.
Elinye ixesha onokuthi wenze utshintsho ngalo lixesha lokuvula ubhaliso oluvulekileyo ekuqaleni konyaka ngamnye. Kwaye, utshintsho oluthile kubomi likuvumela ukuba utshintshe isicwangciso sakho ngexesha lokubhaliswa okukhethekileyo.
Xa ulungele ukutshintshela, yazi ukuba unokufumana uncedo ekufumaneni nasekubhaliseni kwisicwangciso esifanelekileyo kuwe.
Eli nqaku lahlaziywa ngo-Novemba 17, 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.
Funda Namhlanje
Iishukela ezi-8 'ezisempilweni' kunye neeSwiti ezinokuba yingozi
