Izinhlelo ze-Indiana Medicare ngo-2021

-Delile

• Yini iMedicare?
• Ingxenye yeMedicare A
• Ingxenye yeMedare B
• Ingxenye C (Medicare Advantage)
• Ingxenye yeMedare D
• Umshuwalense wokwengeza iMedare (iMedigap)
• Yiziphi izinhlelo ze-Medicare Advantage ezitholakala e-Indiana?
• Ngubani ofanelekela i-Medicare e-Indiana?
• Ngingabhalisa nini ezinhlelweni zeMedicare Indiana?
• Isikhathi sokuqala sokubhalisa
• Ukubhaliswa okujwayelekile: Januwari 1 kuya kuMashi 31
• Ukubhaliswa okuvulekile kweMedicare Advantage: Januwari 1 kuya kuMashi 31
• Ukubhaliswa okuvulekile kweMedicare: Okthoba 1 kuya kuDisemba 31
• Isikhathi sokubhalisa esikhethekile
• Amathiphu wokubhalisa kwi-Medicare e-Indiana
• Izinsiza ze-Indiana Medicare
• Yini okufanele ngiyenze ngokulandelayo?

I-Medicare uhlelo lomshuwalense wezempilo olutholakala kubantu abaneminyaka yobudala engama-65 noma ngaphezulu, nakwalabo abangaphansi kweminyaka engama-65 ubudala abanezimo ezithile ezingapheli noma abakhubazekile.

Yini iMedicare?

Izinhlelo zeMedicare e-Indiana zinezingxenye ezine:

• Ingxenye A, okuwukunakekelwa kweziguli ezibhedlela
• Ingxenye B, eyokunakekelwa kweziguli ezingalaliswanga
• Ingxenye C, eyaziwa nangokuthi i-Medicare Advantage
• Ingxenye D, okuyi-prescription drug coverage

Lapho uhlanganisa iminyaka engama-65 ubudala, ungabhalisela iMedicare yangempela (Ingxenye A noNgxenye B).

Ingxenye yeMedicare A

Iningi labantu lifanele ukuthola ukutholakala kweNgxenye A ngaphandle kwephrimiyamu yanyanga zonke. Uma ungafaneleki, ungathenga ukumbozwa.

Ingxenye A efakwa kuhlanganisa:

• ukumbozwa lapho ungeniswa esibhedlela ukunakekelwa kwesikhashana
• ukumbozwa okulinganiselwe kokunakekelwa kwesikhungo sabahlengikazi besikhashana
• ezinye izinsizakalo zokunakekelwa kwezempilo ekhaya ngezikhathi ezithile
• isibhedlela

Ingxenye yeMedare B

Ukuhlanganiswa kwengxenye B kufaka phakathi:

• ukuvakashelwa odokotela
• ukuhlolwa nokuhlolwa kokuvikela
• ukucabanga nokuhlolwa kwelabhorethri
• imishini yezokwelapha ehlala njalo
• Imithi yokwelashwa kanye nezinsizakalo

Ngemuva kokubhalisela i-Medicare yasekuqaleni, unganquma ukuthi ufuna uhlelo lweMedicare Advantage (Ingxenye C) noma uhlelo lweMedigap, kanye nokutholakala kwemithi kadokotela.

Ingxenye C (Medicare Advantage)

Abathwali bomshuwalense abazimele banikela ngezinhlelo zeMedicare Advantage e-Indiana ezihlanganisa izinzuzo ze-Medicare yasekuqaleni ngokutholakala kwemithi kadokotela nezinye izinsizakalo, ezinjengokunakekelwa kwamazinyo noma umbono. Ukufakwa okukhethekile kuyehluka ngohlelo nesithwali.

Enye inzuzo yezinhlelo ze-Advantage umkhawulo wonyaka wokusetshenziswa kwemali ephaketheni. Uma usufinyelele umkhawulo waminyaka yonke obekwe uhlelo, uhlelo lwakho lukhokhela zonke izindleko ezigunyazwe yi-Medicare zokunakekelwa okuhlanganisiwe konyaka.

I-Original Medicare, ngakolunye uhlangothi, ayinayo umkhawulo wonyaka. Ngezingxenye A no-B, uyakhokha

• kudonswa imali njalo uma ungeniswa esibhedlela
• imali ekhishwa minyaka yonke engxenyeni B
• iphesenti lezindleko zokwelashwa ngemuva kokukhokha iNgxenye B edonswayo

Ingxenye yeMedare D

Ingxenye D ihlela imishanguzo kadokotela kanye nemithi yokugoma. Lolu hlobo lokumboza luyadingeka, kepha unezinketho ezimbalwa:

• thenga inqubomgomo yengxenye D nge-Medicare yangempela
• bhalisela uhlelo lwe-Medicare Advantage olufaka ukumbozwa kweNgxenye D
• thola ukumbozwa okulinganayo kolunye uhlelo, njengohlelo oluxhaswe umqashi

Uma ungenayo imishanguzo kadokotela futhi ungayibhaliseli ngesikhathi sokubhaliswa kokuqala, uzokhokha inhlawulo yokubhaliswa kwesikhathi esedlule.

Umshuwalense wokwengeza iMedare (iMedigap)

IMedigap ingasiza ukukhokha izindleko ezikhishwa ephaketheni. Kukhona "amapulani" ayi-10 eMedigap anikeza ukumbozwa: A, B, C, D, F, G, K, L, M, and N.

Uhlelo ngalunye limbozwa ngokuhlukile, futhi akuzona zonke izinhlelo ezithengiswa kuyo yonke indawo. Cabanga ngezidingo zakho ngazinye lapho ubuyekeza izinhlelo zeMedigap, bese usebenzisa ithuluzi lokuthola uhlelo lweMedicare ukubona ukuthi yiziphi izinhlelo ezithengiswa ku-ZIP code yakho.

Ngokuya ngohlelo olukhethayo, iMedigap ihlanganisa ezinye noma zonke lezi zindleko zeMedicare:

• ama-copayments
• ukuqinisekiswa kwemali
• ukudonswa kwemali
• ukunakekelwa kwendawo yabahlengikazi abanamakhono
• ukunakekelwa kwezimo eziphuthumayo

IMedigap itholakala ukusetshenziswa kuphela nge-Medicare yasekuqaleni. Ayikwazi ukuhlanganiswa nezinhlelo zeMedicare Advantage (Ingxenye C). Awungeke ubhalise kuzo zombili i-Medicare Advantage neMedigap.

Yiziphi izinhlelo ze-Medicare Advantage ezitholakala e-Indiana?

E-Indiana, izinhlelo zeMedicare Advantage ziwela ngaphansi kwezigaba eziyisikhombisa:

• Izinhlelo ze-Health Maintenance Organisation (HMO). Ku-HMO, ukhetha umhlinzeki wokunakekelwa okuyisisekelo (i-PCP) kunethiwekhi yohlelo lodokotela. Lowo muntu uqondisa ukunakekelwa kwakho, kufaka phakathi ukuthunyelwa kochwepheshe. Ama-HMO afaka izibhedlela nezinsiza ngaphakathi kwenethiwekhi.
• I-HMO enezinhlelo zamaphuzu wenkonzo (POS). I-HMO enezinhlelo ze-POS zimboza ukunakekelwa ngaphandle kwenethiwekhi yazo. Ngokuvamile zifaka izindleko eziphakeme ezingaphandle kwe-pocket zokunakekelwa ngaphandle kwenethiwekhi, kepha ezinye zalezo zindleko ziyahlanganiswa.
• Izinhlelo ze-Preferred Provider Organisation (PPO). Izinhlelo ze-PPO zinenethiwekhi yabahlinzeki bokunakekelwa nezibhedlela futhi azidingi ukuthi uthole ukuthunyelwa kwe-PCP ukubona isazi. Ukunakekela ngaphandle kwenethiwekhi kungabiza kakhulu noma kungenzeka kungambozwa nhlobo.
• Izinhlelo zokunakekelwa eziphethwe ngumhlinzeki (PSO). Kulezi zinhlelo, abahlinzeki bathatha ubungozi bezezimali bokunakekelwa, ngakho-ke ukhetha i-PCP ohlelweni bese uyavuma ukusebenzisa abahlinzeki bohlelo.
• Ama-akhawunti okonga ama-Medicare (MSAs). I-MSA ifaka uhlelo lomshuwalense oludonswa kakhulu nge-akhawunti yokulondoloza yezindleko zokwelashwa ezifanelekile. I-Medicare ikhokha amaphrimiyamu akho bese ifaka inani elithile ku-akhawunti yakho unyaka nonyaka. Ungafuna ukunakekelwa kunoma yimuphi udokotela.
• Izinhlelo ze-Private Fee-for-Service (PFFS). Lezi yizinhlelo zomshuwalense ezizimele ezibeka amazinga okubuyiselwa kwemali ngqo nabahlinzeki. Ungakhetha noma yimuphi udokotela noma indawo ezokwamukela uhlelo lwakho lwe-PFFS; kodwa-ke, akubona bonke abahlinzeki abazokwenza kanjalo.
• Izinhlelo Zenhlangano Yezinzuzo Zenkolo. Lezi zinhlelo ngama-HMOs, ama-HMO anama-POS, ama-PPO, noma ama-PSO adalwe yinhlangano yenkolo noma yobuzalwane. Ukubhalisa kungakhawulelwa kubantu abakuleyo nhlangano.

Izinhlelo Zezidingo Ezikhethekile (ama-SNP) ziyatholakala uma udinga ukunakekelwa okuhlelekile. Lezi zinhlelo zinikeza ukumbozwa okungeziwe nosizo.

Ungathola i-SNP uma:

• afanelekile kokubili iMedicaid neMedicare
• Unesimo esisodwa noma eziningi ezingapheli noma ezikhubazayo
• hlala esikhungweni sokunakekelwa kwesikhathi eside

Laba bathwali bomshuwalense banikela ngezinhlelo zeMedicare Advantage e-Indiana:

• Aetna
• Konke
• I-Anthem Blue Cross neBlue Shield
• Abahlabeleli Bezingoma
• ICareSource
• Humana
• Izinhlelo zezeMpilo zase-Indiana University
• Ukunakekelwa Kwezempilo KweLasso
• MyTruAdvantage
• UnitedHealthcare
• Zing Impilo

Izinhlelo ezahlukahlukene ziyatholakala esifundeni ngasinye sase-Indiana, ngakho-ke izinketho zakho zixhomeke lapho uhlala khona nekhodi lakho le-ZIP. Akuzona zonke izinhlelo ezitholakala kuzo zonke izindawo.

Ngubani ofanelekela i-Medicare e-Indiana?

Ukuze ufanelekele izinhlelo ze-Medicare Indiana, kufanele:

• ube neminyaka engama-65 noma ngaphezulu
• ube yisakhamuzi saseU.S

Ungafaneleka ngaphambi kokuba ube neminyaka engama-65 uma:

• bathole i-Social Security Disability Insurance (SSDI) noma i-Railroad Retirement Benefits (RRB) izinyanga ezingama-24
• babe nesifo sesifo sezinso sokugcina (ESRD) noma ukufakelwa izinso
• bane-amyotrophic lateral sclerosis (ALS), eyaziwa nangokuthi isifo sikaLou Gehrig

Ngingabhalisa nini ezinhlelweni zeMedicare Indiana?

Abanye abantu babhaliswa ngokuzenzekelayo kwi-Medicare, kepha iningi lidinga ukubhalisa ngesikhathi esifanele sokubhalisa.

Isikhathi sokuqala sokubhalisa

Ukuqala ezinyangeni ezi-3 ngaphambi kwenyanga yosuku lwakho lokuzalwa lwama-65, ungabhalisa kwi-Medicare. Izinzuzo zakho zizoqala ngosuku lokuqala lwenyanga yakho yokuzalwa.

Uma uphuthelwa yisikhathi sokubhalisa sokuqala, usengabhalisa phakathi nenyanga yosuku lwakho lokuzalwa nangezinyanga ezi-3 ngemuva kwalokho, kepha ukumbozwa kuzobambezeleka.

Ngesikhathi sokuqala sokubhalisa, ungabhalisa ezingxenyeni A, B, C, no-D.

Ukubhaliswa okujwayelekile: Januwari 1 kuya kuMashi 31

Uma uphuthelwe yisikhathi sakho sokuqala sokubhalisa, ungabhalisa ekuqaleni konyaka ngamunye, kepha ukumbozwa kwakho ngeke kuqale kuze kube nguJulayi 1. Ukubhaliswa kwesikhathi kwesikhathi kungasho nokuthi uzokhokha inhlawulo noma kunini lapho ubhalisa.

Ngemuva kokubhaliswa okujwayelekile, ungabhalisela i-Medicare Advantage kusuka ngo-Ephreli 1 kuya kuJuni 30.

Ukubhaliswa okuvulekile kweMedicare Advantage: Januwari 1 kuya kuMashi 31

Uma usuvele ubhalisile kuhlelo lwe-Medicare Advantage, ungashintsha izinhlelo noma ubuyele ku-Medicare yasekuqaleni ngalesi sikhathi.

Ukubhaliswa okuvulekile kweMedicare: Okthoba 1 kuya kuDisemba 31

Ebizwa nangokuthi isikhathi sokubhaliswa sonyaka, lesi yisikhathi lapho unga:

• shintsha ukusuka kwi-Medicare yasekuqaleni uye kwi-Medicare Advantage
• shintsha ukusuka kwi-Medicare Advantage uye kwi-Medicare yasekuqaleni
• shintsha kusuka kuhlelo olulodwa lweMedicare Advantage uye kolunye
• shintshela kuhlelo olulodwa lweMedicare Part D (umuthi kadokotela) uye kolunye

Isikhathi sokubhalisa esikhethekile

Ungabhalisa kwi-Medicare ngaphandle kokulinda ukubhaliswa okuvulekile ngokufanelekela isikhathi esikhethekile sokubhalisa. Lokhu kuzokwenzeka kakhulu uma ulahlekelwa ukufakwa ngaphansi kohlelo oluxhaswe umqashi, phuma endaweni yokumbozwa kohlelo lwakho, noma uhlelo lwakho alusatholakali ngesizathu esithile.

Amathiphu wokubhalisa kwi-Medicare e-Indiana

Kubalulekile ukuhlola izidingo zakho zokunakekelwa kwezempilo bese ufunda uhlelo ngalunye ngokucophelela ukuze ukwazi ukukhetha okuhlinzeka ngokutholakala okungcono kakhulu kwezidingo zakho. Cabanga ngokucophelela:

• noma ngabe udinga iMedicare yokuqala noma iMedicare Advantage
• uma odokotela bakho obakhethayo besenethiwekhi yohlelo lweMedicare Advantage
• zithini izindleko zeprimiyamu, idonkiwe, i-copay, i-coinsurance, nezindleko ezingaphandle kwephakethe zohlelo ngalunye

Ukuze ugweme isijeziso sokubhaliswa sekwedlule isikhathi, bhalisela zonke izingxenye ze-Medicare (A, B, ne-D) noma uqiniseke ukuthi unokunye ukumbozwa, njengohlelo oluxhaswe umqashi, lapho uneminyaka engama-65.

Izinsiza ze-Indiana Medicare

Uma udinga imininingwane engaphezulu noma usize ukuqonda izinketho zakho ze-Medicare e-Indiana, lezi zinsiza ziyatholakala:

• Umnyango Womshuwalense wase-Indiana, 800-457-8283, onikeza ukubuka konke kwe-Medicare, izixhumanisi eziwusizo ze-Medicare, nokusiza ukukhokhela i-Medicare
• Uhlelo lwe-Indiana State Health Insurance Program (SHIP), 800-452-4800, lapho amavolontiya aphendula khona imibuzo futhi akusize ngokubhaliswa kwe-Medicare
• I-Medicare.gov, 800-633-4227

Yini okufanele ngiyenze ngokulandelayo?

Nawa amathiphu wokukusiza ubhalise ku-Medicare:

• Qoqa noma yimaphi amarekhodi noma imininingwane mayelana nemiyalelo yakho nemibandela yezokwelapha.
• Buza udokotela wakho ukuthi imuphi umshwalense noma ama-Medicare ahlela ukwamukela noma ukuhlanganyela kuwo.
• Thola ukuthi isikhathi sakho sokubhalisa sinini bese umaka ikhalenda lakho.
• Bhalisela i-Part A ne-Part B, bese unquma ukuthi ungathanda yini uhlelo lwe-Medicare Advantage.
• Khetha uhlelo ngokumbozwa okudingayo nabahlinzeki obathandayo.

Lo mbhalo uvuselelwe ngoNovemba 20, 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.