Zomwe Muyenera Kudziwa Zokhudza Medicare Gawo C

Zamkati

• Kodi Medicare Part C ndi chiyani?
• Kodi mukufuna Medicare Part C?
• Kodi mukuyenera kulandira Medicare Part C?
• Kodi njira za Medicare Part C zilipo?
• Mapulani a Medicare Advantage HMO
• Mapulani a Medicare Advantage PPO
• Kodi Medicare Part C imawononga ndalama zingati?
• Ngati simukufuna Medicare Part C
• Kutenga

Kodi Medicare Part C ndi chiyani?

Medicare Part C, yotchedwanso Medicare Advantage, ndi njira ina ya inshuwaransi kwa anthu omwe ali ndi Original Medicare.

Ndi Medicare yoyambirira, mumaphimbidwa Gawo A (chipatala) ndi Gawo B (lachipatala).

Medicare Part C imapereka chithandizo cha magawo A ndi B kuphatikiza zina, monga mankhwala akuchipatala, mano, masomphenya, ndi zina zambiri.

Munkhaniyi, tiwona zomwe Medicare Part C ikupereka, mtengo wake, komanso momwe mungasankhire dongosolo labwino pazochitika zanu.

Kodi mukufuna Medicare Part C?

Kuphimba kwa Medicare Part C ndikuwonjezeranso kwa ma Medicare omwe amaperekedwa kudzera m'makampani a inshuwaransi. Ndi ndondomekoyi, mutha kupeza chithandizo cha mankhwala akuchipatala, mano ndi masomphenya, ndi ntchito zina zokhudzana ndi thanzi.

Ndi maubwino oyenera a Medicare Part C, mudzapeza izi:

• ntchito zachipatala, chisamaliro cha anamwino, chisamaliro chapanyumba, ndi chisamaliro cha odwala
• ntchito zamankhwala zokhudzana ndi kupewa, kuzindikira, komanso kuchiza mikhalidwe
• ntchito zamisala
• Kuphunzira mankhwala osokoneza bongo
• mano, masomphenya, ndi mautumiki akumva
• chithandizo chazaumoyo, monga umembala wathanzi

Ngati mukusowa zambiri kuposa chipatala ndi inshuwaransi yamankhwala, Medicare Part C ndichofunikira pofikira.

Kodi mukuyenera kulandira Medicare Part C?

Mukuyenerera Medicare Part C ngati muli ndi gawo la Medicare A ndi B, ndipo ngati mumakhala m'dera lothandizira la Medicare Part C omwe mukuwaganizira.

Mu 2021, anthu omwe ali ndi matenda opatsirana a endal (ESRD) ali oyenera kulembetsa mapulani osiyanasiyana a Medicare Advantage chifukwa cha lamulo lomwe Congress idapereka. Lamuloli lisanachitike, mapulani ambiri sangavomereze kapena kukuchepetsani ku Special Needs Plan (SNP) ngati mutapezeka ndi ESRD.

• Kulembetsa ku Medicare ndikofunika kudziwa nthawi ndipo kuyenera kuyambika miyezi itatu musanakwanitse zaka 65. Mutha kulembetsanso ku Medicare mwezi womwe mudzakwanitse zaka 65 komanso miyezi itatu mutatsata zaka 65^th tsiku lobadwa - ngakhale kufalitsa kwanu kudzachedwa.
• Ngati mwaphonya nthawi yoyamba kulembetsa, kulembetsa kumatsegulidwa kuyambira pa Okutobala 15 mpaka Disembala 7 chaka chilichonse.
• Mutha kulembetsa Medicare yoyambirira pa intaneti kudzera pa tsamba la Social Security Administration.
• Mutha kuyerekezera ndi kugula mapulani a Medicare Part C pa intaneti kudzera pazida zopezera mapulani a Medicare.

Kodi njira za Medicare Part C zilipo?

Njira yosavuta yodziwira zomwe Medicare Part C ikupezeka ndikugwiritsa ntchito chida cha Medicare:.

Dongosololi litenga mayankho anu pamafunso ena ndikuchepetsa makampani omwe amapereka mapulani a Medicare Part C omwe akukwaniritsa zosowa zanu. Chida cha Medicare ichi ndi chothandiza kuyerekezera mapulani mdera lanu.

Ngati mwalandira kale kudzera ku kampani yayikulu ya inshuwaransi, itha kukupatsani mapulani a Medicare Part C. Ena mwa makampani akuluakulu a inshuwaransi omwe amapereka Medicare Part C ndi awa:

• Aetna
• Blue Cross Blue Shield
• Cigna
• HealthPartner
• Kaiser Permanente
• SankhaniHealth
• UnitedHealthcare
• UPMC

Mapulani a Medicare Advantage HMO

Mapulani a Health Maintenance Organisation (HMO) ndi njira yotchuka kwa iwo omwe akufuna kufotokozedwa kowonjezera komwe sikuperekedwa ndi Medicare yoyambirira. Mu dongosolo la Medicare Advantage HMO, mutha kulandira chisamaliro kuchokera kwa omwe amakupatsani mwayi wogwiritsa ntchito intaneti, koma muyenera kupeza mwayi wopita kukawona katswiri.

Pali zosankha zambiri pamadongosolo a Medicare Advantage HMO m'boma lililonse, kuphatikiza mapulani okhala ndi ndalama za $ 0, osachotsedwa, komanso zolipiritsa zochepa. Kuti mulembetse dongosolo la Medicare Advantage HMO, muyenera kale kulembetsa ku Medicare yoyambirira.

Mapulani a Medicare Advantage PPO

Mabungwe Opereka Makonda (PPOs) ndiye njira yodziwika bwino yothandizira zaumoyo kuti muwonjezere zina. Mapulani amtunduwu amalola ufulu kwa ogula.

Ndi pulani ya PPO, mutha kupita kwa madokotala omwe mumakonda, akatswiri, ndi malo azaumoyo, kaya ali munthawi yanu kapena ayi. Komabe, mapulani a PPO amalipiritsa mitengo yosiyanasiyana kutengera mndandanda wa omwe ali mu netiweki kapena kunja kwa ma netiweki.

Ma PPO amakhalanso osavuta chifukwa simusowa kutumizidwa kuti muwone katswiri.

Kodi Medicare Part C imawononga ndalama zingati?

Pali zolipira zosiyanasiyana zomwe zimakhudzana ndi dongosolo la Medicare Part C, zomwe zikutanthauza kuti ndalama zomwe muli nazo mthumba zimasiyana.

Madongosolo ena a Medicare Part C amatenga gawo limodzi la gawo lanu mwezi uliwonse. Komabe, ena mwa mapulaniwa amakhalanso ndi phindu lawo komanso amachotsera.

Kuphatikiza pa ndalamazi, mukhozanso kulipira chindapusa panthawi yolandila chithandizo.

Zina mwazinthu zomwe zimapangitsa kuti ndalama za Medicare Part C zikulipireni ndi izi:

• mtundu wamapulani omwe mungasankhe, monga HMO, PPO, PFFS, SNP, kapena MSA
• ndalama zanu, zomwe zingagwiritsidwe ntchito kudziwa ndalama zanu zoyambirira kapena zochotseredwa
• kuchuluka kwanu kwa ndalama
• kangati mumafunikira chithandizo chamankhwala
• kaya mumalandira chithandizo chamankhwala pamaneti kapena panetiweki
• kaya mumalandira thandizo lina lachuma, monga Medicaid

Pali zabwino zambiri zokhala ndi Medicare Part C, kuphatikiza kapu ya pachaka ya momwe mungalipire ndalama zambiri mthumba. Komabe, ndalama zoyambirirazo zimatha kupitilira nthawi musanagwire kapuyo, motero ndikofunikira kulingalira pazonse posankha dongosolo lanu la Medicare Part C.

Ngati simukufuna Medicare Part C

Ngati mukusangalala ndi kufalitsa kwanu kwa Medicare ndipo mukungofuna kulandira chithandizo chamankhwala, njira yodziyimira payokha ya Medicare Part D ikhoza kukhala njira yabwino kwambiri.

Ngati muli ndi chiphaso cha Medicare koma mukusowa thandizo lina pamitengo, malingaliro a Medicare supplemental inshuwaransi (Medigap) atha kukuthandizani.

Kwa anthu ena, Medicare Part C ndi ndalama zowonjezera zomwe sangakwanitse - pankhaniyi, kugula mozungulira gawo la D ndi Medigap kumatha kuthandiza kupulumutsa ndalama.

Kuthandiza wachibale kapena bwenzi kusankha dongosolo la Medicare Part C kungakhale njira yozama, koma sikuyenera kukhala kovuta. Nazi zinthu zofunika kuziganizira mukamawunika mapulani:

• Mtundu wophimba. Ngati wachibale wanu ali ndi chidwi ndi zomwe mungapeze mu gawo A ndi B, yesani kupeza dongosolo lomwe limakhudza madera onse omwe ndi ofunika kwa iwo.
• Mtundu wa mapulani. Kusankha njira yoyenera ya Medicare Part C makamaka kumadalira zomwe amakonda. HMO, PPO, PFFS, SNP ndi dongosolo la MSA zonse ziyenera kuganiziridwa.
• Ndalama zotuluka m'thumba. Ndalama zochepa zimatha kukupangitsani kukhala kovuta kukumana ndi ndalama za Medicare Part C, zochotseredwa, komanso zotuluka m'thumba. Yesetsani kugula mozungulira mitengo yomwe angakwanitse.
• Zochitika zamankhwala. Munthu aliyense ali ndi thanzi labwino lomwe liyenera kuganiziridwa mukamagula chithandizo cha Medicare. Ganizirani zinthu monga zathanzi, kuyenda pafupipafupi, ndi zomwe mumakonda.
• Zinthu zina. Opeza opitilira 800,000 adapeza kuti zinthu monga gawo la msika ndi kuwerengera nyenyezi zimaganiziridwanso posankha dongosolo la Medicare Part C.

Kutenga

• Madongosolo a Medicare Part C, omwe amadziwikanso kuti mapulani a Medicare Advantage, ndi mapulani a inshuwaransi omwe angapindule nawo omwe amapereka zabwino zonse zoyambira komanso zowonjezera za Medicare.
• Medicare Part C ndi njira yabwino kwambiri kwa anthu omwe ali ndi chidwi chofotokozera zamankhwala, masomphenya ndi ntchito zamano, ndi zina zambiri.
• Mtengo wamapulani a Gawo C umadalira pazinthu zosiyanasiyana, kuphatikiza mtengo wapamwezi komanso wapachaka, zolipiritsa, komanso zosowa zanu zachipatala.
• Pitani ku Medicare.gov kuti mupeze dongosolo la Medicare Part C lomwe limakuthandizani.

Nkhaniyi idasinthidwa pa Novembala 13, 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.

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