Ngabe Ixhaswa Kanjani Izinhlelo Zama-Medicare Advantage?

-Delile

• Yiziphi izinto ezithinta izindleko zakho zohlelo lwe-Medicare Advantage?
• Yini ama-Medicare Advantage plans?
• Ngabe ngifanelekile ezinhlelweni ze-Medicare Advantage?
• Ukudla okudlela endlini

Izinhlelo zeMedicare Advantage zonke zingezinye zezindlela ezihlukile zoMuthi wokuqala onikezwa izinkampani ezizimele. Baxhaswa yi-Medicare nangabantu ababhalisela uhlelo oluthile.

Qhubeka ufunda ukuze ufunde kabanzi mayelana nezinhlelo ze-Medicare Advantage nezindleko ezingaphandle kwezikhwama zalezi zinhlelo.

Yiziphi izinto ezithinta izindleko zakho zohlelo lwe-Medicare Advantage?

Inani olikhokhela i-Medicare Advantage lincike ezintweni eziningi, kufaka phakathi:

• Izinkokhelo zanyanga zonke. Ezinye izinhlelo azinawo amaprimiyamu.
• Izinkokhelo zanyanga zonke ze-Medicare Part B. Ezinye izinhlelo zikhokha konke noma ingxenye yamaphrimiyamu engxenye B.
• Ukudonswa konyaka. Kungabandakanya ukudonswa kwemali minyaka yonke noma ukudonswa kwemali okungeziwe.
• Indlela yokukhokha. I-coinsurance noma i-copayment oyikhokhela insizakalo ngayinye noma ukuvakasha.
• Thayipha nobuningi. Uhlobo lwamasevisi owadingayo nokuthi ahlinzekwa kangaki.
• Ukwamukelwa kodokotela / umphakeli. Ithinta izindleko uma ukuhlelo lwe-PPO, PFFS, noma lwe-MSA, noma uphuma kunethiwekhi.
• Imithetho. Ngokuya ngemithetho yakho yohlelo, njengokusebenzisa abahlinzeki benethiwekhi.
• Izinzuzo ezingeziwe. Okudingayo nokuthi uhlelo lukhokhelani.
• Umkhawulo waminyaka yonke. Izindleko zakho ezingaphandle kwesikhwama zazo zonke izinsizakalo zezokwelapha.
• I-Medicaid. Uma unayo.
• Usizo lombuso. Uma uyithola.

Lezi zinto zishintsha minyaka yonke ngokuya nge:

• amaphrimiyamu
• ukudonswa kwemali
• izinsizakalo

Izinkampani ezinikezela ngezinhlelo, hhayi iMedicare, zinquma ukuthi ukhokha malini ngezinsizakalo ezihlanganisiwe.

Yini ama-Medicare Advantage plans?

Kwesinye isikhathi kubhekiswa kuzinhlelo ze-MA noma Ingxenye C, izinhlelo zeMedicare Advantage zinikezwa izinkampani ezizimele ezivunyelwe yiMedicare. Lezi zinkampani zenza isivumelwano noMedare ukuhlanganisa ndawonye lezi zinsizakalo zeMedare:

• I-Medicare Ingxenye A: ukuhlala esibhedlela, ukunakekelwa kwe-hospice, ukunakekelwa esikhungweni sabahlengikazi abanamakhono, nokunakekelwa kwempilo ekhaya
• I-Medicare Part B: izinsizakalo ezithile zikadokotela, ukunakekelwa kweziguli ezingalaliswayo, izinto zokwelashwa, nezinsizakalo zokuvimbela
• I-Medicare Part D (imvamisa): imishanguzo kadokotela

Ezinye izinhlelo ze-Medicare Advantage zinikeza ukufakwa okungeziwe, okufana nalokhu:

• amazinyo
• umbono
• ukuzwa

Izinhlelo ezivame kakhulu zeMedicare Advantage yilezi:

• Izinhlelo ze-HMO (inhlangano yesondlo)
• Izinhlelo ze-PPO (inhlangano yenhlangano ehlinzekwayo)
• Izinhlelo ze-PFFS (imali ekhokhelwa yangasese)
• Ama-SNP (amapulani wezidingo ezikhethekile)

Izinhlelo ezijwayelekile ezingaphansi kwe-Medicare Advantage zifaka:

• Izinhlelo ze-Medicare savings medical savings (MSA)
• Izinhlelo ze-HMOPOS (HMO point of service)

Ngabe ngifanelekile ezinhlelweni ze-Medicare Advantage?

Imvamisa ungajoyina izinhlelo eziningi zeMedicare Advantage uma:

• une-Medicare Part A no-Part B
• hlala endaweni yesevisi yezinhlelo
• anginaso isifo sezinso sesigaba sokuphela (ESRD)

Ukudla okudlela endlini

Izinhlelo ze-Medicare Advantage - ezibizwa nangokuthi ama-MA Plans noma Ingxenye C - zinikezwa yizinkampani ezizimele futhi zikhokhelwa ngabakwaMedicare nangabantu abafanelekayo beMedicare ababhalisela lolu hlelo.

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