Umahluko ophambili phakathi kweSibonelelo seMedare kunye neNcediso yeziCwangciso zoNyango

Umxholo

• Yintoni i-Medicare Advantage?
• Yintoni iMedicare Supplement?
• Ukuthelekisa izicwangciso
• Ngaba ufanelekile?
• Iindleko zesicwangciso seLungelo ngokuchasene neMedigap
• Iindleko zokuLuncedo kwiMedicare
• Uncedo lweMedicare lulungile kuwe ukuba:
• Uncedo lweMedicare alulungelanga wena ukuba:
• Iindleko zokuNcedisa iMedare
• Ukhuselo lwe-Medicare Supplement lunokulungela wena ukuba:
• Ukhuselo lwe-Medicare Supplement alunakulunga kuwe ukuba:
• Ukunceda umntu abhalise?
• Ukuthatha

Ukukhetha i-inshurensi yezempilo sisigqibo esibalulekileyo kwimpilo yakho nakwixesha elizayo. Ngethamsanqa, xa kufikwa ekukhetheni i-Medicare, unokhetho.

Uncedo lweMedicare (Icandelo C) kunye neMedare Supplement (iMedigap) zizicwangciso ezongezelelweyo ezidityaniswa neMedicare yakho yoqobo (iinxalenye A no-B). Banokubonelela ngokwezifiso ozifunayo ukuze uhlangane neemfuno zakho zokhathalelo lwempilo.

Zombini ezi zicwangciso zenzelwe ukubonelela ngesigqubuthelo esingenakho ezinye iinxalenye zeMedare. Nangona kunjalo, awunakuthenga Zombini Uncedo lweMedicare kwaye IMedigap.

Ukuba ufuna ukhuselo olongezelelweyo lweMedare, kufuneka ukhethe iAddare Advantage okanye IMedigap.

Ukuba oko kuvakala kudideka, ungakhathazeki. Siza kuchaza apha ngezantsi.

Yintoni i-Medicare Advantage?

Izicwangciso ze-Medicare eziluncedo ziinketho zeinshurensi zabucala zokugubungela iMedare Ezi zicwangciso zigubungela okwenziwa yiMedicare yoqobo, kubandakanya:

• ukulaliswa esibhedlele
• ezonyango
• amayeza amiselweyo

Kuxhomekeke ekubeni sisiphi isiCwangciso seNzuzo osikhethayo, isicwangciso sakho sinokugubungela:

• zamazinyo
• umbono
• ukuva
• ubulungu bomthambo
• ukuthuthwa kwabaqeshwa bezonyango

I-Medicare.gov inezixhobo zokukunceda ufumane isiCwangciso seNzuzo ye-Medicare ehlangabezana neemfuno zakho.

Yintoni iMedicare Supplement?

I-Medicare Supplement, okanye iMedigap, iseti eyahlukileyo yezicwangciso ezikunceda ukukhupha iindleko ezipokothweni kunye nezinto ezingafakwanga nganto kwisicwangciso sakho sokuqala seMedare, njengee-copayments kunye ne-coinsurance.

Ukusukela nge-1 kaJanuwari 2020, izicwangciso ezisandula ukuthengwa zeMedigap azigubungeli iCandelo B. Ungathenga iMedigap ukongeza kolunye ugcino lweMedicare (iinxalenye A, B, okanye D).

I-Medicare.gov inezixhobo zokukunceda ufumane isicwangciso seMedigap esihlangabezana neemfuno zakho.

Ukuthelekisa izicwangciso

Ukukunceda uthelekise, nazi zombini izicwangciso ecaleni:

Ngaba ufanelekile?

Kukho iimfuno ezininzi ekufuneka uhlangabezane nazo ukuze ufaneleke kwi-Medicare Advantage okanye kwi-Medigap plans. Nantsi indlela yokuxelela ukuba uyafaneleka na kwi-Medicare Advantage okanye kwi-Medicare Supplement:

• Ukufaneleka kweNcedo lweMedare:
  • Ufanelekile kwiCandelo C ukuba ubhalise kwicandelo A no-B.
  • Ufanelekile kwi-Medicare Part A no-B ukuba uneminyaka engama-65 okanye ngaphezulu, ukhubazekile, okanye unesifo se-renal.
• Ulungelelwaniso lwe-Medicare Supplement coverage:
  • Ufanelekile eMedigap ukuba ubhalisile kumacandelo e-Medicare A kunye no-B.
  • Awukabhalisi kwi-Medicare Advantage.
  • Uyahlangabezana neemfuno zikarhulumente wakho zokugubungela iMedigap.

Iindleko zesicwangciso seLungelo ngokuchasene neMedigap

Ungathenga i-Medicare Advantage, okanye i-Medicare Part C, ngokusebenzisa umboneleli wabucala ovunyiweyo njengenxalenye yokugubungela i-Medicare yakho. Iindleko zesicwangciso ngasinye zichazwe ngokwahlukileyo. Funda ukuze ufumane inkcazo yendlela iipremiyamu kunye nemirhumo ezimiselwe ngayo.

Iindleko zokuLuncedo kwiMedicare

Njengalo naliphi na elinye icebo leinshurensi, iipremiyamu zokuxhamla kwiMedare ziyahluka kwibhodi ngokuxhomekeke kumboneleli okhetha ukubhalisa kuye kunye nesicwangciso osikhethayo.

Ezinye izicwangciso azinayo i-premium yenyanga; abanye babiza amakhulu amawaka eedola. Kodwa akunakulindeleka ukuba ubhatale ngaphezulu kweCandelo C kunokuba usenza kwiCandelo B.

Ukongeza, iindleko ezinje ngee-copays kunye neze-deductibles ziya kwahluka ngokwesicwangciso. Eyona nto ukubheja kwakho kukumisela iindleko ezinokubakho kwisicwangciso sakho seMedicare Advantage kukuthelekisa ngononophelo iiplani ngelixa uthenga.

Sebenzisa isixhobo seMedicare.gov ukunceda ukuthelekisa izicwangciso zeMedicare kunye nexabiso.

Eminye imiba enokuthi ichaphazele iindleko zezicwangciso ze-Medicare Advantage zibandakanya:

• loluphi uhlobo lwesicwangciso osikhethayo
• ufuna kangaphi ukufikelela kwiinkonzo zonyango
• apho ufumana khona unyango lwakho (kwinethiwekhi okanye ngaphandle kwenethiwekhi)
• umvuzo wakho (oku kungasetyenziselwa ukumisela ipremiyamu yakho, idizithiwe, kunye nemali ekhutshelweyo)
• ukuba unoncedo lwezezimali njengeMedicaid okanye ukukhubazeka

Uncedo lweMedicare lulungile kuwe ukuba:

• Sele unamacandelo A, B, no-D.
• Unomboneleli ovunyiweyo osele umthanda, kwaye uyazi ukuba bayazamkela izicwangciso zeMedicare kunye neMedicare Advantage.
• Ufuna ezinye izibonelelo ezigutyungelweyo, njengokuva, umbono kunye namazinyo.
• Kungcono ulawule isicwangciso esinye kuzo zonke iimfuno zakho zeinshurensi.

Uncedo lweMedicare alulungelanga wena ukuba:

• Uhamba kakhulu okanye ucwangcise ukuya kwi-Medicare. (Kuya kufuneka uphile ngaphakathi kwendawo yokugubungela isicwangciso sakho, ngaphandle kongxamiseko.)
• Ufuna ukugcina umboneleli ofanayo unyaka nonyaka. (Iimfuno zababoneleli abavunyiweyo ziyatshintsha qho ngonyaka.)
• Ufuna ukugcina inqanaba elifanayo. (Amaxabiso ayatshintsha qho ngonyaka.)
• Unenkxalabo malunga nokuhlawulela ukhuseleko olongezelelweyo ongayi kulusebenzisa.

Iindleko zokuNcedisa iMedare

Kwakhona, isicwangciso ngasinye seinshurensi siyahluka kwixabiso ngokusekwe kukufaneleka kwakho kunye nohlobo lokugubungela olufunayo.

Ngezicwangciso zoNyango lweMedare, ukufihla okungakumbi okufunayo, iindleko ziphezulu. Ukongeza, umdala xa ubhalisa, ipremiyamu ephezulu onokuba nayo.

Sebenzisa isixhobo seMedicare.gov ukunceda ukuthelekisa amaxabiso oNyango lweMedare.

Izinto ezinokuchaphazela indleko yokugubungela iMedigap yakho ibandakanya:

• ubudala bakho (umdala xa ufaka isicelo, ngakumbi unokuhlawula)
• isicwangciso osikhethayo
• ukuba ukulungele ukufumana isaphulelo (ongatshayiyo, owasetyhini, ohlawula ngombane, njl.
• Ukutsalwa kwakho (isicwangciso esiphakamileyo esitsalwayo sinokubiza imali encinci)
• xa uthenge icebo lakho (imigaqo inokutshintsha, kwaye icebo elidala linokubiza imali encinci)

Ukhuselo lwe-Medicare Supplement lunokulungela wena ukuba:

• Ukhetha ukukhetha inani lokugubungela iindleko ezingaphandle kwepokotho ozithengayo.
• Udinga uncedo lokugubungela iindleko ezipokothweni.
• Sele unayo ingxelo oyidingayo ngombono, amazinyo, okanye ukuva.
• Uceba ukuhamba ngaphandle kwe-United States kwaye ufuna ukuzilungiselela.

Ukhuselo lwe-Medicare Supplement alunakulunga kuwe ukuba:

• Sele unesicwangciso seNzuzo yokuNyanga. (Akukho semthethweni ukuba inkampani ikuthengisele iMedigap xa sele unayo i-Medicare Advantage.)
• Ufuna ukugubungela ixesha elide okanye ukhathalelo lwe-hospice.
• Awusebenzisi ukhathalelo lwempilo oluninzi kwaye awuhlali uhlangabezana nenciphiso yakho yonyaka.

Ukunceda umntu abhalise?

Ukubhalisa kwi-Medicare kunokudideka. Ukuba unceda umhlobo okanye ilungu losapho ukubhalisa, kukho izinto ezimbalwa onokuzenza ukwenza inkqubo ibe lula.

Nazi ezinye iingcebiso zokunceda obathandayo babhalise kwi-Medicare:

• Xoxa ukuba loluphi na ukhathalelo lwempilo kunye neemfuno zokugubungela.
• Thatha isigqibo malunga nohlahlo-lwabiwo mali olufikelelekayo noluchanekileyo lweinshurensi.
• Lungisa ulwazi lwakho kunye nolwazi lomntu omthandayo woKhuseleko loLuntu. Basenokufuna ukwazi ukuba ungubani kunye nolwalamano lwakho nomntu omncedayo ukubhalisa.
• Thetha nomntu wakho omthandayo malunga nokuba bazakudinga ukhuselo olongezelelweyo njengeCandelo C okanye iMedigap.

Ngelixa unokunceda umntu wakho ukuba avavanye izicwangciso kwaye aqonde ukhetho lwabo, awungekhe ubhalise omnye umntu kwi-Medicare ngaphandle kokuba unegunya elinamandla legqwetha laloo mntu. Olu luxwebhu olusemthethweni olukunika imvume yokwenza izigqibo egameni lomnye umntu.

Ukuthatha

• Ukufakwa kwe-Medicare kubonelela ngeendlela ezahlukeneyo zokukhetha.
• Uncedo lweMedicare lugubungela icandelo lakho A, B, kwaye uhlala u-D ecwangcisa nangaphezulu.
• IMedigap inceda ukuhlawula ngaphandle kweepokotho iindleko ezinje ngee-copays kunye ne-coinsurance.
• Awunakho ukuzithenga zombini, ke kubalulekile ukuba wazi iimfuno zakho kwaye ukhethe ukhetho oludibana nazo.

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.