Ungasikhansela nini futhi kanjani isimangalo se-Medicare osifakile

-Delile

• Ngisikhansela kanjani isimangalo seMedicare engizifakele sona?
• Ngingakwazi ukuhlola isimo sezimangalo zami?
• Ngisifaka kanjani isicelo se-Medicare?
• Ngabe ngizodinga nini ukufaka isicelo sami?
• Ngingakwazi ukufaka isikhalazo uma umhlinzeki engangifaki?
• Ngabe ngidinga ukufaka amafayili wezinsizakalo engizitholile ngaphandle kwezwe?
• Ngabe zonke izingxenye zeMedicare ziyangivumela ukuthi ngifake izimangalo zami?
• Ingxenye yeMedicare C
• Ingxenye yeMedare D
• I-Medigap
• Ukuthatha

• Ungashayela i-Medicare ukukhansela isimangalo osifakile.
• Udokotela wakho noma umhlinzeki uzokufakela izimangalo.
• Kungase kudingeke ukuthi ufake isimangalo sakho uma udokotela wakho engeke noma engakwazi.
• Uma usebenzisa i-Medicare yangempela, ungafaka izimangalo zezinsizakalo zeNgxenye B noma izinsizakalo zeNgxenye A ezitholwe kwelinye izwe.
• Ungafaka izimangalo zeNgxenye C, Ingxenye D, neMedigap ngohlelo lwakho ngqo.

Izimangalo yizikweletu ezithunyelwa ku-Medicare ngezinsizakalo noma okokusebenza okutholile. Ngokuvamile, udokotela noma umhlinzeki wakho uzokufakela izimangalo, kepha kungahle kube nezikhathi lapho uzodinga ukuzifakela khona. Uma udinga ukukhansela isimangalo osenze wedwa, ungashayela i-Medicare.

Inqubo yezimangalo iyahluka kuye ngokuthi iyiphi ingxenye ye-Medicare oyisebenzisayo. Izimangalo ze-Medicare yasekuqaleni (izingxenye A no-B) zicutshungulwa ngokuhlukile kwizicelo zezinye izingxenye ze-Medicare. Akunandaba noma yini, kuzodingeka ugcwalise ifomu lezimangalo bese uthumela isikweletu sakho.

Ngisikhansela kanjani isimangalo seMedicare engizifakele sona?

Ungahle ufune ukukhansela isimangalo se-Medicare uma ukholwa ukuthi wenze iphutha. Indlela esheshayo yokukhansela isimangalo ukubiza iMedarere ku-800-MEDICARE (800-633-4227).

Tshela ummeleli ukuthi udinga ukukhansela isimangalo osifake wena. Ungase udluliselwe kuchwepheshe noma emnyangweni wezimangalo wombuso wakho weMedicare.

Uzodinga ukunikela ngolwazi olumayelana nawe nesimangalo, okubandakanya:

• igama lakho eligcwele
• inombolo yakho ye-Medicare ID
• usuku lwenkonzo yakho
• imininingwane ngenkonzo yakho
• isizathu sokuthi ukhansele isimangalo sakho

Kungathatha i-Medicare izinsuku ezingama-60 noma ngaphezulu ukucubungula isimangalo. Lokhu kusho ukuthi uma ushaya ngemuva nje kokuba uthumele, ungakwazi ukumisa isimangalo ngaphambi kokuthi kucutshungulwe nhlobo.

Ngingakwazi ukuhlola isimo sezimangalo zami?

Ungahlola isimo sezimangalo zakho ngokubhalisela i-akhawunti kwa-MyMedicare. Uzodinga imininingwane elandelayo ukuze ubhalisele i-MyMedicare:

• isibongo sakho
• usuku lwakho lokuzalwa
• ubulili bakho
• ikhodi yakho ye-ZIP
• inombolo yakho ye-Medicare ID
• usuku okuqale ngalo uhlelo lwakho lwe-Medicare

Ungathola inombolo yakho ye-Medicare ID ekhadini lakho le-Medicare. Uma usunayo i-akhawunti, ungabona izimangalo zakho ngokushesha lapho zicubungulwa. Ungashayela i-Medicare uma ubona amaphutha noma amaphutha ngezimangalo zakho.

Ungase futhi ulinde i-Medicare ukuthi ithumele isaziso sakho esifingqiwe, esiqukethe zonke izimangalo zakho ze-Medicare. Kufanele uthole lesi saziso njalo ezinyangeni ezi-3.

Ngisifaka kanjani isicelo se-Medicare?

Ukugcwalisa isimangalo nge-Medicare kungahle kubonakale kukhungathekisa, kepha ungakusingatha ngezinyathelo ezimbalwa. Ukulandela lezi zinyathelo ngokulandelana kuzosiza ukuqinisekisa ukuthi isimangalo sakho sicutshungulwa yi-Medicare.

Ukufaka isimangalo, udinga:

1. Shayela i-Medicare ku-800-MEDICARE (800-633-4227) bese ucela umkhawulo wesikhathi ekufakeni isimangalo senkonzo noma ukunikezwa. I-Medicare izokwazisa uma usenesikhathi sokwenza isimangalo nokuthi umnqamulajuqu uyini.
2. Gcwalisa isicelo sesiguli sefomu lokukhokha lezokwelapha. Ifomu liyatholakala nangeSpanishi.
3. Hlanganisa imibhalo esekelayo yesimangalo sakho, kufaka phakathi inkokhelo oyitholile kudokotela wakho noma kumhlinzeki wesevisi.
4. Qiniseka ukuthi imibhalo yakho esekelayo icacile. Isibonelo, uma odokotela abaningi bebalwe kubhili yakho, zungeza udokotela owakwelapha. Uma kunezinto kusikweletu uMedicare asezikhokhele kakade, zihlukanise.
5. Uma unolunye uhlelo lomshuwalense kanye neMedicare, faka imininingwane yalolo hlelo nemibhalo yakho ekuxhasayo.
6. Bhala incwadi emfushane echaza ukuthi kungani ufaka isimangalo.
7. Thumela ifomu lakho lesimangalo, amadokhumende asekelayo, kanye nencwadi ehhovisi le-Medicare lombuso wakho. Amakheli ehhovisi ngalinye lombuso abhalwe kwifomu lesicelo sokukhokha.

I-Medicare izobe icubungula isimangalo sakho. Kufanele uvumele okungenani izinsuku ezingama-60 zalokhu. Ngemuva kwalokho, uzothola isaziso ngeposi ngesinqumo sika-Medicare. Ungahlola i-akhawunti yakho ye-MyMedicare ukubona ukuthi isimangalo sakho sivunyiwe yini.

Ngabe ngizodinga nini ukufaka isicelo sami?

Ngokuvamile, udokotela wakho noma umhlinzeki wesevisi uzokulethela izimangalo kwi-Medicare. Uma isimangalo singakafakwa, ungacela udokotela noma umhlinzeki wakho ukuthi asifake.

Izimangalo ze-Medicare zidinga ukufakwa kungakapheli unyaka kulandela insizakalo oyitholile, noma kunjalo. Ngakho-ke, uma kusondela umnqamulajuqu futhi kungekho simangalo esifakiwe, ungahle udinge ukuthi uzifayele wedwa. Lokhu kungenzeka ngoba:

• udokotela noma umhlinzeki wakho akahlanganyeli kwi-Medicare
• udokotela wakho noma umhlinzeki wenqaba ukufaka isimangalo
• udokotela noma umhlinzeki wakho akakwazi ukufaka isicelo kusimangalo

Isibonelo, uma uthole ukunakekelwa okuvela ehhovisi likadokotela okuvalwe ezinyangeni ezimbalwa kamuva, kungadingeka ukuthi ufake isicelo sakho sokuvakasha.

Ngingakwazi ukufaka isikhalazo uma umhlinzeki engangifaki?

Ungafaka isikhalazo kwa-Medicare uma udokotela wakho enqaba ukufaka isimangalo egameni lakho. Ungakwenza lokhu ngaphezu kokufaka isimangalo ngokwakho. Ungafaka isikhalazo ngokushayela i-Medicare futhi uchaze isimo.

Khumbula ukuthi ukufaka isikhalazo nge-Medicare akufani nokufaka isikhalazo. Uma ufaka isikhalazo, ucela i-Medicare ukuthi icabange kabusha ukukhokhela into noma isevisi. Uma ufaka isikhalazo, ucela i-Medicare ukuthi ibheke udokotela noma omunye umhlinzeki.

Ngabe ngidinga ukufaka amafayili wezinsizakalo engizitholile ngaphandle kwezwe?

Kungase kudingeke nokuthi ufake nezimangalo zakho uma uthola ukunakekelwa kwezempilo ngenkathi uhamba ezweni. Khumbula ukuthi i-Medicare izobhekela kuphela ukunakekelwa okutholayo emazweni angaphandle ezimweni ezithile, kufaka phakathi:

• Usemkhunjini futhi kungakapheli amahora angu-6 usukile noma ufikile e-United States. Uma ungaphezu kwamahora angu-6 usuka ethekwini lase-U.S., Isimo esiphuthumayo sakho sezokwelapha kufanele ukuthi siqale ngenkathi usesefasiteleni lamahora ayisithupha. Udinga futhi ukusondela ethekwini langaphandle nesibhedlela kunaleso esise-United States, futhi udokotela omsebenzisayo kufanele anikezwe ilayisense ngokugcwele kulelo zwe langaphandle.
• Use-United States futhi unesimo esiphuthumayo kwezokwelapha, kodwa isibhedlela esiseduzane sikwelinye izwe.
• Uhlala e-United States, kepha isibhedlela esiseduzane nekhaya lakho esingalapha isimo sakho sikwelinye izwe. Isibonelo, ungahlala eduze kakhulu nomngcele waseCanada noma waseMexico, kanti isibhedlela esiseduze sangaphandle singasondela kakhulu kuwe kunesasekhaya esiseduzane.
• Uhamba udabula iCanada uya noma usuka e-Alaska nakwesinye isimo futhi unesimo esiphuthumayo kwezokwelapha. Ukuze lo mthetho usebenze, udinga ukuthi ube sendleleni eqondile phakathi kwe-Alaska nesinye isimo, futhi isibhedlela saseCanada othathwe kuso kumele sisondele kunanoma yisiphi isibhedlela sase-U.S. Udinga futhi ukuhamba ngaphandle kwalokho iMedicare ikubiza ngokuthi "ukubambezeleka okungenangqondo."

Ungahambisa isimangalo ku-Medicare uma uthole ukunakekelwa kwesinye sezimo ezingenhla.

Landela izinyathelo ezifanayo ezivezwe ekuqaleni kwendatshana, bese ufaka ubufakazi bokuthi awukwazanga ukwelashwa esibhedlela sase-U.S. Noma ukuthi isibhedlela sangaphandle besiseduze. Kwifomu elijwayelekile, uzomaka ukuthi umhlinzeki wakho wesevisi akazange abambe iqhaza kwi-Medicare, bese unikeza incazelo eningiliziwe encwadini yakho.

Abahlomuli abahamba kaningi bangafuna ukubheka uhlelo lweMedigap noma uhlelo lweMedicare Advantage Private Fee-for-Service (). Lezi zinhlelo zingasiza ukumboza izindleko zakho zokunakekelwa kwezempilo ngenkathi ungekho ezweni,

Ngabe zonke izingxenye zeMedicare ziyangivumela ukuthi ngifake izimangalo zami?

Ngokuvamile, uma ufaka isimangalo sakho, kuzoba ngezinsizakalo zeNgxenye B, ngaphandle kokuthi ufaka ukunakekelwa kwesibhedlela ezweni langaphandle.

I-Original Medicare yakhiwe ngeNgxenye A no-B. Ingxenye A ingumshwalense wesibhedlela kanti Ingxenye B ingumshwalense wezokwelapha. Ingxenye B ikhokhela izinsizakalo ezifana nemishini yezokwelapha, ukuvakashelwa kodokotela, ukuqashwa kwabelashwa, ukunakekelwa kokuvikela, kanye nezinsizakalo eziphuthumayo.

Ingxenye A ayikhahleli ngaphandle kokuthi ungeniswe esibhedlela noma esikhungweni noma uthola ukunakekelwa kwempilo ekhaya. Isibonelo, uma uvakashela i-ER, Ingxenye B izofaka ukuvakasha kwakho. Uma ungeniswe esibhedlela, i-Part A izobhekelela ukuhlala kwakho esibhedlela.

Inqubo yezimangalo iyafana kuzo zombili izingxenye ze-Medicare yasekuqaleni.

• Qiniseka ukuthi ufaka isikweletu sakho.
• Nikeza noma yibuphi ubufakazi noma imininingwane eyengeziwe ongayenza.
• Gcwalisa ifomu ngemininingwane eminingi ngangokunokwenzeka.
• Thumela izimangalo zakho kungakapheli unyaka uthole insizakalo.

Ingxenye yeMedicare C

Ngokuvamile awudingi ukufaka izimangalo zakho ze-Medicare Advantage, ezibizwa nangokuthi i-Medicare Part C. Izinhlelo ze-Medicare Advantage azisebenzisi izimangalo ngoba i-Medicare ikhokha lezi zinhlelo inani lemali elibekiwe inyanga ngayinye ukuhlinzekwa ngezimali. Imvamisa awukwazi ukufaka isimangalo sohlelo lwe-Medicare Advantage.

Okuwukuphela kokuhlukile kulo mthetho kungaba uma uphuma kunethiwekhi ngensizakalo. Uma uhlelo lwakho lwe-Medicare Advantage lukuvumela ukuthi ufake izicelo zokuthola izinsizakalo ezitholwe ngaphandle kwenethiwekhi, imininingwane izoba semininingwane yohlelo lwakho.

Izinhlelo eziningi zinamafomu atholakala ku-inthanethi noma ngeposi. Uma ungaqiniseki, ungashayela inombolo yocingo ekhadini lakho lomshuwalense bese ubuza. Uzofaka isimangalo ngqo ohlelweni lwakho lwe-Advantage.

Ingxenye yeMedare D

I-Medicare Part D iwukusetshenziswa kwezidakamizwa kadokotela. Ungayisebenzisa eceleni kweMedicare yangempela noma uhlelo lwe-Advantage.

Akudingeki ukuthi ufake isimangalo sakho uma ugcwalisa imiyalo yakho usebenzisa ikhemisi eku-inethiwekhi. Kepha uma usebenzisa ikhemisi engaphandle kwenethiwekhi, ungahle uthumele isimangalo. Kunamanye amacala ambalwa lapho ungadinga ukufaka isimangalo sakho se-Part D, kufaka phakathi:

• Ube nesikhathi sokubuka esibhedlela futhi awuvunyelwe ukuza nemithi yakho yansuku zonke. I-Medicare Part D ingayifaka le mithi ngesikhathi uhlala khona uma uthumela isimangalo.
• Ukhohlwe ikhadi lakho le-ID le-Medicare Part D ngenkathi uthenga incwadi kadokotela. Uma ukhohlwe ikhadi lakho futhi wakhokha inani eligcwele kukhawunta, ungahambisa isimangalo kuhlelo lwakho lwe-Part D lokumbozwa.

Njengezinhlelo ze-Advantage, izimangalo ze-Medicare Part D ziya ngqo ohlelweni lwakho lwengxenye D. Imvamisa ungathola amafomu wesimangalo kuwebhusayithi yohlelo lwakho noma ngeposi. Ungashayela nohlelo lwakho ukucela imininingwane eyengeziwe ngenqubo yezimangalo.

I-Medigap

Izinhlelo zeMedigap zikusiza ukuthi ukhokhe izindleko ezingaphandle kwezikhwama zeMedicare, ezinjengezinkokhelo ze-coinsurance nezinciphisiwe. Ezimweni eziningi, i-Medicare izothumela izimangalo ngqo ohlelweni lwakho lweMedigap.

Kepha ezinye izinhlelo zeMedigap zidinga ukuthi uzenzele izimangalo zakho. Uhlelo lwakho luzokwazisa ukuthi ngabe udinga yini ukuhambisa izimangalo zakho noma cha.

Uma udinga ukuhambisa izimangalo zakho, kuzofanele uthumele isaziso sakho esifingqiwe se-Medicare ngqo ohlelweni lwakho lwe-Medigap kanye nesimangalo sakho. Ngemuva kokuthi uhlelo lwakho luthole isaziso esifingqiwe, luzokhokha ezinye noma zonke izinkokhelo uMedicare angazange azikhokhe.

Uma ungaqiniseki ukuthi ungazithumela kanjani izimangalo zakho noma uma ufuna imininingwane ethe xaxa ngale nqubo, shayela uhlelo lwakho lweMedigap.

Ukuthatha

• Ngeke kudingeke ukuthi ufake izimangalo zakho ze-Medicare zezinsizakalo eziningi ozitholayo.
• Uma udinga ukufaka isimangalo sakho, kuzodingeka uthumele imininingwane eminingi mayelana nensizakalo ngangokunokwenzeka kwi-Medicare, kanye nefomu lokufuna.
• Ungahlola isimo sezimangalo zakho nganoma yisiphi isikhathi eMyMedicare. Ukukhansela isimangalo, ungashayela i-Medicare.
• Ngezimangalo ezingaphandle kwe-Medicare yoqobo - njenge-Medigap, i-Medicare Part D, noma i-Medicare Advantage - kuzodingeka uzihambise kuhlelo lwakho ngqo.