Ndondomeko Zowonjezera za Medicare: Zomwe Muyenera Kudziwa Zokhudza Medigap

Zamkati

• Mapulani owonjezera a Medicare
• Kuphunzira za gawo B loyamba
• Tchati chofanizira chowonjezera cha Medicare
• Mtengo wowonjezera wa Medicare
• Ubwino wosankha dongosolo la Medigap
• Zoyipa zosankha dongosolo la Medigap
• Medigap vs. Medicare Phindu
• Kodi ndine woyenera kulandira dongosolo lowonjezera la Medicare?
• Ndingalembetse bwanji?
• Kutenga

Madongosolo owonjezera a Medicare ndi mapulani a inshuwaransi achinsinsi omwe cholinga chake ndi kudzaza mipata ina mu Medicare. Pachifukwa ichi, anthu amatchulanso ndalamazi kuti Medigap. Medicare imathandizira inshuwaransi monga zinthu zochotseredwa ndi zolipira.

Ngati mumagwiritsa ntchito chithandizo chamankhwala mukakhala ndi Medicare inshuwaransi, Medicare imalipira gawo lawo choyamba, ndiye kuti dongosolo lanu la Medicare limalipira zolipira zilizonse zotsalira.

Pali zifukwa zambiri zofunika kuziganizira mukamasankha dongosolo lowonjezera la Medicare. Pemphani kuti mupeze maupangiri pakusankha ngati mukufuna dongosolo la Medigap ndikuyerekeza zosankha.

Mapulani owonjezera a Medicare

Pali madongosolo 10 a inshuwaransi owonjezera omwe amapezeka. Komabe, mapulani ena salinso olembetsa atsopano. Medicare imagwiritsa ntchito zilembo zazikulu kutanthauzira mapulaniwa, koma sizogwirizana ndi magawo a Medicare.

Mwachitsanzo, Medicare Part A ndi mtundu wina wophimba kuposa Medigap Plan A. Ndikosavuta kusokonezeka mukayerekezera magawo ndi mapulani. Madongosolo 10 a Medigap akuphatikiza mapulani A, B, C, D, F, G, K, L, M, ndi N.

Madongosolo owonjezera a Medicare amakhala okhazikika m'maiko ambiri. Izi zikutanthauza kuti mfundo zomwe mumagula ziyenera kupindulitsanso chimodzimodzi ngakhale mutagula kampani ya inshuwaransi iti.

Kupatulapo ndi malingaliro a Medigap ku Massachusetts, Minnesota, ndi Wisconsin. Mapulaniwa atha kukhala ndi maubwino osiyana siyana kutengera zofunikira zalamulo mderalo.

Ngati kampani ya inshuwaransi igulitsa mapulani owonjezera a Medicare, ayenera kupereka Medigap Plan A komanso Plan C kapena Plan F. Komabe, boma silifuna kuti kampani ya inshuwaransi ipereke dongosolo lililonse.

Kampani ya inshuwaransi siyingakugulitseni kapena wokondedwa wanu pulogalamu ya inshuwaransi ya Medicare ngati muli ndi chiphaso kudzera mu Medicaid kapena Medicare Advantage. Komanso, mapulani owonjezera a Medicare amangokhudza munthu m'modzi - osati okwatirana.

Kuphunzira za gawo B loyamba

Ngati mungakhale woyenera pa Januware 1, 2020 kapena pambuyo pake, simungathe kugula pulani yomwe imakhudza gawo loyamba la Gawo B. Izi zikuphatikiza Medigap Plan C ndi Plan F.

Komabe, ngati mudali kale ndi imodzi mwamapulani awa, mutha kuyisunga. Kuphatikiza apo, ngati mukadakhala woyenera Medicare isanafike Januware 1, 2020, mutha kugula Plan C kapena Plan F.

Tchati chofanizira chowonjezera cha Medicare

Dongosolo lililonse la Medigap limalipira zina mwa zomwe mumagula mu Gawo A, kuphatikiza ndalama zandalama, zolipira kuchipatala, ndi ndalama zothandizira odwala kapena ma copayment.

Madongosolo onse a Medigap amalipiranso zina mwamagawo anu a Gawo B, monga ndalama zachitetezo kapena zolipiritsa, zochotseredwa, ndi ma painti anu atatu oyamba amwazi ngati mukufuna kuikidwa magazi.

Tchati chili pansipa chikufanizira kufalitsa ndi mtundu uliwonse wa dongosolo la Medigap:

Mtengo wowonjezera wa Medicare

Ngakhale mapulani owonjezera a Medicare ndi ofanana potengera maubwino omwe amapereka, amatha kusiyanasiyana pamtengo malinga ndi kampani ya inshuwaransi yomwe imagulitsa.

Zimakhala ngati kugula pogulitsa: Nthawi zina, mapulani omwe mumafuna amawononga ndalama pang'ono m'sitolo ina komanso kwina, koma ndizofanana.

Makampani a inshuwaransi nthawi zambiri amalipira mitengo ya Medigap m'njira imodzi mwanjira zitatu izi:

• Anthu adavotera. Anthu ambiri amalipira chimodzimodzi, mosasamala zaka kapena kugonana. Izi zikutanthauza kuti ndalama za inshuwaransi za munthu zikakwera, lingaliro lakukulitsa likugwirizana kwambiri ndi chuma kuposa thanzi la munthu.
• Zaka zakubadwa zidavotera. Izi zimakhudzana ndi msinkhu wa munthu pomwe adagula. Mwambiri, achinyamata amalipira ndalama zochepa ndipo achikulire amalipira zambiri. Ndalama zomwe munthu amapeza zimatha kukulira akamakalamba chifukwa chakuchuma, koma osati chifukwa chakuti akukalamba.
• Zakwaniritsidwa zaka. Ndalama iyi ndiyotsika kwa achinyamata ndipo imakwera pamene munthu akukalamba. Itha kukhala yotsika mtengo kwambiri pomwe munthu amagula koyamba, koma itha kukhala yotsika mtengo kwambiri akamakalamba.

Nthawi zina, makampani a inshuwaransi amapereka kuchotsera pazinthu zina. Izi zimaphatikizapo kuchotsera anthu omwe samasuta, azimayi (omwe amakhala ndi ndalama zochepa zothandizira zaumoyo), komanso ngati munthu amalipira pasadakhale pachaka chilichonse.

Ubwino wosankha dongosolo la Medigap

• Ndondomeko ya inshuwaransi yothandizidwa ndi Medicare itha kuthandiza kubweza ndalama monga kuchotseredwa ndalama, kutsimikiziridwa ndalama, ndi ndalama zolipirira.
• Malingaliro ena a Medigap atha kumachotsera ndalama zotulutsira mthumba za munthu.
• Ngati mungalembetse nawo nthawi yolembetsa mutakwanitsa zaka 65, makampani a inshuwaransi sangakupatutseni kutengera zaumoyo.
• Ndondomeko za Medigap zithandizira 80 peresenti yazithandizo zanu zadzidzidzi mukamapita kunja kwa United States.
• Njira zingapo zomwe mungasankhe kuti zigwirizane ndi zosowa zanu zathanzi.

Zoyipa zosankha dongosolo la Medigap

• Ngakhale malingaliro a Medigap atha kukuthandizani kulipirira zina mwa zomwe mumapeza mu Medicare, sizikukhudzana ndi mankhwala, masomphenya, mano, kumva, kapena zina zilizonse zathanzi, monga ziwalo zolimbitsa thupi kapena mayendedwe.
• Kuti mulandire chithandizo chamankhwala chomwe chatchulidwa pamwambapa, muyenera kuwonjezera njira ya Medicare Part D kapena kusankha dongosolo la Medicare Advantage (Gawo C).
• Ndondomeko zovomerezeka za Medigap zimakulipirani ndalama zambiri mukamakalamba.
• Sizinthu zonse zomwe zimapereka chithandizo cha malo oyamwitsa aluso kapena chisamaliro cha odwala, chifukwa chake onani mapindu anu ngati mungafunike ntchitozi.

Medigap vs. Medicare Phindu

Medicare Advantage (Gawo C) ndi dongosolo la inshuwaransi. Mulinso Gawo A ndi Gawo B, komanso Gawo D nthawi zambiri.

Madongosolo a Medicare Advantage atha kukhala otsika mtengo kuposa Medicare yoyambirira kwa anthu ena. Madongosolo a Medicare Advantage atha kuperekanso maubwino ena, monga mano, kumva, kapena kufotokozera masomphenya.

Tawonani mwachidule zomwe muyenera kudziwa za Medicare Advantage ndi Medigap:

• Mapulani onsewa akuphatikizapo kufotokozera za Medicare Part A (kuchipatala) ndi Gawo B (inshuwaransi ya zamankhwala).
• Ndondomeko zambiri za Medicare Advantage zimaphatikizapo Gawo D (chiphaso cha mankhwala). Medigap sangakwanitse kulipira ndalama zamankhwala.
• Ngati muli ndi Medicare Advantage, simungagule dongosolo la Medigap. Ndi anthu okha omwe ali ndi Medicare yapachiyambi omwe ali oyenera mapulaniwa.

Nthawi zambiri, chisankho chimadalira zosowa zaumoyo wa munthu aliyense komanso kuchuluka kwa mapulani ake. Mapulani owonjezera a Medicare atha kukhala okwera mtengo kuposa Medicare Advantage, koma amathanso kulipira ndalama zowonjezera zokhudzana ndi kuchotsera ndi mtengo wa inshuwaransi.

Mungafunikire kuyang'anitsitsa pazinthu zomwe mungapeze kapena wokondedwa wanu kuti muthandize kusankha bwino.

Kodi ndine woyenera kulandira dongosolo lowonjezera la Medicare?

Mukuyenera kuti mulembetse nawo dongosolo lowonjezera la Medicare munthawi yoyamba kulembetsa ku Medigap. Nthawi imeneyi ndi miyezi itatu musanakwanitse zaka 65 ndikulembetsa Gawo B, mpaka miyezi itatu mutabadwa. Munthawi imeneyi, muli ndi ufulu wotsimikiza kugula dongosolo lowonjezera la Medicare.

Ngati mungakhalebe olembetsa ndikulipira ndalama zanu, kampani ya inshuwaransi siyingathetse dongosolo. Komabe, ngati muli ndi Medicare kale, kampani ya inshuwaransi imatha kukana kukugulitsani mfundo zowonjezera za Medicare kutengera thanzi lanu.

Ndingalembetse bwanji?

Kugula ndondomeko yowonjezera ya Medicare kungatenge nthawi ndi khama, koma ndibwino. Izi ndichifukwa choti anthu ambiri amasunga malingaliro awo a Medigap kwa moyo wawo wonse.

Kuyambira ndi mfundo zomwe zikugwirizana ndi zosowa zanu kapena za wokondedwa wanu zitha kuthandiza kupulumutsa kukhumudwa ndipo nthawi zambiri ndalama nthawi ina.

Nazi njira zofunika kugula mfundo za Medigap:

• Ganizirani zabwino zomwe zili zofunika kwambiri kwa inu. Kodi ndinu okonzeka kulipira ndalama zochotsera, kapena mukufunikira kuchotsera kwathunthu? Kodi mukuyembekeza kuti mukufuna chithandizo chamankhwala kudziko lina kapena ayi? (Izi ndizothandiza ngati mungayende kwambiri.) Yang'anani pa tchati chathu cha Medigap kuti mudziwe mapulani omwe angakupatseni zabwino kwambiri pamoyo wanu, pachuma, komanso thanzi.
• Sakani makampani omwe amapereka mapulani owonjezera a Medicare pogwiritsa ntchito chida chofufuzira cha Medigap kuchokera ku Medicare. Webusaitiyi imapereka zidziwitso pamalingaliro ndi kufotokozedwa kwake komanso makampani a inshuwaransi mdera lanu omwe amagulitsa ndalamazi.
• Imbani 800-MEDICARE (800-633-4227) ngati mulibe intaneti. Oimira omwe akugwira ntchitoyi akhoza kukuthandizani zomwe mukufuna.
• Lumikizanani ndi makampani a inshuwaransi omwe amapereka mfundo mdera lanu. Ngakhale zimatenga nthawi, osangoyitanitsa kampani imodzi. Mitengo imatha kusiyanasiyana ndi kampani, chifukwa chake ndibwino kufananiza. Mtengo suli zonse, komabe. Dipatimenti ya inshuwaransi ya boma lanu ndi ntchito ngati weissratings.com zitha kukuthandizani kudziwa ngati kampani ili ndi madandaulo ambiri motsutsana nayo.
• Dziwani kuti kampani ya inshuwaransi sayenera kukukakamizani kuti mugule mfundo. Ayeneranso kunena kuti amagwira ntchito ku Medicare kapena kunena kuti mfundo zawo ndi gawo la Medicare. Ndondomeko za Medigap ndizachinsinsi osati za boma.
• Sankhani dongosolo. Mukayang'ana zonsezo, mutha kusankha mfundo ndi kuzilembera.

Mapulani owonjezera a Medicare atha kukhala ovuta kuyenda. Ngati muli ndi funso linalake, mutha kuyitanitsa State Health Insurance Assistance Program (SHIP). Awa ndi mabungwe aboma omwe amathandizidwa ndi mabungwe omwe amapereka uphungu waulere kwa anthu omwe ali ndi mafunso okhudza Medicare ndi mapulani owonjezera.

Ngati mukuthandiza wokondedwa wanu kulembetsa ku Medicare, ganizirani izi:

• Onetsetsani kuti amalembetsa nthawi yomwe yapatsidwa. Kupanda kutero, atha kukumana ndi ndalama zazikulu ndi zilango zolembetsa mochedwa.
• Funsani momwe kampani ya inshuwaransi imagulira mitengo yake, monga "zaka zakubadwa" kapena "zaka zakubadwa." Izi zingakuthandizeni kuyerekezera momwe mfundo za wokondedwa wanu zingakwerere pamtengo.
• Funsani kuchuluka kwa mfundo zomwe mwayang'anitsitsa zakula mtengo pazaka zingapo zapitazi. Izi zingakuthandizeni kuwunika ngati wokondedwa wanu ali ndi ndalama zokwanira kulipirira ndalamazo.
• Onetsetsani kuti wokondedwa wanu ali ndi njira yokhoma yolipirira ndondomekoyi. Ndondomeko zina zimalipira cheke mwezi uliwonse, pomwe zina zimalembedwa kuchokera ku akaunti yakubanki.

Kutenga

Ma inshuwaransi owonjezera a Medicare atha kukhala njira yochepetsera mantha osayembekezereka, potengera mtengo wamankhwala. Amatha kuthandizira kulipira ndalama zakuthumba zomwe Medicare sangakwanitse kulipira.

Kugwiritsa ntchito zinthu zaulere, monga dipatimenti ya inshuwaransi ya boma lanu, ingakuthandizeni kapena wokondedwa wanu kupanga chisankho chabwino chokhudza kufalitsa.

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.