Mapulani a Indiana Medicare mu 2021

Zamkati

• Medicare ndi chiyani?
• Medicare Gawo A
• Medicare Gawo B
• Gawo C (Medicare Advantage)
• Gawo la Medicare D.
• Inshuwaransi yothandizira ya Medicare (Medigap)
• Ndi mapulani ati a Medicare Advantage omwe amapezeka ku Indiana?
• Ndani ali woyenera ku Medicare ku Indiana?
• Ndingalembetse liti ku mapulani a Medicare Indiana?
• Nthawi yoyamba kulembetsa
• Kulembetsa wamba: Januware 1 mpaka Marichi 31
• Kulembetsa kwa Medicare Advantage kutsegulidwa: Januware 1 mpaka Marichi 31
• Kulembetsa kwa Medicare kotseguka: Okutobala 1 mpaka Disembala 31
• Nthawi yolembetsa yapadera
• Malangizo polembetsa ku Medicare ku Indiana
• Zothandizira ku Indiana Medicare
• Ndiyenera kuchita chiyani kenako?

Medicare ndi pulogalamu ya inshuwaransi yazaumoyo yomwe imapezeka kwa anthu azaka 65 kapena kupitilira apo, komanso kwa iwo ochepera zaka 65 omwe ali ndi matenda kapena zilema.

Medicare ndi chiyani?

Madongosolo a Medicare ku Indiana ali ndi magawo anayi:

• Gawo A, lomwe ndi chisamaliro cha odwala kuchipatala
• Gawo B, lomwe ndi chisamaliro cha kuchipatala
• Gawo C, lotchedwanso Medicare Advantage
• Gawo D, lomwe limafalitsa mankhwala

Mukakwanitsa zaka 65, mutha kulembetsa Medicare yoyambirira (Gawo A ndi Gawo B).

Medicare Gawo A

Anthu ambiri amayenera kulandira gawo la A popanda kulipidwa pamwezi. Ngati simukuyenerera, mutha kugula chiphaso.

Gawo A Kuphatikiza limaphatikizapo:

• Kuphunzira mukalowa kuchipatala kuti mukalandire chithandizo kwakanthawi kochepa
• Kuphunzira zochepa za chisamaliro chanthawi yayitali chisamaliro cha anamwino
• zina zantchito zantchito zanyumba
• chipatala

Medicare Gawo B

Kuphunzira kwa Gawo B kumaphatikizapo:

• maulendo a madotolo
• Kuwonetsetsa komanso kupewa
• kuyerekezera ndi kuyesa labotale
• zida zamankhwala zolimba
• Chithandizo cha kuchipatala ndi ntchito

Mutatha kulembetsa Medicare yapachiyambi, mutha kusankha ngati mukufuna Medicare Advantage (Gawo C) kapena dongosolo la Medigap, komanso chithandizo chamankhwala.

Gawo C (Medicare Advantage)

Onyamula ma inshuwaransi apadera amapereka mapulani a Medicare Advantage ku Indiana omwe amaphatikiza zabwino za Medicare zoyambirira ndi mankhwala omwe amaperekedwa ndi mankhwala ndi ntchito zina, monga chisamaliro cha mano kapena masomphenya. Kuphunzira kwapadera kumasiyanasiyana ndi mapulani ndionyamula.

Ubwino wina wamapulani a Advantage ndi malire omwe mumagwiritsa ntchito kuthumba. Mukafika kumapeto kwa chaka malinga ndi ndondomekoyi, ndondomeko yanu imalipira ndalama zonse zomwe Medicare amavomereza kuti muzisamalira chaka chonse.

Choyambirira Medicare, kumbali inayo, ilibe malire pachaka. Ndi magawo A ndi B, mumalipira

• deductible nthawi iliyonse mukalowa kuchipatala
• kuchotsera pachaka ku Gawo B
• kuchuluka kwa ndalama zamankhwala mutalipira Gawo B deductible

Gawo la Medicare D.

Gawo D likukonzekera za mankhwala ndi katemera. Kuphunzira kotere kumafunikira, koma muli ndi njira zingapo:

• Gulani ndondomeko ya Part D ndi Medicare yoyambirira
• lembani dongosolo la Medicare Advantage lomwe limaphatikizapo kufotokozera gawo D
• pezani kufotokozedwa kofananira ndi pulani ina, monga njira yothandizidwa ndi olemba anzawo ntchito

Ngati mulibe mankhwala omwe mumalandira ndipo musamalembetse nawo mukamalembetsa koyamba, mudzalipira ngongole yanthawi yonse yolembetsa.

Inshuwaransi yothandizira ya Medicare (Medigap)

Medigap itha kuthandiza kulipira ndalama m'thumba. Pali "mapulani" 10 a Medigap omwe amapereka kufalitsa: A, B, C, D, F, G, K, L, M, and N.

Ndondomeko iliyonse ili ndi kufotokozera pang'ono, ndipo sizinthu zonse zomwe zimagulitsidwa mdera lililonse. Ganizirani zosowa zanu mukawunika mapulani a Medigap, ndipo gwiritsani ntchito chida chopezera njira ya Medicare kuti muwone mapulani omwe amagulitsidwa mu ZIP code yanu.

Kutengera dongosolo lomwe mungasankhe, Medigap imalipira zina kapena zonse za Medicare izi:

• zokopa
• chitsimikizo
• kuchotsedwa
• kusamalira maluso oyamwitsa
• chithandizo chadzidzidzi

Medigap imapezeka kuti ingagwiritsidwe ntchito ndi Medicare yoyambirira. Sizingaphatikizidwe ndi mapulani a Medicare Advantage (Part C). Simungalembetse ku Medicare Advantage ndi Medigap.

Ndi mapulani ati a Medicare Advantage omwe amapezeka ku Indiana?

Ku Indiana, mapulani a Medicare Advantage agwera m'magulu asanu ndi awiri:

• Mapulani a Health Maintenance Organisation (HMO). Mu HMO, mumasankha wopereka chithandizo choyambirira (PCP) kuchokera pagulu la madokotala. Munthu ameneyu amayang'anira chisamaliro chanu, kuphatikiza kutumizidwa kwa akatswiri. Ma HMO amaphatikizanso zipatala ndi malo omwe ali mu netiweki.
• HMO yokhala ndi mapulani a point of service (POS). HMO yokhala ndi mapulani a POS imaphimba chisamaliro kunja kwa netiweki yawo. Kawirikawiri zimaphatikizapo ndalama zowonjezera kunja kwa thumba zothandizira kunja kwa intaneti, koma zina mwa ndalamazo zimaphimbidwa.
• Mapulani a Preferred Provider Organisation (PPO). Mapulani a PPO ali ndi netiweki ya othandizira ndi zipatala ndipo safuna kuti mutumizidwe ku PCP kuti mukawone katswiri. Kusamalira kunja kwa netiweki kumatha kukhala ndalama zambiri kapena sikungaphimbidwe konse.
• Ndondomeko zosamaliridwa ndi othandizira (PSO). M'mapulani awa, operekera ndalama amatenga zovuta zachuma za chisamaliro, ndiye mumasankha PCP kuchokera pa pulaniyo ndikuvomera kugwiritsa ntchito omwe akupereka ndondomekoyi.
• Maakaunti osunga a Medicare (MSAs). MSA imakhala ndi pulani ya inshuwaransi yodula kwambiri yomwe imakhala ndi akaunti yosungira ndalama zoyendetsera bwino kuchipatala. Medicare imalipira ndalama zanu ndipo imayika ndalama zina kuakaunti yanu chaka chilichonse. Mutha kupeza chithandizo kuchokera kwa dokotala aliyense.
• Ndondomeko za Fizi-for-Service (PFFS). Awa ndi mapulani a inshuwaransi achinsinsi omwe amakhazikitsa mitengo yobwezera mwachindunji ndi omwe amapereka. Mutha kusankha dokotala kapena malo omwe angavomereze dongosolo lanu la PFFS; komabe, si onse opereka chithandizo.
• Chipembedzo cha Fraternal Benefits Society chikukonzekera. Mapulaniwa ndi ma HMO, ma HMO okhala ndi ma POS, ma PPO, kapena ma PSO opangidwa ndi gulu lachipembedzo kapena lachibale. Kulembetsa kumatha kukhala kwa anthu omwe ali mgululi.

Mapulani a Zosowa Zapadera (SNPs) amapezekanso ngati mukufuna chisamaliro chokwanira. Mapulaniwa amapereka zowonjezera ndikuthandizira.

Mutha kupeza SNP ngati:

• ali oyenerera onse Medicaid ndi Medicare
• ali ndi vuto limodzi kapena angapo osatha kapena olumala
• khalani kumalo osamalira anthu kwanthawi yayitali

Onyamula ma inshuwaransi amapereka mapulani a Medicare Advantage ku Indiana:

• Aetna
• Chabwino
• Nyimbo ya Blue Cross ndi Blue Shield
• Anthem HealthKeepers
• CareSource
• Humana
• Mapulani azaumoyo ku Indiana University
• Lasso Healthcare
• MyTruAdvantage
• UnitedHealthcare
• Zing Health

Mapulani osiyanasiyana amapezeka mdera lililonse la Indiana, chifukwa chake zosankha zanu zimatengera komwe mumakhala ndi ZIP code yanu. Sizinthu zonse zomwe zikupezeka mdera lililonse.

Ndani ali woyenera ku Medicare ku Indiana?

Kuti muyenerere mapulani a Medicare Indiana, muyenera:

• kukhala wazaka 65 kapena kupitirira
• kukhala nzika yaku U.S. kapena wovomerezeka mwalamulo kwa zaka 5 kapena kupitilira apo

Mutha kukhala oyenerera musanakwanitse zaka 65 ngati:

• adalandira Social Security Disability Insurance (SSDI) kapena Railroad Retirement Benefits (RRB) kwa miyezi 24
• ali ndi matenda amtsogolo (ESRD) kapena kumuika impso
• ali ndi amyotrophic lateral sclerosis (ALS), yotchedwanso matenda a Lou Gehrig

Ndingalembetse liti ku mapulani a Medicare Indiana?

Anthu ena amalembetsa ku Medicare, koma ambiri amafunika kuti alembetse nthawi yoyenera.

Nthawi yoyamba kulembetsa

Kuyambira miyezi itatu isanathe mwezi wakubadwa kwanu 65, mutha kulembetsa ku Medicare. Mapindu anu ayamba tsiku loyamba la mwezi wobadwa.

Ngati mwaphonya nthawi yolembetsayi, mutha kulembetsanso mwezi womwe mwabadwa komanso miyezi 3 itatha, koma kufalitsa kumachedwa.

Munthawi yoyamba kulembetsa, mutha kulembetsa magawo A, B, C, ndi D.

Kulembetsa wamba: Januware 1 mpaka Marichi 31

Ngati mwaphonya nthawi yanu yoyamba kulembetsa, mutha kulembetsa koyambirira kwa chaka chilichonse, koma kufalitsa kwanu sikuyamba mpaka Julayi 1. Kulembetsa mochedwa kungatanthauzenso kuti mudzalipira chindapusa mukalembetsa.

Pambuyo polembetsa ambiri, mutha kulembetsa Medicare Advantage kuyambira Epulo 1 mpaka Juni 30.

Kulembetsa kwa Medicare Advantage kutsegulidwa: Januware 1 mpaka Marichi 31

Ngati mwalembetsa kale mu pulani ya Medicare Advantage, mutha kusintha mapulani kapena kubwerera ku Medicare yoyambirira panthawiyi.

Kulembetsa kwa Medicare kotseguka: Okutobala 1 mpaka Disembala 31

Imatchedwanso nthawi yolembetsa pachaka, ino ndi nthawi yomwe mutha:

• sinthani kuchokera ku Medicare yoyambirira kupita ku Medicare Advantage
• sinthani kuchokera ku Medicare Advantage kupita ku Medicare yoyambirira
• sintha kuchoka pa pulani imodzi ya Medicare Advantage kupita ku ina
• sintha kuchoka pa dongosolo limodzi la Medicare Part D (mankhwala akuchipatala) kupita ku linzake

Nthawi yolembetsa yapadera

Mutha kulembetsa ku Medicare osadikirira kuti adzalembetsedwe pofika poyenerera kulembetsa. Izi zimachitika makamaka mukataya mwayi wothandizidwa ndi olemba anzawo ntchito, mutuluke m'dera lanu, kapena dongosolo lanu silikupezeka pazifukwa zina.

Malangizo polembetsa ku Medicare ku Indiana

Ndikofunika kuwunika zosowa zanu zaumoyo ndikuwerenga ndondomeko iliyonse mosamala kuti muthe kusankha yomwe imapereka chithunzithunzi chabwino cha zosowa zanu. Ganizirani mosamala:

• ngati mukufuna Medicare yoyambirira kapena Medicare Advantage
• ngati madokotala omwe mumawakonda ali mu netiweki ya Medicare Advantage
• Zomwe umapereka, kuchotsera, kupopera, kutsimikizika ndalama, komanso ndalama zotulutsira mthumba ndizomwe zimayendera dongosolo lililonse

Kuti mupewe kulipira mochedwa kulembetsa, lembetsani magawo onse a Medicare (A, B, ndi D) kapena onetsetsani kuti muli ndi zina zofananira, monga pulani yothandizidwa ndi olemba anzawo ntchito, mukakwanitsa zaka 65.

Zothandizira ku Indiana Medicare

Ngati mukufuna zambiri kapena kuthandizira kumvetsetsa zosankha zanu za Medicare ku Indiana, izi zilipo:

• Indiana Department of Insurance, 800-457-8283, yomwe imapereka chithunzithunzi cha Medicare, maulalo othandizira a Medicare, ndikuthandizira kulipira Medicare
• Indiana State Health Insurance Program (SHIP), 800-452-4800, pomwe odzipereka amayankha mafunso ndikukuthandizani polembetsa ku Medicare
• Medicare.gov, 800-633-4227

Ndiyenera kuchita chiyani kenako?

Nawa maupangiri okuthandizani kulembetsa ku Medicare:

• Sungani zolemba zilizonse kapena zidziwitso zamalamulo anu ndi zamankhwala.
• Funsani dokotala wanu za inshuwaransi kapena Medicare yomwe angavomereze kapena kutenga nawo mbali.
• Sankhani nthawi yanu yolembetsa ndikulemba kalendala yanu.
• Lowani Gawo A ndi Gawo B, kenako sankhani ngati mungafune dongosolo la Medicare Advantage.
• Sankhani mapulani omwe mungafune ndi omwe mungakonde.

Nkhaniyi idasinthidwa pa Novembala 20, 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.