Ndingarhoxa nini kwisicwangciso sam seMedicare?

Umxholo

• Ndingabhalisa nini okanye ndilahle isicwangciso seMedare?
• Ubhaliso lokuqala
• Ubhaliso oluvulekileyo
• Ubhaliso olulodwa
• Izizathu zokuwisa okanye ukutshintsha isicwangciso sakho
• Ungayikhetha njani ingxelo efanelekileyo
• Amanyathelo alandelayo: Ungazikhusela njani okanye utshintshe izicwangciso
• Ukuthatha

• Izicwangciso ze-Medicare ze-Advantage zibonelela nge-Medicare yoqobo kodwa zihlala zinezibonelelo ezongezelelweyo.
• Emva kokuba ubhalisele i-Medicare Advantage, ukhetho lwakho lokulahla okanye ukutshintsha isicwangciso sakho lukhawulelwe kumaxesha athile.
• Ngala maxesha, ungabuyela kwiMedicare yoqobo okanye tshintshela kwisicwangciso esahlukileyo seMedicare.

Uyenzile uphando lwakho kwaye wenze umtsi ukusuka kwi-Medicare yoqobo ukuya kwi-Medicare Advantage. Kodwa kwenzeka ntoni xa utshintsha ingqondo yakho okanye uthatha isigqibo sokuba ayisosicwangciso silungileyo kuwe? Ukuba ufuna ukungabhalisi okanye utshintshe isicwangciso sakho seMedicare Advantage, kuya kufuneka ulinde ubhaliso oluthile windows, ezifanayo naxa ubhalisela okokuqala.

Siza kudlulela kwelinye lala maxesha obhaliso, sichaze ukuba loluphi uhlobo lwesicwangciso onokuthi ulukhethe ngala maxesha, indlela yokukhetha esona sicwangciso silungileyo, kunye nokunye.

Ndingabhalisa nini okanye ndilahle isicwangciso seMedare?

Uncedo lweMedicare yimveliso oyikhethayo oyithenga ngomboneleli wabucala weinshurensi. Idibanisa yonke imiba ye-Medicare yoqobo (Icandelo A kunye neCandelo B) kunye neenkonzo ezongeziweyo okanye ezinganyanzelekanga ezinje ngeMedicare Part D yokugubungela amayeza kunye neinshurensi yokuxhasa.

Eyaziwa nangokuthi yi-Medicare Part C, i-Medicare Advantage sisicwangciso sokudibanisa sabucala esibonelela ngokugubungela isigulana esibhedlele kunye nesigulana esingaphandle sogqatso kunye neenkonzo ezongezelelweyo.

Ubhaliso lokuqala

Ungabhalisela i-Medicare Advantage xa ​​uqala ukufumana iMedicare. Ufanelekile kwi-Medicare ngomhla wokuzalwa kwakho wama-65, kwaye ungayibhalisela le nkqubo kwisithuba seenyanga ezisi-7 (iinyanga ezi-3 ngaphambi kokuba ube neminyaka engama-65, inyanga yokuzalwa kwakho, kunye neenyanga ezi-3 emva).

Ukuba ubhalisa ngeli xesha, kulapho unokulindela ukuba ukhuseleko luqale:

• Ukuba ubhalisa ngexesha le Kwiinyanga ezi-3 ngaphambili usuku lwakho lokuzalwa lwama-65, ukugubungela kwakho kuqala kusuku lokuqala lwenyanga emva kokuba ubeneminyaka engama-65 ubudala (umzekelo: usuku lwakho lokuzalwa nguMeyi 15 kwaye ubhalisa ngoFebruwari, Epreli, okanye ngoMatshi, ingxelo yakho iya kuqala ngoMeyi 1).
• Ukuba ubhalisa phakathi enyangeni umhla wokuzalwa kwakho, ukhuselo lwakho luza kuqala kwinyanga enye emva kokuba ubhalisile.
• Ukuba ubhalisa ngexesha le Kwiinyanga ezi-3 emva usuku lwakho lokuzalwa, ukogquma kwakho kuqala kwiinyanga ezi-2 ukuya kwezi-3 emva kokuba ubhalisile.

Ukuba ukhetha isicwangciso se-Medicare Advantage ngexesha lokubhaliswa kokuqala, ungatshintshela kwelinye icebo le-Medicare Advantage okanye ubuyele kwi-Medicare yasekuqaleni kwiinyanga ezintathu zokuqala zokugubungela.

Ubhaliso oluvulekileyo

Emva kokuba ubhalisile ngexesha lokubhalisa kokuqala, kukho amaxesha ambalwa kuphela unyaka xa unokutshintsha okanye ulahle i-Medicare Advantage coverage. Ezi zihlandlo zenzeka ngexesha elifanayo ngonyaka.

• Ixesha elibhalisiweyo lokuvula amayeza (ngo-Okthobha u-15-Disemba 7). Eli lixesha lonyaka onokuthi uphonononge ukogquma kwakho kwaye wenze utshintsho xa kufuneka njalo. Ngeli xesha, unokwenza utshintsho kwisicwangciso sakho sokuqala seMedicare, ubhalisele i-Medicare Advantage okanye i-Medicare Part D, okanye utshintshe isicwangciso esinye se-Medicare Advantage siye kwesinye.
• Unyango lweMedicare ithuba lonyulo lonyaka (nge-1 Januwari-Matshi 31). Ngeli xesha, ungatshintsha ukusuka kwi-Medicare Advantage ubuyele kwi-Medicare yasekuqaleni kunye nokunye. Unokutshintsha kwisicwangciso seMedicare Advantage okanye ukongeze iCandelo le-Medicare Part D.

Ukubhalisa okanye ukutshintsha izicwangciso ngala maxesha athile kunokukunceda uphephe izohlwayo zokubhaliswa kade.

Ubhaliso olulodwa

Kukho iimeko ezizodwa ezingaphandle kolawulo lwakho, njengokufudukela kwindawo apho isicwangciso sakho singasebenziyo. Kwezi ntlobo zeemeko, i-Medicare ikuvumela ukuba wenze utshintsho ngaphandle kwamaxesha aqhelekileyo ngaphandle kwesihlwayo.

Amaxesha obhaliso akhethekileyo aqala ukusebenza xa uwafuna. Umzekelo, ukuba ufudukile kwaye isicwangciso sakho sangoku seMedicare Advantage asiyigubungeli indawo entsha ohlala kuyo, ixesha lakho lokubhalisa elikhethekileyo lingaqala kwinyanga engaphambi kokuhamba kwakho emva kweenyanga ezi-2 emva kokuba ushukume. Amaxesha okubhalisa awodwa aqala xa uwafuna kwaye ahlala malunga neenyanga ezimbini emva kwesiganeko esifanelekileyo.

Eminye imizekelo embalwa yezi ziganeko iya kuba:

• ungene okanye uphuma kwindawo yokuhlala abaguli (indawo yononophelo enobuchule, indawo yokuhlala encedisayo, njl.
• awusakulungelanga ukugubungela iMedicaid
• Unikwa ingxelo ngomqeshi okanye umbutho wabasebenzi
  

Siza kuxoxa ngakumbi ngezizathu onokuthi ufune ukutshintsha izicwangciso kwicandelo elilandelayo.

Nokuba iimfuno zakho zitshintshile, ufudukile, okanye awuyithandi nje isicwangciso sakho sangoku, amaxesha ahlukeneyo obhaliso akuvumela ukuba wenze naluphi na utshintsho olufunekayo. Oku akuthethi nje ukuba kufuneka ubuyele kwi-Medicare yoqobo-ungasoloko utshintsha isicwangciso esinye se-Medicare Advantage siye kwesinye. Uyakwazi ukutshintsha ugqirha wakho wokugubungela amayeza ngokunjalo.

Izizathu zokuwisa okanye ukutshintsha isicwangciso sakho

Ngelixa umgudu omkhulu usenza isigqibo sokuqala kwizicwangciso zeMedare, unokufuna ukutshintsha ngenxa yezizathu ezahlukeneyo. Mhlawumbi isicwangciso sitshintshe iminikelo yayo, okanye iimfuno zakho zitshintshile.

Ukuba isicwangciso sakho se-Medicare Advantage asihlangabezani neemfuno zakho, unokufuna ukubuyela kwi-Medicare yasekuqaleni okanye utshintshe izicwangciso zeCandelo C. Ungadinga ukongeza okanye ukutshintsha isicwangciso sakho sokuyalela, tshintshela kwisicwangciso seMedicare Advantage esigubungela ababoneleli okanye iinkonzo ezahlukeneyo, okanye ufumane isicwangciso esigubungela indawo entsha.

Ezinye zezizathu eziqhelekileyo zokutshintsha izicwangciso zibandakanya:

• ufudukile
• ulahlekelwe kukugubungela okwangoku
• unethuba lokufumana ingxelo komnye umthombo, njengomqeshi okanye umbutho wabasebenzi
• I-Medicare iphelisa isivumelwano sayo nesicwangciso sakho
• umboneleli wakho uthatha isigqibo sokuba anganikeli isicwangciso sakho kwakhona
• uyafaneleka ukufumana iinkonzo ezongezelelweyo, njengoNcedo olongezelelweyo okanye iSicwangciso seMfuno eziZodwa

Zonke ezi meko zingasentla ziya kulungela ixesha elithile lobhaliso.

Ungayikhetha njani ingxelo efanelekileyo

Zininzi izinto ekufuneka ziqwalaselwe xa ukhetha isicwangciso seMedare, kwaye iimfuno zakho okanye iimali zakho zinokutshintsha ezantsi kwendlela. Linganisa ngononophelo ukhetho lwakho ekuqaleni, ugcine iimfuno zakho zangoku nezexesha elizayo kunye nohlahlo-lwabiwo mali lwakho.

Izicwangciso ze-Medicare Advantage zibonelela ngeenkonzo ezongezelelekileyo kodwa ziya kubiza ngaphezulu kwe-Medicare yoqobo. Ezinye zeendleko ozihlawula kwangaphambili kunye neMedicare Advantage inokukugcinela imali ekuhambeni kwexesha, ngakumbi kwiinkonzo ezongezelelekileyo ezinje ngokugqunywa ngugqirha, umbono kunye nokunakekelwa kwamazinyo.

Ukuba uhamba nesicwangciso seMedicare Advantage, kuya kufuneka uphinde uphonononge ubungakanani bomgangatho wesicwangciso nokuba ngaba ababoneleli bakho bezempilo abakhoyo okanye abakhethiweyo banamanethiwekhi. Thelekisa izicwangciso ngononophelo ukuze ufumane enye ehambelana neemfuno zakho ezithile.

Kuya kufuneka uphonononge isicwangciso sakho sokukhetha amayeza, ucinga ukuba zeziphi izicwangciso ezigubungela amayeza akho. Isicwangciso ngasinye kufuneka sichaze uluhlu lweendleko zamachiza ohlukeneyo. Qinisekisa ukuba into oyifunayo ihlawulwe ngexabiso onokufikelela ngalo.

Amanyathelo alandelayo: Ungazikhusela njani okanye utshintshe izicwangciso

Nje ukuba uthathe isigqibo sokulahla okanye sokutshintsha isicwangciso sakho seMedicare, inyathelo lokuqala kukubhalisa kwisicwangciso esitsha osikhethileyo. Yenza oku ngokugcwalisa isicelo sobhaliso ngesicwangciso esitsha ngexesha elivulekileyo okanye lobhaliso olukhethekileyo ukunqanda izohlwayo. Emva kokuba ubhalisile ngesicwangciso esitsha kunye nokuqala kwakho ukugubungela, uya kukhutshwa ngokuzenzekelayo kwisicwangciso sakho sangaphambili.

Ukuba ushiya i-Medicare Advantage ukubuyela kwi-Medicare yoqobo, ungatsalela umnxeba i-800-MEDICARE ukuze uphinde uqalise iinkonzo zangaphambili ze-Medicare.

Ukuba unengxaki, ungaqhagamshelana noLawulo lweNtlalo yoKhuseleko, eqhuba inkqubo ye-Medicare, okanye i-SHIP yakho yasekhaya (Inkqubo yoNcedo lwe-Inshurensi yezeMpilo).

Ukuthatha

• Izicwangciso ze-Medicare Advantage ziyanda kwiinkonzo kunye nokugubungela okunikezelwa yiMedicare yoqobo, kodwa zinokubiza ngaphezulu.
• Ukuba ubhalisile kwisicwangciso seMedicare Advantage, ungatshintsha izicwangciso zeAdvantage okanye ubuyele kwiMedicare yoqobo ngexesha elithile lamaxesha.
• Ukuthintela izohlwayo, kuya kufuneka utshintshe okanye ulahle izicwangciso ngexesha lokubhaliswa okuvulekileyo okanye lonyaka, okanye ujonge ukuba ulilungele na ixesha elithile lobhaliso.

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.