Yintoni amayeza? Yonke into ofuna ukuyifumana malunga neZiseko zeMedare

Umxholo

• Yintoni amayeza?
• Icandelo lezaMayeza A
• Icandelo leMedare B
• Icandelo lonyango Medic C
• Icandelo leMedare D
• IMedigap
• Yintoni egqunywa ngamayeza?
• Icandelo A ukugubungela
• Icandelo B ukugubungela
• Icandelo le-C
• Icandelo D lokugubungela
• Inkcazo yeMedigap
• Ulungelelwaniso lweMedicare
• Ukubhalisa kwiMedicare
• Zithini iindleko?
• Icandelo A iindleko
• Iindleko zeCandelo B
• Iindleko zeCandelo C
• Icandelo D iindleko
• Iindleko zeMedigap
• Uthini umahluko phakathi kweMedicare neMedicaid?
• Ukuthatha

• I-Medicare lukhetho lweinshurensi yezempilo olufumanekayo kubantu abaneminyaka engama-65 nangaphezulu nangaphezulu kwaye abo baneemeko ezithile zempilo okanye abakhubazekileyo.
• YoqoboI-Medicare (icandelo A no-B) ligubungela uninzi lwesibhedlele sakho kunye neemfuno zonyango.
• Ezinye iindawo zeI-Medicare (Icandelo C, Icandelo D, kunye neMedigap) zizicwangciso zeinshurensi zabucala ezibonelela ngezibonelelo ezongezelelweyo kunye neenkonzo.
• Iindleko zeMedicare zenyanga nenyanga zibandakanya iipremiyamu, iimali ezikhutshiweyo, iikopi kunye nokuqinisekiswa kwemali.

I-Medicare lukhetho lwe-inshurensi yezempilo exhaswa ngurhulumente efumanekayo kubantu baseMelika abaneminyaka engama-65 nangaphezulu kunye nabo baneemeko ezithile zempilo ezingapheliyo kunye nokukhubazeka. Kukho iindlela ezininzi ezahlukeneyo zokugubungela i-Medicare, ke kubalulekile ukuba uqonde ukuba loluphi uhlobo lokugubungela isicwangciso ngasinye onokukunika sona.

Kule nqaku, siza kuphonononga yonke into ekufuneka siyazi malunga neziseko zeMedare, ukusuka kugqatso, ukuya kwiindleko, ukuya kubhaliso, kunye nokunye.

Yintoni amayeza?

I-Medicare yinkqubo exhaswa ngurhulumente ebonelela nge-inshurensi yezempilo kubantu baseMelika abaneminyaka engama-65 nangaphezulu. Abanye abantu abangaphantsi kweminyaka yobudala engama-65 kwaye baneemeko zempilo ezingapheliyo okanye ukukhubazeka banokuthi bafaneleke kwi-Medicare.

I-Medicare inezinto ezininzi onokuzibhalisa kwiintlobo ezahlukeneyo zempilo.

Icandelo lezaMayeza A

Icandelo leMedicare A, ekwabizwa ngokuba yi-inshurensi yesibhedlele, ligubungela iinkonzo ozifumanayo xa ungeniswe esibhedlele okanye kwelinye iziko lezonyango. Kukho ukutsalwa okuza kudibana kunye neefizi zokuqinisekisa. Kuya kufuneka uhlawule ipremiyamu kwiCandelo A lokugubungela, kuxhomekeke kwinqanaba lakho lomvuzo.

Icandelo leMedare B

Icandelo lonyango i-Medicare Icandelo B, ekwabizwa ngokuba yi-inshurensi yezonyango, igubungela iinkonzo zokuthintela abaguli, zokuxilonga, kunye nezonyango ezinxulumene neemeko zakho zempilo. Kukho ukutsalwa kwemali yonyaka kunye neprimiyamu yenyanga yokuhlawula, kunye neendleko zokuqinisekisa.

Ngokudibeneyo, amacandelo e-Medicare A kunye no-B ayaziwa ngokuba yi "original Medicare."

Icandelo lonyango Medic C

I-Medicare Icandelo C, ekwabizwa ngokuba yi-Medicare Advantage, lukhetho lwe-inshurensi yabucala egubungela zombini iinkonzo zeMedicare A kunye neCandelo B. Uninzi lwezicwangciso ze-Medicare Advantage zikwabonelela ngokugubungela amayeza amayeza, umbono, amazinyo, ukuva, kunye nokunye. Unokuhlawula iipremiyamu zenyanga nenyanga kunye nokukopa ngezi zicwangciso, nangona nganye ineendleko ezahlukeneyo.

Icandelo leMedare D

Icandelo lonyango i-Medicare Part D, ekwabizwa ngokuba kukugubungela iziyobisi, unokongezwa kwi-Medicare yoqobo kwaye uncede ukuhlawula ezinye zeendleko zonyango. Uya kuhlawula imali eyahlukileyo yokutsalwa kunye nepremiyamu yesi sicwangciso.

IMedigap

I-Medigap, ekwabizwa ngokuba yi-Medicare inshurensi yokuxhasa, inokongezwa kwi-Medicare yoqobo kwaye inceda ukuhlawula ezinye zeendleko zakho ze-Medicare ezingaphandle. Uya kuhlawula ipremiyamu eyahlukileyo yesi sicwangciso.

Yintoni egqunywa ngamayeza?

Ukukhutshwa kwe-Medicare yakho kuxhomekeke kumacandelo e-Medicare obhalise kuwo.

Icandelo A ukugubungela

Icandelo leMedicare A ligubungela uninzi lweenkonzo zesibhedlele, kubandakanya:

• Ukunyamekela esibhedlele
• ukhathalelo lokunyanga ngaphakathi
• Unonophelo lwengqondo
• ukhathalelo olunobuchule kwiziko lokonga
• ukhathalelo lwempilo ekhaya
• Unonophelo lwehosisi

Icandelo le-Medicare Icandelo A alizibandakanyi iinkonzo zezigulana ezingalaliswayo, ezinje ngokundwendwelwa kwamagumbi kaxakeka okungakhokeleli ekuhlaleni ngaphakathi. Endaweni yoko, iinkonzo zesibhedlele ezinganyangekiyo zigutyungelwe phantsi kweCandelo leMedareare B.

ICandelo A aliquki uninzi lwezinto eziluncedo kwigumbi lasesibhedlele, ukhathalelo lwabucala nolondolozo, okanye ukhathalelo lwexesha elide.

Icandelo B ukugubungela

Icandelo leMedicare B ligubungela iinkonzo zothintelo, zokuxilonga, kunye nezonyango, kubandakanya:

• iinkonzo zokuthintela
• ukuthuthwa kwe-ambulensi engxamisekileyo
• Iinkonzo zokuchonga isifo, njengovavanyo lwegazi okanye iX-reyi
• Unyango kunye namayeza alawulwa yingcali yezempilo
• izixhobo zonyango ezizinzileyo
• iinkonzo zophando lwezonyango
• Iinkonzo zempilo yengqondo

Icandelo leMedicare B ligubungela uthotho lweenkonzo zokuthintela, ukusuka kuvavanyo lwezifo ukuya kuvavanyo lwempilo yengqondo. Ikwabandakanya ugonyo oluthile, kubandakanya nolo lomkhuhlane, i-hepatitis B, kunye nenyumoniya.

ICandelo B aliquki amayeza amiselweyo kwaye libonelela kuphela ngeziyobisi ezinqongopheleyo.

Icandelo le-C

Icandelo le-Medicare Icandelo C ligubungela yonke into phantsi kwentsusa ye-Medicare Icandelo A kunye neCandelo B. Uninzi lwezicwangciso ze-Medicare Icandelo C zikwangomba:

• amayeza amiselweyo
• Iinkonzo zamazinyo
• iinkonzo zombono
• iinkonzo zokuva
• iinkqubo zokuzilolonga kunye nobulungu bokuzivocavoca
• ezongeziweyo ezempilo

Ayizizo zonke izicwangciso ze-Medicare Advantage ezigubungela ezi nkonzo zilapha ngasentla, ke kubalulekile ukuba uthelekise ukhetho lwakho lokugubungela xa uthenga malunga nesona sicwangciso silungileyo seMedicare.

Icandelo D lokugubungela

Icandelo leMedicare D ligubungela amayeza amiselweyo. Isicwangciso ngasinye sonyango sonyango esineyeza sine-formulary, okanye uluhlu lwamachiza avunyiweyo agutyungelweyo. I-formulary mayibe namayeza amabini ubuncinci kudidi ngalunye lweziyobisi ezichaziweyo, kunye:

• iziyobisi zomhlaza
• ii-anticonvulsants
• iziyobisi
• Unyango lwengqondo
• Iziyobisi ze-HIV / AIDS
• iziyobisi ezikhuselayo

Kukho amayeza athile amiselweyo angagutyungelwanga phantsi kweCandelo D, afana nalawo asetyenziselwa ukunyanga ukungasebenzi kakuhle kwe-erectile okanye iziyobisi.

Isicwangciso ngasinye samachiza amiselweyo sinemithetho yaso, ke kubalulekile ukuba uyithathele ingqalelo le nto xa uthelekisa izicwangciso.

Inkcazo yeMedigap

Kukho izicwangciso ezili-10 ezahlukeneyo zeMedigap onokuzithenga ngeenkampani zabucala zeinshurensi. Izicwangciso zeMedigap zinceda ukuhlawula iindleko zokuphuma epokothweni ezinxulunyaniswa neenkonzo zakho zeMedare, ezinokuthi zibandakanye:

• Icandelo A litsale
• Icandelo A ukuqinisekiswa kwemali kunye neendleko zesibhedlele
• Icandelo A lokuqinisekisa okanye lokuhlawula iindleko ze-hospice
• Icandelo B litsale kunye nenyanga yenyanga
• Icandelo B ukuqinisekiswa kwemali okanye iindleko zokuhlawula
• Icandelo B iintlawulo ezingaphezulu
• utofelo-gazi (iipilisi zokuqala ezi-3)
• iindleko zononophelo lwezibonelelo zononophelo
• iindleko zonyango xa usiya ngaphandle kwe-United States

Kubalulekile ukuba wazi ukuba izicwangciso zeMedigap aziboneleli ngokhuselo lweMedare eyongezelelweyo. Endaweni yoko, banceda kuphela kwiindleko ezinxulumene nezicwangciso zeMedicare obhalise kuzo.

Ulungelelwaniso lweMedicare

Uninzi lwabantu lunelungelo lokuqalisa ukubhalisa kwiMedicare yoqobo kwiinyanga ezintathu ngaphambi kokuzalwa kwabo kwama-65. Nangona kunjalo, kukho iimeko ezithile apho unokufanelekela ukukhutshwa kwi-Medicare nangaliphi na ubudala. Oku kubandakanywa kubandakanya:

• Ukukhubazeka okuthile. Ukuba ufumana izibonelelo zenyanga zokukhubazeka kuLawulo loKhuseleko lweNtlalontle okanye kwiBhodi yoRhola uMhlala phantsi (RRB), uyakufanelekela ukufumana amayeza emva kweenyanga ezingama-24.
• I-Amyotrophic lateral sclerosis (ALS). Ukuba unayo i-ALS kwaye ufumana ukhuseleko lweNtlalontle okanye iRRB izibonelelo, ulungele iMedicare ukusukela kwinyanga yokuqala.
• Isifo sokugqibela se-renal (ESRD). Ukuba unayo i-ESRD, uvumelekile ngokuzenzekelayo ukuba ubhalise kwi-Medicare.

Nje ukuba babhalise kwicandelo leMedicare A kunye no-B, abantu baseMelika abafanelekileyo banokubhalisa kwisicwangciso seMedicare Advantage.

Ukubhalisa kwiMedicare

Uninzi lwabantu abakulungeleyo ukugubungela iMedare kufuneka babhalise ngexesha lokubhaliswa. Amaxesha kunye nemihla yokugqibela yobhaliso lwe-Medicare ibandakanya:

• Ubhaliso lokuqala. Oku kubandakanya iinyanga ezi-3 ngaphambili, inyanga, kunye neenyanga ezi-3 emva kokuba uneminyaka engama-65.
• Ubhaliso ngokubanzi. Oku kusuka kuJanuwari 1 ukuya kuMatshi 31 ukuba uliphosile ixesha lakho lokuqala lokubhalisa. Nangona kunjalo, iifizi zobhaliso kade zinokusebenza.
• Ubhaliso olulodwa. Olu khetho lunenani elithile leenyanga kuxhomekeke kwisizathu sakho sokufaneleka.
• Ubhaliso lweMedigap. Oku kubandakanya iinyanga ezi-6 emva kokuba ugqiba iminyaka engama-65 ubudala.
• Ubhaliso kwiCandelo D. Oku kusuka ku-Epreli 1 ukuya kuJuni 30 ukuba uliphosile ixesha lakho lokuqala lobhaliso.
• Ubhaliso oluvulekileyo. Ungalutshintsha ugcino lwakho ukusuka ngo-Okthobha u-15 ukuya ku-Disemba 7 qho ngonyaka ukuba ufuna ukubhalisa, ukulahla, okanye ukutshintsha isicwangciso seMedicare.

Uya kubhaliswa ngokuzenzekelayo kumacandelo e-Medicare A no-B ukuba:

• Uguqula iminyaka engama-65 kwiinyanga ezi-4 kwaye sele ufumana izibonelelo zokukhubazeka
• awuguquki iminyaka engama-65 kodwa sele ufumana izibonelelo zokukhubazeka iinyanga ezingama-24
• awuguquki iminyaka engama-65 kodwa ufumene ukuba une-ALS okanye i-ESRD

Kubantu abangabhalisanga ngokuzenzekelayo kwi-Medicare, kuyakufuneka ubhalise kwiwebhusayithi yoKhuseleko lweNtlalo. Ukuba awubhalisi ngexesha lokubhalisa, kukho izohlwayo zokubhalisa kade.

Zithini iindleko?

Iindleko zakho ze-Medicare ziya kuxhomekeka kuhlobo lwesicwangciso onaso.

Icandelo A iindleko

Icandelo le-Medicare Icandelo liquka:

• Icandelo lePremiyamu: isezantsi njenge- $ 0 (iPremiyamu engena-premium A) okanye ephezulu njenge- $ 471 ngenyanga, kuxhomekeke ekubeni wena okanye iqabane lakho nisebenze ixesha elingakanani ebomini
• Icandelo A litsale: I-1,484 yeedola ngexesha lokuxhamla
• Icandelo A ukuqinisekiswa: ukusukela kwi- $ 0 ukuya kwiindleko ezipheleleyo zeenkonzo ngokuxhomekeke kubude bokuhlala kwakho

Iindleko zeCandelo B

Iindleko ze-Medicare Icandelo B zibandakanya:

• Inxalenye yePrimiyamu: ukuqala kwi- $ 148.50 ngenyanga okanye ngaphezulu, ngokusekelwe kumvuzo wakho
• Icandelo B lichithwe: $ 203 ngonyaka
• Icandelo B isiqinisekiso: Iipesenti ezingama-20 zemali evunyiweyo ye-Medicare yeenkonzo zeCandelo B.

Iindleko zeCandelo C

Usaya kuhlawula iindleko zakuqala zeMedare xa ubhalisa kwiCandelo le-Medicare Part C. Izicwangciso ze-Medicare Advantage zinokuhlawulisa iindleko zesicwangciso, ezinokubandakanya:

• Intlawulo yanyanga le
• etsalwayo minyaka le
• iyeza elikhutshiweyo
• Iipopayments kunye noqinisekiso lwemali

Ezi ndleko zesicwangciso seMedicare Advantage zingahluka ngokuxhomekeke kwindawo ohlala kuyo kunye nomboneleli weinshurensi oyikhethayo.

Icandelo D iindleko

Uya kuhlawula ipremiyamu eyahlukileyo yesicwangciso seMedicare Part D, kunye nokuhlawulwa kweyeza lakho. Ezi mali ze-copayment ziyahluka ngokusekwe kumayeza akho amiselweyo awela kuwo. Isicwangciso ngasinye sineendleko ezahlukeneyo kunye neziyobisi ezifakwe kumanqanaba abo.

Iindleko zeMedigap

Uya kuhlawula ipremiyamu eyahlukileyo ngomgaqo-nkqubo weMedigap. Nangona kunjalo, gcinani engqondweni ukuba izicwangciso zeMedigap zenzelwe ukunceda ukuhlawula ezinye zeendleko zokuqala zeMedare.

Ezinye zeendlela zokuhlawula ityala lakho le-Medicare inyanga nenyanga zibandakanya:

• Iwebhsayithi yeMedare, kunye nekhredithi okanye ikhadi lekhredithi
• ngeposi, kusetyenziswa itsheki, iodolo yemali, okanye ifom yokubhatala

Enye indlela yokuhlawula i-Medicare bill yakho ibizwa ngokuba yi-Medicare Easy Pay. I-Medicare Easy Pay yinkonzo yasimahla ekuvumela ukuba uhlawule inyanga nenyanga ye-Medicare Icandelo A kunye neeprimiyamu zeCandelo B ngokurhoxa ibhanki ngokuzenzekelayo.

Ukuba ubhalisile kumacandelo e-Medicare A kunye no-B, unokufumana ngakumbi malunga nendlela yokubhalisa kwi-Medicare Easy Pay ngokunqakraza apha.

Uthini umahluko phakathi kweMedicare neMedicaid?

Unyango yinkqubo ye-inshurensi yezempilo exhaswa ngurhulumente efumanekayo kubantu baseMelika abaneminyaka engama-65 nangaphezulu kunye nabo baneemeko ezithile okanye abakhubazekileyo.

Unyango yinkqubo yeinshurensi yezempilo exhaswa ngurhulumente efumanekayo kubantu baseMelika abafanelekileyo abanengeniso ephantsi.

Unokufanelekela zombini i-Medicare kunye neMedicaid. Ukuba oku kuyenzeka, i-Medicare iya kuba yeyona inshurensi yakho iphambili kwaye iMedicaid iya kuba kukuhlawulwa kwesibini kweinshurensi ukukunceda kwiindleko kunye nezinye iinkonzo ezingafakwanga yiMedicare.

Ukufaneleka kweMedicaid kugqitywa ngurhulumente ngamnye kwaye kusekelwe kwezi ndlela zilandelayo:

• Ingeniso yonyaka
• ubukhulu bendlu
• ubume bosapho
• imeko yokukhubazeka
• inqanaba lokuba ngummi

Ungabona ukuba ukulungele na ukugubungela iMedicaid ngokunxibelelana okanye ngokundwendwela iofisi yakho yeenkonzo zentlalo ukuze ufumane ulwazi oluthe kratya.

Ukuthatha

I-Medicare lukhetho olukhethiweyo lweinshurensi yezempilo kubantu baseMelika abaneminyaka engama-65 nangaphezulu okanye abanokukhubazeka okuthile. Icandelo leMedicare A ligubungela iinkonzo zesibhedlele, ngelixa i-Medicare Icandelo B ligubungela iinkonzo zonyango.

Icandelo leMedicare D linceda ukuhlawula iindleko zamachiza amiselweyo, kunye nesicwangciso seMedigap sinceda ukuhlawula iindleko zeMedicare kunye neendleko zokuqinisekisa. Izicwangciso ze-Medicare ze-Advantage zibonelela ngokulula kwazo zonke iinketho zokugubungela endaweni enye.

Ukufumana nokubhalisa kwisicwangciso seMedicare kwindawo yakho, ndwendwela i-Medicare.gov kwaye usebenzise isixhobo sokufumana isicwangciso esikwi-Intanethi.

Eli nqaku lahlaziywa ngo-Novemba 18, 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.