Izinhlelo ze-Oregon Medicare ngo-2021

-Delile

• Yini iMedicare?
• Izinhlelo zokwengeza ze-Medicare
• Izinhlelo zemithi kadokotela
• Izinhlelo zeMedicare Advantage (Ingxenye C)
• Yiziphi izinhlelo ze-Medicare Advantage ezitholakala e-Oregon?
• Ngubani ofanelekela i-Medicare e-Oregon?
• Ngingabhalisa nini ezinhlelweni ze-Medicare Oregon?
• Amathiphu wokubhalisa kwi-Medicare e-Oregon
• Izinsizakusebenza ze-Medicare Oregon
• Yini okufanele ngiyenze ngokulandelayo?

Noma ngabe uthenga izinhlelo ze-Medicare e-Oregon okokuqala noma ucabanga ukushintsha ukumbozwa kwakho kwamanje kwe-Medicare, kubalulekile ukuthi uqale uqonde konke ongakhetha kukho.

Funda ukuze ufunde ngezinhlelo ezahlukahlukene ze-Medicare ezitholakala e-Oregon, izinkathi zokubhalisa, nokuningi.

Yini iMedicare?

I-Medicare wuhlelo lukazwelonke lomshuwalense wezempilo olulawulwa nguhulumeni wesifundazwe. Kutholakala kubantu abaneminyaka engama-65 nangaphezulu, kanye nalabo banoma yimiphi iminyaka abanokukhubazeka okuthile noma izimo zezempilo.

Izingxenye A no-B zakha i-Medicare yoqobo ongayithola kuhulumeni. Kuyo yonke le minyaka, uhlelo lokuqala lweMedicare selukhulisiwe lwafaka izinhlelo ongazithenga kubashuwalense abazimele. Lezi zinhlelo zingangeza noma zishintshe ukumbozwa okutholayo ngaphansi kwe-Medicare yasekuqaleni.

Ingxenye A ngumshwalense wesibhedlela. Kuyasiza ukukhokha izindleko ze:

• usizo lwezempilo lweziguli oluthola esibhedlela
• ukuhlala okulinganiselwe esikhungweni sabahlengikazi abanamakhono
• ukunakekelwa kwe-hospice
• ezinye izinsizakalo zezempilo zasekhaya ezinomkhawulo

Uma wena noma oshade naye nikhokhe intela yamaholo akwa-Medicare phakathi neminyaka yenu yokusebenza, ngeke kudingeke ukuthi nikhokhele imali ekhokhelwa iNgxenye A.

Ingxenye B isiza ukukhokha izindleko zokunakekelwa kweziguli ezingaphandle, njengezinsizakalo noma izinto ozithola kudokotela wakho oyinhloko noma uchwepheshe, kufaka phakathi ukunakekelwa kokuvimbela. Uyayikhokha imali yePrimiyamu yengxenye B. Leyo mali incike ezicini ezahlukahlukene, kufaka phakathi iholo lakho.

Izingxenye A no-B zihlanganisa izinsizakalo eziningi, kodwa kuningi iMedare yokuqala engakuhlanganisi. Akukho ukutholakala kwemithi kadokotela, ukunakekelwa kwesikhathi eside, noma amazinyo, umbono, noma izinsizakalo zokuzwa.

Ngisho nezinsizakalo iMedicare ezikhokhelayo, ukumbozwa akuyona iphesenti le-100. Kusazodingeka ukhokhe imali ebonakalayo ephaketheni lapho ubona udokotela, njengama-copays, ama-coinsurance, kanye nama-deductibles.

Unganweba ukumbozwa kwakho ngokuthenga izinhlelo ezinikezwa ngabanikezeli bomshuwalense abazimele. Lokhu kufaka phakathi ukwengeza kwe-Medicare, imithi kadokotela, kanye nezinhlelo ze-Medicare Advantage.

Izinhlelo zokwengeza ze-Medicare

Izinhlelo zokwengeza ze-Medicare, kwesinye isikhathi ezibizwa ngeMedigap, zengeza ukumbozwa kwi-Medicare yakho yoqobo. Bangasiza ukwehlisa inani olikhokhayo ephaketheni lapho ufuna ukunakekelwa. Bangangeza futhi amazinyo, umbono, ukunakekelwa kwesikhathi eside, noma okunye ukufakwa.

Izinhlelo zemithi kadokotela

Ingxenye D yezinhlelo zezinhlelo zemithi kadokotela. Bagxila kuphela ekusizeni ukukhokhela izindleko zemithi.

Izinhlelo zeMedicare Advantage (Ingxenye C)

Izinhlelo zeMedicare Advantage (Ingxenye C) zinikela ngokufaka “konke okukodwa” esikhundleni seMedicare yangempela kanye nokufakwa okungeziwe. Esikhundleni sokuba nenhlanganisela yezinhlelo zomphakathi nezangasese, ungathola uhlelo lweMedicare Advantage olufaka isethi ephelele yezinzuzo, kufaka phakathi ukumbozwa kwemithi kadokotela, umbono kanye namazinyo, ukunakekelwa kwesikhathi eside, ukuzwa, nokuningi.

Futhi, izinhlelo zeMedicare Advantage zivame ukufaka okungeziwe okuningi, njengezaphulelo kanye nezinhlelo zezempilo nezempilo.

Yiziphi izinhlelo ze-Medicare Advantage ezitholakala e-Oregon?

Izinkampani zomshuwalense ezizimele ezilandelayo zinikela ngezinhlelo zeMedicare Advantage e-Oregon:

• I-Aetna Medicare
• Izinhlelo ze-Atrio Health
• Impilo Net
• Humana
• UKaiser Permanente
• Ukunakekelwa Kwezempilo KweLasso
• Uhlelo lweModa Health Plan, Inc.
• I-PacificSource Medicare
• Izinhlelo ze-Providence Medicare Advantage
• I-Regence BlueCross BlueShield yase-Oregon
• UnitedHealthcare

Iminikelo yohlelo iyahlukahluka ngesifunda, ngakho-ke izinketho zakho zizoya ngokuthi yini etholakala esifundeni lapho uhlala khona.

Ngubani ofanelekela i-Medicare e-Oregon?

Ukufaneleka kweMedicare kuya ngeminyaka yakho noma isimo sempilo. Uvumelekile ukubhalisa uma:

• uneminyaka engama-65 noma ngaphezulu
• ngaphansi kweminyaka yobudala engama-65 futhi unokukhubazeka okufanelekile
• noma yibuphi ubudala futhi unesifo sesifo sokuphela kwesigaba (ESRD) noma i-amyotrophic lateral sclerosis (ALS)

Ngingabhalisa nini ezinhlelweni ze-Medicare Oregon?

Uma ukufaneleka kwakho kwe-Medicare kususelwa eminyakeni yobudala, ungaqala inqubo yokubhalisa ezinyangeni ezintathu ngaphambi kwenyanga yosuku lwakho lokuzalwa lwama-65. Lesi yisikhathi sakho sokuqala sokubhalisa. Bese ihlala izinyanga ezintathu ngemuva kwenyanga lapho uhlanganisa iminyaka engama-65 ubudala.

Ngokuvamile kunengqondo ukubhalisa okungenani Ingxenye A ngesikhathi sokuqala sokubhalisa, ngoba kungenzeka ufaneleke ukuthola izinzuzo zeNgxenye A ngaphandle kokukhokha imali ekhokhwayo.

Uma wena noma oshade naye ukhetha ukuqhubeka nokusebenza futhi niqhubeke nokufanelekela ukutholakala okuxhaswe ngumqashi, ungahle uthande ukuyeka ukubhalisa engxenyeni B noma kunoma yikuphi ukufakwa okungeziwe. Ezimweni ezinjalo, uzofanelekela isikhathi sokubhalisa esikhethekile ngokuhamba kwesikhathi.

Ungenza ushintsho kuhlelo olukhona lokuqala lweMedicare noma ubhalise okokuqala eMedicare ngesikhathi sokubhalisa esivulekile kusuka ngo-Okthoba 15 kuya kuDisemba 7.

Kukhona nesikhathi sokubhalisa esivulekile seMedicare Advantage unyaka nonyaka. Ngalesi sikhathi, ungashintsha ukumbozwa kusuka ku-Medicare yangempela uye kuhlelo lwe-Medicare Advantage. Isikhathi sokubhalisa esivulekile sezinhlelo zeMedicare Advantage sisukela ngoJanuwari 1 kuya kuMashi 31.

Amathiphu wokubhalisa kwi-Medicare e-Oregon

Lapho uthenga izinhlelo zeMedicare e-Oregon, uzofuna ukukhumbula ukuthi izinkampani zomshuwalense ezizimele zinokuguquguquka okuningi, ukuze zikwazi ukuhlela izinhlelo zazo ngezindlela ezahlukene.

Isibonelo, ezinye izinhlelo ze-Medicare Advantage zingaba yizinhlelo ze-Health Maintenance Organisation (HMO), ezidinga ukuthi ukhethe udokotela oyinhloko onakekela ukunakekelwa kwakho futhi okufanele akuthumele uma udinga ukubona ongoti.

Abanye bangaba yizinhlelo ze-Preferred Provider Organisation (PPO) ezikunikeza ukufinyelela kubahlinzeki benethiwekhi yabo bonke amakhono ngaphandle kwesidingo sokudluliselwa.

Yiluphi uhlobo lwecebo olunengqondo kuwe? Lokho kuya ngezimo zakho nezintandokazi zakho. Ungahle uthande ukubheka le mibuzo elandelayo lapho ulinganisa izinketho zakho:

• Ngabe lolu hlelo luzongibiza malini? Malini amaprimiyamu? Ngabe kukhona izindleko eziphuma ephaketheni lapho ngibona udokotela noma ngigcwalisa incwadi kadokotela?
• Ngabe ngizokwazi ukufinyelela odokotela nezibhedlela ezingilungele? Ingabe inethiwekhi ibandakanya abahlinzeki engivele nginobudlelwano nabo? Ngingambozwa yini uma ngidinga ukunakekelwa ngenkathi ngisohambweni?
• Yiziphi izinhlobo zezinhlelo ezifakiwe? Ngabe lezi zinhlelo zizoba wusizo kimi?

Izinsizakusebenza ze-Medicare Oregon

Lezi zinsiza zingaba wusizo uma ungathanda ukufunda kabanzi mayelana nezinhlelo ze-Medicare e-Oregon:

• Usizo Lwezinzuzo Zomshuwalense Wezempilo Omkhulu, ngokusebenzisa i-OregonHealthCare.gov
• I-Medicare.gov, iwebhusayithi esemthethweni ye-Medicare
• Ukuphathwa Kwezokuphepha Komphakathi

Yini okufanele ngiyenze ngokulandelayo?

Uma usukulungele ukuthatha isinyathelo esilandelayo sokubhalisa kwi-Medicare, cabanga ngalezi zenzo:

• Yenza olunye ucwaningo ngezinketho zakho zohlelo ngalunye. Uhlu olungenhla lungaba yisiqalo esiwusizo sokubheka ezinhlelweni ze-Medicare Advantage e-Oregon. Kungaba wusizo ukuxhumana nomenzeli womshuwalense onganikeza ukuqondiswa okwenziwe kwaba ngokwakho.
• Uma njengamanje ufanelekile ukubhalisa, ungaqala inqubo ngokugcwalisa isicelo esiku-inthanethi kuwebhusayithi ye-SSA. Isayithi lifaka ngisho nohlu lokuhlola olunemininingwane yolwazi ozodinga ukulusebenzisa.

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.