Izinhlelo Zama-Medicare Advantage: Ngubani Ozinikezayo nokuthi Ungabhalisa Kanjani

-Delile

• Yini i-Medicare Advantage (Medicare Part C)?
• Ngubani othengisa izinhlelo zeMedicare Advantage?
• Kubiza malini i-Medicare Advantage?
• Amathiphu wokukhetha uhlelo lwe-Medicare Advantage
• Ngubani ofanelekela ama-Medicare Advantage Plans?
• Izikhathi zokugcina zokubhalisa ze-Medicare
• Ukuthatha

I-Medicare Advantage enye inketho ye-Medicare efaka nokufakwa kwemithi kadokotela, amazinyo, umbono, ukuzwa, nezinye izinzuzo zezempilo.

Uma usanda kubhalisela i-Medicare, ungahle uzibuze ukuthi ngubani othengisa izinhlelo ze-Medicare Advantage endaweni yangakini. IMedicare Advantage inikezwa yizinkampani zomshuwalense ezizimele ezinenkontileka neMedarear ukumboza izinsizakalo zakho zokunakekelwa kwezempilo.

Kulesi sihloko, sizobuyekeza lokho okudingeka ukwazi nge-Medicare Advantage, ukuthi ungabhalisa kanjani, nokuthi yini ongayilindela ezinkampanini ezinikeza lezi zinhlelo.

Yini i-Medicare Advantage (Medicare Part C)?

I-Medicare Advantage, eyaziwa nangokuthi i-Medicare Part C, yi-Medicare efakwa izinkampani zomshuwalense ezizimele ezithengisayo. Ngaphezu kokumboza i-Medicare Part A ne-Part B, iningi lezinhlelo ze-Medicare Advantage libuye lihlanganise nemithi kadokotela, kanye namazinyo, umbono nezinsizakalo zokuzwa.

Amanye ama-Medicare Part C ahlela ngisho nokuhlanganisa izinzuzo zezempilo njengobulungu bokuqina kanye nezinsizakalo ezithile zezempilo zasekhaya.

Izinhlelo eziningi ze-Medicare Advantage zihlanganisa lezi zinsizakalo ezilandelayo:

• ukunakekelwa esibhedlela
• izinsizakalo zezokwelapha ezingaphandle
• imishanguzo kadokotela
• amazinyo, umbono, nokunakekelwa kokuzwa
• izinzuzo zezempilo ezengeziwe

Izinhlelo zeMedicare Advantage zingaba yindlela enhle kubantu abafuna ukumbozwa okungeziwe ngaphezu kwezingxenye zeMedicare A no-B futhi bazihlanganise konke ngaphansi kohlelo olulodwa. I-Medicare Part C nayo iyindlela ethandwayo kubantu abafuna ukukhetha ezinhlakeni ezahlukahlukene zohlelo, njengama-HMO, ama-PPO, nokuningi.

Ekugcineni, uphakamise ukuthi i-Medicare Advantage ingakongela imali uma iqhathaniswa neMedicare yasekuqaleni uma kukhulunywa ngezindleko zemishini yokunakekelwa kwempilo.

Ngubani othengisa izinhlelo zeMedicare Advantage?

Izinhlelo zeMedicare Advantage zithengiswa izinkampani ezinkulu zomshuwalense ezizimele, kufaka phakathi:

• I-Aetna Medicare
• Blue Cross Blue Isihlangu
• I-Cigna
• Humana
• UKaiser Permanente
• KhethaHealth
• UnitedHealthcare

Iminikelo ye-Medicare Part C iyahlukahluka kuye ngesifundazwe, futhi inkampani ngayinye yomshuwalense inelungelo lokunquma ukuthi izothengisa yini izinhlelo ze-Medicare Advantage unyaka nonyaka.

Isibonelo, ezinye izinkampani zinganikela ngezinhlelo ezindaweni ezimbalwa ezikhethiwe kepha hhayi kwezinye. Lokhu kusho ukuthi noma ngabe umngani wakho ubhalisele uhlelo lweMedicare Advantage endaweni yabo, lelocebo elifanayo ngeke linikezwe lapho uhlala khona.

Uma usuvele uthola izinsizakalo ezivela kumhlinzeki omkhulu womshuwalense ngomqashi wakho, ungafinyelela bese ubuza ukuthi ngabe bathengisa izinhlelo ze-Medicare Advantage.

Enye indlela yokubuyekeza yonke iminikelo yakho yohlelo ukusebenzisa ithuluzi lokuthola uhlelo olunikezwa yiMedicare. Leli thuluzi likuvumela ukuthi useshe futhi uqhathanise izinhlelo ze-Medicare Advantage edolobheni lakho, isifundazwe, noma ikhodi ye-ZIP.

Kubiza malini i-Medicare Advantage?

Izinhlelo zeMedicare Advantage zifaka phakathi zombili izindleko zokuqala zeMedicare, kanye nezindleko eziqondene nohlelo. Azikho izindleko ezilodwa zokubhalisa kuhlelo lweMedicare Advantage ngoba kunezinto eziningi ezingathinta ozokukhokha.

Zonke lezi zindleko zithonywe yisimo lapho uhlala khona, izindleko zokuphila, iholo lakho, lapho uya khona ngezinsizakalo zezempilo, ukuthi udinga usizo kangaki nokuthi uthola noma yiluphi uhlobo losizo lwezezimali.

Nakhu ukwehlukaniswa kwalokho ongalindela ukukukhokha ngo-2021 lapho ubhalisa ohlelweni lweMedicare Advantage:

• Amaphrimiyamu. Uma ungafanele ukuthola i-Part A engena-premium, i-premium yakho ye-Part A ingabiza kufika ku- $ 471 ngenyanga. Iphrimiyamu yengxenye B ibiza u- $ 148.50 ngenyanga noma ngaphezulu, kuya ngeholo lakho. Ezinye izinhlelo zeMedicare Advantage zizohlanganisa lezi zindleko zanyanga zonke ze-premium. Ngaphezu kwalokho, ngenkathi ezinye izinhlelo zeMedicare Advantage zingenayo i-premium, ezinye ziphinde zikhokhise imali ekhokhelwayo yanyanga zonke yohlelo.
• Okudonswayo. Ingxenye A inenani elikhokhwayo lama- $ 1,484 ngasikhathi senzuzo ngasinye. Ingxenye B inenani elikhokhwayo lama- $ 203 ngonyaka. Uma uhlelo lwakho lwe-Medicare Advantage luhlanganisa imishanguzo kadokotela, ungahle futhi ukhokhe umuthi odonswa kadokotela nawo.
• Amakhophi. Uhlelo ngalunye lweMedicare Advantage luzoba namanani athile okukhokha ngokuvakashela odokotela nokunakekelwa okuyinhloko. Lezi zimali zingahluka ngokuya ngesakhiwo sakho sohlelo nokuthi ngabe uthola izinsizakalo kusuka kumhlinzeki wenethiwekhi noma ongaphandle kwenethiwekhi.
• Coinsurance. Ingxenye Yesibambiso semali ingabiza okuncane njenge- $ 0 noma okungama- $ 742 ngosuku, kuye ngobude bokuhlala kwakho esibhedlela. Ingxenye B coinsurance ngamaphesenti angama-20 azo zonke izinsizakalo zezempilo ezivunyelwe yi-Medicare ngemuva kokuthi kuhlangatshezwe ukudonswa kwemali.

Amathiphu wokukhetha uhlelo lwe-Medicare Advantage

Uma ufuna uhlelo oluhle kakhulu lwe-Medicare Advantage lwezidingo zakho, cabanga ngalokhu okulandelayo:

• uhlobo lokumbozwa oludingayo, olungaba nomthelela kuhlobo luni lwecebo olikhethayo nokuthi hlobo luni lomnikelo ozowufuna
• inani lokuguquguquka kwabahlinzeki olidingayo, elingakusiza ukuthola ukuthi yiluphi uhlobo lwesakhiwo sohlelo lwe-Advantage okufanele ungene kulo
• izindleko ezijwayelekile zokuphuma ephaketheni zanyanga zonke nonyaka
• udinga ukunakekelwa kangaki nokuthi hlobo luni lokunakekelwa oludingayo, olungakusiza ukuthi ubhalise kuhlelo oluhlangabezana nezidingo zakho zezezimali nezokwelapha

Ngemuva kokuthi ucubungule zonke izinto ezihlobene nesimo sakho, ungasebenzisa ukuthola ithuluzi lokuhlela le-Medicare ukuthola uhlelo ngqo lweMedicare Advantage oluzokusiza kakhulu.

Ngubani ofanelekela ama-Medicare Advantage Plans?

Noma ngubani obhalise kwi-Medicare Part A no-Part B ufanelekile ukubhalisa kwi-Medicare Advantage.

Ngo-2021, abantu abanesifo sokuqeda isifo sezinso (ESRD) banelungelo lokubhalisa ezinhlwini ezibanzi zezinhlelo zeMedicare Advantage ngenxa yomthetho ophasiswe yiCongress. Ngaphambi kwalo mthetho, izinhlelo eziningi bezingeke zikwamukele noma zikukhawulele ku-Chronic Condition SNP (C-SNP) uma ubuthola ukuthi une-ESRD.

Izikhathi zokugcina zokubhalisa ze-Medicare

Uma usukulungele ukubhalisa ohlelweni lwe-Medicare Advantage, kuzodingeka unake kakhulu lezi zinsuku zokugcina:

Ukuthatha

Izinkampani eziningi zomshuwalense ezinkulu e-United States zidayisa izinhlelo ze-Medicare Advantage. Ukunikezwa kohlelo lweMedicare Part C akulinganiselwe futhi kwehlukile kumbuso kuya esifundazweni naphakathi kwezinkampani.

Uma ubhalisa kwi-Medicare Advantage, ungalindela ukukhokha zonke izindleko zoqobo ze-Medicare kanye nanoma yiziphi izindleko zohlelo lwe-Medicare Advantage.

Ngaphambi kokuba ubhalise kwi-Medicare Part C, qiniseka ukuthi ubuyekeza isimo sakho siqu ukuze ukhethe inketho engcono kakhulu yezidingo zakho zesikhathi eside zezezimali nezokwelapha.

Lo mbhalo uvuselelwe ngoNovemba 19, 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.