Kodi Medicare Imaphimba Mayeso Amwazi?

Zamkati

• Ndi magawo ati a Medicare omwe amayesa kuyesa magazi?
• Kodi kuyesa magazi kumawononga ndalama zingati?
• Mtengo wa Medicare Part A
• Mtengo wa Medicare Part B
• Mtengo wa Medicare Advantage
• Mitengo ya Medigap
• Kodi ndingapeze kuti kukayezetsa?
• Kodi ndimayeso amtundu wanji omwe amayesedwa?
• Ndi mitundu iti yamayeso amachitidwe a labu yomwe imaphimbidwa?
• Kutenga

• Medicare imakayezetsa kuyezetsa magazi koyenera malinga ndi malangizo a Medicare.
• Mapulani a Medicare Advantage (Gawo C) atha kuyesedwa kwambiri, kutengera dongosolo.
• Palibe malipiro osiyana a kuyezetsa magazi pansi pa Medicare yoyambirira.
• Dongosolo lowonjezera (Medigap) limatha kuthandizira kutuluka mthumba ngati ndalama zochotseredwa.

Kuyezetsa magazi ndi chida chofunikira chofufuzira chomwe madokotala amagwiritsa ntchito poyang'ana pazomwe zingaike pachiwopsezo ndikuwunika momwe thanzi lilili. Imeneyi ndi njira yosavuta yoyerekeza momwe thupi lanu limagwirira ntchito ndikupeza zizindikilo zoyambirira.

Medicare imakhudza mitundu yambiri yololeza omwe amakuthandizani kuti azisamalira thanzi lanu komanso kuti azitha kuteteza matenda. Kuphunzira kungadalire kukumana ndi njira zoyeserera za Medicare.

Tiyeni tiwone mbali ziti za Medicare zomwe zimayesa kuyezetsa magazi ndi mayeso ena azidziwitso.

Ndi magawo ati a Medicare omwe amayesa kuyesa magazi?

Medicare Part A imapereka chithandizo chazoyeserera zamagazi zofunikira. Mayeso atha kuyitanidwa ndi dokotala wa chipatala chakuchipatala, unamwino waluso, hospice, thanzi lakunyumba, ndi ntchito zina zokhudzana ndi izi.

Medicare Part B imakayezetsa kuyezetsa magazi kwa wodwala komwe adalamulidwa ndi dokotala wodziwa zamankhwala mogwirizana ndi malangizo a Medicare. Zitsanzo zingakhale kuyesa magazi kuti adziwe kapena kuthana ndi vutoli.

Medicare Advantage, kapena Gawo C, amapanganso kuyesa magazi. Mapulaniwa atha kuphatikizanso mayeso ena omwe sanapezeke ndi Medicare yoyambirira (gawo A ndi B). Dongosolo lililonse la Medicare Advantage limapereka maubwino osiyanasiyana, chifukwa chake onani njira yanu yokhudza kuyesa magazi. Komanso ganizirani zopita kwa ma network ndi ma lab kuti mupeze zabwino zonse.

Medicare Part D imapereka chithandizo chamankhwala chamankhwala ndipo sichikuphimba magazi.

Kodi kuyesa magazi kumawononga ndalama zingati?

Mtengo woyesera magazi ndi kuyezetsa kwina kwa labu kapena kuyezetsa matenda kumatha kusiyanasiyana. Mtengo wake umachokera pamayeso, malo omwe muli, ndi labu yogwiritsidwa ntchito. Mayeso amatha kuchokera kumadola ochepa mpaka madola masauzande. Ndicho chifukwa chake ndikofunikira kuti muwone ngati mayeso anu ataphimbidwa musanachite.

Nawa ena mwa kuyezetsa magazi komwe mungayembekezere ndi magawo osiyanasiyana a Medicare.

Mtengo wa Medicare Part A

Ntchito yakuchipatala yamagazi yomwe adalamulidwa ndi dokotala nthawi zambiri imadzazidwa pansi pa Medicare Part A. Komabe, mukufunikirabe kukumana ndi deductible yanu.

Mu 2020, Gawo A deductible ndi $ 1,408 kwa ambiri opindula panthawiyi. Nthawi yopindulitsa imachokera tsiku lomwe mumalowa mchipatala masiku 60 otsatira. Ndizotheka kukhala ndi nthawi zingapo zopindulitsa mchaka.

Mtengo wa Medicare Part B

Medicare Part B imakhudzanso kuyezetsa magazi komwe kumafunika kuchipatala. Muyeneranso kukumana ndi deductible yanu yapachaka kuti mupatsidwenso. Mu 2020, deductible ndi $ 198 kwa anthu ambiri. Kumbukirani, muyeneranso kulipira gawo lanu loyamba la Part B, lomwe ndi $ 144.60 mu 2020 kwa ambiri opindula.

Mtengo wa Medicare Advantage

Ndalama zomwe zili ndi dongosolo la Medicare Advantage zimadalira momwe mungapangire pulogalamuyo. Fufuzani ndi pulani yakomweko mdera lanu zamapopopayi, ndalama zochotsedwera, ndi zina zilizonse zomwe mungawononge m'thumba.

Madongosolo ena a Medicare Advantage atha kuperekanso chiphaso chachikulu, chifukwa chake simuyenera kulipira chilichonse mthumba.

Mitengo ya Medigap

Mapulani a Medigap (Medicare supplemental inshuwaransi) atha kuthandiza kulipira ndalama zotuluka munthumba monga ndalama zandalama, zochotseredwa, kapena zolipiritsa zowunikira ndi mayeso ena azidziwitso.

Mmodzi mwa mapulani 11 omwe alipo a Medigap ali ndi maubwino ndi mtengo wake, chifukwa chake fufuzani mosamala kuti mupeze zosowa zanu.

Pali zochitika zina pomwe ndalama zoyesera magazi zitha kukhala zapamwamba kuposa masiku onse, kuphatikiza:

• mumayendera omwe amapereka kapena ma lab omwe samalandira ntchito
• muli ndi dongosolo la Medicare Advantage ndikusankha dotolo wapaintaneti kapena malo a labu
• dokotala amalamula kuti mukayezetse magazi nthawi zambiri kuposa momwe mumaphimbira kapena ngati mayesowo sanapezeke ndi Medicare (mayeso ena owunikira sanaphimbidwe ngati palibe zizindikiro kapena matenda kapena palibe mbiri)

Tsamba la Medicare lili ndi chida chofufuzira chomwe mungagwiritse ntchito kupeza madotolo ndi ma lab.

Kodi ndingapeze kuti kukayezetsa?

Mutha kuyezetsa magazi pamitundu ingapo yamailabu. Dokotala wanu adzakudziwitsani komwe mungayesedwe. Onetsetsani kuti wothandizirayo alandila ntchitoyo.

Mitundu ya ma labu omwe Medicare amaphatikiza ndi awa:

• maofesi a madotolo
• malo azipatala
• Labs odziyimira pawokha
• malo osungira anthu okalamba
• malo ena othandizira

Ngati mungalandire kapena kufunsidwa kuti musayine Chidziwitso cha Advance Beneficiary (ABN) kuchokera ku labu kapena wothandizira, mutha kukhala ndi udindo pakulipirako chifukwa sikunapikidwe. Funsani mafunso okhudza udindo wanu pazandalama musanasaine.

Kodi ndimayeso amtundu wanji omwe amayesedwa?

Njira zoyambirira za Medicare ndi Medicare Advantage zimakhudza mitundu yambiri yoyezetsa magazi komanso kuyezetsa magazi. Pakhoza kukhala malire pazomwe Medicare imakwaniritsa mayeso ena.

Mutha kuyitanitsa chisankho chofunsa ngati inu kapena dokotala mukuwona kuti kuyesedwa kuyenera kubisidwa. Mayeso ena owunika magazi, monga omwe ali ndi matenda amtima, amaphimbidwa kwathunthu popanda kuchotsera kapena kuchotsera.

Nazi zina mwazomwe zimayesedwa nthawi zambiri poyesa magazi komanso kuti mungawachitire kangati ndikuwunika kwa Medicare:

• Matenda a shuga: kamodzi pachaka, kapena kawiri pachaka ngati muli pachiwopsezo chachikulu
• Matenda a mtima: cholesterol, lipids, triglycerides kuwunika kamodzi zaka zisanu
• HIV: kamodzi pachaka kutengera zoopsa
• Hepatitis (B ndi C): kamodzi pachaka kutengera chiopsezo
• Khansa yoyipa: kamodzi pachaka
• Khansa ya Prostate (PSA [prostate specific antigen]) kamodzi pachaka
• Matenda opatsirana pogonana: kamodzi pachaka

Ngati dokotala akuganiza kuti mukufunika kuyesedwa pafupipafupi pazomwe mungayesedwe chifukwa chazomwe mungachite pachiwopsezo, mungafunike kulipira kuti mukayesedwe pafupipafupi. Funsani dokotala wanu ndi labu kuti mumve zambiri za mayeso anu.

Kungakhale kothandiza kukhala ndi dongosolo lowonjezera loyeserera pafupipafupi. Mutha kupita patsamba la Medicare Medigap kuti mumve zambiri zamapulani a 2020 ndi zomwe zaphimbidwa. Muthanso kuyitanitsa pulaniyo mwachindunji kuti mumve zambiri.

Ndi mitundu iti yamayeso amachitidwe a labu yomwe imaphimbidwa?

Medicare Part B imafotokoza mitundu yambiri yazachipatala yomwe idalamulidwa ndi madokotala monga kuyesa mkodzo, kuyesa mayeso a minofu, ndi kuyesa kuyezetsa. Palibe zolipiritsa pamayesowa, koma zomwe mumachotsera zikugwirabe ntchito.

Zitsanzo za mayeso okutidwa ndi awa:

* Medicare imafotokoza ma mamilogramu azachipatala pafupipafupi ngati dokotala akuwalamula. Muli ndi udindo wolipira ndalama 20%.

Zojambula zina zosafunikira za Medicare zimaphatikizapo ma X-ray, PET scan, MRI, EKG, ndi CT scan. Muyenera kulipira chitsimikizo chanu cha 20% komanso ma deductible anu ndi ma copay. Kumbukirani kupita kwa omwe amapereka ntchito kuti avomereze milandu yomwe Medicare silingakwanitse.

• Medicare imapereka chida chomwe mungagwiritse ntchito kuti muwone mayeso omwe akupezeka.
• Muthanso kupita apa kuti mukawone pamndandanda wa mayeso okutidwa kuchokera ku Medicare.
• Nawu mndandanda wamakalata ndi mayeso omwe Medicare amachita ayi chophimba. Musanasaine ABN, funsani za mtengo wamayeso ndikugulitsa mozungulira. Mitengo imasiyanasiyana malinga ndi komwe amapereka.

Kutenga

Medicare imakhudza mitundu yambiri yamayeso ofananirana amwazi omwe amafunikira kuti azindikire ndikusamalira zikhalidwe zaumoyo malinga ngati ndizofunikira. Nawa maupangiri omaliza oti muganizire:

• Funsani dokotala wanu kuti mudziwe zambiri za mtundu wanu wamagazi komanso momwe mungakonzekerere (ngati muyenera kudya kapena musadye musanadye, ndi zina).
• Pitani kwa omwe amapereka ntchito kuti apewe kulipira ndalama m'thumba pazantchito zaphimbidwa
• Ngati muli ndi vuto lomwe limafuna kuyesedwa pafupipafupi, ganizirani dongosolo lowonjezera ngati Medigap kuti muthandizire ndalama zomwe sizikupezeka m'thumba.
• Ngati ntchito siyinaphimbidwe, yang'anani kuti mupeze omwe amapereka ndalama zotsika mtengo kwambiri.

Werengani nkhaniyi m'Chisipanishi