Medicare ku California: Zomwe Muyenera Kudziwa

Zamkati

• Medicare Gawo A
• Medicare Gawo B
• Medicare Gawo C (Medicare Advantage)
• Gawo la Medicare D.
• Inshuwaransi yothandizira ya Medicare (Medigap)
• Kodi masiku olembetsa a magawo a Medicare ndi ati?
• Kutenga

Medicare ndi pulogalamu yothandizira zaumoyo yomwe imagwiritsidwa ntchito makamaka ndi anthu azaka 65 kapena kupitilira apo. Anthu azaka zilizonse olumala komanso omwe ali ndi vuto la impso (ESRD) kapena amyotrophic lateral sclerosis (ALS) amathanso kulandira Medicare.

Ngati mukukhala ku California ndikukwaniritsa zofunikira ku Medicare, ndiye kuti mukuyenera kulandira Medicare yoyambirira (gawo A ndi B) ndi Medicare Part D, ziribe kanthu komwe mukukhala. Kupezeka kwa Medicare Part C (Medicare Advantage) ndikosiyana m'malo ena ku California kuposa momwe kumakhalira m'maiko ena ambiri.

Kuyenerera kwa Medicare Part C ku California kutengera dera ndi ZIP code yakomwe mukukhalamo.

Medicare Gawo A

Medicare Part A imadziwikanso kuti inshuwaransi ya chipatala. Gawo A limafotokoza za chisamaliro cha odwala kuchipatala, chisamaliro cha anamwino, chithandizo chamankhwala kunyumba, komanso kuchepa ndi ntchito zantchito yosamalira okalamba (SNF).

Ngati inu kapena mnzanu mumagwira ntchito ndikulipira misonkho ya Medicare kwa zaka zosachepera 10, mudzakhala oyenera kulandira Gawo A lopanda premium popanda kulipira mwezi uliwonse. Ngakhale simukuyenera kulandira Gawo A lopanda premium, mutha kugula Part A (gawo loyamba A).

Medicare Gawo B

Medicare Part B imafotokoza zofunikira zamankhwala, monga kusankhidwa kwa adotolo ndi ma ambulansi. Ikufotokozanso za njira zodzitetezera, monga katemera wambiri. Pamodzi ndi Gawo A, Medicare Part B imapanga Medicare yoyambirira. Muyenera kulipira pamwezi pamwezi pa Medicare Part B.

Medicare Gawo C (Medicare Advantage)

Medicare Part C imagulidwa kudzera kuma inshuwaransi apadera omwe amavomerezedwa ndi Medicare. Mwalamulo, dongosolo la Medicare Part C liyenera kukhudza pafupifupi pafupifupi mbali zoyambirira za Medicare A ndi B,. Ambiri mwa magawo C amakwaniritsa ntchito zambiri kuposa zomwe Medicare yoyambirira imapereka, koma nthawi zambiri amafuna kuti mugwiritse ntchito netiweki ya madokotala. Madongosolo ena a Medicare Part C amaphatikizira kupezeka kwa mankhwala, koma ena satero.

Medicare Part C sikupezeka kulikonse ku California. Maboma ena ali ndi mapulani ambiri. Maboma ena ali ndi ochepa okha. Pafupifupi zigawo 115 ku California, monga Calaveras County, amachita ayi mutha kugwiritsa ntchito mapulani aliwonse a Medicare Advantage.

Lowetsani zip code yanu apa kuti muwone mapulani a Medicare omwe amapezeka mdera lanu.

Makampani ambiri amapereka malingaliro a Advantage m'malo ena a California. Zikuphatikizapo:

• Aetna Medicare
• Dongosolo Laumoyo Waumoyo
• Nyimbo Buluu
• Blue Cross yaku California
• Tsiku Latsopano
• Dongosolo La Central Health Medicare
• Ndondomeko Yaumoyo Wanzeru
• Dziko la Golden
• Health Net Community Solutions, Inc. ndalama zazikulu
• Health Net yaku California
• Humana
• Imperial Health Plan yaku California, Inc.
• Kaiser Permanente
• Sakanizani Mapulani A Zaumoyo
• UnitedHealthcare
• Kusamalira

Zambiri mwazinthu zomwe amaperekedwa ndi Health Maintenance Organisation (HMO) zomwe zimayambira pamtengo wa $ 0 pamwezi. Ndalama zomwe mumalipira mthumba zomwe mumayenera kulipira pachaka zimatha kusiyanasiyana pakapangidwe kameneka. Mapulani a HMO amafunikanso kuti mukalipire kopay paulendo uliwonse wa dokotala.

Mitundu ina yamapulani a Medicare Advantage ndi mapulani a Preferred Provider Organisation (PPO). Zina mwazi zimakhala ndi malipiro apamwamba pamwezi kuposa ma HMO kuphatikiza pazotuluka mthumba ndi ma copay. Ndikofunikira kuwunika zomwe mukuganiza, chifukwa zimasiyana osati mtengo wokha komanso ntchito zomwe zimaperekedwa.

Gawo la Medicare D.

Medicare Part D ndi gawo la Medicare lomwe limakhudza mankhwala omwe mungalandire. Amayenera kugwiritsidwa ntchito ndi Medicare yoyambirira (gawo A ndi B). Ngati muli ndi dongosolo la Advantage lomwe limaphatikizapo mankhwala, simufunikanso kugula gawo la D.

Ngati mulibe mankhwala akuchipatala kudzera pagwero lina, monga inshuwaransi yazaumoyo yomwe mumapeza kuntchito, ndikofunikira kulembetsa ku Medicare Part D mukakhala oyenera ku Medicare. Ngati simutero, mungafunike kulipira mitengo yokwera kwambiri ngati chindapusa cha mwezi uliwonse kwa nthawi yonse yomwe mukufotokozera gawo D.

Medicare Part D imaperekedwa ndi makampani azinsinsi za inshuwaransi. Pali mapulani a Gawo D omwe amapezeka mchigawo chonse cha California. Mapulaniwa amasiyana malinga ndi mankhwala omwe amalemba, komanso mtengo wake.

Ndi zosankha zambiri, kulembetsa ku Medicare kumatha kukhala kosokoneza. Mabungwewa amatha kukupatsirani chidziwitso chomwe mungafune ndikusankha mu Medicare dongosolo labwino ngati mungakhale ku California.

• State of California Dipatimenti Yokalamba
• California Dipatimenti ya Inshuwaransi
• HICAP (Dongosolo La Upangiri wa Inshuwaransi Yathanzi & Cholimbikitsa)
• Mapulogalamu Othandizira Inshuwaransi ya State (SHIP)

Inshuwaransi yothandizira ya Medicare (Medigap)

Medicare yowonjezera inshuwaransi kapena Medigap yapangidwa kuti ikuthandizireni kulipirira zinthu zomwe sizinapezeke ndi Medicare yoyambirira. Izi zimaphatikizapo copays, coinsurance, ndi deductibles. Ku California, mutha kugula imodzi mwamitundu 10 yamapulani okhazikika omwe amapezeka mdziko lonselo.

Ndondomeko zofananazi zimasankhidwa ndi zilembo za zilembo: A, B, C, D, F, G, K, L, M, ndi N. Ndondomeko iliyonse imasiyanasiyana malinga ndi momwe amachotsera, mtengo wake, komanso kufalitsa kwake. Ku California, kuli ma inshuwaransi ambiri omwe amakwaniritsa zina kapena zonsezi. Ndalama zawo m'mapulani zimakhala zofanana kapena zofanana.

Makampani ena omwe amapereka Medigap ku California ndi awa:

• Aetna
• Nyimbo ya Blue Cross - California
• Blue Shield yaku California
• Cigna
• Kampani Ya Inshuwaransi Yophatikiza ya America
• Everence Association Inc.
• Munda Wamunda
• Kampani ya Globe Life and Accident Insurance
• Health Net
• Humana
• Mgwirizano wa Omaha
• National Guardian
• Kampani ya National Health Insurance
• Oxford
• Chitetezo cha Sentinel
• State Farm
• Zachuma Pama Luterans
• USAA
• United American
• UnitedHealthcare

Zolinga zina zimafunikanso kuti mulipire kuchuluka kwa ndalama zantchito zomwe zimapezeka mu Gawo B, kuphatikiza Gawo A lotengedwa.

Pali nthawi yakulembetsa yotseguka ya miyezi 6 pomwe mutha kupeza Medigap. Nthawi imeneyi imayamba patsiku lanu la 65 ndipo imagwirizana ndi kulembetsa kwanu ku Medicare Part B.

M'madera ambiri mdziko muno, ino ndi nthawi yokhayo yomwe mungalembetsere dongosolo la Medigap ndikutsimikizika kuti mudzalandila, ziribe kanthu mtundu wanji waumoyo womwe muli nawo.

Komabe, ku California, mumaloledwa kusinthiratu ku mapulani osiyanasiyana a Medigap okhala ndi chitsimikizo m'masiku 30 kutsatira tsiku lanu lobadwa chaka chilichonse, bola mapulani atsopanowa akupatsirani mwayi wofanana kapena wocheperako kuposa dongosolo lanu la Medigap.

Kodi masiku olembetsa a magawo a Medicare ndi ati?

Nthawi yomaliza yolembetsa ku Medicare ku California ndiyomwe ili mdziko lonselo, kupatula Medigap, yomwe ili ndi nthawi zowerengera zina.

Kutenga

Medicare ndi pulogalamu ya inshuwaransi ya federal yomwe imapezeka ku California kwa iwo omwe ali oyenera. Medicare Advantage (Medicare Part C) sichipezeka mu zip code zonse m'boma. Komabe, Medicare yoyambirira (magawo A ndi B), komanso Medicare Part D ndi Medigap amapezeka mdera lililonse ndi zip code.

Nkhaniyi idasinthidwa pa Okutobala 6, 2020 kuti iwonetse zambiri za 2021 Medicare.

Zomwe zili patsamba lino zimatha kukuthandizani posankha nokha za inshuwaransi, koma cholinga chake si kupereka upangiri wokhudzana ndi kugula kapena kugwiritsa ntchito inshuwaransi kapena zinthu zilizonse za inshuwaransi. Healthline Media siyigulitsa bizinesi ya inshuwaransi mwanjira iliyonse ndipo siyololedwa kukhala kampani ya inshuwaransi kapena opanga madera aliwonse aku U.S. Healthline Media sivomereza kapena kuvomereza aliyense wachitatu yemwe angachite bizinesi ya inshuwaransi.