Mapulani a Delaware Medicare mu 2021

Zamkati

• Medicare ndi chiyani?
• Zomwe zimaphimba
• Mtengo wa Medicare
• Ndi mapulani ati a Medicare Advantage omwe amapezeka ku Delaware?
• Bungwe Loyang'anira Zaumoyo (HMO)
• Bungwe Lopereka Zoyenera (PPO)
• Akaunti yosungira zamankhwala (MSA)
• Ndalama Zoyang'anira payekha (PFFS)
• Ndondomeko Yakusowa Kwapadera (SNP)
• Ndondomeko zomwe zilipo ku Delaware
• Ndani ali woyenera ku Medicare ku Delaware?
• Ndingalembetse liti ku mapulani a Medicare Delaware?
• Kulembetsa zochitika
• Kulembetsa kwapachaka
• Malangizo polembetsa ku Medicare ku Delaware
• Zida za Delaware Medicare
• Delaware Medicare Assistance Bureau (800-336-9500)
• Medicare.gov (800-633-4227)
• Ndiyenera kuchita chiyani kenako?

Medicare ndi inshuwaransi yoyendetsedwa ndi boma yomwe mungapeze mukakwanitsa zaka 65. Medicare ku Delaware imapezekanso kwa anthu azaka zosakwana 65 omwe amakwaniritsa zofunikira zina.

Medicare ndi chiyani?

Medicare ili ndi magawo anayi akuluakulu:

• Gawo A: chisamaliro cha kuchipatala
• Gawo B: chisamaliro cha kuchipatala
• Gawo C: Phindu la Medicare
• Gawo D: mankhwala akuchipatala

Zomwe zimaphimba

Gawo lililonse la Medicare limafotokoza zinthu zosiyanasiyana:

• Gawo A limafotokoza za chisamaliro chomwe mumalandira ngati wodwala kuchipatala ndipo chimaphatikizaponso chisamaliro cha odwala, chithandizo chochepa cha chisamaliro chaophunzira kwakanthawi kochepa (SNF), ndi ntchito zina zanthawi yanyumba.
• Gawo B limafotokoza za kuchipatala, monga maulendo a dokotala, njira zodzitetezera, ndi zida zina zamankhwala zolimba.
• Gawo C limakulitsa gawo lanu la Gawo A ndi Gawo B mu pulani imodzi yomwe ingaphatikizepo maubwino ena, monga kuphimba mano kapena kuwona kwamaso. Zolingazi nthawi zambiri zimaphatikizanso kupezeka kwa mankhwala osokoneza bongo.
• Gawo D limafotokoza zina mwazomwe mumalandira kapena mankhwala anu akuchipatala kunja kwa chipatala (mankhwala omwe mumalandira mukakhala kuchipatala amapezeka pansi pa Gawo A).

Kuphatikiza pa zigawo zinayi zikuluzikulu, palinso mapulani a inshuwaransi ya Medicare. Nthawi zambiri amatchedwa Medigap, mapulaniwa amatenga ndalama zotuluka m'thumba monga ma copays komanso ma coinsurance omwe Medicare amakonzekera sachita ndipo amapezeka kudzera kwa omwe ali ndi ma inshuwaransi achinsinsi.

Simungagule zonse Gawo C ndi Medigap. Muyenera kusankha mtundu umodzi kapena imzake.

Mtengo wa Medicare

Madongosolo a Medicare ku Delaware ali ndi ndalama zina zomwe mumalipira kuti mufotokozere komanso kusamalira.

Gawo A amapezeka popanda kulipidwa pamwezi malinga ngati inu kapena mnzanu mumagwira ntchito kwa zaka 10 kapena kupitilira apo ndikulipira misonkho ya Medicare. Mutha kugulanso kuphimba ngati simukukwaniritsa zofunikira.Zina zimaphatikizapo:

• deductible nthawi iliyonse mukalandiridwa kuchipatala
• ndalama zowonjezera ngati chipatala chanu kapena SNF khalani nthawi yayitali kuposa masiku ena

Gawo B ali ndi chindapusa zingapo komanso mtengo, kuphatikiza:

• ndalama zoyambira pamwezi
• deductible pachaka
• ma copays ndi ndalama za 20% pambuyo poti ndalama zanu zachotsedwa

Gawo C Mapulani atha kukhala ndi phindu pazowonjezera zomwe zimapezeka kudzera mu pulani. Mumalipirabe gawo la B B.

Gawo D mtengo wamapulani umasiyana kutengera kufotokozera.

Kusinkhasinkha mtengo wamapulani umasiyana kutengera dongosolo lomwe mwasankha.

Ndi mapulani ati a Medicare Advantage omwe amapezeka ku Delaware?

Mapulani a Medicare Advantage amavomerezedwa ndi Centers for Medicare and Medicaid Services (CMS) ndipo amapezeka kudzera m'makampani a inshuwaransi. Ubwino wake ndi:

• zabwino zonse kuchokera mbali iliyonse ya Medicare zimaphimbidwa ndi pulani imodzi
• maubwino ena omwe Medicare yoyambirira samaphatikizapo, monga mano, masomphenya, kumva, mayendedwe opita kuchipatala, kapena kubweretsa chakudya kunyumba
• Zowonjezera mthumba za $ 7,550 (kapena zochepa)

Pali mitundu isanu yamapulani a Medicare Advantage ku Delaware. Tiyeni tiwone mtundu uliwonse wotsatira.

Bungwe Loyang'anira Zaumoyo (HMO)

• Mumasankha oyang'anira chisamaliro choyambirira (PCP) omwe amayang'anira chisamaliro chanu.
• Muyenera kugwiritsa ntchito othandizira ndi malo omwe ali mu netiweki ya HMO.
• Nthawi zambiri mumayenera kutumizidwa kuchokera kwa omwe amakupatsani chithandizo chamankhwala (PCP) kuti muwone katswiri.
• Kusamalira kunja kwa netiweki nthawi zambiri sikuphimbidwa kupatula pakagwa mwadzidzidzi.

Bungwe Lopereka Zoyenera (PPO)

• Chisamaliro kuchokera kwa madotolo kapena malo omwe ali mkati mwa netiweki ya PPO yadzaza.
• Kusamalira kunja kwa netiweki kumatha kukhala ndi ndalama zambiri, kapena mwina sikungaphimbidwe.
• Simukusowa kutumizidwa kuti muwone katswiri.

Akaunti yosungira zamankhwala (MSA)

• Mapulaniwa amaphatikiza dongosolo lokwanira lokhalanso ndi thanzi komanso akaunti yosungira.
• Medicare imapereka ndalama zingapo chaka chilichonse kuti zithandizire (mutha kuwonjezera zina).
• Ma MSA atha kugwiritsidwa ntchito pazithandizo zakuchipatala zoyenera.
• Kusungidwa kwa MSA kulibe msonkho (pazamalipiro oyenerera azachipatala) ndipo mumalandira chiwongola dzanja chaulere.

Ndalama Zoyang'anira payekha (PFFS)

• PFFS ndi mapulani opanda netiweki ya madokotala kapena zipatala; mungasankhe kupita kulikonse komwe angavomereze dongosolo lanu.
• Amakambirana mwachindunji ndi omwe amakupatsani mwayi ndikuwona kuchuluka kwa ngongole zomwe mumalandira.
• Si madokotala kapena malo onse omwe amavomereza izi.

Ndondomeko Yakusowa Kwapadera (SNP)

• SNPs idapangidwira anthu omwe amafunikira chisamaliro chokwanira ndikukwaniritsa ziyeneretso zina.
• Muyenera kukhala oyenera kulandira Medicare ndi Medicaid, kukhala ndi thanzi limodzi kapena kupitilira apo, komanso / kapena kukhala kunyumba yosungirako okalamba.

Ndondomeko zomwe zilipo ku Delaware

Makampaniwa amapereka mapulani m'maboma ambiri ku Delaware:

• Aetna Medicare
• Cigna
• Humana
• Lasso Healthcare
• UnitedHealthcare

Mapulani a Medicare Advantage amasiyana malinga ndi dera, chifukwa chake lembani ZIP code yanu posaka mapulani komwe mumakhala.

Ndani ali woyenera ku Medicare ku Delaware?

Kuti muyenerere Medicare, muyenera kukhala:

• Zaka 65 kapena kupitilira apo
• nzika yaku U.S. kapena wovomerezeka mwalamulo kwa zaka 5 kapena kupitilira apo

Ngati muli ochepera zaka 65, mutha kupeza mapulani a Medicare ku Delaware ngati:

• kukhala ndi impso kapena matenda a impso (ESRD)
• ali ndi amyotrophic lateral sclerosis (ALS)
• akhala akulandila mapindu a Social Security kapena Railroad Retirement Board kwa miyezi 24

Mutha kugwiritsa ntchito chida cha Medicare kuti muwone ngati mukuyenera.

Ndingalembetse liti ku mapulani a Medicare Delaware?

Kuti mulandire Medicare kapena Medicare Advantage muyenera kulembetsa nthawi yoyenera.

Kulembetsa zochitika

• Nthawi yoyamba kulembetsa (IEP) ndi zenera la miyezi 7 kuzungulira tsiku lanu lobadwa la 65, kuyambira miyezi itatu isanafike ndikupitilira miyezi itatu mutabadwa. Ngati mungalembetse musanakwanitse zaka 65, kufalitsa kwanu kumayambira mwezi wanu wobadwa. Kulembetsa pambuyo pake kudzatanthauza kuchedwa kufotokozera.
• Nthawi zolembetsa zapadera (SEPs) ndi nthawi zosankhidwa pomwe mungalembetse kunja kwa olembetsa ngati mwataya mwayi pazifukwa zosiyanasiyana, kuphatikiza kutaya dongosolo lolembedwera ndi olemba anzawo ntchito kapena kusunthira kunja kwa malo omwe mudafunsira.

Kulembetsa kwapachaka

• Kulembetsa wamba(Januware 1 mpaka Marichi 31): Ngati simunalembetse Medicare pa IEP yanu, mutha kulembetsa mu Gawo A, Gawo B, Gawo C, ndi Gawo D. Mutha kulipira chindapusa mukalembetsa mochedwa.
• Kulembetsa poyera kwa Medicare Advantage (Januware 1 mpaka Marichi 31): Mutha kusintha njira yatsopano ngati muli kale pa Medicare Advantage kapena mutha kupitiliza ndi Medicare yoyambirira.
• Tsegulani olembetsa(Okutobala 15 mpaka Disembala 7): Mutha kusintha pakati pa Medicare yoyambirira ndi Medicare Advantage, kapena kulembetsa Gawo D ngati simunalembetse pa IEP yanu.

Malangizo polembetsa ku Medicare ku Delaware

Kusankha dongosolo loyenera kutengera izi:

• zosowa zanu zaumoyo
• ndalama zowonetsedwa
• madokotala (kapena zipatala) omwe mukufuna kuwawona kuti akusamalire

Zida za Delaware Medicare

Mutha kupeza mayankho pamafunso anu a Medicare Delaware kuchokera kumabungwe awa:

Delaware Medicare Assistance Bureau (800-336-9500)

• State Health Insurance Assistance Program (SHIP), yomwe kale inkadziwika kuti ELDERzambiri
• uphungu waulere kwa anthu omwe ali ndi Medicare
• malo operekera upangiri kudera lonse la Delaware (imbani 302-674-7364 kuti mupeze anu)
• ndalama zothandizira kuthandizira Medicare

Medicare.gov (800-633-4227)

• imagwira ntchito ngati tsamba lovomerezeka la Medicare
• yaphunzitsa ogwira ntchito kuyimba kuti akuthandizeni kuyankha mafunso anu a Medicare
• ili ndi chida chopezera mapulani kukuthandizani kupeza mapulani a Medicare Advantage, Part D, ndi Medigap mdera lanu

Ndiyenera kuchita chiyani kenako?

Nazi njira zotsatirazi kuti mupeze chithandizo chabwino cha Medicare kuti mukwaniritse zosowa zanu:

• Sankhani ngati mukufuna Medicare yoyambirira kapena Medicare Advantage.
• Sankhani ndondomeko ya Medicare Advantage kapena Medigap, ngati kuli kotheka.
• Dziwani nthawi yanu yolembetsa komanso nthawi yanu.
• Sonkhanitsani zolemba monga mndandanda wamankhwala omwe mumalandira ndi matenda aliwonse omwe muli nawo.
• Funsani dokotala wanu ngati akulandira Medicare, ndi malo omwe ali a Medicare Advantage.

Nkhaniyi idasinthidwa pa Novembala 10, 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.