Kumvetsetsa Medicare

Medicare ndi inshuwaransi yathanzi yaboma kwa anthu azaka 65 kapena kupitilira apo. Anthu ena nawonso atha kulandira Medicare:

• Achinyamata olumala
• Anthu omwe ali ndi vuto la impso kosatha (matenda omaliza a impso) ndipo amafunikira dialysis kapena kumuikira impso

Kuti mulandire Medicare, muyenera kukhala nzika ya United States kapena wovomerezeka mwalamulo yemwe wakhala mdzikolo kwa zaka zosachepera 5.

Medicare ili ndi magawo anayi. Magawo A ndi B amatchedwanso "Original Medicare."

• Gawo A - Chipatala
• Gawo B - Kusamalira odwala
• Gawo C - Phindu la Medicare
• Gawo D - Dongosolo La Mankhwala Othandizira Mankhwala a Medicare

Anthu ambiri amasankha Original Medicare (gawo A ndi B) kapena Medicare Advantage. Ndi Original Medicare, muli ndi mwayi wosankhanso Plan D yamankhwala anu.

Gawo la Medicare A limafotokoza ntchito ndi zofunikira pakuthandizira matenda kapena zovuta zamankhwala zomwe zimachitika nthawi:

• Kusamalira chipatala.
• Kusamalira malo oyamwitsa aluso, mukamatumizidwa kuti mukachiritse matenda kapena njira. (Kusamukira kumalo osungirako anthu okalamba mukakhala kuti simukhalanso kunyumba sikupangidwa ndi Medicare.)
• Kusamalira odwala.
• Maulendo azaumoyo kunyumba.

Ntchito zoperekedwa mukakhala mchipatala kapena malo omwe angaphatikizidwe ndi awa:

• Chisamaliro choperekedwa ndi asing'anga, manesi, ndi othandizira ena azaumoyo
• Mankhwala osokoneza bongo
• Kusamalira unamwino
• Thandizo lothandizira pakulankhula, kumeza, kuyenda, kusamba, kuvala ndi zina zotero
• Kuyesa kwa labu ndi kujambula
• Opaleshoni ndi njira
• Ma wheelchair, oyenda, ndi zida zina

Anthu ambiri samalipira ndalama pamwezi pa Gawo A.

Kusamalira odwala. Medicare Part B imathandizira kulipira chithandizo ndi ntchito zoperekedwa ngati kuchipatala. Chisamaliro cha kuchipatala chitha kuchitika mu:

• Chipinda chodzidzimutsa kapena dera lina lachipatala, koma pomwe simulandilidwa
• Maofesi a othandizira azaumoyo (kuphatikiza namwino wa udotolo, wothandizira, ndi ena)
• Malo opangira opaleshoni
• Labu kapena malo ojambulira
• Nyumba yanu

Ntchito ndi othandizira ena azaumoyo. Amaperekanso chithandizo chamankhwala choteteza, monga:

• Maulendo azaumoyo ndi ntchito zina zodzitetezera, monga chimfine ndi kuwombera chibayo ndi mammograms
• Njira zochitira opareshoni
• Mayeso a labu ndi ma x-ray
• Mankhwala ndi mankhwala omwe simungathe kudzipatsa nokha, monga mankhwala operekedwa kudzera mumitsempha yanu
• Kudyetsa machubu
• Kuyendera ndi wopereka
• Ma wheelchair, walkers, ndi zinthu zina
• Ndi zina zambiri

Anthu ambiri amalipira ndalama pamwezi kwa Gawo B. Mumalipiranso ndalama zochotseredwa pachaka chilichonse. Ndalamazo zikakwaniritsidwa, mumalipira 20% ya mtengo pazantchito zambiri. Izi zimatchedwa chitsimikizo cha ndalama. Mumaperekanso ndalama zolipirira kukaonana ndi dokotala. Imeneyi ndi ndalama zochepa, makamaka pafupifupi $ 25 kapena apo, kwa dokotala aliyense kapena kukaona akatswiri.

Zomwe zaphimbidwa mdera lanu zimadalira:

• Malamulo aboma ndi maboma
• Zomwe Medicare imasankha zaphimbidwa
• Zomwe makampani akomweko asankha kubisa

Ndikofunika kuti nthawi zonse muziyang'ana momwe mungagwiritsire ntchito mankhwalawa musanagwiritse ntchito ntchito kuti mudziwe zomwe Medicare ikulipireni komanso zomwe mungafunikire kulipira.

Madongosolo a Medicare advantage (MA) amapereka zabwino zofananira ndi Gawo A, Gawo B, ndi gawo D. Izi zikutanthauza kuti mumayikidwa kuchipatala komanso kuchipatala komanso mankhwala akuchipatala. Mapulani a MA amaperekedwa ndi makampani a inshuwaransi apadera omwe amapatsidwa ntchito ndi Medicare.

• Mumalipira ndalama pamwezi pamalingaliro amtunduwu.
• Nthawi zambiri muyenera kugwiritsa ntchito madotolo, zipatala, ndi othandizira ena omwe amagwira ntchito ndi pulani yanu kapena mudzalipira ndalama zambiri.
• Mapulani a MA amakwaniritsa ntchito zonse zoyendetsedwa ndi Original Medicare (gawo A ndi gawo B).
• Amaperekanso zowonjezera zowonjezera monga masomphenya, kumva, mano, ndi mankhwala opatsirana. Nthawi zina, mungafunike kulipira zowonjezera pazowonjezera zina monga chisamaliro cha mano.

Ngati muli ndi Medicare Yoyambirira (magawo A ndi B) ndipo mukufuna kupatsidwa mankhwala, muyenera kusankha Medicare Prescription Drug Plan (Plan D). Izi zimaperekedwa ndi makampani a inshuwaransi achinsinsi ovomerezeka ndi Medicare.

Simungasankhe Plan D ngati muli ndi dongosolo la Medicare Advantage chifukwa kufalitsa mankhwala kumaperekedwa ndi mapulani amenewo.

Medigap ndi inshuwaransi ya Medicare yowonjezera yomwe imagulitsidwa ndi makampani wamba. Zimathandizira kulipira ndalama monga zolipiritsa, ndalama zandalama, ndi zochotseredwa. Kuti mupeze malingaliro a Medigap muyenera kukhala ndi Original Medicare (gawo A ndi gawo B). Mumalipira kampani ya inshuwaransi yabwinobwino pamwezi pamtengo wanu wa Medigap kuphatikiza pamalipiro apamwezi a Part B omwe mumalipira ku Medicare.

Muyenera kulowa nawo gawo la Medicare Part A pakati pa miyezi itatu mwezi wanu wobadwa usanakwane (kutembenukira 65) ndi miyezi itatu mutatha mwezi wakubadwa. Mumapatsidwa zenera la miyezi 7 kuti mulowetse.

Ngati simulembetsera Gawo A mkati mwa zenera, mudzalipira chindapusa kuti mulowe nawo, ndipo mutha kulipira ndalama zowonjezera pamwezi. Ngakhale mutakhala kuti mukugwirabe ntchito ndi inshuwaransi ya ntchito, muyenera kulembetsa ku Medicare Part A. Chifukwa chake musayembekezere kulowa nawo Medicare.

Mutha kulembetsa ku Medicare Part B mukayamba kulembetsa gawo A, kapena mutha kudikirira mpaka mutafunsidwa.

Mutha kusankha pakati pa Medicare yoyambirira (Gawo A ndi Gawo B) kapena Medicare Advantage Plan (Gawo C). Nthawi zambiri, mutha kusinthana mobwerezabwereza pakati pa mitundu iyi yolemba kamodzi pachaka.

Sankhani ngati mukufuna kuphimba mankhwala osokoneza bongo kapena Gawo D. Ngati mukufuna kufalitsa mankhwala osokoneza bongo muyenera kufananizira mapulani omwe amayendetsedwa ndi makampani a inshuwaransi. Osangofananitsa ndalama zoyambilira poyerekeza mapulani. Onetsetsani kuti mankhwala anu akuphimbidwa ndi pulani yomwe mukuyang'ana.

Ganizirani zinthu zomwe zili pansipa mukasankha dongosolo:

• Kuphunzira - Dongosolo lanu liyenera kukhudzana ndi ntchito ndi mankhwala omwe mukufuna.
• Mtengo - Yerekezerani zolipira zomwe muyenera kulipira mumapulani osiyanasiyana. Yerekezerani mtengo wa ndalama zomwe mumalandira, zochotseredwa, ndi zina zomwe mungasankhe.
• Mankhwala oyenera kulandira mankhwala - Onetsetsani kuti mankhwala anu onse akuphimbidwa ndi mapulani ake.
• Kusankha kwa Dotolo ndi chipatala - Fufuzani kuti muwone ngati mungagwiritse ntchito adotolo ndi chipatala chomwe mungakonde.
• Chisamaliro chapamwamba - Fufuzani ndemanga ndi mavoti a mapulani ndi ntchito zoperekedwa ndi mapulani mdera lanu.
• Ulendo - Fufuzani ngati dongosololi likuphimba ngati mupita kudera lina kapena kunja kwa United States.

Kuti mudziwe zambiri za Medicare, phunzirani za mapulani a Medicare Advantage omwe akupezeka mdera lanu, ndipo yerekezerani madotolo, zipatala, ndi othandizira ena mdera lanu, pitani ku Medicare.gov - www.medicare.gov.

Malo opangira tsamba la Medicare ndi Medicaid Services. Medicare ndi chiyani? www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices/whats-medicare. Inapezeka pa February 2, 2021.

Malo opangira tsamba la Medicare ndi Medicaid Services. Zomwe Medicare amakonzera zimakhudza. www.medicare.gov/what-medicare-covers/what-medicare-health-plans-cover. Inapezeka pa February 2, 2021.

Malo opangira tsamba la Medicare ndi Medicaid Services. Zowonjezera ndi inshuwaransi ina. www.medicare.gov/supplements-other-inshuwaransi. Inapezeka pa February 2, 2021.

Stefanacci RG, Cantelmo JL. Kusamalira okalamba Achimereka. Mu: Fillit HM, Rockwood K, Young J, eds. Brocklehurst's Textbook of Geriatric Medicine ndi Gerontology. 8th ed. Philadelphia, PA: Elsevier; 2017: mutu 129.

• Mankhwala
• Kupeza Mankhwala Osokoneza Bongo