Izinhlelo zeDelaware Medicare ngo-2021

-Delile

• Yini iMedicare?
• Okumbozayo
• Izindleko ze-Medicare
• Yiziphi izinhlelo zeMedicare Advantage ezitholakala eDelaware?
• Inhlangano Yezempilo (HMO)
• Inhlangano Yomhlinzeki Okhethwayo (i-PPO)
• I-akhawunti yokonga yezokwelapha (MSA)
• Imali Yezinkonzo Ezizimele (PFFS)
• Uhlelo Lwezidingo Ezikhethekile (SNP)
• Izinhlelo ezitholakalayo eDelaware
• Ngubani ofanelekela i-Medicare eDelaware?
• Ngingabhalisa nini kuzinhlelo zeMedicare Delaware?
• Ukubhaliswa kwemicimbi
• Ukubhaliswa konyaka
• Amathiphu wokubhalisa kwi-Medicare eDelaware
• Izinsizakusebenza zeDelaware Medicare
• IDelaware Medicare Assistance Bureau (800-336-9500)
• I-Medicare.gov (800-633-4227)
• Yini okufanele ngiyenze ngokulandelayo?

IMedicare ngumshuwalense wezempilo ophethwe uhulumeni ongawuthola lapho uneminyaka yobudala engama-65. IMedicare eDelaware iyatholakala nakubantu abangaphansi kweminyaka engama-65 abahlangabezana nenqubo ethile.

Yini iMedicare?

I-Medicare ifaka izingxenye ezine eziyinhloko:

• Ingxenye A: ukunakekelwa esibhedlela
• Ingxenye B: ukunakekelwa kweziguli ezingalaliswanga
• Ingxenye C: I-Medicare Advantage
• Ingxenye D: imishanguzo kadokotela

Okumbozayo

Ingxenye ngayinye yeMedicare ihlanganisa izinto ezahlukahlukene:

• Ingxenye A ihlanganisa ukunakekelwa okutholayo njengesiguli esingalalisiwe esibhedlela futhi kubandakanya nokunakekelwa kwe-hospice, ukunakekelwa okulinganiselwe kokunakekelwa kwesikhungo sabahlengikazi besikhashana (SNF), kanye nezinye izinsizakalo zokunakekelwa kwempilo zesikhashana.
• Ingxenye B ihlanganisa ukunakekelwa kweziguli ezingalaliswanga, njengokuvakashelwa udokotela, ukunakekelwa kokuvikela, neminye imishini yezokwelapha ehlala isikhathi eside.
• Ingxenye C ihlanganisa ukumbozwa kwakho kweNgxenye A neNgxenye B kuhlelo olulodwa olungafaka ezinye izinzuzo, njengokufakwa kwamazinyo noma ukumbozwa kombono. Lezi zinhlelo zivame ukufaka nokusakazwa kwezidakamizwa kadokotela.
• Ingxenye D ihlanganisa ezinye noma zonke izindleko zemithi kadokotela ngaphandle kwesibhedlela (imithi oyithola ngesikhathi uhlala esibhedlela imbozwe ngaphansi kweNgxenye A).

Ngaphezu kwezingxenye ezine eziyinhloko, kukhona nezinhlelo zomshuwalense zokwengeza ze-Medicare. Imvamisa ibizwa ngokuthi iMedigap, lawa macebo ahlanganisa izindleko ezingaphandle kwamaphakethe ezinjengama-copay kanye ne-coinsurance ama-Medicare asekuqaleni angahleleli futhi atholakala ngabathwali bomshuwalense abazimele.

Awukwazi ukuthenga zombili Ingxenye C neMedigap. Kufanele ukhethe ukuthayipha eyodwa noma enye.

Izindleko ze-Medicare

Izinhlelo zeMedicare eDelaware zinezindleko ezithile ozikhokhela ukumbozwa nokunakekelwa.

Ingxenye A itholakala ngaphandle kwemali ekhokhwa njalo ngenyanga uma nje wena noma oshade naye nisebenze iminyaka eyishumi noma ngaphezulu emsebenzini futhi nakhokha intela yeMedare. Futhi ungathenga ukumbozwa uma ungahlangabezani nezimfuneko zokufaneleka. Ezinye izindleko zifaka:

• kudonswa imali njalo uma ungeniswa esibhedlela
• izindleko ezengeziwe uma isibhedlela sakho noma i-SNF ihlala isikhathi eside kunesikhathi sezinsuku ezibekiwe

Ingxenye B inezimali nezindleko eziningana, kufaka phakathi:

• imali ekhokhwa njalo ngenyanga
• imali ebanjwayo yonyaka
• ama-copay kanye ne-coinsurance engu-20 yamaphesenti ngemuva kokukhokhwa kwemali yakho ekhishiwe

Ingxenye C amapulani angaba ne-premium yezinzuzo ezengeziwe ezitholakala ngohlelo. Usabuye ukhokhe iphrimiyamu yengxenye B.

Ingxenye D izindleko zohlelo ziyahlukahluka ngokususelwa ekuhlanganisweni.

I-Medigap izindleko zohlelo ziyahlukahluka kuye ngecebo olikhethayo.

Yiziphi izinhlelo zeMedicare Advantage ezitholakala eDelaware?

Izinhlelo zeMedicare Advantage zivunyiwe yiCentre for Medicare and Medicaid Services (CMS) futhi zitholakala ezinkampanini zomshuwalense ezizimele. Izinzuzo zifaka:

• yonke imihlomulo yakho engxenyeni ngayinye yeMedicare imbozwe ngaphansi kohlelo olulodwa
• ezinye izinzuzo i-Medicare yasekuqaleni engazifaki, njengamazinyo, umbono, ukuzwa, ukuthuthwa lapho kubekwa khona abezokwelapha, noma ukulethwa kokudla ekhaya
• Ama-maximum aphuma ephaketheni ka- $ 7,550 (noma ngaphansi)

Kunezinhlobo ezinhlanu zezinhlelo zeMedicare Advantage eDelaware. Ake sibheke uhlobo ngalunye ngokulandelayo.

Inhlangano Yezempilo (HMO)

• Ukhetha umhlinzeki wokunakekelwa okuyisisekelo (PCP) oxhumanisa ukunakekelwa kwakho.
• Kufanele usebenzise abahlinzeki nezinsiza ngaphakathi kwenethiwekhi ye-HMO.
• Imvamisa udinga ukuthunyelwa kusuka kumhlinzeki wakho wokunakekelwa okuyisisekelo (i-PCP) ukuze ubone uchwepheshe.
• Ukunakekelwa ngaphandle kwenethiwekhi akuvalwa ngaphandle kwezimo eziphuthumayo.

Inhlangano Yomhlinzeki Okhethwayo (i-PPO)

• Ukunakekelwa kodokotela noma izikhungo ngaphakathi kwenethiwekhi ye-PPO yohlelo kuyambozwa.
• Ukunakekela ngaphandle kwenethiwekhi kungabiza kakhulu, noma kungambozwa.
• Awudingi ukuthunyelwa ukuze ubone isazi.

I-akhawunti yokonga yezokwelapha (MSA)

• Lezi zinhlelo zihlanganisa uhlelo lwezempilo oludonselwa phezulu kanye ne-akhawunti yokonga.
• I-Medicare inikela ngemali ethile unyaka nonyaka ukukhokhela izindleko (ungangeza ngaphezulu).
• Ama-MSAs angasetshenziselwa kuphela izindleko zokwelashwa ezifanelekile.
• Ukonga kwe-MSA akukhokhiswa intela (ngezindleko ezifanelekile zezokwelapha) futhi uthola inzalo engakhokhiswa intela.

Imali Yezinkonzo Ezizimele (PFFS)

• I-PFFS yizinhlelo ezingenayo inethiwekhi yodokotela noma izibhedlela; ungakhetha ukuya noma yikuphi okwamukela uhlelo lwakho.
• Baxoxisana ngqo nabahlinzeki futhi banqume ukuthi ukweleta malini ngezinsizakalo.
• Akubona bonke odokotela noma izikhungo ezamukela lezi zinhlelo.

Uhlelo Lwezidingo Ezikhethekile (SNP)

• Ama-SNP enzelwe abantu abadinga ukunakekelwa okuhlelekile futhi bahlangabezana neziqu ezithile.
• Kufanele ufaneleke kabili ukuthola i-Medicare neMedicaid, ube nesimo esisodwa noma ngaphezulu sezempilo, futhi / noma uhlale ekhaya lasebekhulile.

Izinhlelo ezitholakalayo eDelaware

Lezi zinkampani zinikela ngezinhlelo ezifundeni eziningi eDelaware:

• I-Aetna Medicare
• I-Cigna
• Humana
• Ukunakekelwa Kwezempilo KweLasso
• UnitedHealthcare

Ukunikezwa kohlelo lweMedicare Advantage kuyahluka ngesifunda, ngakho-ke faka ikhodi yakho ye-ZIP ethize lapho usesha izinhlelo lapho uhlala khona.

Ngubani ofanelekela i-Medicare eDelaware?

Ukuze ufanelekele i-Medicare, kufanele ube:

• Iminyaka engu-65 noma ngaphezulu
• isakhamuzi sase-U.S. noma umhlali ngokomthetho iminyaka engu-5 noma ngaphezulu

Uma umncane kuneminyaka yobudala engama-65, ungathola izinhlelo ze-Medicare eDelaware uma:

• ukufakelwa izinso noma ukuphela kwesifo sezinso (ESRD)
• une-amyotrophic lateral sclerosis (ALS)
• bebelokhu bethola izinzuzo zeSocial Security noma ezeSitimela zeBhodi Yomhlalaphansi izinyanga ezingama-24

Ungasebenzisa ithuluzi le-Medicare ukubona ukuthi ufanelekile yini.

Ngingabhalisa nini kuzinhlelo zeMedicare Delaware?

Ukuze uthole i-Medicare noma i-Medicare Advantage kufanele ubhalise ngesikhathi esifanele.

Ukubhaliswa kwemicimbi

• Isikhathi sokubhalisa sokuqala (IEP) iwindi lezinyanga eziyi-7 elizungeze usuku lwakho lokuzalwa lwama-65, ukuqala ezinyangeni ezintathu ngaphambi nokuqhubeka izinyanga ezintathu ngemuva kosuku lwakho lokuzalwa. Uma ubhalisa ngaphambi kokuba ube neminyaka engama-65 ubudala, ukumbozwa kwakho kuqala ngenyanga yakho yokuzalwa. Ukubhalisa ngemuva kwalesi sikhathi kuzosho ukubambezeleka kokumbozwa.
• Izikhathi zokubhalisa ezikhethekile (SEPs) yizikhathi eziqokiwe lapho ungabhalisa ngaphandle kokubhaliswa okuvulekile uma ulahlekelwa ukumbozwa ngezizathu ezahlukahlukene, kufaka phakathi ukulahlekelwa uhlelo oluxhaswe ngumqashi noma ukuhamba ngaphandle kwendawo yokumboza uhlelo lwakho.

Ukubhaliswa konyaka

• Ukubhaliswa okujwayelekile(Januwari 1 kuya ku-Mashi 31): Uma ungazange ubhalisele i-Medicare phakathi ne-IEP yakho, ungabhalisa kuNgxenye A, Ingxenye B, Ingxenye C, nezinhlelo zeNgxenye D. Ungakhokha inhlawulo ngokubhalisa sekwephuzile.
• Ukubhaliswa okuvulekile kweMedicare Advantage (Januwari 1 kuya kuMashi 31): Ungashintshela kuhlelo olusha uma usuvele uku-Medicare Advantage noma ungaqhubeka nge-Medicare yasekuqaleni.
• Vula ukubhalisa(Okthoba 15 kuya kuDisemba 7): Ungashintsha phakathi kwe-Medicare yangempela ne-Medicare Advantage, noma ubhalisele i-Part D uma ungabhalisanga ngesikhathi se-IEP yakho.

Amathiphu wokubhalisa kwi-Medicare eDelaware

Ukukhetha uhlelo olulungile kuncike kulezi zinto ezilandelayo:

• izidingo zakho zezempilo
• izindleko ezibekiwe
• odokotela (noma izibhedlela) ofuna ukubabona ukuze banakekelwe

Izinsizakusebenza zeDelaware Medicare

Ungathola izimpendulo zemibuzo yakho ye-Medicare Delaware evela kulezi zinhlangano:

IDelaware Medicare Assistance Bureau (800-336-9500)

• Uhlelo lwe-State Health Insurance Assistance Program (SHIP), olwalwaziwa nge-ELDERimininingwane
• ukwelulekwa mahhala kwabantu abane-Medicare
• izindawo zokwelulekwa zendawo kuyo yonke iDelaware (shayela ku-302-674-7364 ukuthola eyakho)
• usizo lwezezimali ukusiza ukukhokhela iMedicare

I-Medicare.gov (800-633-4227)

• isebenza njengendawo esemthethweni ye-Medicare
• uqeqeshe abasebenzi ngezingcingo zokusiza ukuphendula imibuzo yakho ye-Medicare
• inethuluzi lokuthola uhlelo ukukusiza ukuthi uthole ama-Medicare Advantage, Ingxenye D, kanye nezinhlelo zeMedigap endaweni yangakini

Yini okufanele ngiyenze ngokulandelayo?

Nazi izinyathelo zakho ezilandelayo zokuthola ukumbozwa okuhle kakhulu kwe-Medicare ukuhlangabezana nezidingo zakho:

• Nquma ukuthi ngabe ufuna i-Medicare yasekuqaleni noma i-Medicare Advantage.
• Khetha inqubomgomo ye-Medicare Advantage noma iMedigap, uma ikhona.
• Khomba isikhathi sakho sokubhalisa nezinsuku zakho zokugcina.
• Qoqa imibhalo efana nohlu lwemithi kadokotela oyithathayo kanye nanoma yiziphi izimo zempilo onazo.
• Buza udokotela wakho ukuthi bayayemukela yini iMedicare, nokuthi iyiphi inethiwekhi yeMedicare Advantage.

Lo mbhalo uvuselelwe ngoNovemba 10, 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.