Izinhlelo zeNevada Medicare ngo-2021

-Delile

• Yini iMedicare?
• Ingxenye A
• Ingxenye B
• Ingxenye C (Medicare Advantage)
• Ingxenye D
• Umshuwalense owengeziwe we-Medicare (Medigap)
• Yiziphi izinhlelo zeMedicare Advantage ezitholakala eNevada?
• Ngubani ofanelekela i-Medicare eNevada?
• Ngingabhalisa nini ezinhlelweni zeMedicare Nevada?
• Isikhathi sokubhalisa sokuqala (IEP)
• Isikhathi sokubhaliswa okujwayelekile
• Ukubhaliswa okuvulekile kweMedicare Advantage
• Isikhathi sokubhalisa esivulekile
• Izikhathi zokubhalisa ezikhethekile (SEPs)
• Amathiphu wokubhalisa kwi-Medicare eNevada
• Izinsizakusebenza zeNevada Medicare
• Yini okufanele ngiyenze ngokulandelayo?

Uma uhlala eNevada futhi uneminyaka engama-65 noma ngaphezulu, ungahle ufaneleke ukuthola iMedicare. I-Medicare ngumshuwalense wezempilo ngohulumeni wesifundazwe. Ungahle ufaneleke uma ungaphansi kweminyaka engama-65 futhi uhlangabezana nezidingo ezithile zezokwelapha.

Funda ukuze ufunde ngezinketho zakho ze-Medicare eNevada, ukuthi ungabhalisa nini nokuthi kanjani, nezinyathelo ezilandelayo.

Yini iMedicare?

• I-Medicare yangempela: ihlanganisa ukuhlala esibhedlela nokunakekelwa kwabangalaliswa ngaphansi kwezigaba A no-B
• Inzuzo yeMedicare: izinhlelo zomshuwalense wezempilo wangasese ezihlanganisa izinzuzo ezifanayo ne-Medicare yasekuqaleni futhi zinganikela nangezinye izinketho zokuhlanganisa
• Ingxenye yeMedicare D: lezi zinhlelo zomshuwalense wangasese zihlanganisa izindleko zemithi kadokotela
• Umshuwalense wokwengeza we-Medicare (Medigap): Izinhlelo zinikeza ukumbozwa ukusiza ukukhokhela imali edonswayo, ama-copay, i-coinsurance, nezinye izindleko ze-Medicare ezingaphandle kwezikhwama

Ingxenye A

Ingxenye A ihlanganisa ukunakekelwa esibhedlela, isibhedlela sokufinyelela esibucayi, noma isikhathi esilinganiselwe esikhungweni sabahlengikazi abanamakhono.

Uma ufanelekele i-Part A engenayo i-premium, azikho izindleko zenyanga zalokhu kufakwa. Uzokweleta imali edonswayo lapho uvunyelwa ukunakekelwa.

Uma ungafaneleki ingxenye A ngaphandle kwephrimiyamu, usengathola Ingxenye A kodwa kuzofanele ukhokhe imali ekhokhwayo.

Ingxenye B

Ingxenye B ihlanganisa okunye ukunakekelwa kwezempilo ngaphandle kwesibhedlela, kufaka phakathi:

• ukuvakashela kudokotela wakho
• ukunakekelwa kokuvimbela
• izivivinyo zelebhu, ukuhlolwa kokuxilongwa, nemifanekiso
• imishini yezokwelapha ehlala njalo

Izinkokhelo zanyanga zonke zezinhlelo B ziyashintsha unyaka nonyaka.

Ingxenye C (Medicare Advantage)

Abashuwalense abazimele baphinde banikeze ngezinhlelo zeMedicare Advantage (Ingxenye C). Izinhlelo ze-Medicare Advantage zinikeza izinzuzo ezifanayo nezingxenye ze-A no-B ze-Medicare yasekuqaleni kepha zivame ukuba nokutholakala okwengeziwe (nge-premium eyengeziwe) engafaka:

• amazinyo, umbono, nokunakekelwa kokuzwa
• izindlela ezihamba ngezihlalo ezinamasondo
• ukulethwa kokudla ekhaya
• ezokuthutha ezidingekayo ngokwezempilo

Usadinga ukubhalisa ezingxenyeni A noNgxenye B bese ukhokha iphrimiyamu yengxenye B lapho ubhalisa ohlelweni lweMedicare Advantage.

Ingxenye D

Wonke umuntu oku-Medicare ufanelekile ukutholakala kwezidakamizwa kadokotela (Ingxenye D), kodwa kunikezwa kuphela ngomshuwalense wangasese. Kubalulekile ukuqhathanisa amapulani ngoba izindleko nokufakwa kwezimali kuyehluka.

Umshuwalense owengeziwe we-Medicare (Medigap)

I-Medicare supplemental insurance (Medigap) isiza ukukhokha izindleko zokuphuma ephaketheni zezingxenye A no-B. Lezi zinhlelo zinikezwa ngabanikezeli bomshuwalense abazimele.

Izinhlelo zeMedigap zingakulungela kahle uma unezindleko eziphakeme zokunakekelwa kwempilo ngoba iMedicare yangempela ayinayo umkhawulo wonyaka wokusetshenziswa kwemali ephaketheni. Izinhlelo zeMedigap zingasiza futhi ekunciphiseni ukukhathazeka ngezindleko ezingaziwa zokunakekelwa kwezempilo uma ukhetha eyodwa enesikhwama esingaphandle kwesikhwama.

Yiziphi izinhlelo zeMedicare Advantage ezitholakala eNevada?

Izinhlelo zeMedicare Advantage eNevada ziwela ezigabeni ezine:

Inhlangano Yokulondolozwa Kwezempilo (HMO). Nge-HMO, ukunakekelwa kwakho kuqondiswa udokotela oyinhloko (PCP) kunethiwekhi yohlelo okuthumela kubachwepheshe njengoba kudingeka. Uma uphuma kunethiwekhi nganoma yini ngaphandle kokunakekelwa okuphuthumayo noma i-dialysis, kungenzeka ukuthi ngeke ihlanganiswe. Kubalulekile ukufunda nokulandela yonke imithetho yohlelo.

PIzinhlangano Zabahlinzeki ezidlulisiwe (I-PPO). Izinhlelo ze-PPO zinamanethiwekhi odokotela nezinsiza ezihlinzeka ngezinsizakalo ezihlanganiswe ngaphansi kohlelo lwakho. Awudingi ukuthunyelwa ukuze ubone isazi, kodwa ungahle ufune ukuba ne-PCP yokuxhumanisa ukunakekelwa kwakho. Ukunakekela ngaphandle kwenethiwekhi kuzobiza kakhulu.

Imali yangasese-Yensizakalo(PFFS). Nge-PFFS, ungaya kunoma yimuphi udokotela noma indawo evunyelwe yi-Medicare, kepha baxoxisana ngamanani abo. Akubona bonke abahlinzeki abamukela lezi zinhlelo, ngakho-ke hlola ukuthi odokotela bakho obathandayo bayabamba iqhaza ngaphambi kokukhetha le nketho.

Uhlelo Lwezidingo Ezikhethekile (SNP). Ama-SNP ayatholakala kubantu abadinga ukuphathwa nokunakekelwa kwezinga eliphezulu. Ungahle ufanelekele i-SNP uma:

• banezimo ezithile zezempilo, njengezifo zesifo sokugcina (i-ESRD), isifo sikashukela, noma izimo zenhliziyo ezingalapheki
• bafanelekele iMedicare neMedicaid (abafanelekile ababili)
• hlala ekhaya lasebekhulile

Izinhlelo zeMedicare Advantage eNevada zinikezwa ngabathwali bomshuwalense abalandelayo:

• I-Aetna Medicare
• Uhlelo Lokuqondanisa Impilo
• Konke
• I-Anthem Blue Cross neBlue Shield
• Humana
• Izinkampani Zomshuwalense We-Imperial, Inc.
• Ukunakekelwa Kwezempilo KweLasso
• Uhlelo Lokuvelela Kwezempilo
• KhethaHealth
• I-Senior Care Plus
• UnitedHealthcare

Akuzona zonke izinkampani zenethiwekhi ezinikela ngezinhlelo kuzo zonke izifunda zeNevada, ngakho-ke izinketho zakho zizohluka ngokuya ngekhodi lakho le-ZIP.

Ngubani ofanelekela i-Medicare eNevada?

Ufanelekele i-Medicare uma uneminyaka yobudala engama-65 noma ngaphezulu futhi uyisakhamuzi noma umhlali wasemthethweni e-United States eminyakeni emihlanu edlule noma ngaphezulu.

Uma ungaphansi kweminyaka yobudala engama-65, ungahle ufaneleke uma:

• thola izinzuzo zokukhubazeka kwiBhodi Yokuthatha Umhlalaphansi Kajantshi noma Ukuphepha Komphakathi
• bane-ESRD noma bangabemukeli bokufakelwa kwezinso
• une-amyotrophic lateral sclerosis (ALS)

Ukuthola i-Medicare Part A ngaphandle kwe-premium yanyanga zonke, wena noma oshade naye kufanele nihlangabezane nezimfuneko ngokusebenza emsebenzini lapho nikhokhele khona intela yeMedare iminyaka eyishumi noma ngaphezulu.

Ungasebenzisa ithuluzi lokufaneleka eliku-inthanethi le-Medicare ukunquma ukufaneleka kwakho.

Ngingabhalisa nini ezinhlelweni zeMedicare Nevada?

Ama-Original Medicare, Medicare Advantage, kanye nezinhlelo zeMedigap zibeke izikhathi lapho ungabhalisa khona noma ushintshe izinhlelo nezinhlelo. Uma uphuthelwa yisikhathi sokubhalisa, kungenzeka ukhokhe inhlawulo ngokuhamba kwesikhathi.

Isikhathi sokubhalisa sokuqala (IEP)

Iwindi lokuqala lokubhalisa kulapho uneminyaka yobudala engama-65. Ungabhalisa noma kunini ezinyangeni ezi-3 ngaphambili, ngenyanga ka, noma ezinyangeni ezi-3 ngemuva kosuku lwakho lokuzalwa lwama-65.

Uma ubhalisa ngaphambi kwenyanga yakho yokuzalwa, ukumboza kwakho kuzoqala ngenyanga ozoba neminyaka engama-65 ngayo. Uma ulinda kuze kube yinyanga yakho yokuzalwa noma kamuva, kuzoba nokubambezeleka kwezinyanga ezimbili noma ezintathu ngaphambi kokuqala kokumboza.

Ngesikhathi sakho se-IEP uyakwazi ukubhalisela izingxenye A, B, kanye no-D.

Isikhathi sokubhaliswa okujwayelekile

Uma uphuthelwe i-IEP yakho futhi udinga ukubhalisela i-Medicare yangempela noma ushintshe izinketho zohlelo, ungakwenza lokhu ngesikhathi sokubhaliswa okujwayelekile. Isikhathi sokubhalisa esijwayelekile senzeka minyaka yonke phakathi Januwari 1 noMashi 31, kepha ukumbozwa kwakho ngeke kuqale kuze kube nguJulayi 1.

Uyakwazi ukubhalisela izingxenye A no-B noma ushintshe ukusuka ku-Medicare yoqobo kuye kwi-Medicare Advantage ngesikhathi sokubhaliswa okujwayelekile.

Ukubhaliswa okuvulekile kweMedicare Advantage

Ungashintsha kusuka kuhlelo olulodwa lwe-Medicare Advantage uye kolunye noma ushintshele ku-Medicare yasekuqaleni ngesikhathi sokubhaliswa okuvulekile kwe-Medicare Advantage. Ukubhaliswa okuvulekile kweMedicare Advantage kwenzeka minyaka yonke phakathi Januwari 1 noMashi 31.

Isikhathi sokubhalisa esivulekile

Ngesikhathi sokubhaliswa okuvulekile, ungabhalisela uhlelo lwe-Part C (Medicare Advantage) okokuqala noma ubhalisele ukumbozwa kweNgxenye D uma ungakwenzanga ngesikhathi se-IEP.

Ukubhaliswa okuvulekile kwenzeka minyaka yonke phakathi Okthoba 15 noDisemba 7.

Izikhathi zokubhalisa ezikhethekile (SEPs)

Ama-SEP akuvumela ukuthi ubhalise ngaphandle kwezikhathi ezijwayelekile zokubhalisa ngenxa yezizathu ezithile, njengokulahlekelwa uhlelo oluxhaswe umqashi, noma ukuphuma endaweni yesevisi yohlelo lwakho. Ngale ndlela, akudingeki ulinde ukubhaliswa okuvulekile.

Amathiphu wokubhalisa kwi-Medicare eNevada

Njengoba kunezinto eziningi ongakhetha kuzo, kubalulekile ukuthi ubheke izindleko nezidingo zakho zokunakekelwa kwezempilo unyaka nonyaka ukuthola uhlelo olungcono kakhulu kuwe.

Uma ulindele izindleko eziphakeme zokunakekelwa kwezempilo ngonyaka ozayo, ungahle ufune uhlelo lweMedicare Advantage ukuze izindleko zimbozwe ngemuva kokufinyelela kuma-out-of-max max. Uhlelo lweMedigap lungasiza futhi ngezindleko eziphezulu zezokwelapha.

Ezinye izinto okufanele uzicabangele yilezi:

• izindleko zanyanga zonke ze-premium
• ama-deductibles, ama-copay, kanye ne-coinsurance
• abahlinzeki kunethiwekhi yohlelo

Ungabuyekeza izilinganiso zezinkanyezi ze-CMS ukuze ubone ukuthi izinhlelo ezithile zikala kahle kangakanani kukhwalithi nokwaneliseka kweziguli.

Izinsizakusebenza zeNevada Medicare

Ngeminye imininingwane mayelana nezinhlelo zeMedicare eNevada, finyelela kunoma iziphi izinsiza ezilandelayo:

• Uhlelo lwe-State Health Insurance Program (SHIP): 800-307-4444
• I-SeniorRx ngosizo lokukhokhela imishanguzo kadokotela: 866-303-6323
• Imininingwane ngezinhlelo zeMedigap ne-MA
• Ithuluzi le-Medicare rate rate
• I-Medicare: shayela u-800-MEDICARE (800-633-4227) noma uye ku-Medicare.gov

Yini okufanele ngiyenze ngokulandelayo?

Ukuthola nokubhalisa kwiMedicare eNevada:

• Nquma izidingo zakho zezempilo kanye nezindleko zokunakekelwa kwempilo ezingaba khona unyaka nonyaka ukuze ukhethe uhlelo olulungile, kufaka phakathi ukumbozwa okungeziwe noma kweNgxenye D.
• Izinhlelo zokucwaninga zitholakala kubathwali bendawo yangakini.
• Maka ikhalenda lakho ngesikhathi esifanele sokubhalisa ukuze ungaphuthelwa ukubhalisa.

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.