Ngingasula Kanjani Kuhlelo Lwami Lwe-Medicare Advantage?

-Delile

• Ngingabhalisa nini noma ngilahle uhlelo lweMedicare Advantage?
• Ukubhaliswa kokuqala
• Vula ukubhalisa
• Ukubhaliswa okukhethekile
• Izizathu zokulahla noma zokushintsha uhlelo lwakho
• Ungayikhetha kanjani ikhava ekufanele
• Izinyathelo ezilandelayo: Ungakususa kanjani ukubhalisa noma ushintshe izinhlelo
• Ukuthatha

• Izinhlelo zeMedicare Advantage zinikeza ukumbozwa kweMedicare yasekuqaleni kepha kaningi kunezinzuzo ezengeziwe.
• Uma usubhalisele i-Medicare Advantage, izinketho zakho zokulahla noma zokushintsha uhlelo lwakho zikhawulelwe ngezikhathi ezithile.
• Ngalezi zikhathi, ungabuyela ku-Medicare yasekuqaleni noma shintshela kuhlelo oluhlukile lwe-Medicare Advantage.

Wenzé ucwaningo lwakho futhi wenza ukuxhuma kusuka ku-Medicare yasekuqaleni kuya kwi-Medicare Advantage. Kodwa kwenzekani uma ushintsha umqondo wakho noma unquma ukuthi akulona uhlelo olulungele wena? Uma ufuna ukukhipha noma uguqule uhlelo lwakho lwe-Medicare Advantage, kufanele ulinde amafasitela athile wokubhalisa, afana nalapho ubhalisela khona okokuqala.

Sizobheka isikhathi ngasinye sokubhalisa, sichaze ukuthi yiluphi uhlobo lwecebo ongalukhetha ngalezi zikhathi, ukuthi ungalukhethela kanjani uhlelo oluhle kakhulu, nokuningi.

Ngingabhalisa nini noma ngilahle uhlelo lweMedicare Advantage?

I-Medicare Advantage ingumkhiqizo ozikhethela wona we-Medicare owuthenga kumhlinzeki womshuwalense wangasese. Ihlanganisa zonke izici ze-Medicare yasekuqaleni (Ingxenye A neNgxenye B) kanye nezinsizakalo ezingeziwe noma zokuzikhethela ezifana nokutholakala kwemithi ye-Medicare Part D kanye nomshuwalense wokungezelela.

Eyaziwa nangokuthi i-Medicare Part C, i-Medicare Advantage uhlelo lokuhlanganisa oluyimfihlo olunikeza ukumbozwa okuphelele kweziguli ze-Medicare kanye neziguli eziphuma ngaphandle ngezinsizakalo ezingeziwe nezinsizakalo.

Ukubhaliswa kokuqala

Ungabhalisela i-Medicare Advantage lapho uqala ukuthola i-Medicare. Ufanelekela iMedicare ngosuku lwakho lokuzalwa lwama-65, futhi ungabhalisela lolu hlelo isikhathi esiyizinyanga eziyi-7 (izinyanga ezintathu ngaphambi kokuba ube neminyaka engama-65, inyanga yosuku lwakho lokuzalwa, nezinyanga ezintathu emva kwalokho).

Uma ubhalisa ngalesi sikhathi, kulapho-ke lapho ungalindela ukuthi ukumbozwa kuqale:

• Uma ubhalisa ngesikhathi se- Izinyanga ezintathu ngaphambi usuku lwakho lokuzalwa lwama-65, ukumbozwa kwakho kuqala usuku lokuqala lwenyanga ngemuva kokuthi ube neminyaka engama-65 ubudala (isibonelo: usuku lwakho lokuzalwa nguMeyi 15 bese ubhalisa ngoFebhuwari, Ephreli, noma ngoMashi, ukumbozwa kwakho kuzoqala ngoMeyi 1).
• Uma ubhalisa phakathi nenyanga wosuku lwakho lokuzalwa, ukumbozwa kwakho kuzoqala inyanga eyodwa ngemuva kokuthi ubhalisile.
• Uma ubhalisa ngesikhathi se- Izinyanga ezi-3 ngemuva usuku lwakho lokuzalwa, ukumbozwa kwakho kuqala izinyanga ezimbili kuya kwezingu-3 ngemuva kokubhalisa.

Uma ukhetha uhlelo lwe-Medicare Advantage ngesikhathi sokubhalisa kokuqala, ungashintsha kwelinye uhlelo lwe-Medicare Advantage noma ubuyele ku-Medicare yasekuqaleni ezinyangeni ezintathu zokuqala zokubika kwakho.

Vula ukubhalisa

Ngemuva kokuthi ubhalisile ngesikhathi sokubhaliswa kokuqala, kunezikhathi ezimbalwa kuphela onyakeni lapho ungashintsha noma ulahle ukumbozwa kwakho kwe-Medicare Advantage. Lezi zikhathi zenzeka ngezikhathi ezifanayo unyaka ngamunye.

• Isikhathi sokubhalisa esivulekile seMedicare (Okthoba 15 – Disemba 7). Lesi yisikhathi unyaka nonyaka lapho ungabuyekeza ukumbozwa kwakho futhi wenze izinguquko uma kudingeka. Ngalesi sikhathi, ungenza ushintsho ohlelweni lwakho lokuqala lweMedicare, ubhalisele i-Medicare Advantage noma i-Medicare Part D, noma ushintshe kusuka kuhlelo olulodwa lwe-Medicare Advantage uye kolunye.
• Isikhathi sokhetho sonyaka seMedicare Advantage (Januwari 1 – Mashi 31). Ngalesi sikhathi, ungashintsha kusuka ku-Medicare Advantage ubuyele ku-Medicare yasekuqaleni futhi okuphambene nalokho. Ungashintsha kuhlelo oluhlukile lwe-Medicare Advantage noma ungeze ukumbozwa kwe-Medicare Part D.

Ukungena noma ukushintsha izinhlelo ngalezi zikhathi ezithile kungakusiza ukuthi ugweme izinhlawulo zokubhaliswa sekwedlule isikhathi.

Ukubhaliswa okukhethekile

Kunezimo ezithile ezikhethekile ezingaphandle kolawulo lwakho, njengokuya endaweni lapho uhlelo lwakho lungasebenzi khona. Kulezi zinhlobo zezimo, i-Medicare ikuvumela ukuthi wenze ushintsho ngaphandle kwezikhathi ezijwayelekile ngaphandle kwenhlawulo.

Izikhathi ezikhethekile zokubhalisa zisebenza lapho uzidinga. Isibonelo, uma usuhambile futhi uhlelo lwakho lwamanje lwe-Medicare Advantage aluyibandakanyi indawo entsha lapho uhlala khona, isikhathi sakho sokubhalisa esikhethekile singaqala ngenyanga ngaphambi kokuhamba kwakho bese izinyanga ezimbili emva kokuhamba. Izikhathi zokubhalisa ezikhethekile ngokuvamile ziqala lapho uzidinga futhi zihlala cishe izinyanga ezimbili ngemuva komcimbi ofanelekayo.

Ezinye izibonelo ezimbalwa zale micimbi kungaba:

• ungene noma uphuma endaweni yokuhlala iziguli (indawo yabahlengikazi abanamakhono, indawo yokusiza yokuhlala, njll.)
• awusakufanelekeli ukumbozwa kwe-Medicaid
• unikezwa ukumbozwa ngomqashi noma ngenyunyana
  

Sizoxoxa ngezizathu eziningi ongafuna ukushintsha izinhlelo kusigaba esilandelayo.

Noma ngabe izidingo zakho zishintshile, usuhambile, noma awuthandi uhlelo lwakho lwamanje, izikhathi ezahlukahlukene zokubhalisa zikuvumela ukuthi wenze ushintsho oludingekayo. Lokhu akusho nje ukuthi kufanele ubuyele ku-Medicare yasekuqaleni - ungashintsha njalo kusuka kuhlelo olulodwa lweMedicare Advantage uye kolunye. Futhi uyakwazi ukushintsha ukumbozwa kwezidakamizwa ozinikezwa ngudokotela.

Izizathu zokulahla noma zokushintsha uhlelo lwakho

Ngenkathi umzamo omkhulu wenza isinqumo sokuqala ngezinhlelo zeMedare, kungadingeka ukuthi ushintshe ngezizathu ezahlukahlukene. Mhlawumbe uhlelo lushintshe okunikezwayo, noma izidingo zakho zishintshile.

Uma uhlelo lwakho lwe-Medicare Advantage lungahlangabezani nezidingo zakho, ungahle uthande ukubuyela ku-Medicare yasekuqaleni noma ushintshe izinhlelo ze-Part C. Ungadinga ukwengeza noma ukushintsha uhlelo lwakho lokuyalelwa, shintshela kuhlelo lweMedicare Advantage oluhlanganisa abahlinzeki abahlukahlukene noma izinsizakalo, noma uthole uhlelo oluhlanganisa indawo entsha.

Ezinye zezizathu ezivame kakhulu zokushintsha izinhlelo zifaka:

• uhambile
• ulahlekelwe ukumbozwa kwakho kwamanje
• unethuba lokuthola ukumbozwa komunye umthombo, njengomqashi noma inyunyana
• I-Medicare iqeda isivumelwano sayo nohlelo lwakho
• umhlinzeki wakho unquma ukungabe esanikela ngohlelo lwakho
• uyafaneleka ukuthola izinsizakalo ezingeziwe, njengoSizo Olungeziwe noma uHlelo Lwezidingo Ezikhethekile

Zonke lezi zimo ezingenhla zizokufanelekela isikhathi esikhethekile sokubhalisa.

Ungayikhetha kanjani ikhava ekufanele

Kunezici eziningi okufanele uzicabangele lapho ukhetha uhlelo lwe-Medicare, futhi izidingo zakho noma ezezimali zingashintsha emgwaqweni. Linganisa izinketho zakho ngokucophelela ekuqaleni, ugcine izidingo zakho zamanje nezesikhathi esizayo zokunakekelwa kwezempilo kanye nebhajethi yakho engqondweni.

Izinhlelo zeMedicare Advantage zinikela ngezinsizakalo ezingeziwe zokuzikhethela kepha zizobiza ngaphezu kwe-Medicare yasekuqaleni. Ezinye zezindleko ozikhokha phambili nge-Medicare Advantage zingakongela imali ngokuhamba kwesikhathi, ikakhulukazi kuzinsizakalo ezingeziwe njengokutholakala kwemithi kadokotela, umbono nokunakekelwa kwamazinyo.

Uma uhamba nohlelo lwe-Medicare Advantage, kufanele futhi ubuyekeze isilinganiso sekhwalithi yohlelo nokuthi ngabe abahlinzeki bakho bezinsiza ezikhona noma abathandwayo nezinsiza zabo bakunethiwekhi yini. Qhathanisa amacebo ngokucophelela ukuthola okulingana nezidingo zakho ezithile.

Kufanele futhi ubuyekeze izinketho zohlelo lwakho lwezidakamizwa, ucabanga ukuthi yiziphi izinhlelo ezihlanganisa imithi yakho. Uhlelo ngalunye kufanele lubeke ububanzi bezindleko zemithi ehlukahlukene. Qiniseka ukuthi okudingayo kutholakala ngentengo ongayikhokhela.

Izinyathelo ezilandelayo: Ungakususa kanjani ukubhalisa noma ushintshe izinhlelo

Lapho usuthathe isinqumo sokulahla noma sokushintsha uhlelo lwakho lweMedicare Advantage, isinyathelo sokuqala ukubhalisa kuhlelo olusha olukhethile. Yenza lokhu ngokugcwalisa isicelo sokubhalisa ngohlelo olusha ngesikhathi esivulekile noma esikhethekile sokubhalisa ukugwema izinhlawulo. Ngemuva kokuthi ubhalisele uhlelo olusha futhi ukuqala kwakho ukumbozwa, uzokhishwa ngokuzenzakalela ohlelweni lwakho lwangaphambilini.

Uma ushiya i-Medicare Advantage ukuze ubuyele ku-Medicare yasekuqaleni, ungashayela i-800-MEDICARE ukuze uqalise kabusha izinsiza zoqobo ze-Medicare.

Uma uhlangabezana nezinkinga, ungaxhumana ne-Social Security Administration, eqhuba uhlelo lwe-Medicare, noma i-SHIP yangakini (Uhlelo Lwe-State Health Assistance Program).

Ukuthatha

• Izinhlelo zeMedicare Advantage ziyanda kwizinsizakalo nokutholakala okunikezwa yiMedicare yasekuqaleni, kepha kungabiza kakhulu.
• Uma ubhalise kuhlelo lwe-Medicare Advantage, ungashintsha izinhlelo ze-Advantage noma ubuyele ku-Medicare yasekuqaleni ngezikhathi ezithile.
• Ukugwema izinhlawulo, kufanele ushintshe noma ulahle amapulani ngezikhathi zokubhalisa ezivulekile noma zonyaka, noma uhlole ukuze ubone ukuthi ufanelekile yini ukuthola isikhathi esikhethekile sokubhalisa.

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.