Okudingeka Ukwazi Nge-Medicare Part C

-Delile

• Yini i-Medicare Part C?
• Ngabe udinga i-Medicare Part C?
• Ingabe uyakufanelekela ukuthola i-Medicare Part C?
• Yiziphi izinhlelo ze-Medicare Part C ezitholakalayo?
• Izinhlelo ze-Medicare Advantage HMO
• Izinhlelo zeMedicare Advantage PPO
• Kubiza malini i-Medicare Part C?
• Uma ungadingi iMedicare Part C
• Ukuthatha

Yini i-Medicare Part C?

I-Medicare Part C, ebizwa nangokuthi i-Medicare Advantage, iyindlela yokwengeza yomshuwalense kubantu abane-Original Medicare.

Nge-Medicare yasekuqaleni, umbozwe Ingxenye A (isibhedlela) neNgxenye B (yezokwelapha).

I-Medicare Part C inikeza ukumbozwa kwezingxenye A no-B nezinsizakalo ezingeziwe, njengemithi kadokotela, amazinyo, umbono, nokuningi.

Kule ndatshana, sizohlola ukuthi yini iMedicare Part C okufanele inikele ngayo, ukuthi ibiza malini, nokuthi ungakhetha kanjani uhlelo oluhle kakhulu lwesimo sakho.

Ngabe udinga i-Medicare Part C?

Ukutholakala kwe-Medicare Part C kungukufakwa okungeziwe kwe-Medicare okunikezwa ngezinkampani zomshuwalense wangasese.Ngalolu hlelo, ungathola ukumbozwa kwemithi kadokotela, izinsizakalo zamazinyo nezombono, nezinye izinsizakalo ezihlobene nezempilo.

Ngezinzuzo ezifanele ze-Medicare Part C, uzoba nokutholakala kokulandelayo:

• izinsizakalo zesibhedlela, ukunakekelwa kwendawo yokuhlengikaza, ukunakekelwa kwempilo yasekhaya, nokunakekelwa kwabagula kakhulu
• izinsizakalo zezokwelapha ezihlobene nokuvimbela, ukuxilonga, kanye nokwelashwa kwezimo
• izinsizakalo zezempilo yengqondo
• Ukusetshenziswa kwezidakamizwa kadokotela
• amazinyo, umbono, nezinsizakalo zokuzwa
• izinsizakalo zezempilo zokuzikhethela, njengobulungu bokuqina

Uma udinga okungaphezulu nje komshuwalense wesibhedlela kanye nomshuwalense wezokwelapha, i-Medicare Part C iyindlela ebalulekile yokubika.

Ingabe uyakufanelekela ukuthola i-Medicare Part C?

Ufanelekela i-Medicare Part C uma usuvele unezingxenye ze-Medicare A no-B, futhi uma uhlala endaweni yesevisi yomhlinzeki we-Medicare Part C ocabangelayo.

Ngo-2021, abantu abanesifo sokuqeda isifo sezinso (ESRD) banelungelo lokubhalisa ezinhlwini ezibanzi zezinhlelo zeMedicare Advantage ngenxa yomthetho ophasiswe yiCongress. Ngaphambi kwalo mthetho, izinhlelo eziningi bezingeke zikwamukele noma zikukhawulele ku-Special Needs Plan (SNP) uma ubuthola ukuthi une-ESRD.

• Ukubhaliswa ku-Medicare kuyazwela ngesikhathi futhi kufanele kuqalwe cishe izinyanga ezintathu ngaphambi kokuba ube neminyaka engama-65. Ungafaka isicelo seMedicare ngenyanga ohlanganisa iminyaka engama-65 nezinyanga ezi-3 ngemuva kweminyaka engama-65^th usuku lokuzalwa - yize ukumbozwa kwakho kuzobambezeleka.
• Uma uphuthelwa yisikhathi sokuqala sokubhalisa, ukubhaliswa okuvulekile kuqala kusukela ngo-Okthoba 15 kuya kuDisemba 7 minyaka yonke.
• Ungabhalisela i-Medicare yangempela ku-inthanethi ngokusebenzisa iwebhusayithi ye-Social Security Administration.
• Ungaqhathanisa futhi uthengele izinhlelo ze-Medicare Part C ku-inthanethi ngokusebenzisa ithuluzi lokuthola uhlelo lweMedicare.

Yiziphi izinhlelo ze-Medicare Part C ezitholakalayo?

Indlela elula yokuthola ukuthi yimaphi amacebo we-Medicare Part C akhona ukusebenzisa ithuluzi le-Medicare:.

Uhlelo luzothatha izimpendulo zakho emibuzweni ethile futhi linciphise izinkampani ezinikeza ngezinhlelo zeMedicare Part C ezihambelana nezidingo zakho. Leli thuluzi le-Medicare liwusizo ekuqhathaniseni amapulani asendaweni yangakini.

Uma usuvele uthola ukutholakala ngenkampani enkulu yomshuwalense, ingahlinzeka ngamasu we-Medicare Part C. Ezinye zezinkampani ezinkulu zomshuwalense ezinikeza i-Medicare Part C yilezi:

• Aetna
• Blue Cross Blue Isihlangu
• I-Cigna
• Abezempilo
• UKaiser Permanente
• KhethaHealth
• UnitedHealthcare
• UPMC

Izinhlelo ze-Medicare Advantage HMO

Izinhlelo ze-Health Maintenance Organisation (HMO) ziyindlela ethandwayo kulabo abafuna ukumbozwa okungeziwe okunganikezwa yi-Medicare yasekuqaleni. Ohlelweni lwe-Medicare Advantage HMO, ungathola ukunakekelwa kusuka kubahlinzeki bezokunakekelwa kwezempilo bohlelo lwakho ngaphakathi, kodwa uzodinga ukuthola ukuhanjiswa ukuze ubone isazi.

Kunezindlela eziningi ongakhetha kuzo ezinhlelweni ze-Medicare Advantage HMO esifundeni ngasinye, kufaka phakathi izinhlelo ezinamaprimiyamu ka- $ 0, akukho okudonswayo, kanye nezinkokhelo eziphansi. Ukuze ubhalise ohlelweni lwe-Medicare Advantage HMO, kufanele usubhalisile kwi-Medicare yasekuqaleni.

Izinhlelo zeMedicare Advantage PPO

Izinhlangano Zabahlinzeki Abancanyelwayo (ama-PPO) yizona zindlela ezithandwa kakhulu zohlelo lokunakekelwa kwezempilo ukuze kutholwe okunye ukwaziswa Lolu hlobo lwecebo luvumela izinga elikhulu lenkululeko kubathengi.

Ngecebo le-PPO, ungaya kodokotela obathandayo, ongoti, kanye nezikhungo zezempilo, noma ngabe bakunethiwekhi yohlelo lwakho noma cha. Kodwa-ke, izinhlelo ze-PPO zikhokhisa amanani ahlukile ngokususelwa kuhlu lwabahlinzeki be-in-network noma abangaphandle kwenethiwekhi.

Ama-PPO nawo alula ngoba awudingi ukuthunyelwa ukuze ubone isazi.

Kubiza malini i-Medicare Part C?

Kunezindleko ezahlukahlukene ezihlotshaniswa nohlelo lweMedicare Part C, okusho ukuthi izindleko zakho zokuphuma ephaketheni zingahluka.

Ezinye izinhlelo ze-Medicare Part C zizofaka ingxenye ethile ye-Part B yakho yanyanga zonke. Kodwa-ke, ezinye zalezi zinhlelo zine-premium yazo futhi ziyadonswa.

Ngaphezu kwalezi zindleko, futhi ungakweleta i-copayment ngesikhathi sokuthola izinsizakalo.

Ezinye izinto ezifaka isandla ekutheni uhlelo lweMedicare Part C luzokubiza malini zihlanganisa:

• uhlobo lwecebo olikhethayo, njenge-HMO, i-PPO, i-PFFS, i-SNP, noma i-MSA
• imali yakho engenayo, engasetshenziselwa ukunquma i-premium yakho noma inani ledonthi
• iphesenti lakho lezindleko
• udinga kangaki izinsizakalo zezokwelapha
• noma ngabe uthola izinsizakalo zezokwelapha kunethiwekhi noma ngaphandle kwenethiwekhi
• noma ngabe uyaluthola yini olunye usizo lwezezimali, olufana neMedicaid

Kunezinzuzo eziningi zokuba ne-Medicare Part C, kufaka phakathi ikepisi lonyaka lokuthi uzokhokha malini ephaketheni. Noma kunjalo, lezo zindleko zokuqala zingangeza ngokuhamba kwesikhathi ngaphambi kokuthi ushaye leyo cap, ngakho-ke kubalulekile ukubheka zonke izici lapho ukhetha uhlelo lwakho lwe-Medicare Part C.

Uma ungadingi iMedicare Part C

Uma ngabe ujabulile ngokutholakala kwakho kwamanje kwe-Medicare futhi unentshisekelo kuphela ekutholeni ukutholakala kwemithi kadokotela, uhlelo oluzimele lwe-Medicare Part D lungaba yindlela engcono kakhulu.

Uma unokutholakala kwe-Medicare kodwa udinga usizo olwengeziwe ngezindleko, inqubomgomo ye-Medicare eyengeziwe yomshuwalense (iMedigap) ingakusebenzela.

Kwabanye abantu, iMedicare Part C iyizindleko ezingezekile abangenakukwazi ukuzikhokhela - kulokhu, ukuthenga indawo ukuze uthole ukumbozwa kweNgxenye D neMedigap kungasiza ekongeni imali.

Ukusiza ilungu lomndeni noma umngani ukuthi akhethe uhlelo lweMedicare Part C kungaba inqubo ejulile, kodwa akudingeki ukuthi kube nzima. Nazi ezinye izinto okufanele uzicabangele lapho ubuyekeza izinhlelo:

• Uhlobo lokumbozwa. Uma ilungu lomndeni wakho linentshisekelo kuzinketho zokubika ezinganikezwa izingxenye A no-B, zama ukuthola uhlelo oluhlanganisa zonke izindawo ezibalulekile kuzo.
• Uhlobo lwecebo. Ukukhetha uhlobo olufanele lwecebo leMedicare Part C kuncike kakhulu ekuthandeni kwabo. Izakhiwo zohlelo lwe-HMO, PPO, PFFS, SNP kanye ne-MSA kumele konke kubhekwe.
• Izindleko eziphuma ephaketheni. Imali engenayo ephansi ingenza kube nzima ukuhlangabezana ne-premium ye-Medicare Part C, ekhishwayo, nezindleko ezingaphandle kwe-pocket. Zama ukuthenga amanani azokwazi ukukhokha.
• Isimo sezokwelapha. Wonke umuntu unesimo sempilo esiyingqayizivele okufanele sicatshangelwe lapho ethenga ukumbozwa kweMedicare. Cabanga ngezinto ezifana nezimo zezempilo, ukuhamba kaningi, nokuncanyelwayo kwabahlinzeki.
• Ezinye izinto. Abazuzi abangaphezu kuka-800,000 bathole ukuthi izinto ezifana nesabelo semakethe senhlangano nokukalwa kwezinkanyezi nazo ziye zacatshangelwa lapho kukhethwa uhlelo lweMedicare Part C.

Ukuthatha

• Izinhlelo zeMedicare Part C, ezaziwa nangokuthi izinhlelo zeMedicare Advantage, yizinhlelo zomshuwalense ongazikhethela ezinikeza izinzuzo zokutholakala kokuqala nokwengeziwe kweMedicare.
• I-Medicare Part C iyindlela enhle kubantu abanentshisekelo yokutholakala kwemithi kadokotela, umbono nezinsizakalo zamazinyo, nokuningi.
• Izindleko zohlelo lwengxenye C zincike ezintweni ezahlukahlukene, kufaka phakathi izindleko zanyanga zonke nonyaka, ama-copayments, nezidingo zakho zezokwelapha.
• Vakashela i-Medicare.gov ukuthola uhlelo lwe-Medicare Part C olusebenzela wena.

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.

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