Izinhlelo ze-Medicare Supplement: Okudingeka Ukwazi NgeMedigap

-Delile

• Uhlelo lokwengeza lweMedicare
• Ukubonelelwa kwephrimiyamu yengxenye B
• Ishadi lokuqhathanisa uhlelo lwe-Medicare supplement
• Izindleko zohlelo lwe-Medicare supplement
• Izinzuzo zokukhetha uhlelo lweMedigap
• Okumbi kokukhetha uhlelo lweMedigap
• IMedigap vs. Medicare Advantage
• Ngabe ngifanelekile ukuthola uhlelo lokwengezelela lweMedicare?
• Ngibhalisa kanjani?
• Ukuthatha

Izinhlelo zokwengeza ze-Medicare yizinhlelo zomshuwalense wangasese ezenzelwe ukugcwalisa ezinye izikhala ekusetshenzisweni kwe-Medicare. Ngalesi sizathu, abantu babiza lezi zinqubomgomo ngokuthi yi-Medigap. I-Medicare isekela inshuwalense yezinto ezifana nokudonswa kwemali kanye nama-copayments.

Uma usebenzisa izinsizakalo zezokwelapha uma unomshuwalense wokuxhaswa we-Medicare, i-Medicare ikhokha ingxenye yayo kuqala, khona-ke uhlelo lwakho lwe-Medicare supplement luzokhokha noma yiziphi izindleko ezisele ezimboziwe.

Kunezici eziningi okufanele uzicabangele lapho ukhetha uhlelo lokwengeza lwe-Medicare. Funda amathiphu wokunquma ukuthi ngabe udinga uhlelo lweMedigap nokuqhathanisa izinketho.

Uhlelo lokwengeza lweMedicare

Kunezinhlelo eziyi-10 zomshuwalense wokwengeza ezitholakalayo. Kodwa-ke, ezinye izinhlelo azisatholakali kubabhalisi abasha. I-Medicare isebenzisa amagama amakhulu ukubhekisela kulezi zinhlelo, kodwa azihlobene nezingxenye ze-Medicare.

Isibonelo, iMedicare Part A wuhlobo olwehlukile lokwembozwa kuneMedigap Plan A. Kulula ukudideka uma uqhathanisa izingxenye nezinhlelo. Izinhlelo eziyi-10 zeMedigap zifaka phakathi amapulani A, B, C, D, F, G, K, L, M, noN.

Izinhlelo zokwengeza ze-Medicare zihlelwe ezifundazweni eziningi. Lokhu kusho ukuthi inqubomgomo oyithengayo kufanele inikeze izinzuzo ezifanayo noma ngabe uyithenga kuyiphi inkampani yomshuwalense.

Okuhlukile kuzinqubomgomo zeMedigap eMassachusetts, Minnesota naseWisconsin. Lezi zinhlelo zingahle zibe nezinzuzo ezahlukahlukene ezijwayelekile ngokuya ngezidingo zomthetho kuleso sifundazwe.

Uma inkampani yomshwalense ithengisa uhlelo lokwengeza lweMedicare, kufanele inikeze okungenani iMedigap Plan A kanye nePlan C noma iPlan F. Kodwa-ke, uhulumeni akadingi ukuthi inkampani yomshuwalense inikeze lonke uhlelo.

Inkampani yomshuwalense ayikwazi ukukuthengisela noma othandekayo uhlelo lomshuwalense wokwengeza i-Medicare uma usuvele unokutholakala nge-Medicaid noma i-Medicare Advantage. Futhi, izinhlelo zokwengeza zeMedicare zimboza umuntu oyedwa - hhayi umbhangqwana oshadile.

Ukubonelelwa kwephrimiyamu yengxenye B

Uma uvumeleke ngomhla kaJanawari 1, 2020 noma ngemuva kwawo, awukwazi ukuthenga uhlelo oluhlanganisa imali ekhokhwayo yengxenye B. Lokhu kufaka phakathi iMedigap Plan C nePlan F.

Kodwa-ke, uma usuvele unolunye lwalezi zinhlelo, ungalugcina. Ngokwengeziwe, uma ubufanelekela ukuthola iMedicare ngaphambi kukaJanuwari 1, 2020, ungahle ukwazi ukuthenga iPlani C noma uHlelo F futhi.

Ishadi lokuqhathanisa uhlelo lwe-Medicare supplement

Zonke izinhlelo zeMedigap zihlanganisa ezinye izindleko zakho zeNgxenye A, kufaka phakathi i-coinsurance, izindleko zesibhedlela ezinwetshiwe, kanye nokunakekelwa kwe-hospice noma ama-copayments.

Zonke izinhlelo zeMedigap ziphinde zihlanganise ezinye zezindleko zakho zeNgxenye B, njenge-coinsurance noma ama-copayments, adonswayo, namapayipi akho okuqala amathathu egazi uma udinga ukumpontshelwa.

Ishadi elingezansi liqhathanisa ukumbozwa ngohlobo ngalunye lwecebo leMedigap:

Izindleko zohlelo lwe-Medicare supplement

Noma izinhlelo zokwengeza zeMedicare zijwayelekile ngokwezinzuzo abazinikezayo, zingahluka ngamanani ngokususelwa enkampanini yomshuwalense ewathengisayo.

Kufana nokuthenga lapho uthengisa: Kwesinye isikhathi, uhlelo olufunayo lubiza kancane esitolo esisodwa futhi ngaphezulu kwesinye, kepha kungumkhiqizo ofanayo.

Izinkampani zomshuwalense zivame ukukhokha izinqubomgomo zeMedigap ngenye yezindlela ezintathu:

• Umphakathi ulinganisiwe. Iningi labantu likhokha ngokulinganayo, kungakhathalekile ubudala noma ubulili. Lokhu kusho ukuthi uma imali yomshwalense yomuntu inyuka, isinqumo sokuyinyusa sihlobene kakhulu nomnotho kunempilo yomuntu.
• Kukalwe iminyaka yobudala. Le mali ekhokhwayo ihlobene nobudala bomuntu ngenkathi eyithenga. Njengomthetho ojwayelekile, abantu abasha bakhokha kancane futhi abantu abadala bakhokha kakhulu. Iphrimiyamu yomuntu ingakhuphuka njengoba bekhula ngenxa yokwehla kwamandla emali, kodwa hhayi ngoba bekhula.
• Kukalwe iminyaka yobudala. Le premium iphansi kubantu abasha futhi inyuka njengoba umuntu ekhula. Kungabiza kakhulu njengoba umuntu eqala ukuyithenga, kepha ingabiza kakhulu njengoba ikhula.

Kwesinye isikhathi, izinkampani zomshuwalense zizonikela ngezaphulelo zokucatshangelwa okuthile. Lokhu kufaka izaphulelo zabantu abangabhemi, abesifazane (abavame ukuba nezindleko eziphansi zokunakekelwa kwezempilo), futhi uma umuntu ekhokha imali engaphambi konyaka njalo ngonyaka.

Izinzuzo zokukhetha uhlelo lweMedigap

• Izinhlelo zomshuwalense zokwengeza ze-Medicare zingasiza ukumboza izindleko ezinjengokudonswa kwemali, ukuqinisekiswa kwemali, kanye nama-copayments.
• Ezinye izinhlelo zeMedigap zinganciphisa izindleko ezingaphandle kwesikhwama somuntu.
• Uma ubhalisa esikhathini sokubhalisa esivulekile ngemuva kokuhlanganisa iminyaka engama-65, izinkampani zomshuwalense azikwazi ukukukhipha ngokuya ngezimo zezempilo.
• Izinhlelo zeMedigap zizofaka amaphesenti angama-80 ezinsizakalo zakho zezempilo eziphuthumayo lapho usohambweni olungaphandle kwe-United States.
• Izinketho eziningi zohlelo ongakhetha kuzo ukuze zilungele izidingo zakho zokunakekelwa kwezempilo.

Okumbi kokukhetha uhlelo lweMedigap

• Ngenkathi inqubomgomo yeMedigap ingasiza ukumboza ezinye zezindleko zakho zeMedicare, ayihlanganisi umuthi kadokotela, umbono, amazinyo, ukuzwa, noma yiziphi ezinye izinzuzo zezempilo, ezinjengobulungu bokuqina noma ezokuhamba.
• Ukuthola ukufakwa kwezinsizakalo zezokwelapha ezibalwe ngenhla, kuzodingeka ungeze inqubomgomo ye-Medicare Part D noma ukhethe uhlelo lwe-Medicare Advantage (Ingxenye C).
• Izinqubomgomo ze-Medigap ezinikezwe iminyaka yobudala zikhokhisa amaphrimiyamu aphezulu njengoba ukhula.
• Akuzona zonke izinhlelo ezinikeza ukumbozwa kwezikhungo zabahlengikazi ezinamakhono noma ukunakekelwa kwe-hospice, ngakho-ke hlola izinzuzo zohlelo lwakho uma ungazidinga lezi zinsizakalo.

IMedigap vs. Medicare Advantage

I-Medicare Advantage (Ingxenye C) uhlelo lomshuwalense oluyinqwaba. Kufaka phakathi Ingxenye A noNgxenye B, kanye neNgxenye D ezimweni eziningi.

Izinhlelo zeMedicare Advantage zingabiza kancane kuneMedicare yasekuqaleni kwabanye abantu. Izinhlelo zeMedicare Advantage zinganikela nangezinzuzo ezingeziwe, njengokufakwa kwamazinyo, ukuzwa, noma ukumbozwa kombono.

Nakhu ukubuka okusheshayo okufanele ukwazi mayelana neMedicare Advantage neMedigap:

• Zombili lezi zinhlelo zifaka ukumbozwa kweMedicare Part A (ukumbozwa kwesibhedlela) kanye nezindleko zeNgxenye B (yomshuwalense wezokwelapha).
• Izinhlelo eziningi ze-Medicare Advantage zifaka iNgxenye D (ukutholakala kwezidakamizwa kadokotela). IMedigap ayikwazi ukukhokhela izindleko zemithi kadokotela.
• Uma une-Medicare Advantage, awukwazi ukuthenga uhlelo lwe-Medigap. Abantu abane-Medicare yangempela kuphela abafanelekile kulezi zinhlelo.

Imvamisa, isinqumo singena ezidingweni zezempilo ngazinye nokuthi uhlelo ngalunye lubiza malini. Izinhlelo zokwengeza ze-Medicare zingabiza kakhulu kune-Medicare Advantage, kodwa futhi zingakhokhela okunye okuhlobene nezindleko ezikhokhelwayo nezindleko zomshuwalense.

Ungahle udinge ukuthi uthengise ukuthi yiziphi izinhlelo ezitholakalayo kuwe noma othandekayo ukusiza ukwenza ukukhetha okuhle kakhulu.

Ngabe ngifanelekile ukuthola uhlelo lokwengezelela lweMedicare?

Uvumelekile ukubhalisa kuhlelo lwe-Medicare supplement ngesikhathi sokubhaliswa kokuqala kweMedigap. Lesi sikhathi isikhathi esiyizinyanga ezi-3 ngaphambi kokuba ube neminyaka engama-65 bese ubhalisela Ingxenye B, ezinyangeni ezintathu ngemuva kosuku lwakho lokuzalwa. Ngalesi sikhathi, unelungelo eliqinisekisiwe lokuthenga uhlelo lokuxhaswa kwe-Medicare.

Uma uhlala ubhalisile futhi ukhokha i-premium yakho, inkampani yomshuwalense ayikwazi ukukhansela uhlelo. Kodwa-ke, uma usunayo iMedicare, inkampani yomshuwalense ingaphika ukuthi ikuthengisela inqubomgomo yokwengeza ye-Medicare ngokuya ngempilo yakho.

Ngibhalisa kanjani?

Ukuthenga uhlelo lokwengeza lweMedicare kungathatha isikhathi nomzamo, kepha kufanelekile. Lokhu kungenxa yokuthi iningi labantu ligcina izinqubomgomo zabo zeMedigap impilo yabo yonke.

Ukuqala ngenqubomgomo elingana kahle izidingo zakho noma zothandekayo wakho kungasiza ekongeni ukukhungatheka futhi kaningi nemali ngokuhamba kwesikhathi.

Nazi izinyathelo eziyisisekelo zokuthenga inqubomgomo yeMedigap:

• Linganisa ukuthi yiziphi izinzuzo ezibaluleke kakhulu kuwe. Ngabe uzimisele ukukhokha okwehliswayo, noma udinga ukumbozwa okugcwele okungadonswa? Ngabe ulindele ukuthi udinga usizo lwezokwelapha kwelinye izwe noma cha? (Lokhu kuyasiza uma uhamba kakhulu.) Bheka ishadi lethu leMedigap ukuthola ukuthi yiziphi izinhlelo ezikunikeza izinzuzo ezingcono kakhulu zempilo yakho, ezezimali nezempilo.
• Sesha izinkampani ezinikezela ngezinhlelo zokwengeza ze-Medicare ngokusebenzisa ithuluzi lokusesha le-Medigap kusuka ku-Medicare. Le webhusayithi inikeza imininingwane ngezinqubomgomo kanye nokusabalala kwazo kanye nezinkampani zomshuwalense endaweni yangakini ezithengisa izinqubomgomo.
• Shayela ku-800-MEDICARE (800-633-4227) uma ungenakho ukufinyelela kwe-inthanethi. Abamele abasebenza kulesi sikhungo bangasiza ukukunikeza imininingwane oyidingayo.
• Xhumana nezinkampani zomshuwalense ezinikeza izinqubomgomo endaweni yangakini. Yize kuthatha isikhathi esithile, ungabizi inkampani eyodwa kuphela. Amanani angahluka ngenkampani, ngakho-ke kungcono ukuqhathanisa. Izindleko akuyona yonke into, noma kunjalo. Umnyango womshuwalense wombuso wakho kanye nezinsizakalo ezifana ne-weissratings.com zingakusiza ukuthi uthole ukuthi ngabe inkampani inezikhalazo eziningi ngayo.
• Yazi ukuthi inkampani yomshuwalense akufanele ikucindezele ukuthi uthenge inqubomgomo. Akufanele futhi bathi basebenzela iMedicare noma bathi inqubomgomo yabo iyingxenye yeMedicare. Izinqubomgomo zeMedigap ziyimfihlo hhayi umshwalense kahulumeni.
• Khetha uhlelo. Uma usubheke yonke imininingwane, ungathatha isinqumo ngenqubomgomo bese uyayifaka.

Izinhlelo zokwengeza ze-Medicare zingaba nzima ukuzulazula. Uma unombuzo othile, ungashayela uhlelo lwakho lwe-State Health Insurance Assistance Program (SHIP). Lawa ngama-ejensi kahulumeni axhaswa ngemali ahlinzeka ngokwelulekwa kwamahhala kubantu abanemibuzo mayelana neMedicare nezinhlelo zokwengeza.

Uma usiza othandekayo ukuthi abhalise ku-Medicare, cabanga ngalezi zeluleko:

• Qinisekisa ukuthi bayabhalisa esikhathini esabiwe. Ngaphandle kwalokho, bangabhekana nezindleko ezinkulu nezinhlawulo zokubhalisa sekwedlule isikhathi.
• Buza ukuthi inkampani yomshuwalense intengo kanjani ngezinqubomgomo zayo, ezinjengokuthi “khipha iminyaka” noma “ufinyelele eminyakeni yobudala.” Lokhu kungakusiza ucabange ukuthi inqubomgomo kothandekayo wakho ingakhuphuka kanjani entengo.
• Buza ukuthi ngabe inqubomgomo noma izinqubomgomo ozihlolisisa kahle zikhuphuke kangakanani ezindlekweni kule minyaka embalwa edlule. Lokhu kungakusiza ukuthi uhlole ukuthi ngabe othandekayo wakho unezimali ezanele ukumboza izindleko.
• Qinisekisa ukuthi othandekayo wakho unendlela evikelekile yokukhokhela inqubomgomo. Ezinye izinqubomgomo zikhokhwa ngesheke nyanga zonke, kanti ezinye zibhalwa kwi-akhawunti yasebhange.

Ukuthatha

Izinqubomgomo zomshuwalense wokwengeza iMedicare kungaba yindlela yokunciphisa ukwesaba okungalindelekile, ngokwezindleko zokunakekelwa kwezempilo. Bangasiza ukukhokhela izindleko zokuphuma ephaketheni okungenzeka ukuthi iMedare ayinakukhokha.

Usebenzisa izinsiza zombuso wamahhala, njengomnyango womshuwalense wombuso wakho, kungakusiza noma othandekayo enze isinqumo esihle maqondana nokutholakala.

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.