I-Medicare eCalifornia: Okudingeka Ukwazi

-Delile

• Ingxenye yeMedicare A
• Ingxenye yeMedare B
• I-Medicare Part C (i-Medicare Advantage)
• Ingxenye yeMedare D
• Umshuwalense wokwengeza iMedare (iMedigap)
• Yiziphi izikhathi zokugcina zokubhaliswa kwezingxenye nezinhlelo ze-Medicare?
• Ukuthatha

I-Medicare uhlelo lokunakekelwa kwezempilo olusetshenziswa ikakhulu ngabantu abaneminyaka engama-65 nangaphezulu. Abantu banoma yibuphi ubudala abakhubazekile nalabo abanesifo sokusha kwezinso (ESRD) noma i-amyotrophic lateral sclerosis (ALS) nabo bayakwazi ukuthola iMedicare.

Uma uhlala eCalifornia futhi uhlangabezana nezimfuneko ze-Medicare, ufanelekile ukuthola i-Medicare yangempela (izingxenye A no-B) kanye ne-Medicare Part D, noma ngabe uhlala kuphi. Ukutholakala kweMedicare Part C (Medicare Advantage) kuhlukile kwezinye izindawo zaseCalifornia kunakwamanye amazwe amaningi.

Ukufaneleka kweMedicare Part C eCalifornia kusekelwe kwikhodi yesifunda ne-ZIP yokuhlala kwakho okuyinhloko.

Ingxenye yeMedicare A

I-Medicare Part A yaziwa nangokuthi umshuwalense wesibhedlela. Ingxenye A ihlanganisa ukunakekelwa kweziguli ezibhedlela, ukunakekelwa kwabagula kakhulu, ezinye izinsizakalo zezempilo ekhaya, ukuhlala okulinganiselwe nezinsizakalo esikhungweni sabahlengikazi abanamakhono (SNF).

Uma wena noma oshade naye nisebenze futhi nakhokha intela ye-Medicare okungenani iminyaka eyishumi, maningi amathuba okuthi nithole i-Part A yamahhala ngaphandle kwenkokhelo yanyanga zonke. Noma ungafanelekile ukuthola ingxenye engu-A engena-premium, ungakwazi ukuthenga i-Part A (i-premium Part A).

Ingxenye yeMedare B

I-Medicare Part B ihlanganisa izinsizakalo ezidingekayo kwezokwelapha, njengokuqokwa kukadokotela nezinsizakalo ze-ambulensi. Iphinde ihlanganise ukunakekelwa kokuvikela, njengemithi yokugoma eminingi. Kanye nengxenye A, iMedicare Part B yakha iMedicare yangempela. Kuzofanele ukhokhe imali ekhokhwa nyangazonke ye-Medicare Part B.

I-Medicare Part C (i-Medicare Advantage)

I-Medicare Part C ithengwa ngabashuwalense abazimele abavunywa yiMedicare. Ngokomthetho, uhlelo lweMedicare Part C kumele lumboze okungenani inani lezingxenye zangempela ze-Medicare A no-B. Izinhlelo eziningi ze-Part C zihlanganisa izinsizakalo eziningi kunezihlinzekwa yi-Medicare yasekuqaleni, kepha imvamisa zidinga ukuthi usebenzise inethiwekhi yodokotela ethile. Ezinye izinhlelo ze-Medicare Part C zifaka ukumbozwa kwezidakamizwa kadokotela, kepha ezinye azikwenzi.

I-Medicare Part C ayitholakali yonke indawo eCalifornia. Ezinye izifunda zikwazi ukufinyelela ezinhlelweni eziningi. Ezinye izifunda zikwazi ukufinyelela ezimbalwa kuphela. Cishe izifunda eziyi-115 eCalifornia, ezinjengeCalaveras County, ziyakwenza hhayi ukufinyelela kunoma yiziphi izinhlelo ze-Medicare Advantage.

Faka ikhodi yakho ye-ZIP lapha ukuze ubone izinhlelo ze-Medicare ezitholakala endaweni yangakini.

Izinkampani eziningi zinikeza izinqubomgomo ze-Advantage ezingxenyeni ezithile zeCalifornia. Kubandakanya:

• I-Aetna Medicare
• Uhlelo Lokuqondanisa Impilo
• I-Anthem Blue Cross
• IBlue Cross yaseCalifornia
• Usuku olusha ceke
• Uhlelo lwe-Central Health Medicare
• Uhlelo lwezempilo lweClever Care
• IGolden State
• I-Health Net Community Solutions, Inc.
• Impilo Net yaseCalifornia
• Humana
• Uhlelo lwe-Imperial Health of California, Inc.
• UKaiser Permanente
• Skena Uhlelo Lwezempilo
• UnitedHealthcare
• I-WellCare

Izinhlelo eziningi ezinikezwayo yizinhlelo ze-Health Maintenance Organisation (HMO) eziqala ngo- $ 0 ngenyanga. Izindleko eziphezulu kakhulu zokuphuma ephaketheni okudingeka uzikhokhe njalo ngonyaka zingahluka kakhulu kulezi zinhlelo. Izinhlelo ze-HMO ngokuvamile zidinga nokuthi ukhokhe i-copay ekuvakasheni kukadokotela ngamunye.

Ezinye izinhlobo zamasu we-Medicare Advantage afaka phakathi izinhlelo ze-Preferred Provider Organisation (PPO). Ezinye zalezi zingaba namaphrimiyamu aphezulu enyanga kunama-HMOs ngaphezu kwezindleko ezingaphandle kwe-pocket nama-copay. Kubalulekile ukubuyekeza amapulani owacabangayo, njengoba ehlukahluka hhayi kuzindleko kuphela kepha nasezinsizakalweni nasezindabeni ezinikeziwe.

Ingxenye yeMedare D

I-Medicare Part D yingxenye yeMedicare ehlanganisa imishanguzo kadokotela. Ihloselwe ukusetshenziswa ne-Medicare yasekuqaleni (izingxenye A no-B). Uma unohlelo lwe-Advantage olufaka imishanguzo, awudingi ukuthenga nohlelo lwengxenye D.

Uma ungenayo imishanguzo kadokotela ngomunye umthombo, njengomshuwalense wezempilo owuthola emsebenzini, kubalulekile ukubhalisa kwi-Medicare Part D lapho uqala ukuthola iMedicare. Uma ungakwenzi, kungadingeka ukhokhe amanani aphezulu ngesimo senhlawulo yanyanga zonke sonke isikhathi sokutholakala kwakho kweNgxenye D.

I-Medicare Part D inikezwa izinkampani zomshuwalense ezizimele. Kunamapulani engxenye D atholakala kusona sonke isifundazwe saseCalifornia. Lezi zinhlelo ziyahlukahluka ngokwemithi abayisebenzisayo, kanye nezindleko zabo.

Ngezinketho eziningi kangaka, ukubhalisa kwi-Medicare kungadideka. Lezi zinhlangano zinganikeza imininingwane oyidingayo ukuze uyikhethe futhi ubhalise ohlelweni oluhle kakhulu lweMedicare uma uhlala eCalifornia.

• State of California uMnyango Wokuguga
• Umnyango Womshuwalense waseCalifornia
• I-HICAP (Uhlelo Lokululekwa Komshwalense Wezempilo Nokukhuthaza)
• Izinhlelo Zosizo Lomshuwalense Wezwe (SHIP)

Umshuwalense wokwengeza iMedare (iMedigap)

Umshuwalense wokungezelela iMedicare noma iMedigap yakhelwe ukukusiza ukuthi ukhokhele izinto ezingamboziwe yiMedicare yasekuqaleni. Lezi zindleko zifaka ama-copays, i-coinsurance, kanye nama-deductibles. ECalifornia, uyakwazi ukuthenga eyodwa yezinhlobo eziyi-10 zezinhlelo eziqinisekisiwe ezitholakala kulo lonke izwe.

Lezi zinhlelo ezihleliwe zikhethwa ngezinhlamvu zamagama: A, B, C, D, F, G, K, L, M, noN. Uhlelo ngalunye luyahlukahluka ngokokudonswa kwalo, izindleko, nokufakwa kwalo. ECalifornia, kunabaningi bomshuwalense abemboza ezinye noma zonke lezi zinhlelo. Izindleko zabo ngaphakathi kwezinhlelo zivame ukufana noma zifane kakhulu.

Ezinye izinkampani ezinikeza iMedigap eCalifornia zifaka:

• Aetna
• I-Anthem Blue Cross - eCalifornia
• IBlue Shield yaseCalifornia
• I-Cigna
• Inkampani Ehlanganisiwe Yomshuwalense waseMelika
• I-Everence Association Inc.
• IGarden State
• Inkampani Globe Life and Accident Insurance
• Impilo Net
• Humana
• Ukuvumelana kwe-Omaha
• UMgcini Kazwelonke
• Inkampani Yomshwalense Wezempilo Kazwelonke
• I-Oxford
• Ukuphepha kwe-Sentinel
• State Ipulazi
• Izimali Ezichumayo KwamaLuterans
• I-USAA
• I-United American
• UnitedHealthcare

Ezinye izinhlelo zidinga nokuthi ukhokhe iphesenti lezindleko zezinsizakalo ezihlanganiswe ngaphansi kwengxenye B, kanye nengxenye A edonswayo.

Kukhona isikhathi sokubhalisa esivulekile sezinyanga eziyi-6 lapho ungathola khona iMedigap. Lesi sikhathi siqala ngosuku lwakho lokuzalwa lwama-65th futhi sihambisana nokubhaliswa kwakho kwi-Medicare Part B.

Ezingxenyeni eziningi zezwe, lesi isikhathi kuphela lapho ungabhalisa kuhlelo lweMedigap futhi uqiniseke ukuthi uzolithola, noma ngabe unaziphi izinhlobo zezinkinga zezempilo.

Kodwa-ke, eCalifornia, uvunyelwe ukushintshela kuhlelo oluhlukile lweMedigap olunenkinga eqinisekisiwe phakathi nezinsuku ezingama-30 ezilandela usuku lwakho lokuzalwa unyaka nonyaka, inqobo nje uma uhlelo olusha lukunika ukumboza okulinganayo noma okuncane kunecebo lakho lamanje leMedigap.

Yiziphi izikhathi zokugcina zokubhaliswa kwezingxenye nezinhlelo ze-Medicare?

Isikhathi esinqunyiwe sokubhaliswa kwabakwaMedicare eCalifornia siyefana nakwamanye amazwe, ngaphandle kweMedigap, enezikhathi ezingeziwe zokubhalisa.

Ukuthatha

I-Medicare uhlelo lomshuwalense wesifundazwe olutholakala eCalifornia kulabo abafanelekile. I-Medicare Advantage (Medicare Part C) ayitholakali kuyo yonke ikhodi ye-zip esifundazweni. Kodwa-ke, iMedicare yangempela (izingxenye A no-B), kanye neMedicare Part D neMedigap ayatholakala kuzo zonke izifunda nekhodi ye-ZIP.

Lo mbhalo uvuselelwe ngo-Okthoba 6, 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.