14 Imibuzo Ebuzwa Njalo Yokwelapha

-Delile

• 1. Yini i-Medicare embozayo?
• Imithi Yangempela
• Ingxenye yeMedicare A
• Ingxenye yeMedare B
• I-Medicare Part C (i-Medicare Advantage)
• Ingxenye yeMedare D
• Isengezo seMedicare (iMedigap)
• 2. Ngabe imishanguzo kadokotela ihlanganiswa yiMedicare?
• Ingxenye D
• Ingxenye C
• 3. Ngikufanele nini ukuthola i-Medicare?
• 4. Ngingabhalisa nini ku-Medicare?
• 5. Ngabe iMedicare imahhala?
• 6. Ibiza malini iMedicare ngo-2021?
• Ingxenye A
• Ingxenye B
• Ingxenye C
• Ingxenye D
• I-Medigap
• 7. Iyini iMedicare edonswayo?
• 8. Iyini i-Medicare premium?
• 9. Iyini iCopay yeMedare?
• 10. Kuyini i-Medicare coinsurance?
• 11. Yini i-Medicare ephume ephaketheni ephezulu?
• 12. Ngingayisebenzisa iMedicare lapho ngingaphandle kwesifundazwe sami?
• 13. Ngingaziguqula nini izinhlelo zeMedicare?
• 14. Ngenzenjani uma ngilahlekelwa yikhadi lami le-Medicare?
• Ukuthatha

Uma wena noma othandekayo usanda kubhalisela i-Medicare noma uhlela ukubhalisa kungekudala, ungahle ube nemibuzo ethile. Leyo mibuzo ingafaka: Yini i-Medicare embozayo? Yiluphi uhlelo lweMedicare oluzobheka imishanguzo yami kadokotela? Zizoba malini izindleko zami zenyanga ze-Medicare?

Kule ndatshana, sizohlola izihloko ezinjengokumbozwa, izindleko, nokuningi ukusiza ukuphendula eminye yaleyo mibuzo evame ukubuzwa ye-Medicare.

1. Yini i-Medicare embozayo?

I-Medicare iqukethe Ingxenye A, Ingxenye B, Ingxenye C (Inzuzo), Ingxenye D, neMedigap - konke okunikezela ngezidingo zakho eziyisisekelo zezokwelapha.

Imithi Yangempela

I-Medicare Part A ne-Part B zaziwa ngokuhlanganyela njenge-Medicare yasekuqaleni. Njengoba uzofunda, i-Medicare yasekuqaleni ihlanganisa kuphela izidingo zakho zesibhedlela kanye nalezo ezidinga ukwelashwa noma zokuvimbela. Ayibandakanyi imishanguzo kadokotela, ukuhlolwa kwamazinyo noma ukubonwa minyaka yonke, noma ezinye izindleko ezihambisana nokunakekelwa kwakho kwezokwelapha.

Ingxenye yeMedicare A

Ingxenye A ihlanganisa izinsizakalo zesibhedlela ezilandelayo:

• ukunakekelwa esibhedlela
• ukunakekelwa kokuvuselelwa kweziguli
• ukunakekelwa kwendawo yokunakekela abanamakhono okulinganiselwe
• ukunakekelwa kwamakhaya asebekhulile (hhayi isikhathi eside)
• ukunakekelwa kwempilo okulinganiselwe ekhaya
• ukunakekelwa kwe-hospice

Ingxenye yeMedare B

Ingxenye B ihlanganisa izinsizakalo zezokwelapha kubandakanya:

• ukunakekelwa kokuvikela
• ukunakekelwa kwezokwelapha kokuxilonga
• ukwelashwa kwezimo zezokwelapha
• imishini yezokwelapha ehlala njalo
• izinsizakalo zezempilo yengqondo
• imishanguzo ethile yokuhlinzekwa iziguli eziphuthumayo
• izinsizakalo ze-telehealth (njengengxenye yempendulo yamanje ekuqubukeni kwe-COVID-19)

I-Medicare Part C (i-Medicare Advantage)

I-Medicare Advantage iyindlela ye-Medicare enikezwa izinkampani zomshuwalense ezizimele. Lezi zinhlelo zihlanganisa izinsizakalo zokuqala zeMedicare Part A no-B. Abaningi baphinde banikeze ukumbozwa kwemithi kadokotela; izinsizakalo zamazinyo, umbono, nokuzwa; izinsizakalo zokufaneleka; futhi nokuningi.

Ingxenye yeMedare D

I-Medicare Part D isiza ukumboza izindleko zemithi kadokotela. Izinhlelo zeMedicare Part D zithengiswa yizinkampani zomshuwalense ezizimele futhi zingangezwa ku-Medicare yasekuqaleni.

Isengezo seMedicare (iMedigap)

Izinhlelo zeMedigap zisiza ukumboza izindleko ezihambisana neMedicare yasekuqaleni. Lokhu kungafaka ukudonswa kwemali, ukukhokhelwa kwemali, kanye nama-copayments. Ezinye izinhlelo zeMedigap zisiza nokukhokha izindleko zezokwelapha ongahle uzithole lapho uhamba ngaphandle kwezwe.

2. Ngabe imishanguzo kadokotela ihlanganiswa yiMedicare?

I-Medicare yangempela ihlanganisa eminye imithi. Ngokwesibonelo:

• I-Medicare Part A ihlanganisa imithi esetshenziselwa ukwelashwa kwakho lapho usesibhedlela. Iphinde ihlanganise eminye imithi esetshenziswa ngesikhathi sempilo yasekhaya noma ukunakekelwa kwe-hospice.
• I-Medicare Part B ihlanganisa imishanguzo ethile ehlinzekwa ezindaweni ezingalaliswayo, njengehhovisi likadokotela. Ingxenye B nayo ihlanganisa imigomo yokugoma.

Ukuze uthole ukutholakala kwezidakamizwa okugcwele kadokotela nge-Medicare, kufanele ubhalise ku-Medicare Part D noma ohlelweni lwe-Medicare Part C olunokutholakala kwezidakamizwa.

Ingxenye D

I-Medicare Part D ingangezwa kwi-Medicare yasekuqaleni ukusiza ukukhokhela izindleko zemithi yakho kadokotela. Uhlelo ngalunye lweNgxenye D lune-formulary, okuluhla lwemithi kadokotela ezolukhipha. Le mithi kadokotela iwela ezigabeni ezithile, imvamisa ihlukaniswa ngenani nomkhiqizo. Zonke izinhlelo zeMedicare Part D kumele zifake okungenani imishanguzo emibili ezigabeni ezinkulu zemithi.

Ingxenye C

Iningi lezinhlelo zeMedicare Advantage libuye linikeze ukumbozwa kwezidakamizwa kadokotela. Njenge-Medicare Part D, uhlelo ngalunye lwe-Advantage luzoba nemithetho yalo yokuhlela nokuhlanganisa. Mane ukhumbule ukuthi ezinye izinhlelo zeMedicare Health Maintenance Organisation (HMO) kanye nePreferred Provider Organisation (PPO) zingakhokhisa imali ethe xaxa ngemiyalo yakho uma usebenzisa amakhemisi angaphandle kwenethiwekhi.

3. Ngikufanele nini ukuthola i-Medicare?

Abantu baseMelika abaneminyaka engama-65 nangaphezulu bavunyelwe ngokuzenzakalela ukubhalisa kwi-Medicare. Abanye abantu abangaphansi kweminyaka engama-65 abanokukhubazeka kwesikhathi eside nabo bayafaneleka. Nakhu ukuthi ukufaneleka kwe-Medicare kusebenza kanjani:

• Uma uneminyaka engama-65 ubudala, uvumelekile ukubhalisa kwi-Medicare izinyanga ezintathu ngaphambi kosuku lwakho lokuzalwa lwama-65 kuya ezinyangeni ezintathu ngemuva kwalokho.
• Uma uthola izinzuzo zokukhubazeka zanyanga zonke ngokusebenzisa i-Social Security Administration noma i-Railroad Retirement Board, ufanelekile ukuthola i-Medicare ngemuva kwezinyanga ezingama-24.
• Uma une-amyotrophic lateral sclerosis (ALS) futhi uthola izinzuzo zenyanga zokukhubazeka, ufanelekile ukuthola i-Medicare ngokushesha.
• Uma utholwe unesifo se-renal end (ESRD) futhi uke wafakelwa izinso noma udinga i-dialysis, ufanelekile ukubhalisa kwi-Medicare.

4. Ngingabhalisa nini ku-Medicare?

Kunezikhathi eziningi zokubhalisa zeMedicare. Lapho usuhlangabezane nezimfuneko zokufaneleka, ungabhalisa phakathi nezikhathi ezilandelayo.

Kwezinye izimo, ukubhaliswa kwe-Medicare kuyazenzakalela. Isibonelo, uzobhaliswa ngokuzenzekelayo kwi-Medicare yangempela uma uthola izinkokhelo zokukhubazeka futhi:

• Uhlanganisa iminyaka engama-65 ezinyangeni ezine ezilandelayo.
• Uthole izinkokhelo zokukhubazeka izinyanga ezingama-24.
• Utholwe ukuthi une-ALS.

5. Ngabe iMedicare imahhala?

Ezinye izinhlelo zeMedicare Advantage zikhangiswa njengezinhlelo “zamahhala”. Yize lezi zinhlelo zingakhokhiswa i-premium, azikho mahhala ngokuphelele: Kusazodingeka ukhokhe izindleko ezithile eziphuma ephaketheni.

6. Ibiza malini iMedicare ngo-2021?

Ingxenye ngayinye ye-Medicare oyibhalayo inezindleko ezihambisana nayo, kufaka phakathi ama-premium, ama-deductibles, ama-copayments, kanye ne-coinsurance.

Ingxenye A

Izindleko ze-Medicare Part A zifaka:

• i-premium yanoma yikuphi kusuka ku- $ 0 kuya ku- $ 471 ngenyanga, kuya ngeholo lakho
• kudonswa imali engu- $ 1,484 ngesikhathi ngasinye sezinzuzo
• ukubonelelwa ngemali engu- $ 0 ezinsukwini zokuqala ezingama-60 zokulaliswa kweziguli, kuze kufike ezindlekweni ezigcwele zezinsizakalo kuya ngokuthi uvunyelwe isikhathi esingakanani

Ingxenye B

Izindleko ze-Medicare Part B zifaka:

• imali ekhokhelwa u- $ 148.50 noma ngaphezulu ngenyanga, kuya ngeholo lakho
• imali engadonswa engu- $ 203
• i-coinsurance yamaphesenti angama-20 wezindleko zemali yakho evunyelwe yi-Medicare yezinsizakalo
• inkokhelo eyeqile kuze kufike kumaphesenti ayi-15 uma izindleko zezinsizakalo zakho zingaphezu kwenani eligunyaziwe

Ingxenye C

Izindleko ze-Medicare Part C zingahluka ngokuya ngendawo yakho, umhlinzeki wakho, kanye nohlobo lokumbozwa uhlelo lwakho olunikezayo.

Izindleko ze-Medicare Part C zifaka:

• Izindleko zengxenye A
• Izindleko zengxenye B
• imali ekhokhwa nyangazonke yohlelo lwengxenye C
• idonselwa minyaka yonke kuhlelo lwengxenye C
• uhlelo lwezidakamizwa oludonswayo (uma uhlelo lwakho lubandakanya ukumbozwa kwezidakamizwa kadokotela)
• inani le-coinsurance noma inani le-copayment lokuvakashelwa udokotela ngamunye, ukuvakashelwa ngongoti, noma ukugcwaliswa kabusha kwezidakamizwa kadokotela

Ingxenye D

Izindleko ze-Medicare Part D zifaka:

• imali ekhokhwa njalo ngenyanga
• imali ekhishwa minyaka yonke engama- $ 445 noma ngaphansi
• i-coinsurance noma inani le-copayment lokugcwaliswa kwemithi yakho kadokotela

I-Medigap

Izinhlelo ze-Medigap zikhokhisa i-premium ehlukile yanyanga zonke ethonywe uhlelo lwakho lwe-Medigap, indawo okuyo, inani labantu ababhalise kuhlelo, nokuningi. Kepha izinhlelo zeMedigap nazo ziyasiza ukumboza ezinye izindleko zeMedicare yasekuqaleni.

7. Iyini iMedicare edonswayo?

I-Medicare ekhishwayo inani lemali olikhipha ephaketheni unyaka nonyaka (noma isikhathi) sezinsizakalo zakho ngaphambi kokutholakala kokutholakala kwe-Medicare. Izingxenye ze-Medicare A, B, C, no-D zonke zinokudonswa kwemali.

8. Iyini i-Medicare premium?

I-Medicare premium iyinani elikhokhwa nyangazonke ukuze ubhalise ohlelweni lwe-Medicare. Ingxenye A, Ingxenye B, Ingxenye C, Ingxenye D, neMedigap konke kukhokhisa amaphrimiyamu nyangazonke.

9. Iyini iCopay yeMedare?

I-Medicare copayment, noma i-copay, inani okufanele ulikhokhe ephaketheni njalo lapho uthola izinsizakalo noma ugcwalisa umuthi kadokotela.

Izinhlelo zeMedicare Advantage (Ingxenye C) zikhokhisa amanani ahlukene ngokuvakasha kukadokotela nochwepheshe. Ezinye izinhlelo zikhokhisa ama-copayment aphezulu kubahlinzeki abangaphandle kwenethiwekhi.

Amasu wezidakamizwa ze-Medicare akhokhisa ukukhokha okuhlukile kwezidakamizwa ngokususelwa ezingeni le-formulary kanye ne-tier yemithi oyiphuzayo. Isibonelo, izidakamizwa ze-tier 1 zivame ukwenziwa futhi zibize kancane.

Amakhophi akho akhethekile azoncika ohlelweni lwe-Advantage noma lwe-Part D olikhethayo.

10. Kuyini i-Medicare coinsurance?

I-Medicare coinsurance yiphesenti olikhokha ephaketheni ngezindleko zemisebenzi yakho evunyelwe yi-Medicare.

I-Medicare Part A ikhokhisa imali ethe xaxa uma uhlala esibhedlela. Ngo-2021, Ingxenye A ye-coinsurance ingama- $ 371 ezinsukwini zesibhedlela 60 kuya ku-90 kanye no- $ 742 ngezinsuku 91 nangaphezulu.

I-Medicare Part B ikhokhisa inani elibekiwe lesamba semali esingu-20%.

I-Medicare Part D ihlela ukukhokhisa imali ye-coinsurance ngendlela efanayo neyama-copayments, imvamisa ukuthola umuthi ophakeme, imishanguzo yegama lomkhiqizo - futhi izokukhokhisa kuphela i-copay noma i-coinsurance kodwa hhayi yomibili.

11. Yini i-Medicare ephume ephaketheni ephezulu?

Isilinganiso esiphezulu se-Medicare esikhwameni semali umkhawulo wokuthi uzokhokha malini ephaketheni kuzo zonke izindleko zakho ze-Medicare ngonyaka owodwa. Akukho mkhawulo ezindlekweni ezingaphandle kwezikhwama ku-Medicare yasekuqaleni.

Zonke izinhlelo ze-Medicare Advantage zinenani eliphakeme lokuphuma ephaketheni laminyaka yonke, elihluka ngokuya ngecebo obhalise kulo. Ukubhalisa kuhlelo lweMedigap kungasiza futhi ukwehlisa izindleko zokuphuma ephaketheni minyaka yonke.

12. Ngingayisebenzisa iMedicare lapho ngingaphandle kwesifundazwe sami?

I-Original Medicare inikeza ukufakwa ezweni lonke kubo bonke abahlomuli. Lokhu kusho ukuthi umbozwe ukunakekelwa kwezempilo okungaphandle kwezwe.

Amasu we-Medicare Advantage, ngakolunye uhlangothi, ahlinzeka ngokutholakala kuphela ezweni ohlala kulo, noma ngabe abanye banganikela nangezinsizakalo zenethiwekhi ngaphandle kwezwe.

Noma ngabe unayo i-Medicare yangempela noma i-Medicare Advantage, kufanele uhlale uqinisekisa ukuthi umhlinzeki omvakashelayo wamukela isabelo se-Medicare.

13. Ngingaziguqula nini izinhlelo zeMedicare?

Uma ubhalise ohlelweni lwe-Medicare futhi ufuna ukushintsha uhlelo lwakho, ungakwenza lokho ngesikhathi sokubhalisa esivulekile, esivela ku- Okthoba 15 kuya kuDisemba 7 unyaka ngamunye.

14. Ngenzenjani uma ngilahlekelwa yikhadi lami le-Medicare?

Uma ulahlekelwe yikhadi lakho le-Medicare, unga-oda ukufaka esikhundleni kusuka kuwebhusayithi Yezokuphepha Komphakathi. Mane nje ungene ku-akhawunti yakho bese ucela ukumiselela ngaphansi kwethebhu ethi “Imibhalo Yokushintshwa”. Ungaphinda ucele ikhadi elizongena esikhundleni ngokushayela u-800-MEDICARE.

Kungathatha cishe izinsuku ezingama-30 ukuthola ikhadi lakho le-Medicare elishintshayo. Uma udinga ikhadi lakho ukuze ubonane ngaphambi kwalapho, ungaphrinta ikhophi yalo ngokungena ku-akhawunti yakho ye-myMedicare.

Ukuthatha

Ukuqonda iMedicare kungazizwa kukhungathekisa, kepha kunezinsizakusebenza eziningi onazo. Uma udinga usizo olwengeziwe ubhalisela i-Medicare noma usenemibuzo engaphenduliwe, nazi ezinye izinsiza ezingasiza.

• I-Medicare.gov inolwazi mayelana nabahlinzeki bendawo, amafomu abalulekile, izincwajana ezilusizo ezilandekayo, nokuningi.
• I-CMS.gov inolwazi olusesikhathini samanje mayelana nezinguquko ezisemthethweni zomthetho nezibuyekezo zohlelo lweMedicare.
• I-SSA.gov ikuvumela ukuthi ufinyelele i-akhawunti yakho ye-Medicare nezinye izinsizakusebenza ze-Social Security ne-Medicare.

Lo mbhalo uvuselelwe ngoNovemba 19, 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.