Yiziphi Izinhlobo Ezihlukile ZamaMedicare?
-Delile
- Yini iMedicare Part A?
- Yini iMedicare Part B?
- Yini i-Medicare Part C (Medicare Advantage)?
- Yini i-Medicare Part D?
- Uyini umshuwalense wokwengeza we-Medicare (Medigap)?
- Ukuthatha
- Ukutholakala kwemithi ye-Medicare kuhlukaniswe kwaba izingxenye eziningana ukuthi ngamunye uhlanganisa isici esihlukile sokunakekelwa.
- I-Medicare Part A ihlanganisa ukunakekelwa kweziguli futhi kaningi ayina-premium.
- I-Medicare Part B ihlanganisa ukunakekelwa kweziguli ezingaphandle futhi ine-premium esuselwa emholweni.
- I-Medicare Part C (Medicare Advantage) ingumkhiqizo womshuwalense wangasese ohlanganisa izingxenye A no-B nezinzuzo ezengeziwe.
- I-Medicare Part D ingumkhiqizo wangasese womshuwalense ohlanganisa imishanguzo kadokotela.
I-Medicare inikeza ukunakekelwa kwezempilo kubantu abangaphezu kweminyaka engama-65 nalabo abakhubazekile noma izimo ezithile zezempilo. Lolu hlelo oluyinkimbinkimbi lunezingxenye eziningi, futhi lubandakanya uhulumeni wobumbano nabashuwalense abazimele abasebenza ndawonye ukunikela ngezinsizakalo nemikhiqizo eyahlukahlukene.
I-Original Medicare yakhiwe ngezingxenye A no-B. Lokhu kufakwa kukuvumela ukuthi uye kodokotela nasezikhungweni ezamukela iMedicare ngaphandle kokuthola imvume noma ukuvunyelwa ngaphambi kwesikhathi ohlelweni lwakho. Amaphrimiyamu nama-copayments ayasebenza, kepha imvamisa kususelwa kumholo futhi kunganikwa uxhaso.
Izinhlelo zeMedicare Advantage (Ingxenye C) yizinhlelo zomshuwalense wangasese. Lezi zinhlelo zihlanganisa izinto eziningi ze-Medicare, njengezingxenye ze-A ne-B, nezinye izinsizakalo, njenge-kadokotela, ukumbozwa kwamazinyo nokubukwa kombono. Banikela ngezinsizakalo eziningi, kepha bangabiza kakhulu futhi beze nemikhawulo yenethiwekhi.
Ngenkathi izinketho eziningi zeMedicare zikunikeza ukuguquguquka kokutholakala kokunakekelwa kwezempilo, kusho nokuthi kufanele uzulazule futhi uqonde imininingwane eminingi.
Funda ngokucekeceka okuningiliziwe kwezingxenye ezahlukahlukene zeMedicare nokuthi zingakusiza kanjani.
Yini iMedicare Part A?
I-Medicare Part A yingxenye ye-Medicare yasekuqaleni ehlanganisa izindleko zakho zesibhedlela nokunye ukunakekelwa kweziguli. Iningi labantu alikhokhi imali ekhokhwa ngenyanga kwiNgxenye A ngoba bakhokha ohlelweni ngentela phakathi neminyaka yabo yokusebenza.
Ngokuqondile, iMedicare Part A izobheka:
- ukuhlala esibhedlela
- ukuhlala okulinganiselwe esikhungweni sabahlengikazi abanamakhono
- hlala esibhedlela sokunakekelwa isikhathi eside
- ukunakekelwa kwamakhaya asebekhulile okungesona isikhathi eside noma ukugcinwa
- ukunakekelwa kwe-hospice
- ukunakekelwa kwempilo yesikhashana noma ngezikhathi ezithile ekhaya
Ukuqinisekisa ukuthi i-Medicare ifaka ukuhlala kwakho, kufanele:
- yiba nomyalelo osemthethweni ovela kudokotela wakho othi udinga ukunakekelwa kokugula noma kokulimala
- qiniseka ukuthi indawo yamukela iMedicare
- qinisekisa ukuthi usalelwe yizinsuku esikhathini sakho somhlomulo ongazisebenzisa (ukuhlala endaweni enamakhono abahlengikazi)
- qinisekisa ukuthi i-Medicare kanye nesikhungo kuvuma isizathu sokuhlala kwakho
Ngaphansi kweMedicare Part A, ungalindela ukukhokha izindleko ezilandelayo ngo-2021:
- ayikho imali ekhokhelwayo uma ubusebenza okungenani amakota angama-40 (iminyaka eyi-10) empilweni yakho futhi wakhokha intela yeMedare (uzokhokha kufika ku- $ 471 ngenyanga uma usebenza ngaphansi kwamakota angama-40)
- kudonswa u- $ 1,484 ngasikhathi ngasinye senzuzo
- izindleko zansuku zonke zokuthola imali ngokuya ngobude besikhathi sokuhlala kwakho kweziguli: $ 0 izinsuku 1 kuya ku-60, $ 371 ngosuku ngezinsuku 61 kuya ku-90, kanye no- $ 742 ngosuku ngezinsuku 91 nangaphezulu
- zonke izindleko uma usesibhedlela izinsuku ezingaphezu kwezingama-90 esikhathini esisodwa somhlomulo futhi weqe izinsuku zakho ezingama-60 zokulondolozwa kwempilo yakho yonke
Yini iMedicare Part B?
I-Medicare Part B yingxenye ye-Medicare yasekuqaleni ehlanganisa izindleko zokunakekelwa kwakho kweziguli. Uzokhokha imali ekhokhwa nyangazonke yalokhu kufakwa ngokususelwa ezingeni leholo lakho.
I-Medicare Part B izokhokhela izindleko zezinto ezinjenge:
- ukuvakashelwa odokotela
- izidingo zokwelashwa ezidingekayo kanye nezinsizakalo
- izinsizakalo zokunakekelwa kokuvikela
- ezokuthutha eziphuthumayo ze-ambulensi
- imishini ethile yezokwelapha
- izinsizakalo zempilo yengqondo ezingalaliswayo neziguliswa esibhedlela
- eminye imishanguzo yokuhlinzekwa yimithi yokwelashwa
Ukuze uqiniseke ukuthi iMedicare Part B ihlanganisa ukuqokwa kwakho, insizakalo, noma okokusebenza kwezokwelapha, buza ukuthi udokotela wakho noma umhlinzeki wesevisi uyayemukela yini iMedicare.Ungasebenzisa futhi ithuluzi lokumboza le-Medicare ukunquma ukuthi ukuqokwa kwakho noma insizakalo yakho ihlanganisiwe.
Ngaphansi kweMedicare Part B, ungalindela ukukhokha izindleko ezilandelayo ngo-2021:
- imali ekhokhwa okungenani engu- $ 148.50 ngenyanga (leli nani liyakhuphuka uma imali oyitholayo ingaphezu kwama- $ 88,000 ngonyaka noma i- $ 176,000 ngonyaka ngemibhangqwana eshadile)
- kudonswa u- $ 203 ngonyaka
- Amaphesenti angama-20 wemali evunyelwe yi-Medicare ngemuva kokuthi i-deductible yakho ihlangane nonyaka
Yini i-Medicare Part C (Medicare Advantage)?
I-Medicare Part C (i-Medicare Advantage) ingumkhiqizo womshuwalense wangasese okunikeza konke ukumbozwa kwezingxenye ze-Medicare A no-B, kanye nezinsizakalo ezingeziwe.
Iningi lalezi zinhlelo zinikela ngokutholakala kwemithi kadokotela ngaphezu kwezinsizakalo zeziguli ezingalalisiwe neziguliswa ngaphandle. Izinzuzo ezinjengokufakwa kwamazinyo nombono nazo zingangezwa.
Ungenza ngokwezifiso uhlelo lwakho lwe-Medicare Advantage ngokususelwa kulokho inkampani elawula uhlelo lwakho olunikezayo nokuthi yini ofuna ukuyikhokha.
I-Medicare izokhokha inani elibekiwe inyanga ngayinye kumhlinzeki wakho wohlelo lwe-Medicare Advantage ukuze anikele engxenyeni yesembozo sakho.
Izinhlelo zeMedicare Part C zivame ukuwela ezigabeni ezimbalwa ezahlukahlukene:
- Izinhlelo ze-Health Maintenance Organisation (HMO) zidinga ukuthi uthole ukunakekelwa okungaphuthumayo kwabanikeli abathile ngaphakathi kwenethiwekhi yohlelo lwakho.
- Izinhlelo ze-Preferred Provider Organisation (PPO) zikuvumela ukuthi usebenzise abahlinzeki ngaphakathi noma ngaphandle kwenethiwekhi yakho, kepha ukhokha kancane ukunakekelwa okuphakathi kwenethiwekhi.
- Izinhlelo ze-Private Fee-for-Service (PFFS) zikuvumela ukuthi ubone abahlinzeki abangaphakathi noma ngaphandle kwenethiwekhi yohlelo; kodwa-ke, uhlelo lubeka amanani alokho okuzokhokhela izinsizakalo zalo zamalungu nokuthi isabelo sakho sizoba yini.
- Izinhlelo Zezidingo Ezikhethekile (ama-SNP) yizinhlelo ze-Medicare Advantage ezenzelwe abantu abanezifo noma izimo ezithile. Lezi zinhlelo zivumelanisa izinsizakalo nokufakwa esimeni sakho esithile.
Izindleko ze-Medicare Part C ziyahlukahluka kuye ngohlobo lohlelo nomhlinzeki womshuwalense owukhethayo.
Yini i-Medicare Part D?
I-Medicare Part D wuhlelo olunikeza ukumbozwa kwemithi kadokotela.
Lolu uhlelo lwe-Medicare lokuzikhethela, kepha uma ungabhalisi lapho uqala ukufaneleka, ungakhokha izinhlawulo lapho ubhalisa kamuva. Lezo zinhlawulo zizosebenza inqobo nje uma unohlelo lwezidakamizwa futhi zizofakwa ezindlekweni ze-premium yakho yanyanga zonke.
Ukutholakala kwemithi kadokotela kufanele kunikezwe ezingeni elijwayelekile elibekwe yiMedicare. Kepha izinhlelo ezahlukahlukene zingakhetha ukuthi imiphi imishanguzo abayifaka kuhlu lwabo lwezidakamizwa, noma amafomula. Iningi lezinhlelo zemithi kadokotela lihlanganisa imishanguzo ngu:
- formulary, okuluhlu lwemithi kadokotela ehlanganiswe kuhlelo - imvamisa enezinketho okungenani ezimbili zesigaba ngasinye sezidakamizwa noma isigaba
- imishanguzo ejwayelekile engashintshwa ngemithi yamagama anomphumela ofanayo
- Izinhlelo ezinamazinga ahlinzeka ngamazinga ahlukahlukene emithi (ejwayelekile kuphela, igama lomkhiqizo elijwayelekile, njalonjalo) ngamanani amaningi okukhokha akhuphuka ngamanani akho emithi
Izindleko zezinhlelo zeMedicare Part D zixhomeke kulokho okukhethayo nokuthi iyiphi imithi oyidingayo. Ungaqhathanisa izindleko zezinhlelo ezahlukahlukene zemithi yokwelashwa ye-Medicare online ngokuchofoza lapha.
Uyini umshuwalense wokwengeza we-Medicare (Medigap)?
Imishwalense yokwengeza ye-Medicare, noma iMedigap, yimikhiqizo yomshwalense wangasese ehloselwe ukusiza ukukhokhela izindleko ezingakhokhelwe izingxenye zeMedicare A, B, C, noma D. Lezi zinhlelo ziyakhethwa.
Izinhlelo zeMedigap zingasiza ukumboza izindleko zeMedicare njenge:
- ama-copayments
- izinhlamvu zemali
- ukudonswa kwemali
Izinguquko ezimbalwa ezinkulu zenziwe ohlelweni lweMedigap ngo-2020.
Izinhlelo zeMedigap ngeke zisasetshenziselwa ukukhokhela imali ebanjwayo ye-Medicare Part B. Lokhu kusho ukuthi izinhlobo ezimbili zezinhlelo zeMedigap - uHlelo C noHlelo F - ziyeke ukuthengiswa kumalungu amasha kusukela ngoJanuwari 1, 2020. Abantu asebenazo lezi zinhlelo, nokho, bayakwazi ukugcina ukumbozwa kwabo.
Izinhlelo zeMedigap kungenzeka zingakhokhi zonke izindleko ezingaphandle kwephaketheni, kepha ungathola leyo evumelana kangcono nezidingo zakho zezezimali nezempilo. Unezinhlelo ezahlukahlukene namazinga wokuhlanganisa ongakhetha kuwo.
Nakhu ukubuka konke lokho okukodwa kwezinhlelo eziyi-10 ze-Medigap okumbozayo:
| Uhlelo lweMedigap | Ukufunda |
|---|---|
| Hlela A | I-Medicare Part A coinsurance nezindleko zokunakekelwa okungabiza izinsuku ezingama-365 ngemuva kokuphela kwezinzuzo ze-Medicare, PartURE coinsurance noma ama-copayments, amaphepha amathathu okuqala okumpontshelwa igazi, kanye nokunakekelwa kwe-hospice noma i-copayments |
| Hlela uB | I-Medicare Part A coinsurance nezindleko zokunakekelwa okungabiza izinsuku ezingama-365 ngemuva kokuphela kwezinzuzo ze-Medicare, PartURE coinsurance noma ama-copayments, amaphepha amathathu okuqala okumpontshelwa igazi, ukunakekelwa kwe-hospice noma i-copayments, kanye ne-Part A yakho edonswayo |
| Uhlelo C | I-Medicare Part A coinsurance kanye nezindleko zokunakekelwa kwezinsuku ezingama-365 ngemuva kokuphela kwezinzuzo zeMedicare, Parturance B coinsurance noma ama-copayments, amaphuzu amathathu okuqala okumpontshelwa igazi, ukunakekelwa kwe-hospice noma i-copayments, ikhono lokunakekelwa kwabahlengikazi abanekhono, i-Part A yakho iyadonswa , Ingxenye B yakho idonswa *, kanye nokuhwebelana kohambo lwangaphandle kufikela kuma-80% |
| Hlela uD | I-Medicare Part A coinsurance kanye nezindleko zokunakekelwa kwezinsuku ezingama-365 ngemuva kokuphela kwezinzuzo ze-Medicare, PartURE coinsurance noma ama-copayments, amaphuzu amathathu okuqala okumpontshelwa igazi, ukunakekelwa kwe-hospice noma i-copayments, i-coinsurance yezikhungo zabahlengikazi abanekhono, i-Part A yakho ukudonswa kwemali, kanye nokuhwebelana kwamanye amazwe kuze kufike kuma-80% |
| Hlela uF | I-Medicare Part A coinsurance nezindleko zokunakekelwa kwezinsuku ezingama-365 ngemuva kokuphela kwezinzuzo ze-Medicare, Parturance coinsurance noma ama-copayments, amaphuzu amathathu okuqala okumpontshelwa igazi, ukunakekelwa kwe-hospice noma i-copayments, i-coinsurance yezikhungo zabahlengikazi abanekhono, i-Part A yakho kudonswa imali, ingxenye yakho B idonswa *, Ingxenye B ibiza umhlinzeki wakho akhokhise ngaphezu kwalokho okuvunyelwa yi-Medicare (izindleko ezingaphezulu), kanye nokuhwebelana kwamanye amazwe kuze kufike ku-80% |
| Hlela uG | I-Medicare Part A coinsurance nezindleko zokunakekelwa kwezinsuku ezingama-365 ngemuva kokuphela kwezinzuzo ze-Medicare, Parturance coinsurance noma ama-copayments, amaphuzu amathathu okuqala okumpontshelwa igazi, ukunakekelwa kwe-hospice noma i-copayments, i-coinsurance yezikhungo zabahlengikazi abanekhono, i-Part A yakho idonswa, Ingxenye B ibiza umhlinzeki wakho akhokhise ngaphezu kwalokho okuvunyelwa yiMedicare (izindleko ezingaphezulu), kanye nokuhwebelana kwamanye amazwe kuze kufike kuma-80% |
| Hlela uK | I-Medicare Part A coinsurance kanye nezindleko zokunakekelwa kwezinsuku ezingama-365 ngemuva kokuphela kwezinzuzo ze-Medicare, ama-50% weNgxenye B yesinxephezelo noma ama-copayments, ama-50% wezindleko zamaphayinti amathathu okuqala okumpontshelwa igazi, ama-50% wokunakekelwa kwe-hospice noma ama-copayment, ama-50% we-coinsurance yezikhungo zabahlengikazi abanamakhono, ama-50% engxenye yakho A idonswa - ngomkhawulo ophuma ephaketheni ka- $ 6,220 ngo-2021 |
| Hlela uL | I-Medicare Part A coinsurance kanye nezindleko zokunakekelwa kwezinsuku ezingama-365 ngemuva kokuphela kwezinzuzo ze-Medicare, ama-75% weNgxenye B yemali noma ama-copayment, ama-75% wezindleko zamaphayinti amathathu okuqala okumpontshelwa igazi, ama-75% wokunakekelwa kwemali yokunakekelwa kwabahlengikazi noma ama-copayments, ama-75% we-coinsurance yezindawo zabahlengikazi abanamakhono, ama-75% engxenye yakho A idonswa - ngomkhawulo ophuma ephaketheni ka- $ 3,110 ngo-2021 |
| Hlela uM | I-Medicare Part A coinsurance kanye nezindleko zokunakekelwa kwezinsuku ezingama-365 ngemuva kokuphela kwezinzuzo zeMedicare, Parturance B coinsurance noma ama-copayments, amaphuzu amathathu okuqala okumpontshelwa igazi, ukunakekelwa kwe-hospice noma i-copayments, i-coinsurance yezikhungo zabahlengikazi abanekhono, ama-50% Ingxenye yakho idonselwa, futhi ukushintshaniswa kohambo lwangaphandle kufinyelela kuma-80% |
| Hlela uN | I-Medicare Part A coinsurance nezindleko zokunakekelwa kwezinsuku ezingama-365 ngemuva kokuphela kwezinzuzo ze-Medicare, Parturance coinsurance noma ama-copayments, amaphuzu amathathu okuqala okumpontshelwa igazi, ukunakekelwa kwe-hospice noma i-copayments, i-coinsurance yezikhungo zabahlengikazi abanekhono, i-Part A yakho ukudonswa kwemali, kanye nokuhwebelana kwamanye amazwe kuze kufike kuma-80% |
* Ngemuva kukaJanuwari 1, 2020, abantu abasha ku-Medicare abakwazi ukusebenzisa izinhlelo zeMedigap ukukhokha iMedicare Part B ebanjwayo. Kepha uma usuvele ubhalisile kwi-Medicare futhi uhlelo lwakho njengamanje luyayikhokha, ungagcina lelo hlelo kanye nenzuzo.
Ukuthatha
Kungathatha isikhathi nomzamo ukuhlunga izinhlobo eziningi zamasu we-Medicare. Kepha lezi zinketho zikunikeza ukukhetha okuningi uma kukhulunywa ngokumbozwa kanye nezindleko zokunakekelwa kwakho kwezempilo.
Lapho uqala ukuthola iMedicare, qiniseka ukuthi ubuyekeza zonke izingxenye zayo ukuthola okukulungele kakhulu futhi uvikele izinhlawulo ngokuhamba kwesikhathi.
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.
Imibhalo Emisha
Ukuhlolwa Kwendlala Yendlala
