Umehluko Osemqoka Phakathi Kwezinhlelo zeMedicare Advantage kanye neMedicare Supplement Plans

-Delile

• Yini i-Medicare Advantage?
• Yini i-Medicare Supplement?
• Ukuqhathanisa amapulani
• Ingabe ufanelekile?
• Izindleko zezinhlelo ze-Advantage vs. Medigap
• Izindleko ze-Medicare Advantage
• I-Medicare Advantage ilungele wena uma:
• I-Medicare Advantage ayikulungele kahle uma:
• Izindleko ze-Medicare Supplement
• Ukutholakala kwe-Medicare Supplement kungahle kukufanele uma:
• Ukutholakala kwe-Medicare Supplement kungahle kungakulungeli uma:
• Usiza othile ukuthi abhalise?
• Ukuthatha

Ukukhetha umshuwalense wezempilo kuyisinqumo esibalulekile empilweni yakho nekusasa lakho. Ngenhlanhla, uma kukhulunywa ngokukhetha i-Medicare, uthole izinketho.

I-Medicare Advantage (Ingxenye C) ne-Medicare Supplement (Medigap) yizinhlelo ezingeziwe ezihambisana ne-Medicare yakho yokuqala (izingxenye A no-B). Bangakunikeza okwenziwe ngokwezifiso okudingayo ukuze uhlangabezane nezidingo zakho zokunakekelwa kwezempilo.

Zombili lezi zinhlelo zenzelwe ukunikeza ukumbozwa okungenziwa ngezinye izingxenye zeMedicare. Noma kunjalo, ungahle ungathengi Kokubili Inzuzo yeMedicare futhi I-Medigap.

Uma ufuna ukufakwa okwengeziwe kweMedare, kufanele ukhethe iMedicare Advantage noma I-Medigap.

Uma lokho kuzwakala kudida kancane, ungakhathazeki. Sizochaza ngezansi.

Yini i-Medicare Advantage?

Izinhlelo zeMedicare Advantage yizinketho zomshuwalense wangasese zokutholakala kweMedare. Lezi zinhlelo zimboza okwenziwa yiMedicare yangempela, kufaka phakathi:

• ukulaliswa esibhedlela
• ezokwelapha
• imishanguzo kadokotela

Ngokuya ngokuthi iliphi i-Advantage Plan oyikhethayo, uhlelo lwakho lungabuye luhlanganise:

• amazinyo
• umbono
• ukuzwa
• ubulungu bejimu
• ukuthuthwa lapho kubekwa khona abezempilo

I-Medicare.gov inethuluzi lokukusiza uthole uhlelo lweMedicare Advantage oluhlangabezana nezidingo zakho.

Yini i-Medicare Supplement?

I-Medicare Supplement, noma iMedigap, iqoqo lezinhlelo ezihlukile ezisiza ukumboza izindleko zokuphuma ephaketheni nezinto ezingafakwanga ngenye indlela ohlelweni lwakho lokuqala lweMedicare, njengama-copayments kanye ne-coinsurance.

Kusukela ngoJanuwari 1, 2020, izinhlelo ezisanda kuthengwa zeMedigap azibandakanyi ukudonswa kwengxenye B. Ungathenga iMedigap ngokungeziwe kokunye ukufakwa kwakho kwangempela kwe-Medicare (izingxenye A, B, noma D).

I-Medicare.gov inethuluzi lokukusiza uthole uhlelo lweMedigap oluhlangabezana nezidingo zakho.

Ukuqhathanisa amapulani

Ukukusiza uqhathanise, nazi zombili izinhlelo zihambisana:

Ingabe ufanelekile?

Kunezidingo eziningana okufanele uhlangabezane nazo ukuze ufanelekele izinhlelo zeMedare Advantage noma iMedigap. Nakhu ukuthi ungatshela kanjani ukuthi ufanelekile yini ukuthola i-Medicare Advantage noma i-Medicare Supplement:

• Ukufaneleka kwe-Medicare Advantage:
  • Ufaneleke ku-Part C uma ubhalise kuzingxenye A no-B.
  • Ufanelekele i-Medicare Part A no-B uma uneminyaka engama-65 noma ngaphezulu, ukhubazekile, noma unesifo sezinso sesigaba sokuphela.
• Ukufaneleka kwe-Medicare Supplement coverage:
  • Ufanelekele iMedigap uma ubhalise ezingxenyeni ze-Medicare A no-B.
  • Awukabhaliswa ku-Medicare Advantage.
  • Uhlangabezana nezidingo zombuso wakho zokutholakala kwe-Medigap.

Izindleko zezinhlelo ze-Advantage vs. Medigap

Ungathenga i-Medicare Advantage, noma i-Medicare Part C, ngokusebenzisa umhlinzeki wangasese ovunyelwe njengengxenye yokutholakala kwakho kwe-Medicare. Izindleko zohlelo ngalunye zinqunywa ngokuhlukile. Qhubeka ufunde ukuze uthole incazelo yokuthi amaprimiyamu nezimali zinqunywa kanjani.

Izindleko ze-Medicare Advantage

Ngokufana nanoma yiluphi olunye uhlelo lomshuwalense, ama-premium akhokhelwa yi-Medicare ayahlukahluka ebhodini kuye ngomhlinzeki okhetha ukubhalisa naye kanye nohlelo olukhethayo.

Ezinye izinhlelo azinayo i-premium yenyanga; abanye bakhokhisa amadola angamakhulu amaningana. Kodwa mancane amathuba okuthi uzokhokha kakhulu i-Part C yakho kunalokho okwenzela i-Part B.

Ngokwengeziwe, izindleko ezinjengama-copay nama-deductibles nazo zizohluka ngohlelo. Ukubheja kwakho okuhle kakhulu lapho kunqunywa izindleko ezingaba khona kuhlelo lwakho lwe-Medicare Advantage ukuqhathanisa ngokucophelela amapulani ngenkathi uthenga.

Sebenzisa ithuluzi leMedicare.gov ukusiza ukuqhathanisa amapulani nezindleko ze-Medicare Advantage.

Ezinye izinto ezingathinta izindleko zezinhlelo ze-Medicare Advantage zifaka:

• yiluphi uhlelo lwe-Advantage olukhethayo
• ufuna kangaki ukufinyelela ezinsizakalweni zezokwelapha
• lapho uthola khona ukunakekelwa kwezokwelapha (kunethiwekhi noma ngaphandle kwenethiwekhi)
• iholo lakho (lokhu kungasetshenziselwa ukunquma inani lakho le-premium, elikhishwayo, nelikopisha)
• uma unosizo lwezezimali njengeMedicaid noma ukukhubazeka

I-Medicare Advantage ilungele wena uma:

• Usuvele unezingxenye A, B, no-D.
• Unomhlinzeki ovunyelwe osuvele umthanda, futhi uyazi ukuthi bayazamukela izinhlelo zeMedicare neMedicare Advantage.
• Ufuna izinzuzo ezengeziwe ezihlanganisiwe, njengokuzwa, umbono kanye namazinyo.
• Kungcono uphathe uhlelo olulodwa kuzo zonke izidingo zakho zomshuwalense.

I-Medicare Advantage ayikulungele kahle uma:

• Uhamba kakhulu noma uhlela ngenkathi uku-Medicare. (Kufanele uhlale ngaphakathi kwendawo yokumboza uhlelo lwakho, ngaphandle kwezimo eziphuthumayo.)
• Ufuna ukugcina umhlinzeki ofanayo unyaka nonyaka. (Izidingo zabahlinzeki abagunyaziwe ziyashintsha minyaka yonke.)
• Ufuna ukugcina isilinganiso esifanayo. (Amanani ayashintsha minyaka yonke.)
• Ukhathazekile ngokukhokhela ukumbozwa okungeziwe ongeke ukusebenzise.

Izindleko ze-Medicare Supplement

Futhi, uhlelo ngalunye lomshuwalense luyahlukahluka ngentengo ngokuya ngokufaneleka kwakho nohlobo lokumbozwa olufunayo.

Ngezinhlelo ze-Medicare Supplement, lapho ufuna ukumbozwa okuningi, izindleko ziyanda. Ngokwengeziwe, uma umdala lapho ubhalisa, iprimiyamu ephakeme ongayithola.

Sebenzisa ithuluzi leMedicare.gov ukusiza ukuqhathanisa amazinga we-Medicare Supplement.

Izici ezingathinta izindleko zokufakwa kwakho kweMedigap zifaka:

• iminyaka yakho (umdala lapho ufaka isicelo, ungakhokha kakhulu)
• isu olikhethayo
• uma ufanele ukuthola isaphulelo (ongabhemi, owesifazane, okhokha ngekhompyutha, njll.)
• imali yakho ekhishwayo (uhlelo oluphakeme olungadonswa lungabiza kancane)
• lapho uthenga uhlelo lwakho (imithetho ingashintsha, futhi uhlelo oludala lungabiza kancane)

Ukutholakala kwe-Medicare Supplement kungahle kukufanele uma:

• Ukhetha ukukhetha inani lokumbozwa kwezindleko ezingaphandle kwephakethe ozithengayo.
• Udinga usizo lokukhokhela izindleko zangaphandle.
• Usuvele unakho ukumbozwa okudingayo ngombono, amazinyo, noma ukuzwa.
• Uhlela ukuhamba ngaphandle kwe-United States futhi ufuna ukuzilungiselela.

Ukutholakala kwe-Medicare Supplement kungahle kungakulungeli uma:

• Usunayo uhlelo lweMedicare Advantage. (Akukho emthethweni ukuthi inkampani ikuthengisele iMedigap lapho usunayo iMedicare Advantage.)
• Ufuna ukumbozwa ngokunakekelwa kwesikhathi eside noma ukunakekelwa kwe-hospice.
• Awusebenzisi kakhulu ukunakekelwa kwezempilo futhi akuvamile ukuhlangabezana nemali yakho edonselwayo yonyaka.

Usiza othile ukuthi abhalise?

Ukubhalisa ku-Medicare kungadideka. Uma usiza umngani noma ilungu lomndeni ukubhalisa, kunezinto ezimbalwa ongazenza ukwenza inqubo ibe lula.

Nawa amanye amathiphu okusiza othandekayo wakho abhalise kwi-Medicare:

• Xoxa ngokuthi ziyini izidingo zabo zokunakekelwa kwezempilo nokutholakala
• Nquma ngesabelomali esingabizi futhi esinengqondo somshuwalense.
• Lungisa imininingwane yakho nolwazi lomuntu omthandayo we-Social Security. Bangadinga ukwazi ukuthi ungubani nobudlelwano bakho nomuntu osiza ukubhalisa.
• Khuluma nothandekayo wakho mayelana nokuthi bazodinga yini ukufakwa okwengeziwe njengeNgxenye C noma iMedigap.

Ngenkathi ungasiza othandiweyo wakho ahlole amapulani futhi aqonde ukukhetha kwabo, awungeke ubhalise omunye umuntu eMedicare ngaphandle kokuthi unamandla amakhulu okuhlala lommeli walowo muntu. Le yidokodo elisemthethweni elikunikeza imvume yokwenza izinqumo egameni lomunye umuntu.

Ukuthatha

• Ukutholakala kwe-Medicare kunikeza izinketho ezahlukahlukene zohlelo.
• I-Medicare Advantage ihlanganisa ingxenye yakho A, B, futhi kaningi u-D uhlela nokuningi.
• IMedigap isiza ukukhokha izindleko zokuphuma ephaketheni ezinjenge-copays kanye ne-coinsurance.
• Awukwazi ukuthenga zombili, ngakho-ke kubalulekile ukwazi izidingo zakho bese ukhetha inketho ehlangabezana nazo kangcono.

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.