Kungani Ezinye Izinhlelo Zama-Medicare Advantage Zikhululekile?

-Delile

• Yini i-Medicare Advantage?
• Yini ehlanganiswe ezinhlelweni 'zamahhala'?
• Ingabe ‘kumahhala’ ngempela?
• Uhlelo lwe-Advantage premium yanyanga zonke
• Ingxenye B ye-premium yenyanga
• Okudonswayo
• Coinsurance / ama-copayments
• Uhlobo lwecebo
• Ziyini izindleko ze-Medicare?
• Ingxenye yeMedicare A
• Ingxenye yeMedare B
• Ezinye izinketho
• Ngabe ufanelekile ukuthola iMedicare?
• Ingabe ufanelekela izinhlelo zamahhala 'Zenzuzo'?
• Ukuthatha

Uma ubusanda kuthenga uhlelo lweMedicare Advantage, kungenzeka ukuthi uqaphele ukuthi ezinye zalezi zinhlelo zikhangiswa njenge "mahhala."

Izinhlelo ezithile ze-Advantage zibizwa mahhala ngoba zinikela nge-premium engu- $ 0 yenyanga ukubhaliswa kuhlelo. Lokhu kwenza u-zero premium Medicare Advantage ahlele ukunikezwa okukhangayo kulabo abafuna ukonga imali ngezindleko zanyanga zonke ze-Medicare.

Le ndatshana izobheka ukuthi zithini lezi zinhlelo zamahhala ze-Medicare Advantage, yiziphi izindleko ezengeziwe ongase uhlangane nazo, nokuthi ngubani ofanelekela uhlelo lwamahhala lwe-Medicare Part C.

Yini i-Medicare Advantage?

I-Medicare Advantage, ebizwa nangokuthi i-Medicare Part C, inikezwa izinkampani zomshuwalense ezizimele zabantu abafanelekayo abafuna okungaphezulu kokutholakala kwe-Original Medicare.

Izinhlelo zeMedicare Advantage zihlinzeka ngokufakwa okuphoqelekile okulandelayo:

• Ukutholakala kwesibhedlela (Medicare Part A). Lokhu kuhlanganisa izinsizakalo ezihlobene nezibhedlela, ukunakekelwa kwempilo yasekhaya, ukunakekelwa kwasekhaya lasebekhulile, nokunakekelwa kwabagula kakhulu.
• Ukutholakala kwezokwelapha (Medicare Part B). Lokhu kuhlanganisa ukuvimbela, ukuxilonga, kanye nokwelashwa kwezimo zezokwelapha.

Izinhlelo eziningi ze-Advantage zihlanganisa nezidingo ezingeziwe zezokwelapha, njenge:

• Ukusetshenziswa kwezidakamizwa kadokotela
• ukumbozwa kwamazinyo, ukubona, nokuzwa
• ukuvikelwa komzimba
• ezinye izinzuzo zezempilo

Uma ukhetha uhlelo lweMedicare Advantage kusuka enkampanini yangasese, kunezindlela ezahlukahlukene ongakhetha kuzo. Izinhlelo eziningi ze-Advantage yilezi:

• Izinhlelo ze-Health Maintenance Organisation (HMO). Lezi zinsizakalo ezimbozayo ezivela kodokotela be-in-network nabahlinzeki kuphela.
• Izinhlelo ze-Preferred Provider Organisation (PPO). Lezi zikhokhisa amanani ahlukile wezinsizakalo ezingaphakathi kwenethiwekhi nangaphandle kwenethiwekhi.

Kukhona nezinye izinhlaka ezintathu zohlelo lwezinhlelo ze-Medicare Part C:

• Izinhlelo ze-Private Fee-for-Service (PFFS). Lezi izinhlelo zokukhokha ezikhethekile ezinikeza ukumbozwa kwabahlinzeki okuguqukayo.
• Izinhlelo Zezidingo Ezikhethekile (SNP). Lokhu kuyindlela yokukhava kubantu abanezimo zezokwelapha zesikhathi eside.
• Izinhlelo ze-Medicare Medical Savings Account (MSA). Lezi zinhlelo zihlanganisa uhlelo lwezempilo oludonswa kakhulu ne-akhawunti yokonga yezokwelapha.

Yini ehlanganiswe ezinhlelweni 'zamahhala'?

Izinhlelo zamahhala ze-Medicare Advantage yizinhlelo ze-Medicare Part C ezinikela nge-premium engu- $ 0 ngonyaka.

Uma kuqhathaniswa nezinye izinhlelo zeMedicare, lezi zinhlelo ze-zero premium Medicare Advantage azikhokhisi inani laminyaka yonke ukuthi zibhaliswe kuhlelo.

Ngokuvamile awukho umehluko ekusetshenzisweni phakathi kohlelo lwamahhala nohlelo olukhokhelwayo. Kungakhathalekile ukuthi kubiza malini, iningi lezinhlelo zeMedicare Part C zinikeza izingxenye A no-B, umuthi kadokotela, nokunye ukufakwa okungeziwe.

Ngakho-ke, kungani izinkampani zinikela ngalezi zinhlelo ze-zero premium Medicare? Lapho inkampani isebenza ne-Medicare, inikezwa inani elibekiwe lemali ukumboza izingxenye zomshwalense u-A no-B.

Uma inkampani ingonga imali kwenye indawo, njengokusebenzisa abahlinzeki be-in-network, ingakwazi ukudlulisela leyo mali eyengeziwe kumalungu. Lokhu kungaholela ekukhokhweni kwemali yamahhala yanyanga zonke.

Lezi zinhlelo zamahhala zeMedicare Advantage nazo ziyindlela enhle yokuthi izinkampani zikhangise imali ekhangayo kulabo abangase bahlomule.

Ingabe ‘kumahhala’ ngempela?

Noma izinhlelo ze-zero premium Medicare Advantage zimakethwa njengemahhala, kusazodingeka ukhokhe ezinye izindleko zokuphuma ephaketheni ukumbozwa.

Uhlelo lwe-Advantage premium yanyanga zonke

Uma uhlelo lweMedicare Advantage lumahhala, ngeke kudingeke ukhokhe imali ekhokhwa nyangazonke ukuze ubhaliswe.

Ingxenye B ye-premium yenyanga

Izinhlelo eziningi zamahhala ze-Medicare Advantage zisakhokhisa imali ehlukile yenyanga engu-Part B. Ezinye izinhlelo zizokhokhela le mali, kepha ezinye kungenzeka.

I-premium B yenyanga nenyanga iqala ku- $ 135.50, noma ngaphezulu kuye ngeholo lakho.

Okudonswayo

Kunezinhlobo ezimbili zokudonswa konyaka ezihlotshaniswa nezinhlelo eziningi ze-Medicare Advantage:

• Uhlelo ngokwalo lungahle ludonswe minyaka yonke, okuyimali ekhishwa ephaketheni oyikhokhayo ngaphambi kokuba umshwalense wakho ukhokhe.
• Uhlelo lungaphinde lukukhokhise ngomuthi odonswayo.

Coinsurance / ama-copayments

Iningi lezinhlelo zeMedicare Advantage likhokhisa imali ekhokhelwa ukuvakashelwa. Imali ekhokhwayo iyimali ekhokhwa ngaphandle ephaketheni oyikhokhayo njalo lapho uthola izinsizakalo zezokwelapha.

Amanye amapulani angakhokhisa i-coinsurance. Leli yipesenti yazo zonke izindleko zokwelashwa obhekene nazo zokukhokha.

Uhlobo lwecebo

Izinhlelo zeMedicare Advantage nazo zingahluka ngezindleko ngokususelwa kuzakhiwo zazo. Isibonelo, izinhlelo ze-PPO zikhokhisa amanani ahlukile we-copayment ngokususelwa ekutheni umhlinzeki wakho uku-network noma ngaphandle kwenethiwekhi.

Lezi zindleko zingahluka unyaka nonyaka. Isibonelo, izinhlelo ze-PFFS zithole ukwanda ngamaphesenti amancane ezindleko minyaka yonke kule minyaka embalwa edlule.

Ziyini izindleko ze-Medicare?

I-Medicare ayiwona umshuwalense wezempilo wamahhala. Kunezindleko eziningi ezahlukahlukene ezihlotshaniswa nokutholakala kwe-Medicare.

Ngaphambi kokuthi ubhalise ohlelweni lwe-Medicare Advantage, kufanele ube nezingxenye ze-Medicare nokutholakala kwe-B. Ngezansi uzothola izindleko ezihambisana nalezo zinhlelo.

Ingxenye yeMedicare A

I-Medicare Part A ikhokhisa imali ekhokhwa njalo ngenyanga, engaba kusuka ku- $ 240 kuye ku- $ 437. Kodwa-ke, abantu abaningi bakhululiwe kule mali.

Uma ukhokhe intela yeMedicare ngenkathi usebenza noma uthola (noma ufanelekile) Ukuphepha Komphakathi noma izinzuzo zokuthatha umhlalaphansi kujantshi, ungaxolelwa.

I-Medicare Part A ibuye ikhokhise imali engu- $ 1,364 ekhokhelwa isikhathi ngasinye sezinzuzo kanye nenani le-coinsurance, elisukela ku- $ 341 liye ku- $ 682-plus.

Ingxenye yeMedare B

I-Medicare Part B ikhokhisa imali ekhokhwayo ejwayelekile yanyanga zonke engu- $ 135.50 noma ngaphezulu, kuya ngeholo lakho lonyaka. Uzokweleta le-premium B yengxenye B njengengxenye yohlelo lwakho lwamahhala lwe-Medicare Advantage ngaphandle kokuthi lumbozwe uhlelo.

I-Medicare Part B ibuye ikhokhise u- $ 185 ongadonswa ngonyaka, ngemuva kwalokho uzokweleta inani lama-20 le-coinsurance kuzo zonke izinsizakalo.

Ezinye izinketho

Uma ukhetha ukubhalisela uhlelo lokwengeza lweMedicare njengeMedicare Part D noma iMedigap njengenye indlela ye-Medicare Advantage, uzokweleta imali ekhokhwa ngenyanga kanye nezinye izindleko ezihambisana nalezi zinhlelo.

Izindleko zeMedicare Part D neMedigap zinqunywa ngohlelo olukhethayo.

Ngokungafani nobukhulu obuphuma ephaketheni ngecebo le-Medicare Advantage, akunamkhawulo enanini lezindleko ezingaphandle kwezikhwama ozozikhokhela izingxenye ze-Medicare A, B, D, noma iMedigap.

Ngabe ufanelekile ukuthola iMedicare?

Ufanelekele i-Medicare ngaphansi kwale mibandela elandelayo:

• Uneminyaka engu-65 noma ngaphezulu. Bonke abantu baseMelika abaneminyaka engama-65 noma ngaphezulu banelungelo lokuthola i-Medicare ngokuzenzakalela. Ungafaka isicelo seMedicare kuze kufike ezinyangeni ezintathu ngaphambi kosuku lwakho lokuzalwa lwama-65.
• Unokukhubazeka. Noma ungaphansi kweminyaka engama-65, ufanelekile ukuthola i-Medicare uma uthola izinkokhelo zokukhubazeka Kwezenhlalakahle. Ukuphepha Komphakathi kunikeza izinzuzo zokukhubazeka ezigabeni ezingaba ngu-14 zokukhubazeka.
• Une-ALS. Uma une-ALS futhi uthola izinzuzo zokukhubazeka, ufaneleke ngokuzenzakalela ku-Medicare.
• Unesifo sezinso sesigaba sokuphela. Uma unokuhluleka kwezinso unomphela, ufanelekile ukuthola i-Medicare. Kodwa-ke, kubalulekile ukuthi uqaphele ukuthi abantu abanalesi simo abafanelekile ukuthuthukela kuhlelo lweMedicare Advantage.

Izindlela ezithile, njengokuthola izinzuzo zokukhubazeka izinyanga ezingama-24, zizokubhalisela i-Medicare ngenyanga yama-25. Uma kunjalo, awudingi ukuzibhalisela izingxenye ze-Medicare A no-B.

Kodwa-ke, uma ufanele iMedicare kodwa ungabhaliswanga ngokuzenzakalela, kuzodingeka ufake isicelo kuwebhusayithi Yezokuphepha Komphakathi.

Ingabe ufanelekela izinhlelo zamahhala 'Zenzuzo'?

Azikho iziqu zezinhlelo zamahhala ze-Medicare Advantage. Izinhlelo eziningi ze-Advantage zinikela nge-premium yamahhala yanyanga zonke njengengxenye yeminikelo yabo yezokunakekelwa kwempilo.

Ungathola amapulani we-Medicare Part C endaweni yangakini nge-premium engu- $ 0 ngokusebenzisa ithuluzi lecebo likaMedicare.gov's Find 2020 Medicare.

Ngesikhathi sosesho lwakho, ungasebenzisa isici se- "Hlunga ngamanani aphansi kakhulu we-premium yanyanga zonke" ukubona amapulani we-zero premium Medicare Advantage endaweni yangakini.

Enye yezindlela ezibaluleke kakhulu zokuphatha izindleko zakho ze-Medicare ukusebenzisa izinsiza ezikhona ukusiza ukumboza noma ukwehlisa izindleko zakho. Lezi zinsizakusebenza zifaka:

• I-Medicaid. Lolu hlelo lusizile ukumboza izindleko zokwelashwa ngaphezu kwabantu abahola kancane noma abangenazo izinsiza zokukhokhela izindleko zokwelashwa.
• Izinhlelo Zokulondolozwa Kwemithi. Lezi zinhlelo zingasiza abahlomuli abahola kancane ukukhokha amaphrimiyamu e-Medicare Advantage, ama-deductibles, ama-copayments, kanye ne-coinsurance.
• Ukuvikeleka Komphakathi Okungeziwe. Le nzuzo inikeza abantu abakhubazekile, abangaboni, noma abangaphezu kwama-65 inkokhelo yanyanga zonke, engasiza ukukhokhela izindleko zeMedicare.
• Izinsiza ezingeziwe. Kunezinye izinhlelo ezinganikeza usizo kubantu abahlala ezindaweni ezithile zase-U.S. Noma abanezindleko eziphezulu zemithi kadokotela.

Enye indlela yokugcina umkhondo wezindleko zakho ze-Medicare Advantage ukunaka Ubufakazi Bokutholakala kanye Nesaziso Sonyaka Sokushintsha sazisa ukuthi uhlelo lwakho lukuthumela unyaka nonyaka. Lokhu kuzokusiza ukuthi uhlale phezulu kunoma iluphi ushintsho lwamanani noma ukukhushulwa kwemali.

Ukuthatha

Izinhlelo zamahhala ze-Medicare Advantage yizinhlelo zangasese zomshuwalense we-Medicare ezinikezela nge-premium engu- $ 0 ngenyanga.

Yize lezi zinhlelo zikhangiswa njengemahhala, kusazodingeka ukhokhe izindleko ezijwayelekile zokuphuma ephaketheni kwamanye amaprimiyamu, imali ekhishwayo, kanye nama-copayments.

Uma ufanelekela iMedicare futhi ubhalise ezingxenyeni A no-B, ungasebenzisa ithuluzi lokuthola uhlelo lwe-Medicare lika-2020 ukusesha amapulani we-zero premium Medicare Advantage endaweni yangakini.

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.