Zeziphi iintlobo ezahlukeneyo zeMedical?
Umxholo
- Yintoni iCandelo leMedicare A?
- Yintoni i-Medicare Icandelo B?
- Yintoni i-Medicare Icandelo C (i-Medicare Advantage)?
- Yintoni i-Medicare Icandelo D?
- Yintoni i-inshurensi yokuxhasa iMedare (iMedigap)?
- Ukuthatha
- Ukugubungela i-Medicare yahlulwe yangamacandelo aliqela agubungela icandelo ngalinye lokhathalelo.
- Icandelo leMedicare A ligubungela ukhathalelo lwezigulana kwaye zihlala zingena-premium.
- Icandelo leMedicare B ligubungela ukhathalelo lwezigulana ezingalaliswayo kwaye linepremiyamu esekwe kumvuzo.
- I-Medicare Icandelo C (i-Medicare Advantage) yimveliso ye-inshurensi yabucala edibanisa icandelo A no-B kunye nezinye izibonelelo.
- Icandelo leMedicare Icandelo D yimveliso yeinshurensi yabucala egubungela amayeza amiselweyo.
I-Medicare ibonelela ngokhuseleko kwezempilo kubantu abangaphezulu kweminyaka engama-65 kunye nabo bakhubazekileyo okanye iimeko ezithile zempilo. Le nkqubo inzima inamacandelo amaninzi, kwaye ibandakanya urhulumente wobumbano kunye neinshurensi zabucala abasebenza kunye ukubonelela ngeenkonzo ezahlukeneyo kunye neemveliso.
I-Medicare yoqobo yenziwe ngamacandelo A kunye no-B. Olu bhengezo likuvumela ukuba uye koogqirha nakwizibonelelo ezamkela i-Medicare ngaphandle kokufumana imvume okanye imvume kwangaphambili kwisicwangciso sakho. Iimali zanyanga le kunye neentlawulo ezikhutshiweyo ziyasebenza, kodwa zihlala zisuselwa kwingeniso kwaye zinokuxhaswa.
Uncedo lweMedicare (Icandelo C) zizicwangciso zeinshurensi zabucala. Ezi zicwangciso zidibanisa izinto ezininzi zeMedare, ezinje ngamacandelo A kunye no-B, kunye nezinye iinkonzo, ezinje ngommiselo, amazinyo kunye nokugubungela umbono. Banikezela ngeenkonzo ezininzi, kodwa banokuxabisa ngaphezulu kwaye beza nezithintelo zenethiwekhi.
Ngelixa ukhetho oluninzi lweMedicare lukunika ubhetyebhetye kukhuselo lwakho lokhathalelo lwempilo, kukwathetha ukuba kufuneka uhambe kwaye uqonde ulwazi oluninzi.
Funda malunga nokwaphuka okuneenkcukacha kwamacandelo ahlukeneyo eMedare kunye nendlela abanokukunceda ngayo.
Yintoni iCandelo leMedicare A?
Icandelo leMedicare A yinxalenye ye-Medicare yoqobo egubungela iindleko zesibhedlele kunye nolunye unyango lwangaphakathi. Uninzi lwabantu aluyihlawuli i-premium yenyanga kwiCandelo A kuba bahlawule kwinkqubo ngerhafu ngexesha labo lokusebenza.
Ngokukodwa, icandelo le-Medicare A liya kubandakanya:
- Ukuhlala esibhedlele
- ukuhlala ixesha elifutshane kwiziko lokonga
- hlala esibhedlele esikhathalela ixesha elide
- ukhathalelo lwasekhaya lokugcina ixesha elide okanye ukugcinwa
- Unonophelo lwehosisi
- okwexeshana okanye ukhathalelo lwempilo ekhaya
Ukuqinisekisa ukuba i-Medicare iyakugubungela ukuhlala kwakho, kuya kufuneka:
- Umyalelo osemthethweni ovela kugqirha echaza ukuba ufuna ukhathalelo lokugula okanye ukonzakala
- Qinisekisa ukuba iziko liyayamkela iMedare
- Qinisekisa ukuba uneentsuku ezishiyekileyo kwixesha lakho lokuxhamla ekufuneka uzisebenzisile (ukulungiselela indawo yokuhlala yabongikazi)
- qinisekisa ukuba i-Medicare kunye nezixhobo ziyasivuma isizathu sokuhlala kwakho
Ngaphantsi kwecandelo leMedicare A, ungalindela ukuhlawula ezi ndleko zilandelayo ngo-2021:
- akukho mrhumo ukuba usebenze ubuncinci iikota ezingama-40 (iminyaka eli-10) ebomini bakho kwaye uhlawule irhafu ye-Medicare (uyakuhlawula ukuya kuthi ga kwi-471 yeedola ngenyanga ukuba usebenze ngaphantsi kweekota ezingama-40)
- itsaliwe i-1,484 yeedola kwithuba ngalinye lesibonelelo
- Iindleko zemali yemihla ngemihla ngokusekwe kubude bokuhlala kwakho ngaphakathi: $ 0 ngeentsuku 1 ukuya ku-60, $ 371 ngosuku ngeentsuku ezingama-61 ukuya kuma-90, kunye nee-742 zeedola ngosuku ngeentsuku ezingama-91 nangaphaya
- Zonke iindleko ukuba usesibhedlele ngaphezulu kweentsuku ezingama-90 kwithuba lesibonelelo esinye kwaye ugqithe kwiintsuku ezingama-60 zobomi obubekiwe
Yintoni i-Medicare Icandelo B?
I-Medicare Icandelo B yinxalenye ye-Medicare yoqobo egubungela iindleko zonyango lwakho lwangaphandle. Uya kuhlawula ipremiyamu yenyanga yolu khuselo ngokusekwe kwinqanaba lakho lomvuzo.
Icandelo leMedicare B liya kugubungela iindleko zezinto ezinje:
- utyelelo loogqirha
- Unyango kunye neenkonzo eziyimfuneko
- Iinkonzo zokukhusela
- ukuthuthwa kwe-ambulensi engxamisekileyo
- ezinye izixhobo zonyango
- iinkonzo zonyango ezingalaliswanga nezingalaliswayo
- amayeza amayeza aphuma ngaphandle
Ukuqinisekisa ukuba icandelo leMedicare B ligubungela ukuqeshwa kwakho, inkonzo, okanye izixhobo zonyango, buza ukuba ugqirha wakho okanye umboneleli ngenkonzo uyayamkela na iMedicare.Unokusebenzisa isixhobo sokugubungela i-Medicare ukumisela ukuba ukuqeshwa kwakho okanye inkonzo iyagutyungelwa.
Ngaphantsi kwecandelo leMedicare B, ungalindela ukuhlawula ezi ndleko zilandelayo ngo-2021:
- I-premium ubuncinci eyi- $ 148.50 ngenyanga (le mali iyonyuka ukuba umvuzo wakho ungaphezulu kwe- $ 88,000 ngonyaka okanye i- $ 176,000 ngonyaka kwizibini ezitshatileyo)
- itsaliwe i $ 203 ngonyaka
- Iipesenti ezingama-20 zeemali ezivunyiweyo ze-Medicare emva kokuba i-deductible idibene nayo ngonyaka
Yintoni i-Medicare Icandelo C (i-Medicare Advantage)?
I-Medicare Icandelo C (i-Medicare Advantage) yimveliso ye-inshurensi yabucala ekunika lonke ukhuseleko kumalungu e-Medicare A no-B, kunye neenkonzo ezongezelelweyo.
Uninzi lwezi zicwangciso zibonelela ngogqirha ngokufaka kwizigulana ezingalaliswayo kunye neenkonzo zonyango. Izibonelelo ezinje ngamazinyo kunye nokugubungela umbono zinokongezwa nazo.
Unokwenza isilungiselelo sakho seMedicare Advantage ngokusekelwe kwinto elawula isicwangciso sakho kunye nento ofuna ukuyihlawula.
I-Medicare iya kuhlawula imali ebekiweyo inyanga nenyanga kumboneleli wakho wesicwangciso se-Medicare Advantage ukuze enze igalelo kwisabelo sakho.
Izicwangciso ze-Medicare Icandelo C zihlala ziwela kuluhlu olwahlukeneyo:
- Izicwangciso zoMbutho weSondlo sezeMpilo (HMO) zifuna ukuba ufumane unonophelo olungxamisekileyo kubanikezeli abathile ngaphakathi kwenethiwekhi yesicwangciso sakho.
- Izicwangciso zoMbutho woMboneleli okhethiweyo (PPO) zikuvumela ukuba usebenzise ababoneleli ngaphakathi okanye ngaphandle kwenethiwekhi yakho, kodwa uhlawula kancinci kukhathalelo lwenethiwekhi.
- Izicwangciso zeNtlawulo yabucala yeNkonzo (PFFS) zikuvumela ukuba ubone ababoneleli abangaphakathi okanye ngaphandle kwenethiwekhi yesicwangciso; Nangona kunjalo, esi sicwangciso simisela amaxabiso ezinto esiza kuzihlawula ngeenkonzo zelungu kunye nesabelo sakho.
- IziCwangciso zeMfuno eziZodwa (SNPs) zizicwangciso zeMedicare Advantage ezenzelwe abantu abanezifo ezithile okanye iimeko ezithile. Ezi zicwangciso zilungiselela iinkonzo kunye nokugubungela imeko yakho ethile.
Iindleko zeCandelo leMedare C ziyahluka ngokuxhomekeka kuhlobo lwesicwangciso kunye nomboneleli weinshurensi oyikhethayo.
Yintoni i-Medicare Icandelo D?
Icandelo le-Medicare Icandelo D sisicwangciso esibonelela ngogqirha kumayeza amiselweyo.
Le yinkqubo yokuzikhethela yeMedare, kodwa ukuba awubhalisi xa uvumelekile okokuqala, ungahlawula izohlwayo xa usayina kamva. Ezo zohlwayo ziya kusebenza ngalo lonke ixesha unesicwangciso samachiza kwaye ziya kongezwa kwiindleko zepremiyamu yakho yenyanga.
Ukugqunywa ngamayeza kagqirha kufuneka kubonelelwe kwinqanaba elisetwe yiMedicare. Kodwa izicwangciso ezahlukeneyo zinokukhetha amayeza abawadwelise kuluhlu lwabo lweziyobisi, okanye iifomula. Uninzi lwezicwangciso zamachiza amayeza ahlanganisa amayeza ngu:
- formulary, olu luluhlu lwamayeza amayeza agqunywe kwisicwangciso-ikakhulu ubuncinci ubuncinci ekukhetheni iklasi nganye yeziyobisi okanye udidi
- amayeza enziwe afana nalawo enziwa ngumenzi anokuthi afakwe endaweni yamayeza egama elinophawu olufanayo
- Iinkqubo ezinamacandelo anikezela ngamanqanaba ohlukeneyo amayeza (i-generic kuphela, i-generic plus brand brand, njalo njalo) kuluhlu lweentlawulo ezonyusa ngamaxabiso amayeza akho
Iindleko zezicwangciso ze-Medicare Part D zixhomekeke kwisicwangciso osikhethayo kunye naluphi unyango olifunayo. Ungathelekisa iindleko zamacebo amayeza amayeza ahlukeneyo kwi-Intanethi ngokunqakraza apha.
Yintoni i-inshurensi yokuxhasa iMedare (iMedigap)?
I-inshurensi yokuncedisa i-Medicare, okanye iMedigap, izicwangciso ziyimveliso yeinshurensi yabucala eyenzelwe ukunceda ukuhlawula iindleko ezingahlawulwanga ngamacandelo e-Medicare A, B, C, okanye D. Ezi zicwangciso azinyanzelekanga.
Izicwangciso zeMedigap zinokunceda ukuhlawula iindleko zeMedare ezifana:
- iikopayi
- ezemali
- utsalo
Utshintsho olukhulu lwenziwe kwinkqubo yeMedigap ngo-2020.
Izicwangciso zeMedigap azisenakusetyenziselwa ukuhlawulela i-Medicare Icandelo B elitsalelweyo. Oku kuthetha ukuba iintlobo ezimbini zezicwangciso zeMedigap - isiCwangciso C kunye noCwangciso F - ziyekile ukuthengiswa kumalungu amatsha ukusukela nge-1 kaJanuwari ka-2020. Abantu abasele benazo ezi zicwangciso, nangona kunjalo, bayakwazi ukugcina ingxelo yabo.
Izicwangciso zeMedigap azinakugubungela zonke iindleko eziphuma epokothweni, kodwa ungayifumana eyona ilungele iimfuno zakho zezemali nezempilo. Unezicwangciso ezahlukeneyo kunye nenqanaba lokugubungela onokukhetha kulo.
Nalu ushwankathelo lwento nganye kwezi zicwangciso ezili-10 zeMedigap:
| Isicwangciso seMedigap | Ukufunda |
|---|---|
| Cwangcisa uA | Icandelo le-Medicare Icandelo le-coinsurance kunye neendleko zokhathalelo lweentsuku ezingama-365 emva kokuba izibonelelo zeMedare ziphelile, Icandelo B iimali ezihlawulwayo okanye ii-copayments, iiponti ezintathu zokuqala zokutofelwa igazi, kunye nokunakekelwa kwe-hospice okanye i-copayments |
| Cwangcisa B | Icandelo le-Medicare Icandelo le-coinsurance kunye neendleko zokhathalelo lweentsuku ezingama-365 emva kokuba izibonelelo zeMedare ziphelile, iCandelo B iimali ezihlawulwayo okanye ii-copayments, iipenti ezintathu zokuqala zokutofelwa igazi, ukhathalelo lwe-hospice okanye i-copayments, kunye neCandelo A lakho |
| Isicwangciso C | Icandelo le-Medicare Icandelo le-coinsurance kunye neendleko zononophelo lweentsuku ezingama-365 emva kokuba izibonelelo zeMedare ziphelile, iCandelo B ukuqinisekiswa kwemali okanye ukukhutshwa kwemali, iipilisi zokuqala ezi-3 zokutofelwa igazi, ukunakekelwa kwe-hospice okanye i-copayments, izibonelelo zononophelo lweziko lokonga, i-Part A Icandelo B linokutsalwa, kunye notshintsho lwangaphandle lokuya kuthi ga kwiipesenti ezingama-80 |
| Cwangcisa uD | Icandelo le-Medicare Icandelo lokuhlawulwa kwemali kunye neendleko zokhathalelo lweentsuku ezingama-365 emva kokuba izibonelelo zeMedare ziphelile, Icandelo B iimali ezihlawulwayo okanye ii-copayments, iipilisi zokuqala ezintathu zotofelo-gazi, i-hospice yokhathalelo lweemali zokuhlawula okanye iicopayments, i-coinsurance yamaziko onesi anobuchule, icandelo lakho A Ukutsalwa, kunye nokutshintshiselana kwamanye amazwe ukuya kuthi ga kwiipesenti ezingama-80 |
| Isicwangciso F | Icandelo le-Medicare Icandelo lokuhlawulwa kwemali kunye neendleko zokhathalelo lweentsuku ezingama-365 emva kokuba izibonelelo zeMedare ziphelile, Icandelo B iimali ezihlawulwayo okanye ii-copayments, iipilisi zokuqala ezintathu zokutofelwa igazi, ukhathalelo lwe-hospice okanye i-copayments, i-coinsurance yamaziko abongikazi abanezakhono, icandelo lakho A Ukuxhuzulwa, iSahlulo B sakho sincitshisiwe, Icandelo B libiza iindleko umboneleli wakho ahlawulise ngaphezulu kwento evunyelwe yiMedare (intlawulo egqithisileyo), kunye notshintshiselwano lokuhamba lwangaphandle ukuya kuthi ga kwiipesenti ezingama-80 |
| Cwangcisa uG | Icandelo le-Medicare Icandelo lokuhlawulwa kwemali kunye neendleko zokhathalelo lweentsuku ezingama-365 emva kokuba izibonelelo zeMedare ziphelile, Icandelo B iimali ezihlawulwayo okanye ii-copayments, iipilisi zokuqala ezintathu zokutofelwa igazi, ukhathalelo lwe-hospice okanye i-copayments, i-coinsurance yamaziko abongikazi abanezakhono, icandelo lakho A Ukuxhuzulwa, iCandelo B libiza ukuba umboneleli wakho ahlawulise ngaphaya kwento evunyelwe yiMedare (iindleko ezingaphezulu), kunye notshintshiselwano lokuhamba kwamanye amazwe ukuya kuthi ga kuma-80% |
| Cwangcisa uK | Icandelo le-Medicare Icandelo le-coinsurance kunye neendleko zononophelo lweentsuku ezingama-365 emva kokuba izibonelelo zeMedare ziphelile, iipesenti ezingama-50 zeCandelo B okanye i-copayments, i-50% yeendleko zeepilisi zokuqala ezintathu zokutofelwa igazi, iipesenti ezingama-50 zononophelo lwe-hospice okanye ukukhutshwa kwemali, iipesenti ezingama-50 zeemali ezihlawulwa ngamaziko okunyamekela abanezakhono, iipesenti ezingama-50 zeCandelo A litsaliwe - kunye nomda ongaphandle kwe-pocket we $ 6,220 ngo-2021 |
| Cwangcisa uL | Icandelo le-Medicare Icandelo lokuhlawulwa kwemali kunye neendleko zononophelo lweentsuku ezingama-365 emva kokuba izibonelelo zeMedare ziphelile, iipesenti ezingama-75 zeCandelo B okanye i-copayments, iipesenti ezingama-75 zeendleko zeepilisi zokuqala ezintathu zokutofelwa igazi, iipesenti ezingama-75 zononophelo lwe-hospice okanye ukukhutshwa kweemali, iipesenti ezingama-75 zeemali ezihlawulwa ngamaziko okunonophela abanezakhono, iipesenti ezingama-75 zeCandelo A litsaliwe - ngomda ongaphandle epokothweni wama- $ 3,110 ngo-2021 |
| Cwangcisa uM | Icandelo le-Medicare Icandelo le-coinsurance kunye neendleko zononophelo lweentsuku ezingama-365 emva kokuba izibonelelo zeMedare ziphelile, iCandelo B ukuqinisekiswa kwemali okanye ukukhutshwa kwemali, iipilisi zokuqala ezi-3 zokutofelwa igazi, ukunyanzeliswa kwe-hospice okanye i-copayments, i-coinsurance yeendawo zononophelo, 50% Icandelo lakho litsaliwe, kunye notshintshiselwano ngohambo lwangaphandle ukuya kuthi ga kwiipesenti ezingama-80 |
| Cwangcisa uN | Icandelo le-Medicare Icandelo lokuhlawulwa kwemali kunye neendleko zokhathalelo lweentsuku ezingama-365 emva kokuba izibonelelo zeMedare ziphelile, Icandelo B iimali ezihlawulwayo okanye ii-copayments, iipilisi zokuqala ezintathu zokutofelwa igazi, ukhathalelo lwe-hospice okanye i-copayments, i-coinsurance yamaziko abongikazi abanezakhono, icandelo lakho A Ukutsalwa, kunye nokutshintshiselana kwamanye amazwe ukuya kuthi ga kwiipesenti ezingama-80 |
* Emva komhla kaJanuwari 1, 2020, abantu abatsha kwi-Medicare abanakho ukusebenzisa izicwangciso zeMedigap zokuhlawula i-Medicare Part B. Kodwa ukuba sele ubhalisile kwi-Medicare kwaye isicwangciso sakho ngoku siyayihlawula, ungasigcina eso sicwangciso kunye nesibonelelo.
Ukuthatha
Kungathatha ixesha kunye nomzamo wokucoca kwiindidi ezininzi zezicwangciso zeMedare. Kodwa ezi ndlela zikunika ukhetho ngakumbi xa kuziwa kukugubungela kunye neendleko zokhathalelo lwempilo yakho.
Xa uqala ukufumana i-Medicare, qiniseka ukuba uphonononge onke amalungu ayo ukuze ufumane olona lufanelekileyo kuwe kwaye uphephe izohlwayo kamva.
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.
Sicebisa Ukuba Ufunde
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