Yikuphi uHlelo lwe-Medicare Advantage olunikezwa nguHumana ngo-2021?

-Delile

• Izinhlelo ze-Humana Medicare Advantage HMO
• Izindleko
• Ukufunda
• Izinhlelo ze-Humana Medicare Advantage PPO
• Izindleko
• Ukufunda
• Izinhlelo zeHumana Medicare Advantage PFFS
• Izindleko
• Ukufunda
• IHumana Medicare Advantage SNPs
• Izindleko
• Ukufunda
• Yini i-Medicare Advantage?
• Ukuthatha

• IHumana inkampani yomshwalense yangasese enikeza ngezinhlelo zeMedicare Advantage (Ingxenye C).
• IHumana inikeza izinketho zohlelo lwe-HMO, PPO, PFFS, ne-SNP.
• Akuzona zonke izinhlelo ze-Humana Medicare Advantage ezingatholakala endaweni yangakini.

Uma ususithathile isinqumo sokuhamba nohlelo lweMedicare Advantage (Medicare Part C), kusamele uthathe izinqumo ezithile. Omunye wabo ngumhlinzeki womshuwalense ozokunikeza ukumbozwa kwakho.

UHumana uyinkampani yomshuwalense wezempilo engenisa inzuzo ezinze eKentucky futhi uvunywa yiMedicare ukuthengisa izinhlelo zePart C. Sizokhuluma ngezinhlelo uHumana azinikezayo, izindleko zazo, lokho ezikukhokhelayo, nokuningi.

Izinhlelo ze-Humana Medicare Advantage HMO

Izindleko

Izinhlelo ze-Health Maintenance Organisation (HMO) ziyakhanga kubantu abaningi ngenxa yokuthi bayakwazi ukuzikhokhela. Kumakhodi amaningi we-ZIP, kunezinhlelo ezitholakalayo ze- $ 0 premium yenyanga.

Amakhophi aphansi azodingeka lapho ubona abahlinzeki, njengongoti. Lezi zimali ziyahlukahluka, ngokuya ngendawo, kepha zisukela cishe ku- $ 0 kuye ku- $ 50 ezindaweni eziningi. Ezimweni eziningi, udokotela wakho wokunakekela oyinhloko ngeke adinge i-copay.

Ukudonswa kwemali minyaka yonke kwezinhlelo ze-Humana HMO kuyahluka kusuka ku- $ 0 kuye ku- $ 800, ngokuya ngendawo yakho nohlelo olukhethayo.

Kungase kube nokudonswa kwemali minyaka yonke kokutholakala kwezidakamizwa kadokotela. Lokhu kuyahluka kusuka ku- $ 0 kuye ku- $ 445, ngokuya ngendawo yakho nohlelo olukhethayo.

Izindleko zakho zonyaka eziphuma kakhulu ephaketheni nazo zizohluka ngokuya ngecebo olikhethayo, kepha ubukhulu benoma yiluphi uhlelo lweMedicare Advantage ngu- $ 7,550 ngo-2021.

Ukufunda

Kudingeka ngokomthetho, lezi zinhlelo zimboza okungenani iMedicare yangempela, ngakho-ke ungaqiniseka ngokuthola ukumbozwa kokulaliswa esibhedlela, ukunakekelwa kwezokwelapha, nokunakekelwa kokuvimbela, kufaka phakathi ukuqokwa kwaminyaka yonke kanye nemithi yokugoma.

Njenganoma iyiphi i-HMO, kudingeka ukuthi ukhethe odokotela bakho, kufaka phakathi udokotela wakho wokunakekela oyinhloko (PCP), ngaphakathi kwenethiwekhi yomhlinzeki wohlelo. UHumana unikeza uhlelo lwePoint-of-Service (HMO-POS) olukuvumela ukuthi ukhethe abahlinzeki abangaphandle kwenethiwekhi ezimweni ezithile.

Uzodinga ukuthunyelwa kusuka ku-PCP yakho ukubona ochwepheshe nabanye abahlinzeki.

Ama-HMO kaHumana ahlanganisa ukunakekelwa kwezimo eziphuthumayo ngaphandle kwase-United States.

Amanye ama-HMO we-Humana afaka nokufakwa kwezidakamizwa kadokotela okulingana noma okungcono kunezinhlelo ezizimele ze-Medicare Part D.

Iningi lalezi zinhlelo zifaka ubulungu bamahhala emajimini amaningi endawo nasemakilabhini ezempilo. Akuzona zonke izindawo zokuzivocavoca ezifakiwe kulolu hlu.

Izinhlelo ze-Humana Medicare Advantage PPO

Izindleko

Izinhlelo ze-Preferred Provider Organisation (PPO) zikunikeza inkululeko yokukhetha noma yimuphi udokotela ovunyelwe yi-Medicare ofisa ukukubona. Kodwa-ke, abahlinzeki abangaphandle kohlelo bazobiza kakhulu ezimweni eziningi.

Amaphrimiyamu wakho wohlelo lwenyanga nenyanga nama-copay angaba phezulu kunama-HMO kwamanye amakhodi we-ZIP kepha asabizi. Ama-Copays ongoti asukela ku- $ 20 kuya ku- $ 40 ezimweni eziningi.

Ukuhlolwa okuningi kokuvikela unyaka nonyaka kungatholakala mahhala.

Futhi, izindleko zakho zonyaka eziphuma kakhulu ephaketheni nazo zizohluka ngokuya ngohlelo olikhethayo kepha alungeqi ku- $ 7,550.

Ukufunda

Njengoba kudingwa ngumthetho, lezi zinhlelo zimboza okungenani iMedicare yangempela, ngakho-ke ungaqiniseka ngokuthola ukwelashwa esibhedlela kanye nokuthola usizo lwezokwelapha olungaphandle.

Uzokwenza kanjalo hhayi Udinga ukuthunyelwa ukuze ubone isazi.

Lezi zinhlelo zinikeza ukunakekelwa kwezempilo kwasekhaya okuxhumene nenethiwekhi. Banikela ngezengezo ezingakhethwa, ezinjengombono, amazinyo, ukumbozwa kwezidakamizwa kadokotela, nezinhlelo zokufaneleka.

Ukunakekelwa okuphuthumayo ngaphandle kwe-United States kungenye inzuzo eyengeziwe.

Izinhlelo zeHumana Medicare Advantage PFFS

Izindleko

Izinhlelo zangasese zezinsizakalo (PFFS) azitholakali yonke indawo.

Ngohlelo lwe-PFFS, ungabona noma yimuphi udokotela ovunyelwe yi-Medicare, inqobo nje uma bemukele imigomo yokusebenza ne-PFFS kaHumana nemibandela yokukhokha.

Izinhlelo zeHumana PFFS zehlukile kwezokuqala zeMedicare nakwezinye izinhlelo zokwengeza. Njengomshuwalense, uHumana, hhayi iMedicare, ozonquma ukuthi bakhokhela ini abahlinzeki bezokunakekelwa kwempilo nezibhedlela nokuthi kudingeka malini ukukhokha ukunakekelwa kwakho.

Ngecebo le-PFFS, akudingeki ukhethe udokotela wokunakekelwa oyinhloko. Ngeke futhi udinge ukuthunyelwa ukuze ubone uchwepheshe.

Ukuhlolwa okuningi kokuvikela unyaka nonyaka kungatholakala mahhala.

Kubaluleke kakhulu ukuqinisekisa ukuthi udokotela wakho unesivumelwano esiqhubekayo nenethiwekhi ye-Humana PFFS ngaphambi kokuthola izinsizakalo. Ngaphandle kokuthi udinga izinsizakalo eziphuthumayo, ngeke uqinisekiswe ukuthi udokotela ombonayo uzokuphatha noma amukele inkokhelo yohlelo lwakho.

Izindleko zakho zingahluka ngokuya ngecebo olikhethayo. Ngokuqinisekile uzokhokha izindleko zokwabelana ngezindleko ezinqunywe ngohlelo lwakho, njengama-copayments asethiwe kanye nokuqinisekiswa kwemali. Kungadingeka ukuthi ukhokhe isikweletu somhlinzeki ngaphezu kwalezi zimali ezibekiwe.

Ukufunda

Ngokomthetho, lezi zinhlelo zimboza okungenani iMedicare yasekuqaleni, ngakho-ke ungaqiniseka ukuthi uzothola izinsizakalo zezokwelapha nezibhedlela ezingalaliswayo.

Ukutholakala kwezidakamizwa kadokotela kufakiwe kuningi, kepha hhayi konke, izinhlelo ze-PFFS.

Ukunakekelwa okuphuthumayo ngaphandle kwe-United States kuhlanganisiwe.

Njengoba odokotela abangaxhumani nenethiwekhi bangakhetha ukwamukela ukukhokhelwa ngohlelo lwe-PFFS olususelwa kusevisi enikeziwe noma esimweni ngasinye, awunakuqiniseka ukuthi udokotela uzokulapha, noma ngabe belaphe esinye isiguli esine Uhlelo olufanayo lwe-PFFS olwenzayo.

IHumana Medicare Advantage SNPs

Izindleko

Izinhlelo Ezikhethekile Zezidingo (ama-SNP) imahhala futhi ayidingi ukukopishwa, amaprimiyamu noma ukuqinisekiswa kwemali.

Ama-SNP atholakala kuphela uma uhlangabezana nenqubo ethile, efana nale:

• uhlala ezinhlotsheni ezithile zezindawo ezingalalisiwe, njengekhaya lasebekhulile
• ukuba nesimo esingalapheki esivimbela i-Medicare nge-SNP
• ukufaneleka kweMedicare neMedicaid

I-Humana inikeza izinhlobo ezimbili ze-SNP ezitholakala cishe ezifundazweni ezingama-20. Uhlobo olulodwa olwabantu abafanelekela iMedicaid neMedicare. Olunye uhlobo olwenzelwe labo abanezimo ezithile ezingapheli zezempilo, njenge:

• isifo senhliziyo nemithambo yegazi
• isifo senhliziyo esingelapheki
• isifo samaphaphu esingelapheki
• isifo sikashukela
• isifo sesigaba sokugcina (ESRD)

Ukufunda

Uma ufanelekela i-Humana SNP, uzothola zonke izinzuzo ze-Medicare yasekuqaleni kanye ne-Medicare Part D.

Izinhlelo zezempilo nenhlalakahle nazo zingafakwa ezimeni ezifana nesifo sikashukela kanye nokunakekelwa kokuvikela. I-SNP yakho ingabuye ihlanganise ukunakekelwa kwamazinyo okuvamile, ukunakekelwa kwamehlo, ukunakekelwa kokuzwa, kanye nezinsizakalo zokuhamba zezempilo ezingekho eziphuthumayo. Isibonelelo se-over-the-counter (OTC) ngokuvamile sifakwa ngenani elibekiwe.

Yini i-Medicare Advantage?

Izinhlelo zeMedicare Advantage (Ingxenye C) yizinhlelo ezinikeza ukumbozwa okwengeziwe ngalokho okunikezwa yiMedicare yangempela. Izindleko zohlelo ngalunye ziyahlukahluka kuye ngezinga lokusibekela okhetha ukungena kulo, kanye nendawo okuyo.

Izinhlelo zeMedicare Advantage kumele zihlanganise ngokusemthethweni okungenani iMedicare yokuqala. Izinsizakalo ezingeziwe abazinikezayo zifaka phakathi ukumbozwa kwamazinyo, umbono, ukuzwa, nemithi kadokotela.

Akuzona zonke izinhlobo zamapulani ezitholakala kuzo zonke izifunda. I-Medicare yokuthola ithuluzi lokuhlela ingakusiza ukuthi ubuyekeze izinhlelo ze-Medicare ezitholakala endaweni yakho. Uzodinga ukufaka ikhodi yakho ye-ZIP.

Ukuthatha

I-Humana inikeza izinhlelo ezahlukahlukene ze-Medicare Advantage kulo lonke izwe.Lezi zinhlelo zidingeka ngokomthetho ukuthi zinikeze okungenani ukumbozwa okuningi njenge-Medicare yasekuqaleni.

Izinhlelo eziningi zinikela ngezinhlobo eziningi zokumbozwa, ezifana nombono, amazinyo, nemithi kadokotela. Uhlelo okwazi ukulukhetha kufanele lunikeze ikhodi yakho ye-ZIP. Izindleko ziyahluka ngohlelo.

Lo mbhalo uvuselelwe ngoNovemba 13, 2020, ukukhombisa imininingwane ye-2021 Medicare.

Imininingwane ekule webhusayithi ingakusiza ekwenzeni izinqumo eziphathelene nomshuwalense, kepha ayihloselwe ukunikeza iseluleko maqondana nokuthengwa noma ukusetshenziswa kwanoma imuphi umshwalense noma imikhiqizo yomshuwalense. I-Healthline Media ayisebenzisi ibhizinisi lomshwalense nganoma iyiphi indlela futhi ayinamalayisensi njengenkampani yomshuwalense noma umkhiqizi kunoma iyiphi indawo yase-U.S. I-Healthline Media ayincomi noma ivumele noma yiziphi izinkampani zangaphandle ezingase zenze ibhizinisi lomshwalense.