Kutheni le nto ezinye iziCwangciso eziLuncedo zaMayeza zisimahla?

Umxholo

• Yintoni i-Medicare Advantage?
• Yintoni egqunywe kwizicwangciso 'zasimahla'?
• Ngaba ngokwenene 'kukhululekile'?
• Isicwangciso sokunceda ipremiyamu yenyanga
• Inxalenye B yipremiyamu yenyanga
• Ukutsalwa
• UQinisekiso / ukhuphelo
• Uhlobo lwesicwangciso
• Zithini iindleko zonyango?
• Icandelo lezaMayeza A
• Icandelo leMedare B
• Olunye ukhetho
• Ngaba uyakufanelekela ukufumana amayeza?
• Ngaba uyakufanelekela ukwenza izicwangciso 'zasimahla'?
• Ukuthatha

Ukuba ubusandul 'ukuyokuthenga izicwangciso ze-Medicare Advantage, usenokuba uqaphele ukuba ezinye zezi zicwangciso zibhengezwa njenge "mahala."

Izicwangciso ezithile zeAdvantage zibizwa ngokuba simahla kuba zibonelela nge- $ 0 yenyanga yenyanga yokubhalisa kwisicwangciso. Oku kwenza i-zero ye-premium ye-Medicare Advantage icwangcise isibonelelo esinomtsalane kwabo bafuna ukugcina imali kwiindleko ze-Medicare zenyanga.

Eli nqaku liza kuvavanya ukuba zithini na ezi zicwangciso zasimahla ze-Medicare Advantage, zeziphi iindleko ezongezelelekileyo onokuhlangabezana nazo, kwaye ngubani ofanelekileyo kwisicwangciso samahhala se-Medicare Part C.

Yintoni i-Medicare Advantage?

Uncedo lweMedare, ekwabizwa ngokuba yiMedicare Icandelo C, inikezelwa ziinkampani zeinshurensi zabucala kubantu abafanelekileyo abafuna ngaphezulu kokugubungela iMedicare yoqobo.

Izicwangciso ze-Medicare Advantage zibonelela ngezi zinto zilandelayo:

• Ukufakwa esibhedlele (i-Medicare Icandelo A). Oku kubandakanya iinkonzo ezinxulumene nesibhedlele, ukhathalelo lwempilo lwasekhaya, ukhathalelo lwasekhaya lokonga, kunye nokunyamekela abaguli.
• Ukukhutshwa kwezonyango (Icandelo leMedicare B). Oku kubandakanya ukuthintela, ukufumanisa isifo, kunye nonyango lweemeko zonyango.

Izicwangciso ezininzi zokuNceda zikwabandakanya iimfuno ezongezelelweyo zonyango, ezinje:

• Ukukhutshwa kweziyobisi ngugqirha
• wamazinyo, umbono, kunye nokugubungela ukuva
• ukhuseleko lomzimba
• ezinye izinto zempilo

Xa ukhetha isicwangciso seMedicare Advantage kwinkampani yabucala, kukho iindlela ezahlukeneyo onokukhetha kuzo. Uninzi lwezicwangciso zokuNceda zi:

• Izicwangciso zoMbutho wezeMpilo (HMO). Ezi nkonzo zigquma koogqirha abakunethiwekhi kunye nababoneleli kuphela.
• Izicwangciso zoMbutho woMboneleli okhethiweyo (PPO). Ezi ntlawulo zibiza amaxabiso awohlukeneyo ngeenkonzo zenethiwekhi kunye nezangaphandle.

Kukho ezinye izicwangciso ezintathu zezicwangciso ze-Medicare Part C:

• Izicwangciso zabucala zeNkonzo-yeNkonzo (PFFS). Ezi zezicwangciso zokuhlawula ezizodwa ezibonelela ngenkxaso yokubonelela ngombane.
• Izicwangciso zeMfuno eziZodwa (SNP). Olu lukhetho lokugubungela abantu abaneemeko zonyango lwexesha elide.
• Izicwangciso zeakhawunti yoLondolozo lwezoNyango iMedicare (MSA). Ezi zicwangciso zidibanisa isicwangciso sezempilo esitsalwayo esiphakamileyo kunye neakhawunti yokonga yezonyango.

Yintoni egqunywe kwizicwangciso 'zasimahla'?

Izicwangciso zasimahla zoLuncedo kwiMedare zizicwangciso zeCandelo leMedicare ezibonelela ngepremiyamu yonyaka eyi- $ 0.

Xa kuthelekiswa nezinye izicwangciso ze-Medicare, ezi zicwangciso zeprimiyamu ye-Medicare Advantage azihlawulisi mali ngonyaka ukuba zibhaliswe kwisicwangciso.

Ngokubanzi akukho mahluko kukugubungela isicwangciso sasimahla kunye nesicwangciso esihlawulelweyo. Nokuba zithini iindleko, uninzi lwezicwangciso ze-Medicare Part C zibonelela ngamacandelo A no-B, amayeza amiselweyo, kunye nolunye uhlobo olongezelelweyo.

Ke, kutheni iinkampani zibonelela ngezi zicwangciso ze-premium ze-Medicare? Xa inkampani ingena kwisivumelwano neMedicare, inikwa isixa semali esigqibeleleyo sokugubungela i-inshurensi ye-A kunye ne-B.

Ukuba inkampani inokugcina imali kwenye indawo, njengokusebenzisa ababoneleli benethiwekhi, inokukwazi ukugqithisela olo londolozo longezelelekileyo kumalungu. Oku kunokubangela ipremiyamu yasimahla yenyanga.

Ezi zicwangciso zeMedicare Advantage ziyindlela efanelekileyo yokuba iinkampani zibhengeze ukonga okunomtsalane kwabo banokuba ngabaxhamli.

Ngaba ngokwenene 'kukhululekile'?

Nangona izicwangciso zeprimiyamu ze-Medicare Advantage zithengiswa simahla, kuya kufuneka uhlawule iindleko zokuphuma epokothweni zokugubungela.

Isicwangciso sokunceda ipremiyamu yenyanga

Ukuba isicwangciso seMedicare Advantage simahla, awuzukuhlawula ipremiyamu yenyanga ukuze ubhalise.

Inxalenye B yipremiyamu yenyanga

Uninzi lwezicwangciso ze-Medicare Advantage zisabiza intlawulo yenyanga eyahlukileyo yenyanga. Ezinye izicwangciso ziya kuyigubungela le mali, kodwa abanye abanako.

Inxalenye B yenyanga yenyanga iqala kwi- $ 135.50, okanye ngaphezulu ngokuxhomekeke kumvuzo wakho.

Ukutsalwa

Zimbini iintlobo zokutsalwa konyaka ezinxulunyaniswa nezicwangciso ezininzi zeMedicare Advantage:

• Isicwangciso ngokwaso sinokuba nokutsalwa ngonyaka, okuyimali ephumayo epokothweni oyihlawulayo ngaphambi kokuba i-inshurensi yakho ihlawule.
• Isicwangciso sinokukuhlawulisa iziyobisi.

UQinisekiso / ukhuphelo

Uninzi lwezicwangciso ze-Medicare Advantage zihlawulisa iintlawulo zokutyelela. Intlawulo ekhutshiweyo ngumrhumo ophuma epokothweni owuhlawulayo ngalo lonke ixesha ufumana iinkonzo zonyango.

Ezinye izicwangciso zinokuhlawulisa i-coinsurance. Le yipesenti yazo zonke iindleko zonyango onoxanduva lokuhlawula.

Uhlobo lwesicwangciso

Izicwangciso zeMedare eziluncedo zinokwahluka kwiindleko ngokusekwe kubume bazo. Umzekelo, iiplani ze-PPO zihlawulisa imali eyahlukeneyo yokuhlawula ngokusekwe ekubeni umboneleli wakho ukwi-network okanye ngaphandle kwenethiwekhi.

Ezi ndleko zinokwahluka unyaka nonyaka. Umzekelo, izicwangciso ze-PFFS ziye zafumana ukwanda kwepesenti encinci kwiindleko minyaka le kule minyaka imbalwa idlulileyo.

Zithini iindleko zonyango?

I-Medicare ayisiyi-inshurensi yezempilo yasimahla. Kukho iindleko ezininzi ezahlukeneyo ezinxulunyaniswa nokugubungela iMedare.

Ngaphambi kokuba ubhalise kwisicwangciso se-Medicare Advantage, kufuneka ube neendawo ze-Medicare kunye ne-B. Apha ngezantsi uyakufumana iindleko ezinxulumene nezo zicwangciso.

Icandelo lezaMayeza A

Icandelo leMedicare A lihlawula ipremiyamu yenyanga, enokuthi isuke kwi-240 ukuya kwi-437 yeedola. Nangona kunjalo, abantu abaninzi baxolelwe kule ntlawulo.

Ukuba uhlawule irhafu ye-Medicare ngelixa usebenza okanye ufumana (okanye ulungele) uKhuseleko lweNtlalo okanye izibonelelo zomhlala phantsi zikaloliwe, unokuxolelwa.

Icandelo le-Medicare A libiza imali eyi-1,364 yeedola kwisibonelelo ngasinye kunye nesixa semali esihlawulwa kwi-341 ukuya kwi-682 yeedola.

Icandelo leMedare B

I-Medicare Icandelo B lihlawulisa i-premium yenyanga eyi-135.50 okanye ngaphezulu, kuxhomekeke kumvuzo wakho wonyaka. Uya kuba netyala lePremiyamu yeCandelo B njengenxalenye yesicwangciso sakho samahhala seMedare ngaphandle kokuba sigutyungelwe sisicwangciso.

I-Medicare Icandelo B likwahlawulisa i-185 yeedola ngonyaka, emva koko uyakutyala isixa semali esingama-20 seepesenti kuzo zonke iinkonzo.

Olunye ukhetho

Ukuba ukhetha ukubhalisa kwisicwangciso sokuncedisa kwi-Medicare njenge-Medicare Part D okanye iMedigap njengenye indlela ye-Medicare Advantage, uya kuba neprimiyamu yenyanga kunye nezinye iindleko ezinxulumene nezi zicwangciso.

Iindleko zeMedicare D kunye neMedigap zichongiwe sisicwangciso osikhethayo.

Ngokungafaniyo nokuphuma epokothweni okuphezulu kunye nesicwangciso seMedicare Advantage, akukho mda kumyinge weendleko zokuphuma epokothweni oza kuzihlawula kumayeza e-Medicare A, B, D, okanye eMedigap.

Ngaba uyakufanelekela ukufumana amayeza?

Ufanelekile kwi-Medicare phantsi kwezi ndlela zilandelayo:

• Uneminyaka engama-65 okanye ngaphezulu. Bonke abantu baseMelika abaneminyaka engama-65 okanye nangaphezulu bafaneleke ngokuzenzekelayo kwi-Medicare. Unokufaka isicelo seMedicare ukuya kwiinyanga ezintathu ngaphambi kokuzalwa kwakho kwama-65.
• Ukhubazekile. Nokuba ungaphantsi kweminyaka engama-65, uvumelekile ukuba ufumane i-Medicare ukuba ufumana iintlawulo zokukhubazeka kwezentlalo. Ukhuseleko lwezeNtlalontle lubonelela ngezibonelelo zokukhubazeka malunga neendidi ezili-14 zokukhubazeka.
• Unayo i-ALS. Ukuba unayo i-ALS kwaye ufumana izibonelelo zokukhubazeka, uyafaneleka ngokuzenzekelayo kwi-Medicare.
• Unesifo sezintso zokuphela kwenqanaba. Ukuba unesifo sezintso esisigxina, uyakufanelekela ukufumana unyango. Nangona kunjalo, kubalulekile ukuba uqaphele ukuba abantu abanale meko abafanelekanga ukuphucula isicwangciso se-Medicare Advantage.

Iikhrayitheriya ezithile, ezinje ngokufumana izibonelelo zokukhubazeka iinyanga ezingama-24, ziya kuthi zikubhalise ngokuzenzekelayo kwi-Medicare ngenyanga ye-25. Ukuba kunjalo, awudingi ukuzibhalisela icandelo lama-Medicare A no-B.

Nangona kunjalo, ukuba ufanelekile kwi-Medicare kodwa ungabhaliswanga ngokuzenzekelayo, kuya kufuneka ufake isicelo kwiwebhusayithi yoKhuseleko lweNtlalo.

Ngaba uyakufanelekela ukwenza izicwangciso 'zasimahla'?

Akukho ziqinisekiso kwizicwangciso zasimahla zeMedicare. Uninzi lwezicwangciso zokuNceda zibonelela ngeprimiyamu yasimahla yenyanga njengenxalenye yesicwangciso sabo sezempilo.

Unokufumana izicwangciso zeMedicare Part C kwindawo yakho nge- $ 0 yeprimiyamu ngokusebenzisa i-Medicare.gov's Fumana isixhobo sesicwangciso seMedicare ka-2020.

Ngexesha lokukhangela kwakho, ungasebenzisa "Uhlobo lokuhlenga nge: Eyona mali iphantsi yenyanga" ukuze ubone iipremiyamu ze-Medicare Advantage kwindawo yakho.

Enye yezona ndlela zibalulekileyo zokulawula iindleko zakho zeMedicare kukusebenzisa izixhobo ezikhoyo ukunceda ukogquma okanye ukunciphisa iindleko zakho. Ezi zixhobo zibandakanya:

• Unyango. Le nkqubo incedise ekuhlawuleni iindleko zonyango ngaphezu kwabantu abanengeniso ephantsi okanye abangenazo izixhobo zokuhlawula iindleko zonyango.
• Iinkqubo zoLondolozo lweMedare. Ezi nkqubo zinokunceda abaxhamli bemivuzo ephantsi bahlawule iipremiyamu zeMedicare Advantage, ezitsalwayo, iikopayments kunye nokuqinisekiswa kwemali.
• Ukhuseleko lweNtlalo. Esi sibonelelo sinika abantu abakhubazekileyo, abangaboniyo, okanye ngaphezulu kwe-65 yokuhlawula inyanga nenyanga, ezinokukunceda ekuhlawuleni iindleko zeMedicare.
• Izixhobo ezongezelelweyo. Kukho ezinye iinkqubo ezinokubonelela ngoncedo kubantu abahlala kwimimandla ethile yase-U.S. Okanye abaneendleko eziphezulu zeziyobisi.

Enye indlela yokugcina umkhondo weendleko zakho ze-Medicare Advantage kukunika ingqalelo ubungqina boKhuseleko kunye neSaziso soNyaka soTshintsho ukuba izicwangciso zakho zikuthumela unyaka nonyaka. Oku kuya kukunceda uhlale phezulu kulo naluphi na utshintsho lwamaxabiso okanye ukunyuswa kwemali.

Ukuthatha

Izicwangciso zasimahla ze-Medicare eziluncedo zi-inshurensi yabucala ye-Medicare enikezela i-premium yenyanga eyi-0.

Ngelixa ezi zicwangciso zipapashwa simahla, kuya kufuneka uhlawule iindleko ezisemgangathweni eziphuma epokothweni zezinye iipremiyamu, iimali ezixhuzulwayo, kunye neentlawulo ezikhutshiweyo.

Ukuba ukulungele ukufumana i-Medicare kwaye ubhalise kumacandelo A no-B, ungasebenzisa esi sixhobo sokufumana isicwangciso se-Medicare sango-2020 ukukhangela izicwangciso zeprimiyamu ye-Medicare Advantage kwindawo yakho.

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.