Konke Okudingeka Ukwazi Uma Ufuna Ukushintsha Izinhlelo Zama-Medicare Advantage
-Delile
- Ngiwashintsha kanjani amasu e-Medicare Advantage?
- Ngingaziguqula nini izinhlelo zeMedicare Advantage?
- Isikhathi sokuqala sokubhalisa
- Ukubhaliswa okuvulekile kweMedicare Advantage
- Isikhathi sokubhalisa esivulekile
- Izinkathi zokubhalisa ezikhethekile
- Ngubani ofanelekela i-Medicare Advantage?
- Yini ama-Medicare Advantage plans?
- Ukuthatha
- Unamathuba amaningana wokushintsha uhlelo lwakho lwe-Medicare Advantage unyaka wonke.
- Ungashintsha uhlelo lwakho lokutholakala kwemithi kadokotela ngesikhathi seMedicare noma ngesikhathi sokubhalisa esivulekile seMedicare Advantage.
- Ungashintsha futhi uhlelo lwakho lwe-Medicare Advantage ngesikhathi sokubhalisa esikhethekile esidalwa ushintsho olukhulu empilweni yakho.
Uma izimo zakho zishintshile selokhu wabhalisela uhlelo lweMedicare Advantage, kungenzeka ukuthi manje usufuna uhlelo oluhlukile oluhlangabezana kangcono nezidingo zakho. Kepha ungalahla uhlelo olulodwa bese ushintshela kolunye?
Impendulo emfushane ithi, yebo. Impendulo ende: Ungashintsha uhlelo lwakho lwe-Medicare Advantage kodwa kuphela ngezikhathi ezithile zokubhalisa phakathi nonyaka. Akunzima, kepha kubalulekile ukukwenza ngesikhathi esifanele. Ngaphandle kwalokho, ungalahlekelwa ukumbozwa noma udale izikhala ekusetshenzisweni kwakho.
Nakhu okudingeka ukwazi mayelana nokuthi ungalushintsha nini futhi kanjani uhlelo lwakho lwe-Medicare Advantage.
Ngiwashintsha kanjani amasu e-Medicare Advantage?
Izinhlelo zeMedicare Advantage (Ingxenye C) zinikezwa izinkampani zomshuwalense ezizimele.Uma unecebo le-Medicare Advantage, unga:
- shintshela kuhlelo oluhlukile lweMedicare Advantage olunikeza ukumbozwa kwezidakamizwa
- shintshela kuhlelo oluhlukile lweMedicare Advantage olunganikeli ngezidakamizwa
- shintshela ku-Medicare yoqobo (izingxenye A no-B) kanye nohlelo D Part D (umuthi kadokotela)
- shintshela ku-Medicare yasekuqaleni ngaphandle kokungeza uhlelo lwengxenye D.
Imvamisa ungenza ushintsho olulodwa kuphela kuhlelo lwakho ngesikhathi sokubhalisa esivulekile seMedicare Advantage.
Ukushintsha izinhlelo, xhumana nomhlinzeki womshuwalense wohlelo oluthandayo bese ufaka isicelo sokutholakala. Uma ungaqiniseki ukuthi ungaxhumana kanjani nomhlinzeki, ithuluzi lokuthola uhlelo lwe-Medicare lingasiza. Uzokhishwa ohlwini lwakho lwangaphambilini ngokushesha nje lapho uhlelo lwakho olusha luqala ukusebenza.
Uma ushintsha kusuka kuhlelo lwe-Medicare Advantage uye kwi-Medicare yasekuqaleni, ungashayela uhlelo lwakho lwangaphambili noma ubhalise nge-Medicare ngokubiza u-800-MEDICARE.
Ngingaziguqula nini izinhlelo zeMedicare Advantage?
Ungashintsha amasu e-Medicare Advantage ngezikhathi ezibekiwe zokubhalisa unyaka ngamunye nangesikhathi esithile esibekiwe ngemuva kwemicimbi ethile yokuphila. Nazi izinsuku ezithile nemithetho yokuthi ungashintsha nini izinhlelo ze-Medicare Advantage.
Isikhathi sokuqala sokubhalisa
Ungashintsha uhlelo lwakho lwe-Medicare Advantage nganoma yisiphi isikhathi ngesikhathi sokubhalisa kwakho kokuqala.
Uma ufanelekela i-Medicare ngokuya ngeminyaka yakho, ukubhaliswa kwakho kokuqala kuqala izinyanga ezintathu ngaphambi kwenyanga yokuzalwa kwakho kwama-65, kufaka phakathi inyanga yakho yokuzalwa, bese uqhubeka izinyanga ezintathu ngemuva kwalokho. Sekukonke, isikhathi sokuqala sokubhalisa sihlala izinyanga ze-7.
Uma ufanelekela iMedicare ngokuya ngokukhubazeka, isikhathi sakho sokuqala sokubhalisa siqala izinyanga ezintathu ngaphambi kwenyanga yakho yama-25 yokuthola izinzuzo zomshwalense wokukhubazeka kwezenhlalakahle noma izinzuzo zeBhodi Yezitimela, kufaka phakathi inyanga yakho yama-25, bese uqhubeka izinyanga ezintathu ngemuva kwalokho.
Ukubhaliswa okuvulekile kweMedicare Advantage
Ungenza ushintsho kuhlelo lwakho nganoma yisiphi isikhathi ngesikhathi sokubhalisa esivulekile seMedicare Advantage kusuka ngoJanuwari 1 kuya kuMashi 31 minyaka yonke. Lesi futhi yisikhathi sokubhaliswa okujwayelekile kweMedicare.
Izinguquko ozenzayo zizosebenza ngosuku lokuqala lwenyanga olulandela inyanga owenza ngayo ushintsho.
Isikhathi sokubhalisa esivulekile
Ungenza ushintsho kuhlelo lwakho lwe-Medicare Advantage nganoma yisiphi isikhathi ngesikhathi sokhetho lonyaka, esaziwa njengokubhaliswa okuvulekile. Lokhu kusuka ngo-Okthoba 15 kuye kuDisemba 7 unyaka nonyaka. Izinguquko ozenzayo zizoqala ukusebenza ngoJanuwari 1 wonyaka olandelayo.
Izinkathi zokubhalisa ezikhethekile
Imicimbi ethile yempilo ingadala ithuba lokushintsha uhlelo lwakho lweMedicare Advantage. Uma uthuthela endaweni entsha, izinketho zakho zokuhlanganisa ziyashintsha, noma uhlangabezana nezinye izimo zokuphila, abakwaMedicare bangakunikeza isikhathi esikhethekile sokubhalisa.
Nasi isifinyezo saleyo micimbi kanye nezinketho ozoba nazo:
| Uma lokhu kwenzeka… | Ngiyakwazi… | Ngikude lokhu ukwenza izinguquko… |
|---|---|---|
| Ngiphuma endaweni yesevisi yami yohlelo | shintshela kuhlelo olusha lweMedicare Advantage noma Ingxenye D | Izinyanga ezi-2 * |
| Ngiyahamba futhi izinhlelo ezintsha ziyatholakala lapho ngihlala khona | shintshela ohlelweni olusha lweMedicare Advantage noma lwePart D | Izinyanga ezi-2 * |
| Ngibuyela e-United States | ujoyine uhlelo lwe-Medicare Advantage noma lwe-Part D | Izinyanga ezi-2 * |
| Ngiphuma noma ngiya esikhungweni sabahlengikazi abanekhono noma esikhungweni sokunakekelwa kwesikhathi eside | ujoyine uhlelo lweMedicare Advantage noma lwePart D, shintsha izinhlelo ze-Medicare Advantage, noma lahla i-Medicare Advantage bese ushintshela ku-Medicare yasekuqaleni | inqobo nje uma uhlala kuleso sikhungo nezinyanga ezi-2 emva kokushiya |
| Ngikhululiwe ejele | ujoyine uhlelo lwe-Medicare Advantage noma lwe-Part D | Izinyanga ezi-2 * |
| Angisayifanele iMedicaid | ujoyine uhlelo lweMedicare Advantage noma lwePart D, shintsha izinhlelo ze-Medicare Advantage, noma lahla i-Medicare Advantage bese ushintshela ku-Medicare yasekuqaleni | Izinyanga ezi-3 * |
| Angisenampilo yomshuwalense wezempilo kumqashi wami noma inyunyana | ujoyine uhlelo lwe-Medicare Advantage noma lwe-Part D | Izinyanga ezi-2 * |
| Ngibhalisela uhlelo lwePACE | lahla uhlelo lweMedicare Advantage noma lwengxenye D | noma kunini |
| IMedicare ijezisa uhlelo lwami | shintsha izinhlelo ze-Medicare Advantage | isinqumo esimisiwe ngamacala |
| I-Medicare iqeda uhlelo lwami | shintsha izinhlelo ze-Medicare Advantage | kusuka ezinyangeni ezi-2 ngaphambi kokuthi uhlelo luphele kuze kube yinyanga eyi-1 ngemuva kokuphela |
| I-Medicare ayiluvuseleli uhlelo lwami | shintsha izinhlelo ze-Medicare Advantage | kusuka ngoDisemba 8 kuya osukwini lokugcina ngoFeb |
| Ngikubili ngifanele iMedicare neMedicaid | ujoyine, ushintshe, noma ulahle izinhlelo ze-Medicare Advantage | kanye phakathi kukaJan – Mar, Apr – Jun, noJul – Sep |
| Ngibhalisela uhlelo lwe-State Pharmaceutical Assistance (noma ngilahlekelwe uhlelo) | ujoyine uhlelo lweMedicare Advantage ngeNgxenye D | kanye ngonyaka |
| Ngiyeka inqubomgomo yami yeMedigap lapho ngijoyina uhlelo lweMedicare Advantage | lahla i-Medicare Advantage bese ujoyina iMedicare yangempela | Izinyanga eziyi-12 ngemuva kokuthi uqale ujoyine uhlelo lweMedicare Advantage |
| Nginohlelo Lwezidingo Ezikhethekile kepha angisenasidingo esikhethekile | shintshela kuhlelo lweMedicare Advantage noma lwengxenye D | Izinyanga ezi-3 ngemuva kokuphela kwesikhathi somusa |
| Ngijoyina uhlelo olungalungile ngenxa yephutha lesisebenzi sikahulumeni | ujoyine uhlelo lweMedicare Advantage noma lwePart D, shintsha izinhlelo ze-Medicare Advantage, noma wehle i-Medicare Advantage bese ushintshela ku-Medicare yasekuqaleni | Izinyanga ezi-2 * |
| I-Medicare inikeza isilinganiso sezinkanyezi ezi-5 kuhlelo endaweni yangakithi | shintshela kuhlelo lwezinkanyezi ezinhlanu lwe-Medicare Advantage | kanye phakathi kukaDisemba 8 noNovemba 30 |
*Bheka I-Medicare.gov ngemininingwane yokuthi iwashi liqala nini ukuthikha.
Ngubani ofanelekela i-Medicare Advantage?
Ukuze ufanelekele uhlelo lwe-Medicare Advantage, kufanele ubhalise kwi-Medicare yasekuqaleni (Ingxenye A noNgxenye B). Uzodinga futhi ukuhlala endaweni embozwe ngumhlinzeki womshuwalense onikeza ngezinhlelo zeMedicare Advantage kubahlomuli abasha.
Ukuze ufaneleke ukuthola i-Medicare yasekuqaleni, kufanele ube yisakhamuzi sase-U.S. Noma ube ngumhlali unomphela osemthethweni okungenani iminyaka engu-5 futhi ulingane eyodwa noma ngaphezulu yalezi zigaba:
- baneminyaka engama-65 noma ngaphezulu
- ngikhubazekile
- une-amyotrophic lateral sclerosis (ALS)
- babe nesifo sesifo sokuphela kwesigaba (ESRD)
Yini ama-Medicare Advantage plans?
Izinhlelo zeMedicare Advantage (Ingxenye C) yizinhlelo zomshuwalense wezempilo ezithengiswa izinkampani zomshuwalense ezizimele. Banikeza ukumbozwa okufanayo ne-Medicare yasekuqaleni (Ingxenye A neNgxenye B), kanye nezinzuzo ezengeziwe.
Ngokuya ngohlelo, ezinye zalezo zinzuzo ezingeziwe zingabandakanya amazinyo, ukuzwa, umbono, kanye nokusetshenziswa kwezidakamizwa kadokotela. Ungaqhathanisa izinhlelo ngokusebenzisa ithuluzi lokuthola uhlelo lweMedicare. Lokhu kuzokuvumela ukuthi ubone ukumbozwa namanani atholakala eduze kwakho.
Ukuthatha
Ungenza ushintsho kuhlelo lwakho lwe-Medicare Advantage ngo:
- kungaba ukufaka noma ukulahla ukumbozwa kwezidakamizwa kadokotela
- ukushintshela kuhlelo oluhlukile lweMedicare Advantage
- ukubuyela ku-Medicare yasekuqaleni, noma ngaphandle kohlelo lwezidakamizwa
Into ebalulekile okumele uyiqaphele ukuthi ungashintsha uhlelo lwakho kuphela ngezikhathi ezithile phakathi nonyaka. Ungashintsha nganoma yisiphi isikhathi ngesikhathi sakho sokubhalisa sokuqala sezinyanga ezingu-7. Futhi ungashintsha ngesikhathi sokubhalisa esivulekile ukuwa ngakunye.
Esinye isikhathi lapho ungenza ushintsho ngesikhathi sokubhalisa esivulekile seMedicare Advantage ekuqaleni konyaka ngamunye. Futhi, izinguquko ezithile zempilo zikuvumela ukuthi ushintshe uhlelo lwakho ngesikhathi sokubhalisa esikhethekile.
Uma usukulungele ukushintsha, yazi ukuthi ungathola usizo lokuthola nokubhalisela uhlelo olulungele wena.
Lo mbhalo uvuselelwe ngoNovemba 17, 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.
Ukuthola Ukuthandwa
I-Epidermolysis bullosa
