Mafunso Ofunsidwa Komwe Amayankha Mafunso a Medicare

Zamkati

• 1. Kodi Medicare imaphimba chiyani?
• Mankhwala Oyambirira
• Medicare Gawo A
• Medicare Gawo B
• Medicare Gawo C (Medicare Advantage)
• Gawo la Medicare D.
• Mankhwala owonjezera a Medicare (Medigap)
• 2. Kodi mankhwala akuchipatala amathandizidwa ndi Medicare?
• Gawo D
• Gawo C
• 3. Kodi ndiyenera kulandira mankhwala liti?
• 4. Ndingalembetse liti ku Medicare?
• 5. Kodi Medicare ndi yaulere?
• 6. Kodi Medicare amawononga ndalama zingati mu 2021?
• Gawo A
• Gawo B
• Gawo C
• Gawo D
• Kusinkhasinkha
• 7. Kodi Medicare amachotsera chiyani?
• 8. Kodi mtengo wa Medicare ndi chiyani?
• 9. Kodi Medicare copay ndi chiyani?
• 10. Kodi chitsimikizo cha Medicare ndi chiyani?
• 11. Kodi Medicare ili mthumba mtunda wotani?
• 12. Kodi ndingagwiritse ntchito Medicare ndikakhala kunja kwa boma langa?
• 13. Ndingasinthe liti mapulani a Medicare?
• 14. Kodi ndingatani ndikataya khadi yanga ya Medicare?
• Kutenga

Ngati inu kapena wokondedwa wanu mwalembetsa Medicare posachedwa kapena mukukonzekera kulemba posachedwa, mungakhale ndi mafunso. Mafunsowa atha kuphatikizira: Kodi Medicare imaphimba chiyani? Ndi dongosolo liti la Medicare lomwe lingakwaniritse mankhwala omwe ndimalandira? Kodi ndimalipira ndalama zingati pamwezi pa Medicare yanga?

Munkhaniyi, tiwona mitu monga kufalitsa, mtengo, ndi zina kuti tithandizire kuyankha ena mwa mafunso omwe amafunsidwa a Medicare.

1. Kodi Medicare imaphimba chiyani?

Medicare ili ndi Gawo A, Gawo B, Gawo C (Zopindulitsa), Gawo D, ndi Medigap - zonse zomwe zimafotokoza zofunikira pazachipatala.

Mankhwala Oyambirira

Medicare Part A ndi Part B amadziwika kuti Medicare yoyambirira. Monga momwe mudzaphunzirire, Medicare yapachiyambi imakhudza zofunikira zanu zachipatala zokha ndi zomwe ndizofunikira kuchipatala kapena zodzitetezera. Simalipira mankhwala akuchipatala, kuyezetsa mano chaka chilichonse kapena kuwona masomphenya, kapena ndalama zina zokhudzana ndi chithandizo chamankhwala chanu.

Medicare Gawo A

Gawo A limafotokoza ntchito zotsatirazi:

• chisamaliro cha kuchipatala
• chisamaliro chakuchipatala
• chisamaliro chochepa chothandizira okalamba
• chisamaliro cha okalamba (osati nthawi yayitali)
• chithandizo chamankhwala chochepa kunyumba
• chisamaliro cha odwala

Medicare Gawo B

Gawo B limafotokoza ntchito zamankhwala kuphatikiza:

• chithandizo chamankhwala choteteza
• chithandizo chamankhwala
• chithandizo chamankhwala
• zida zamankhwala zolimba
• ntchito zamisala
• mankhwala ena opatsirana kuchipatala
• ntchito za telehealth (monga gawo la zomwe zikuchitika pakadali kubuka kwa COVID-19)

Medicare Gawo C (Medicare Advantage)

Medicare Advantage ndi njira ya Medicare yoperekedwa ndi makampani a inshuwaransi wamba. Izi zikugwira ntchito zoyambirira za Medicare Part A ndi B. Ambiri amaperekanso chithandizo cha mankhwala akuchipatala; mano, masomphenya, ndi kumva; ntchito zolimbitsa thupi; ndi zina zambiri.

Gawo la Medicare D.

Medicare Part D imathandizira kubweza mitengo yamankhwala omwe mumalandira. Mapulani a Medicare Part D amagulitsidwa ndi makampani a inshuwaransi apadera ndipo amatha kuwonjezeredwa ku Medicare yoyambirira.

Mankhwala owonjezera a Medicare (Medigap)

Madongosolo a Medigap amathandizira kulipira ndalama zomwe zimagwirizanitsidwa ndi Medicare yoyambirira. Izi zitha kuphatikizira kuchotsera, kutsimikiziridwa ndalama, ndi ma copayment. Madongosolo ena a Medigap amathandizanso kulipira ndalama zomwe mungakhale nazo mukamapita kunja kwa dziko.

2. Kodi mankhwala akuchipatala amathandizidwa ndi Medicare?

Medicare Yoyambirira imakhudza mankhwala ena. Mwachitsanzo:

• Medicare Part A imakhudza mankhwala omwe mumagwiritsa ntchito mukakhala mchipatala. Ikufotokozanso za mankhwala omwe amagwiritsidwa ntchito panthawi yathanzi kunyumba kapena kuchipatala.
• Medicare Part B imafotokoza mankhwala ena omwe amaperekedwa kuchipatala, monga ofesi ya dokotala. Gawo B limakhudzanso katemera.

Kuti mupeze chithandizo chamankhwala chokwanira ndi Medicare, muyenera kulembetsa mu Medicare Part D kapena dongosolo la Medicare Part C lomwe limafalitsa mankhwala.

Gawo D

Medicare Part D itha kuwonjezeredwa ku Medicare yoyambirira kuti ikuthandizireni kulipirira mtengo wamankhwala omwe mumalandira. Dongosolo lirilonse la Gawo D limakhala ndi formulary, yomwe ndi mndandanda wamankhwala omwe akuperekedwa. Mankhwalawa amachokera m'magulu atatu, nthawi zambiri amagawika pamtengo ndi mtundu. Madongosolo onse a Medicare Part D akuyenera kuphimba mankhwala osachepera awiri m'magulu akulu azamankhwala.

Gawo C

Mapulani ambiri a Medicare Advantage amaperekanso chithandizo chamankhwala chamankhwala. Monga Medicare Part D, dongosolo lililonse la Advantage lidzakhala ndi malamulo ake owerengera ndi kufotokozera. Ingokumbukirani kuti mapulani ena a Medicare Health Maintenance Organisation (HMO) ndi Preferred Provider Organisation (PPO) atha kukulipirani ndalama zambiri ngati mutagwiritsa ntchito ma pharmacies akunja kwa netiweki.

3. Kodi ndiyenera kulandira mankhwala liti?

Anthu aku America azaka 65 kapena kupitilira pamenepo ali ndi mwayi wolembetsa ku Medicare. Anthu ena ochepera zaka 65 omwe ali ndi zilema zazitali nawonso ali oyenerera. Umu ndi momwe kuyenerera kwa Medicare kumagwirira ntchito:

• Ngati mukukhala ndi zaka 65, ndinu woyenera kulembetsa ku Medicare miyezi itatu musanakwanitse zaka 65 komanso mpaka miyezi itatu pambuyo pake.
• Ngati mumalandira zabwino mwezi uliwonse kudzera mu Social Security Administration kapena Railroad Retirement Board, ndiye kuti mukuyenera kulandira Medicare pambuyo pa miyezi 24.
• Ngati muli ndi amyotrophic lateral sclerosis (ALS) ndipo mumalandira maubwino olumala pamwezi, muyenera kulandira Medicare nthawi yomweyo.
• Ngati mwapezeka kuti muli ndi vuto lakumapeto kwa impso (ESRD) ndipo mwadulidwa impso kapena mukufuna dialysis, ndinu oyenera kulembetsa ku Medicare.

4. Ndingalembetse liti ku Medicare?

Pali nthawi zingapo zolembetsa ku Medicare. Mukakwaniritsa zofunikira, mutha kulembetsa munthawi zotsatirazi.

Nthawi zina, kulembetsa ku Medicare kumangodziwonekera. Mwachitsanzo, mudzangolembetsa ku Medicare yoyambirira ngati mukulandira zolakwika ndi:

• Mukutembenuza zaka 65 m'miyezi inayi yotsatira.
• Mwalandira ndalama zolumala kwa miyezi 24.
• Mwapezeka kuti muli ndi ALS.

5. Kodi Medicare ndi yaulere?

Ndondomeko zina za Medicare Advantage zimalengezedwa ngati mapulani "aulere". Ngakhale mapulaniwa atha kukhala opanda mtengo, sakhala mfulu kwathunthu: Muyenera kulipira ndalama zina zotuluka m'thumba.

6. Kodi Medicare amawononga ndalama zingati mu 2021?

Gawo lirilonse la Medicare lomwe mumalembetsa limakhala ndi ndalama zogwirizana nazo, kuphatikizapo ndalama zoyendetsera ndalama, zochotseredwa, zolipiritsa, komanso ndalama zothandizira.

Gawo A

Mtengo wa Medicare Part A umaphatikizapo:

• ndalama zoyambira kulikonse kuyambira $ 0 mpaka $ 471 pamwezi, kutengera ndalama zomwe mumapeza
• Kuchokera kwa $ 1,484 pa nthawi yabwinobwino
• chitsimikizo cha $ 0 m'masiku 60 oyambira kuchipatala, mpaka mtengo wonse wantchito kutengera nthawi yomwe mwalandilidwa

Gawo B

Mtengo wa Medicare Part B umaphatikizapo:

• mtengo wa $ 148.50 kapena kupitilira mwezi, kutengera ndalama zomwe mumapeza
• Kuchokera kwa $ 203
• chitsimikizo cha maperesenti 20 pamtengo wamtengo wovomerezeka ndi Medicare wothandizira
• chindapusa chowonjezera mpaka 15% ngati mtengo wazantchito zanu uposa womwe wavomerezedwa

Gawo C

Ndalama za Medicare Part C zimatha kusiyanasiyana kutengera komwe mumakhala, omwe amakupatsani, komanso mtundu wazomwe mungakwaniritse.

Mtengo wa Medicare Part C umaphatikizapo:

• Gawo A mtengo
• Gawo B ndalama
• malipiro amwezi pamwezi pagawo C.
• deductible yapachaka ya Dongosolo C.
• Ndondomeko ya mankhwala yomwe ingachotsedwe (ngati mapulani anu akuphatikizira mankhwala)
• ndalama zandalama kapena zolipirira paulendo wa dokotala aliyense, kuchezera kwa akatswiri, kapena kukonzanso mankhwala

Gawo D

Mtengo wa Medicare Part D umaphatikizapo:

• ndalama zoyambira pamwezi
• Kuchokera pachaka kwa $ 445 kapena kutsika
• ndalama zandalama kapena zolipirira pamankhwala omwe mumalandira

Kusinkhasinkha

Mapulani a Medigap amalipiritsa ndalama pamwezi zomwe zimakhudzidwa ndi dongosolo lanu la Medigap, malo omwe muli, kuchuluka kwa anthu omwe adalembetsa nawo mapulani, ndi zina zambiri. Koma mapulani a Medigap amathandizanso kulipirira zina mwa zoyambirira za Medicare.

7. Kodi Medicare amachotsera chiyani?

Medicare yomwe ingachotsedwe ndi kuchuluka kwa ndalama zomwe mumagwiritsa ntchito mthumba chaka chilichonse (kapena nyengo) pazantchito zanu chithandizo cha Medicare chisanafike. Medicare magawo A, B, C, ndi D onse amachotsera.

8. Kodi mtengo wa Medicare ndi chiyani?

Medicare premium ndi ndalama zomwe mumalipira pamwezi kuti mulembetse dongosolo la Medicare. Gawo A, Gawo B, Gawo C, Gawo D, ndi Medigap onse amalipiritsa pamwezi.

9. Kodi Medicare copay ndi chiyani?

Ndalama ya Medicare, kapena copay, ndiyo ndalama zomwe muyenera kulipira mthumba nthawi iliyonse mukalandira chithandizo kapena kuwonjezeranso mankhwala omwe mumalandira.

Madongosolo a Medicare Advantage (Gawo C) amalipiritsa ndalama zosiyanasiyana pamaulendo azachipatala komanso akatswiri. Zolinga zina zimapereka chindapusa chapamwamba kwa omwe ali kunja kwa ma netiweki.

Mapulani azamankhwala a Medicare amalipiritsa ndalama zosiyanasiyana pamankhwala osokoneza bongo kutengera mtundu wa mankhwala omwe mumamwa. Mwachitsanzo, mankhwala a tier 1 nthawi zambiri amakhala achibadwa komanso otsika mtengo.

Makopedwe anu enieni atengera mwayi womwe mungasankhe.

10. Kodi chitsimikizo cha Medicare ndi chiyani?

Medicare coinsurance ndiye gawo lomwe mumalipira mthumba pamtengo wothandizidwa ndi Medicare.

Gawo la Medicare A limapereka ndalama zambiri mukakhala kuchipatala. Mu 2021, Part A coinsurance ndi $ 371 masiku achipatala 60 mpaka 90 ndi $ 742 masiku 91 mpaka apo.

Medicare Part B imapereka ndalama zokwanira 20%.

Medicare Part D ikukonzekera kulipiritsa ndalama zandalama mofananamo ndi zolipira, nthawi zambiri pamankhwala apamwamba, dzina lamankhwala - ndipo zimangokupatsani ndalama zolipiritsa kapena ndalama za inshuwaransi koma osati zonse ziwiri.

11. Kodi Medicare ili mthumba mtunda wotani?

Kuchuluka kwa mthumba kwa Medicare ndi malire pamalipiro omwe mungapereke m'thumba pazomwe mumagula ku Medicare chaka chimodzi. Palibe malire pamitengo yakathumba mu Medicare yoyambirira.

Madongosolo onse a Medicare Advantage amakhala ndi ndalama zokwanira kutuluka chaka ndi chaka, zomwe zimasiyanasiyana kutengera dongosolo lomwe mwalembetsa. Kulembetsa mu dongosolo la Medigap kungathandizenso kuchepetsa ndalama zomwe zimatuluka mthumba chaka chilichonse.

12. Kodi ndingagwiritse ntchito Medicare ndikakhala kunja kwa boma langa?

Medicare yapachiyambi imapereka kufalitsa padziko lonse kwa onse opindula. Izi zikutanthauza kuti mumaphimbidwa chifukwa chakuchipatala.

Madongosolo a Medicare Advantage, mbali inayi, amangofotokozera za boma lomwe mumakhala, ngakhale ena atha kuperekanso chithandizo chapaintaneti kunja kwa boma.

Kaya muli ndi Medicare yoyambirira kapena Medicare Advantage, nthawi zonse muyenera kuwonetsetsa kuti omwe mukumuchezera akulandila ntchito ya Medicare.

13. Ndingasinthe liti mapulani a Medicare?

Ngati mwalembetsa dongosolo la Medicare ndipo mukufuna kusintha mapulani anu, mutha kutero nthawi yolembetsa, yomwe imayamba Ogasiti 15 mpaka Disembala 7 chaka chilichonse.

14. Kodi ndingatani ndikataya khadi yanga ya Medicare?

Ngati mwataya khadi yanu ya Medicare, mutha kuyitanitsa kuti mubwezere patsamba lanu la Social Security. Ingolowani muakaunti yanu ndikupempha m'malo mwa tabu "Yosintha Zolemba". Muthanso kufunsa khadi yosinthira poyimbira 800-MEDICARE.

Zitha kutenga masiku 30 kuti mulandire khadi yanu ya Medicare. Ngati mukufuna khadi yanu kuti mudzakonzekere nthawiyo isanakwane, mutha kusindikiza ndikulowa muakaunti yanga ya myMedicare.

Kutenga

Kumvetsetsa Medicare kumatha kumva kukhala kovuta, koma pali zinthu zambiri zomwe mungapeze. Ngati mukufuna thandizo lina kusaina ku Medicare kapena mukukhala ndi mafunso osayankhidwa, Nazi zina zowonjezera zomwe zingathandize:

• Medicare.gov ili ndi chidziwitso chokhudza omwe amapereka, mafomu ofunikira, timabuku totsitsa tothandiza, ndi zina zambiri.
• CMS.gov ili ndi zidziwitso zaposachedwa pakusintha kwamalamulo ndi zosintha mu pulogalamu ya Medicare.
• SSA.gov imakupatsani mwayi wopeza akaunti yanu ya Medicare ndi zina zachitetezo cha Social Security ndi Medicare.

Nkhaniyi idasinthidwa pa Novembala 19, 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.