Ingabe amaVeterans Adinga iMedicare?

-Delile

• Ingabe kufanele ngibhalise ku-Medicare uma ngine-VA coverage?
• Ukusabalala kwezempilo kwe-VA
• Ukutholakala kwe-Medicare
• Ingxenye yeMedicare A
• Ingxenye yeMedare B
• Ingxenye yeMedicare C
• Ingxenye yeMedare D
• Izinhlelo zeMedigap
• I-VA ne-Medicare basebenza kanjani ndawonye?
• Ngabe iMedicare isebenza kanjani ne-TRICARE?
• Ngabe i-TRICARE for Life ihlanganisa ini?
• Isibonelo
• Ngibhalisa kanjani kwi-Medicare?
• Ngilukhetha kanjani uhlelo lokufakwa okwengeziwe?
• Ngigcina kanjani izindleko zami ziphansi?
• Ukuthatha

Umhlaba wezinzuzo zomakadebona ungadideka, futhi kungaba nzima ukwazi ukuthi unenani elingakanani lokutholakala. Ukwengeza ukunakekelwa kwezempilo komakadebona wakho ngohlelo lwe-Medicare kungaba umqondo omuhle, ikakhulukazi ngoba ukumbozwa kokunakekelwa kwezempilo kweVeteran's (VA) kungahluka kakhulu kumuntu nomuntu futhi ngokuhamba kwesikhathi.

Lapha, sizobheka izinhlelo ezahlukahlukene ze-Medicare, i-TRICARE, ne-VA Medical Benefits nokuthi zonke zisebenza kanjani ngokubambisana.

Ingabe kufanele ngibhalise ku-Medicare uma ngine-VA coverage?

Ukutholakala kokunakekelwa kwezempilo okunikezwa yi-VA uhlelo oluhlukile lokunakekelwa kwezempilo kune-Medicare. Imvamisa, lezi zinhlelo azihlangani zodwa, ngakho-ke kuvame ukuba kumakadebona ukuze aqonde ukuthi yikuphi ukunikezwa okuhlinzekwa ngohlelo ngalunye.

Ukusabalala kwezempilo kwe-VA

I-VA yezokunakekelwa kwempilo ihlanganisa izinsizakalo zezimo zezokwelapha zombili ezihlobene nezinsizakalo- nezingahlobene nezinsizakalo. Ukuze uthole ukumbozwa ngamaphesenti ayi-100, kufanele ufune ukunakekelwa esibhedlela se-VA noma emtholampilo.

Uma uthola ukunakekelwa esikhungweni sezokwelapha esingeyona i-VA, kungadingeka ukhokhe i-copay. Kwezinye izimo, i-VA ingagunyaza ukunakekelwa esikhungweni esingeyona i-VA, kepha lokhu kufanele kuvunyelwe ngaphambi kokwelapha.

Ukutholakala kwe-Medicare

Ngakho-ke, kuthiwani uma uthola ukunakekelwa esikhungweni esingeyona i-VA ngesimo esingahlobene nezinsizakalo futhi esingamboziwe ngohlelo lwakho lomshwalense we-VA? Uma ungaphezu kweminyaka engama-65, kulapho iMedicare isiza khona.

Ngokungena engxenyeni ngayinye ye-Medicare, uzakhela ukumbozwa okuphelele kwezempilo. Ngeke futhi ube mancane amathuba okuthi ukhokhe izindleko eziphezulu zokuphuma ephaketheni.

Okulandelayo, ake sibheke izingxenye ezahlukahlukene ze-Medicare.

Ingxenye yeMedicare A

I-Medicare Part A imvamisa imahhala futhi ayinayo iphrimiyamu. Le ngxenye ihlanganisa ukunakekelwa kwesibhedlela okungeyona i-VA uma unesimo esiphuthumayo noma uma uhlala kude nesikhungo se-VA.

Ingxenye yeMedare B

I-Medicare Part B inikeza izinketho eziningi zokumboza zabahlinzeki bezokunakekelwa kwezempilo okungezona i-VA kanye nezinye izinto uhlelo lwakho lwe-VA lokunakekelwa kwezempilo okungenzeka lungazimbozi.

Ukufakwa kwe-VA kungashintsha ngokuhamba kwesikhathi kuye ngezimali ezivela kuCongress. Uma imali inqanyulelwa ukunakekelwa kwezempilo kwe-VA, omakadebona babekwa phambili ngokwesidingo. Lokhu kusho ukuthi ukunakekelwa kwezempilo kwe-VA unomphela akuqinisekisiwe, okubalulekile ukukhumbula lapho ucubungula elinye uhlelo lokunakekelwa kwezempilo njengokumbozwa okungeziwe.

Kubalulekile ukuthi wazi ukuthi uma ungabhaliseli i-Medicare Part B zisuka nje bese ulahlekelwa yi-VA yakho, kuzosebenza imali yokubhaliswa sekwedlule isikhathi.

Ingxenye yeMedicare C

I-Medicare Part C, eyaziwa nangokuthi i-Medicare Advantage, inikeza ukunakekelwa kwezempilo i-VA ne-Medicare eyisisekelo abangakwenzi. Lokhu kufaka phakathi amazinyo, ukubona, ukuzwa, imishanguzo kadokotela, nokuningi.

Kunezinye izinto okufanele uzicabangele lapho unquma ukuthi i-Medicare Advantage ikulungele yini. Ngaphezulu kwezinzuzo zokumbozwa ezingeziwe, izinhlelo zeMedicare Advantage zinikela ngokuhlanganiswa okuyinqwaba kwazo zonke izinsizakalo zakho zezempilo, izinketho ezahlukahlukene ongakhetha kuzo, futhi kaningi ukonga isikhathi eside.

Kodwa-ke, kukhona ezinye izingqinamba ezingabakhona okufanele uzicabangele futhi, kufaka phakathi izindleko zohlelo olwengeziwe, ukuhlala ngaphakathi kwenethiwekhi yomhlinzeki, kanye nokushoda kokutholakala ngenkathi usohambweni.

Cabanga ngezidingo zakho zokuhlanganisa kanye nesabelomali lapho unquma ukuthi hlobo luni lohlelo oluzokusebenzela kangcono.

Ingxenye yeMedare D

I-Medicare Part D wuhlelo lwemithi kadokotela. Yize ngokuvamile inamanani entengo aphezulu emithi kunohlelo lwe-VA, ingahlanganisa izidakamizwa ezingamboziwe yi-VA. Izinhlelo ze-Part D futhi zikuvumela ukuthi uye ekhemisi oyithandayo bese ugcwalisa imiyalo evela kodokotela abangewona ama-VA.

Kodwa-ke, uma ungabhaliseli ngokushesha i-Part D, kukhona enye inkokhiso eyengeziwe uma ubhalisa uma ngabe uhambe ngaphandle kokutholakala kwezidakamizwa kadokotela izinsuku ezingama-63 ezilandelanayo.

Uma unenkinga yokumboza izindleko zemithi yakho, ungahle ufanelekele uhlelo losizo lweMedicare's Extra Help. Eyaziwa nangokuthi yi-Part D Low-Income Subsidy, lolu hlelo luhlinzeka ngosizo olwengeziwe lwemithi kadokotela olususelwa kumholo wakho nasezingeni lesidingo sakho sezezimali.

Izinhlelo zeMedigap

Izinhlelo zokwengeza, ezinjengeMedigap, zilusizo ukumboza izimo eziphuthumayo noma lapho usohambweni olungaphandle kwe-US Zisiza futhi uma ungahlali eduze komhlinzeki ovunyelwe i-VA noma isikhungo sezokwelapha, noma uma ubaluleke kakhulu Iqembu lezinzuzo ze-VA.

I-VA ne-Medicare basebenza kanjani ndawonye?

Uma uthola ukunakekelwa kwezempilo kwe-VA, i-VA ikhokhela ukuvakashelwa odokotela, imiyalo evela kubahlinzeki be-VA, nokuvakashela isikhungo se-VA. I-Medicare izokhokhela noma yiziphi izinsizakalo nemiyalelo evela kubahlinzeki bezempilo nabangewona ama-VA.

Kungaba nezikhathi lapho bobabili i-VA neMedicare bezokhokha. Lokhu kungenzeka uma uya esibhedlela esingeyona i-VA ukuthola insizakalo evunyelwe i-VA noma ukwelashwa, kepha udinga izinqubo ezingeziwe ezingamboziwe uhlelo lokunakekelwa kwezempilo lwe-VA. I-Medicare izothatha ezinye zalezozindleko ezingeziwe.

Khumbula noma kunjalo, usabhekene ne-premium yakho ye-Part B kanye ne-20% ye-copay noma imali yokuqinisekisa imali.

Uma ungabaza, ungahlala uthinta i-VA ne-Medicare nganoma yimiphi imibuzo ethile yokumboza.

• Ngemibuzo yokumbozwa kwezempilo ye-VA, shayela ku-844-698-2311
• Ngemibuzo embozwa yi-Medicare, shayela ku-800-MEDICARE

Ngabe iMedicare isebenza kanjani ne-TRICARE?

I-TRICARE ngumhlinzeki womshuwalense wezokwelapha wezempi. Ihlukaniswe yaba yizinhlelo eziningi ezahlukahlukene, ngokuya ngesimo sakho sempi. Lezi zinhlelo zifaka:

• I-TRICARE Prime
• I-TRICARE Remote Remote
• I-TRICARE Prime Overseas
• I-TRICARE Overseas Remote Overseas
• TRICARE Khetha
• TRICARE Khetha Phesheya
• I-TRICARE Yokuphila
• I-TRICARE Reserve Select
• I-TRICARE Reserve ethathe umhlalaphansi
• I-TRICARE Omdala Omdala
• Uhlelo lwezempilo lomndeni lwase-US

Ngemuva kokuthatha umhlalaphansi emsebenzini wezempi futhi usufinyelele eminyakeni engama-65, uzokwazi ukuthola i-TRICARE for Life uma ubhalise ezingxenyeni ze-Medicare A kanye no-B.

Ngabe i-TRICARE for Life ihlanganisa ini?

I-Tricare for Life ibhekwa njengomkhokhi wesibili. Lokhu kusho ukuthi uhlelo lwakho lwe-Medicare lukhokhiswa kuqala nganoma iluphi usizo lwezokwelapha olutholayo. Ngemuva kokuthi uMedare akhokhe, iTricare izokhokha yonke enye, uma ihlanganisa lezo zinsizakalo.

Isibonelo

Uya emzimbeni wakho wonyaka futhi ubhekiswa kudokotela wenhliziyo okokuqala. Ekuvakasheni kwenhliziyo, utshelwa ukuthi udinga ukuba ne-echocardiogram kanye nokuhlolwa kwengcindezi.

Udokotela wakho wokunakekelwa okuyisisekelo, udokotela wenhliziyo, kanye nendawo lapho uthola khona lokho kuhlolwa kuzokhokhisa uhlelo lwakho lwe-Medicare kuqala. Lapho i-Medicare isikhokhela konke okuhlanganiswe ngaphansi kohlelo lwakho, okusele komthethosivivinywa kuthunyelwa ngokuzenzakalela ku-TRICARE.

Uhlelo lwakho lwe-TRICARE luzohlanganisa izindleko ezisele uMedicare angazange azikhokhele, kanye nanoma yikuphi ukukhokhelwa kwemali kanye nemali ongayikhokha.

Ungabhalisela iTricare for Life ngesikhathi esivulekile sokubhalisa se-TRICARE, esiqala ngoNovemba. Ungabhalisa futhi ngaphandle kwesizini evulekile uma unomcimbi wempilo ofanelekile njengokuthatha umhlalaphansi emsebenzini osebenzayo, umshado, noma ukufa kwelungu lomndeni. Unezinsuku ezingama-90 ngemuva komcimbi wempilo ofanelekile ukushintsha ukumbozwa kwakho noma ukubhaliswa.

Ngibhalisa kanjani kwi-Medicare?

Ungabhalisa kalula kwi-Medicare online.Kunezinto ezimbalwa nje okufanele uzikhumbule:

• Uma ususondela eminyakeni yobudala engama-65, ungabhalisa ngesikhathi sokuqala sokubhalisa. Ukubhaliswa ezingxenyeni ze-Medicare A no-B kuqala izinyanga ezintathu ngaphambi kokuba ube neminyaka engama-65, inyanga yosuku lwakho lokuzalwa, nezinyanga ezintathu ngemuva kokuhlanganisa iminyaka engama-65.
• Uma ungabhalisanga, ufuna ukwenza ushintsho engxenyeni ekhona ye-Medicare A noma B, noma ungaphezu kweminyaka engama-65 kepha usafuna ukubhalisa, isikhathi sokubhalisa esivulekile siba ngoJanuwari 1 - Mashi 31 minyaka yonke.

Ukuze uqalise ngokubhalisa, vakashela ikhasi lokubhalisa lika-Medicare bese ulandela imiyalo.

Ngilukhetha kanjani uhlelo lokufakwa okwengeziwe?

Uma ufuna ukwengeza ukufakwa kwakho kwe-Medicare ne-VA ngezinhlelo ezengeziwe, unezinketho ezimbalwa:

• I-Medicare Advantage (Ingxenye C)
• Ingxenye yeMedare D
• I-Medigap

Lezi zinhlelo zitholakala ngezinkampani zomshuwalense ezizimele futhi zingakwazi ukukhokhela izindleko ezingekho emaphaketheni ezingahlanganiswa nezinhlelo zezempilo ze-VA noma iMedicare. Lezi zindleko zingafaka:

• i-coinsurance, ama-copay, noma ama-premium avela ku-Medicare Part B
• izindleko zemithi kadokotela
• imishini yezokwelapha
• izinsizakalo zombono ukusiza ukukhokhela izingilazi noxhumana nabo
• amazinyo, kufaka phakathi ukumbozwa kokuvikela nokwelashwa
• Ukusetshenziswa kwezidakamizwa kadokotela
• izinsizakalo zokuzwa ukusiza ukukhokhela izinsiza-kuzwa kanye nokuhlolwa
• izinhlelo zokuqina noma zokuphila, kufaka phakathi ubulungu bejimu

Lapho ucubungula ukumbozwa okungeziwe, cwaninga ukuthi iziphi izinsizakalo esezivele zihlanganiswe yizinhlelo zakho ezikhona. Uma ucabanga ukuthi uzodinga ukumbozwa okwengeziwe ngokuzayo noma usanda kutholakala ukuthi unesifo esingelapheki, ungahle uthande ukucabangela ukuthenga amasu wokungezelela.

Nayi imibuzo embalwa okufanele uzibuze yona njengoba ubheka inketho efanele yokumbozwa kwakho:

• Ngabe imiyalo yakho oyikhethile nodokotela bayafakwa kokufakwa kwakho okukhona?
• Ingabe kungenzeka ukuthi uzodinga imishini yezokwelapha noma izindlela zokwelashwa eziningana esikhathini esizayo esiseduze?
• Uma ungenazo izimo ezingalapheki, ingabe unokusabalala okuningi? Ingabe uzoyisebenzisa?

Ngigcina kanjani izindleko zami ziphansi?

Uma izindleko kuyinkinga, kunezinhlelo ze- $ 0 premium Medicare Advantage. Hlala wazi, kungahle kube nemikhawulo ekusetshenzisweni nokuthi yini abahlinzeki ongayibona. Ungasebenzisa futhi ezinye izinhlelo zosizo ezinjengeMedicaid nolunye Usizo, uma uhlangabezana nezimfuneko zokufaneleka.

Ukuthatha

Uma ungumakadebona nge-VA ukunakekelwa kwezempilo futhi uneminyaka engaphezu kwengama-65, ukubhalisa ohlelweni lweMedicare kunganikeza ukumbozwa okuhlelekile.

Izinhlelo ze-VA ne-TRICARE zingasekelwa ngezinhlelo ze-Medicare. Izinhlelo ezengeziwe zokwengeza ziyatholakala nge-Medicare, futhi ungakhetha eyodwa ehlangabezana nezidingo zakho zezindleko nezinzuzo ezithile.

Kunezinketho eziningi zokukusiza ukuthi wakhe uhlelo lokulinganisela lokunakekelwa kwezempilo ngemuva kweminyaka yobudala engama-65.