Kodi Medicare ndi Chiyani?

Zamkati

• Kodi Medicare imagwira ntchito bwanji?
• Kodi magawo a Medicare ndi ati?
• Gawo A (kuchipatala)
• Gawo B (lachipatala)
• Gawo C (Medicare Advantage)
• Gawo D (malangizo)
• Mankhwala owonjezera a Medicare (Medigap)
• Momwe mungapezere Medicare
• Malangizo posankha dongosolo la Medicare
• Kutenga

• Medicare ndi inshuwaransi yolipiridwa ndi federally kwa anthu azaka 65 kapena kupitilira apo komanso anthu omwe ali ndi matenda aakulu kapena olumala.
• Medicare imapereka njira zingapo za inshuwaransi kuti zikuthandizeni kukwaniritsa zosowa zanu.
• Kupanga mndandanda wazomwe muli nazo, mankhwala omwe mumamwa, ndi madotolo omwe mumawawona angakuthandizeni kusankha mapulani a Medicare.

Inshuwaransi imatha kukhala yotsika mtengo, ndipo kuyesa kupeza njira zonse zosamalirira zaumoyo zomwe zingakhale zotopetsa komanso zokhumudwitsa.

Kaya ndinu watsopano ku Medicare kapena mukufuna kungodziwitsidwa, izi ndi zomwe muyenera kudziwa pazoyambira za pulogalamu ya inshuwaransi yazaumoyo.

Kodi Medicare imagwira ntchito bwanji?

Medicare ndi pulogalamu ya inshuwaransi yothandizidwa ndi boma yomwe imapereka chithandizo chamankhwala kwa anthu azaka zopitilira 65. Mutha kukhala oyenera kulandira Medicare ngati:

• Ali ndi chilema ndipo akhala akulandila chithandizo chachitetezo cha chitetezo kwa zaka ziwiri
• ali ndi penshoni yolumala kuchokera ku Railroad Retirement Board
• ali ndi matenda a Lou Gehrig (ALS)
• kukhala ndi kulephera kwa impso (matenda omaliza a impso) ndipo amalandila dialysis kapena adalandilidwa

Inshuwaransi yaumoyo iyi itha kugwiritsidwa ntchito ngati inshuwaransi yayikulu kapena ngati zowonjezera, zowonjezera. Medicare itha kugwiritsidwa ntchito kuthandizira kulipirira chithandizo chamankhwala komanso chisamaliro cha nthawi yayitali, koma sichingakwaniritse zolipira zanu zonse.

Amalipidwa ndi misonkho ndipo, nthawi zina, ndalama zomwe zimachotsedwa macheke anu achitetezo kapena zomwe mumalipira.

Kodi magawo a Medicare ndi ati?

Medicare yapangidwa kuti ikwaniritse zosowa zanu zofunika kuchipatala, monga kupita kuchipatala komanso kupita kuchipatala. Pulogalamuyi ili ndi magawo anayi: Gawo A, Gawo B, Gawo C, ndi Gawo D.

Gawo A ndi Gawo B nthawi zina limatchedwa choyambirira Medicare. Magawo awiriwa amapereka chithandizo chofunikira kwambiri.

Gawo A (kuchipatala)

Medicare Part A imakhudza chisamaliro chanu kuchipatala, kuphatikiza ntchito zosiyanasiyana zokhudzana ndi chipatala. Chithandizo chanu chambiri chokhudzana ndi chithandizo chimakonzedwa ndi Gawo A ngati mukuyenera kupita kuchipatala ngati wodwala. Gawo A limanenanso za chisamaliro cha odwala omwe akudwala mwakayakaya.

Kwa anthu ambiri omwe amapeza ndalama zochepa, sipadzakhala zolipira. Anthu omwe ali ndi ndalama zambiri amatha kulipira pang'ono pamwezi.

Gawo B (lachipatala)

Medicare Part B imakhudza chithandizo chanu chamankhwala ndi chithandizo chamankhwala chomwe mungafunikire kuti mukhale ndi thanzi labwino, kuphatikizapo:

• gawo lalikulu lazithandizo zodzitetezera
• mankhwala (omwe amadziwika kuti zida zolimbitsa thupi, kapena DME)
• mitundu yosiyanasiyana ya mayeso ndi kuwunika
• ntchito zamisala

Nthawi zambiri pamakhala chiphaso cha mtundu uwu wa kufalitsa kwa Medicare, kutengera zomwe mumapeza.

Gawo C (Medicare Advantage)

Medicare Part C yomwe imadziwikanso kuti Medicare Advantage, siyopindulitsa padera pazachipatala. Ndi gawo lomwe limalola makampani ovomerezeka a inshuwaransi kuti azipereka mapulani a inshuwaransi kwa anthu omwe adalembetsa mu Gawo A ndi B.

Mapulaniwa amakhudza maubwino ndi ntchito zonse zomwe gawo la A ndi B limakwirira. Atha kuperekanso maubwino owonjezera, monga mankhwala opangira mankhwala, mano, masomphenya, kumva, ndi ntchito zina. Madongosolo a Medicare Advantage nthawi zambiri amakhala ndi zolipira zina monga ma copay ndi ma deductibles. Zolinga zina zilibe ndalama zoyendetsera ndalama, koma ngati pulani yomwe mungasankhe ili ndi phindu, itha kuchotsedwa pa cheke cha chitetezo chanu.

Gawo D (malangizo)

Medicare Part D imafotokoza za mankhwala omwe mwalandira. Mtengo kapena chindapusa cha dongosololi zimadalira ndalama zomwe mumapeza, ndipo ndalama zomwe mumalandira ndi deductible zimadalira mtundu wa mankhwala omwe mukufuna.

Medicare imapereka mndandanda, womwe umatchedwa formulary, wa mankhwala gawo lililonse la Gawo D limakwirira kuti mudziwe ngati mankhwala omwe mukusowa akuphimbidwa ndi zomwe mukuganiza.

Mankhwala owonjezera a Medicare (Medigap)

Ngakhale mankhwala a Medicare satchedwa "gawo," ndi imodzi mwamitundu isanu yayikulu ya inshuwaransi ya Medicare yomwe muyenera kuganizira. Medigap imagwira ntchito ndi Medicare yoyambirira ndipo imathandizira kulipira ndalama zakuthumba zomwe Medicare yoyambayo siyichita.

Medigap imagulitsidwa ndi makampani wamba, koma Medicare imafuna kuti mayiko ambiri aziperekanso zofananira. Pali madongosolo 10 a Medigap omwe alipo: A, B, C, D, F, G, K, L, M, ndi N. Ndondomeko iliyonse ndiyosiyana pang'ono pazakutchulidwa.

Ngati munayamba kulandira Medicare pambuyo pa Januware 1, 2020, simukuyenera kugula mapulani C kapena F; koma, ngati munali oyenerera tsiku lomwelo lisanakwane, mutha kugula. Medigap Plan D ndi Plan G pakadali pano zikufotokoza chimodzimodzi monga mapulani C ndi F.

Momwe mungapezere Medicare

Mudzalembetsa pulogalamuyi ngati mukulandira kale zachitetezo cha chikhalidwe cha anthu. Ngati simukulandira kale maubwino, mutha kulumikizana ndi ofesi yachitetezo cha anthu mpaka miyezi itatu tsiku lanu lobadwa la 65 lisanachitike.

Social Security Administration imayang'anira kulembetsa kwa Medicare. Pali njira zitatu zosavuta kutsatira:

• pogwiritsa ntchito Medicare pa intaneti patsamba la Social Security Administration
• kuyimbira Social Security Administration pa 1-800-772-1213 (TTY: 1-800-325-0778)
• kukayendera ofesi yakwanuko ya Social Security Administration

Ngati muli pantchito yopuma njanji, lemberani a Railroad Retirement Board ku 1-877-772-5772 (TTY: 1-312-751-4701) kuti mulembetse.

Malangizo posankha dongosolo la Medicare

Posankha njira za Medicare kuti mukwaniritse zosowa zanu zaumoyo, ndikofunikira kulingalira zosowa zanu zaumoyo. Nawa maupangiri angapo osankha mapulani kapena kuphatikiza mapulani oti akugwirireni:

• Yesetsani kulingalira kuchuluka kwa ndalama zomwe mudagwiritsa ntchito posamalira zaumoyo chaka chatha kuti muthe kulingalira zomwe zingakupulumutseni ndalama.
• Lembani zamankhwala anu kuti mutsimikizire kuti akwaniritsidwa ndi zomwe mukuganiza.
• Lembani mndandanda wa madotolo omwe mukuwawona pakadali pano ndikufunsani ngati amavomereza Medicare kapena mabungwe ati a Health Maintenance Organisation (HMO) kapena ma Preferred Provider Organisation (PPO) omwe angakhalemo.
• Lembani mankhwala aliwonse kapena zipatala zomwe mungafune chaka chamawa.
• Zindikirani inshuwaransi ina iliyonse yomwe muli nayo, ngati mungagwiritse ntchito ndi Medicare, ndi momwe mungathetsere kufalitsa ngati kuli kofunikira.
• Mukufuna ntchito yamano, kuvala magalasi kapena zothandizira kumva, kapena mukufuna zina zowonjezera?
• Kodi inu kapena mukukonzekera kupita kunja kwa dera lanu kapena kunja kwa dziko?

Zonsezi zingakuthandizeni kusankha magawo a Medicare omwe angakwaniritse bwino zosowa zanu komanso omwe akufuna kuganizira.

Ngakhale Medicare choyambirira Medicare imapereka chithandizo chazinthu zambiri, sizinthu zonse zamankhwala zomwe zimafotokozedwa. Mwachitsanzo, chisamaliro cha nthawi yayitali sichimawerengedwa kuti ndi gawo la Medicare. Ngati mukufuna chisamaliro cha nthawi yayitali, lingalirani dongosolo la Medicare Advantage kapena Medigap lomwe lingakupatseni phindu lochepera kwakanthawi.

Popeza mankhwala a mankhwala sakutsekedwa ndi Medicare yapachiyambi, ngati mukufuna mankhwala oyenera, muyenera kulembetsa ku Medicare Part D kapena Medicare Advantage, yomwe imapereka mapulani okhudzana ndi mankhwala ena.

Kutenga

• Kudziwa madongosolo omwe akukuyenerani kumadalira ndalama zanu, thanzi lanu lonse, msinkhu wanu, ndi mtundu wanji wachisamaliro chomwe mungafune. Ndibwino kuti muwerenge mautumiki ndi mapulani mosamala ndikusankha mapulani omwe amakuthandizani kwambiri.
• Nthawi zolembetsa ndizochepa pazinthu zina, chifukwa chake onetsetsani kuti mwasayina kuti musakhale ndi mwayi wofikira.
• Ngati mukukhudzidwa ngati ntchito yomwe mukufuna ikuthandizidwa ndi Medicare, mutha kuyankhula ndi dokotala, fufuzani ku Medicare Coverage Database pa intaneti pa www.cms.gov/medicare-coverage-database/, kapena kambiranani ndi Medicare pa 1-800- MEDICARE (1-800-633-4227).