Kodi mitundu yosiyanasiyana ya Medicare ndi iti?

Zamkati

• Kodi Medicare Part A ndi chiyani?
• Kodi Medicare Part B ndi chiyani?
• Kodi Medicare Part C (Medicare Advantage) ndi chiyani?
• Kodi Medicare Part D ndi chiyani?
• Kodi Medicare supplement inshuwaransi (Medigap) ndi chiyani?
• Kutenga

• Kuphunzira kwa Medicare kumagawidwa m'magawo angapo omwe gawo lililonse limafotokoza mbali yosamalira.
• Medicare Part A imafotokoza za chisamaliro cha odwala ndipo nthawi zambiri imakhala yopanda malipiro.
• Medicare Part B imafunikira chithandizo chamankhwala akunja ndipo imakhala ndi ndalama zoyambira kubweza.
• Medicare Part C (Medicare Advantage) ndi inshuwaransi yapadera yomwe imaphatikiza magawo A ndi B ndi maubwino owonjezera.
• Medicare Part D ndi inshuwaransi yabizinesi yomwe imakhudza mankhwala omwe munthu wakupatsani.

Medicare imapereka chithandizo chamankhwala kwa anthu azaka zopitilira 65 komanso omwe ali ndi zilema kapena zina zathanzi. Pulogalamu yovutayi ili ndi magawo ambiri, ndipo imakhudza boma la feduro komanso inshuwaransi yabizinesi yogwirira ntchito limodzi kuti ipereke ntchito zosiyanasiyana ndi zinthu zosiyanasiyana.

Medicare yapachiyambi imapangidwa ndi magawo A ndi B. Kuphunzira uku kumakupatsani mwayi wopita kwa madotolo ndi malo omwe amalandila Medicare popanda chilolezo kapena kuvomerezedwa ndi pulani yanu. Ndalama zoyambirira ndi zolipiritsa zimagwiritsidwa ntchito, koma nthawi zambiri zimakhala zopeza ndalama ndipo zitha kulipidwa.

Madongosolo a Medicare Advantage (Gawo C) ndi mapulani a inshuwaransi achinsinsi. Mapulaniwa amaphatikiza zinthu zingapo za Medicare, monga magawo A ndi B, ndi ntchito zina, monga mankhwala, mano, ndi mawonekedwe owonera. Amapereka ntchito zambiri, koma atha kuwononga ndalama zambiri ndikubwera ndi zoletsa ma netiweki.

Ngakhale zosankha zambiri za Medicare zimakupatsani mwayi wosinthira chithandizo chamankhwala, zimatanthauzanso kuti muyenera kudutsa ndikumvetsetsa zambiri.

Werengani kuti muwone zambiri zakumapeto kwa Medicare ndi momwe angakuthandizireni.

Kodi Medicare Part A ndi chiyani?

Medicare Part A ndi gawo la Medicare yoyambirira yomwe imalipira kuchipatala komanso zina zothandizira odwala. Anthu ambiri samalipira ndalama pamwezi A Part A chifukwa amalipira pulogalamuyi kudzera mumisonkho pazaka zawo zogwira ntchito.

Makamaka, Medicare Part A idzagwira:

• kuchipatala kuchipatala
• kukhala pang'ono pamalo osamalira anthu okalamba
• khalani m'chipatala cha chisamaliro cha nthawi yayitali
• chisamaliro cha nyumba zosamalirako okalamba chomwe sichikhala cha nthawi yayitali kapena kusunga
• chisamaliro cha odwala
• chithandizo chamankhwala chanthawi yayitali kapena chapakatikati

Kuti muwonetsetse kuti Medicare ikuphimba nthawi yanu, muyenera:

• khalani ndi lamulo lovomerezeka kuchokera kwa dokotala wanu kuti mukuyenera chisamaliro cha matenda kapena kuvulala
• onetsetsani kuti malowo akulandira Medicare
• onetsetsani kuti mwatsala ndi masiku ochepa munthawi yanu yopindulitsa (kuti mukhale malo aluso oyamwitsa)
• onetsetsani kuti Medicare ndi malowa akuvomereza chifukwa chokhala

Pansi pa Medicare Part A, mutha kuyembekezera kulipira ndalama izi mu 2021:

• palibe chindapusa ngati mumagwira ntchito osachepera 40 kotala (zaka 10) m'moyo wanu ndipo mumalipira misonkho ya Medicare (mudzalipira mpaka $ 471 pamwezi ngati mutagwira ntchito zosakwana 40 kotala)
• $ 1,484 yochotseredwa panthawi iliyonse yopindulitsa
• ndalama zolipirira ndalama tsiku ndi tsiku kutengera kutalika kwa nthawi yomwe mukukhala odwala: $ 0 masiku 1 mpaka 60, $ 371 patsiku masiku 61 mpaka 90, ndi $ 742 patsiku masiku 91 ndi kupitirira
• zonse zimafunika ngati muli mchipatala kwa masiku opitilira 90 munthawi imodzi yopindulitsa ndipo mwadutsa masiku 60 osungidwa

Kodi Medicare Part B ndi chiyani?

Medicare Part B ndiye gawo la Medicare yoyambirira yomwe imalipira mtengo wa chisamaliro cha odwala. Mulipira mwezi uliwonse pamalipiro onsewa kutengera momwe mumalandirira.

Medicare Gawo B lilipira mtengo wazinthu monga:

• maulendo a madotolo
• mankhwala ndi ntchito zofunikira
• ntchito zothandizira
• mayendedwe azadzidzidzi
• zida zina zamankhwala
• chithandizo chamankhwala opatsirana kuchipatala komanso kuchipatala
• mankhwala ena akuchipatala

Kuti mutsimikizire kuti Medicare Part B imakhudza kusankhidwa kwanu, ntchito, kapena zida zamankhwala, funsani ngati dokotala wanu kapena wothandizira amalandira Medicare.Muthanso kugwiritsa ntchito chida chothandizira ku Medicare kuti muwone ngati kusankhidwa kwanu kapena ntchito yanu yaphimbidwa.

Pansi pa Medicare Part B, mutha kuyembekezera kulipira ndalama izi mu 2021:

• ndalama zosachepera $ 148.50 pamwezi (ndalamazi zimawonjezeka ngati ndalama zanu zimaposa $ 88,000 pachaka kapena $ 176,000 pachaka kwa okwatirana)
• $ 203 yochotseredwa pachaka
• 20% ya ndalama zomwe Medicare imavomereza mukalandira deductible yanu chaka chonse

Kodi Medicare Part C (Medicare Advantage) ndi chiyani?

Medicare Part C (Medicare Advantage) ndi inshuwaransi yachinsinsi yomwe imakupatsirani gawo lililonse la Medicare A ndi B, kuphatikiza mautumiki ena.

Zambiri mwazinthuzi zimapereka chithandizo chamankhwala kuwonjezera pa chithandizo chakuchipatala ndi kuchipatala. Ubwino monga kufotokozera mano ndi masomphenya kumawonjezekanso.

Mutha kusintha mapulani anu a Medicare Advantage kutengera zomwe kampani yomwe imayang'anira dongosolo lanu ikupatsani komanso zomwe mukufuna kulipira.

Medicare imalipira ndalama zoikika mwezi uliwonse kwa omwe amakupatsani mwayi wothandizirana ndi Medicare kuti athandizire kugawana nawo.

Madongosolo a Medicare Part C nthawi zambiri amakhala m'magulu angapo:

• Mapulani a Health Maintenance Organisation (HMO) amafuna kuti mulandire chithandizo chadzidzidzi kuchokera kwa omwe amapereka mwaukonde wanu.
• Mapulani a Preferred Provider Organisation (PPO) amakupatsani mwayi wogwiritsa ntchito omwe amapereka mkati kapena kunja kwa netiweki yanu, koma mumalipira zochepa pakusamalira ma intaneti.
• Ndondomeko za Fizi-for-Service (PFFS) zaokha zimakulolani kuti muwone omwe amapereka omwe ali mkati kapena kunja kwa netiweki; komabe, dongosololi limakhazikitsa mitengo pazomwe zingalipire ndalama zomwe amathandizira mamembala ake komanso gawo lanu.
• Mapulani a Zosowa Zapadera (SNPs) ndi mapulani a Medicare Advantage omwe amapangidwira anthu omwe ali ndi matenda kapena zikhalidwe zina. Mapulaniwa amakwaniritsa ntchito ndikufotokozera momwe zinthu zilili.

Mtengo wa Medicare Part C umasiyana kutengera mtundu wamapulani ndi inshuwaransi yomwe mungasankhe.

Kodi Medicare Part D ndi chiyani?

Medicare Part D ndi dongosolo lomwe limapereka chithandizo chamankhwala akuchipatala.

Iyi ndi pulogalamu ya Medicare yomwe mungasankhe, koma ngati simulembetsa mukakhala oyenerera, mutha kulipira zilango mukalembetsa pambuyo pake. Chilango chimenecho chidzagwiritsidwa ntchito malinga ngati muli ndi mapulani a mankhwala osokoneza bongo ndipo ziziwonjezedwa pamtengo wokhazikika pamwezi.

Kupatsidwa mankhwala akuchipatala kuyenera kuperekedwa pamlingo wokhazikika ndi Medicare. Koma mapulani osiyanasiyana amatha kusankha mankhwala omwe amalembetsa mndandanda wazamankhwala, kapena formularies. Ambiri omwe amapangira mankhwala osokoneza bongo amalemba mankhwala ndi:

• formulary, womwe ndi mndandanda wamankhwala omwe akuperekedwa m'ndondomekoyi - makamaka osankha zisankho ziwiri pagulu lililonse la mankhwala kapena gulu lililonse
• mankhwala achibadwa omwe angalowe m'malo mwa mankhwala odziwika ndi dzina lomwelo
• Mapulogalamu omwe amapereka mitundu ingapo ya mankhwala (generic yokha, generic kuphatikiza dzina la dzina, ndi zina zotero) pamitengo ingapo yamisonkho yomwe imakwera ndi mitengo yamankhwala anu

Mtengo wa mapulani a Medicare Part D umadalira dongosolo lomwe mungasankhe komanso mankhwala omwe mukufuna. Mutha kuyerekezera mtengo wamankhwala osiyanasiyana a Medicare pa intaneti podina apa.

Kodi Medicare supplement inshuwaransi (Medigap) ndi chiyani?

Medicare yowonjezera inshuwaransi, kapena Medigap, mapulani ndi zinthu za inshuwaransi zachinsinsi zotanthauza kuti zithandizire kulipira ndalama zomwe sizinalipidwe ndi Medicare magawo A, B, C, kapena D. Zolingazi ndizosankha.

Ndondomeko za Medigap zitha kuthandiza kubweza ndalama za Medicare monga:

• zokopa
• ndalama
• kuchotsedwa

Zosintha zazikulu zingapo zidapangidwa pulogalamu ya Medigap mu 2020.

Mapulani a Medigap sangagwiritsidwenso ntchito kulipira kuchotsedwa kwa Medicare Part B. Izi zikutanthauza kuti mitundu iwiri ya mapulani a Medigap - Plan C ndi Plan F - idasiya kugulitsidwa kwa mamembala atsopano kuyambira Januware 1, 2020. Anthu omwe anali kale ndi mapulaniwa, amatha kusunga nkhani zawo.

Zolinga za Medigap sizingakwaniritse ndalama zonse zakuthumba, koma mutha kupeza zomwe zikugwirizana ndi zosowa zanu zachuma komanso zathanzi. Muli ndi mapulani osiyanasiyana komanso magawo omwe mungasankhe.

Nayi mwachidule zomwe mapulani 10 aliwonse a Medigap amafotokoza:

* Pambuyo pa Januware 1, 2020, anthu omwe abwera kumene ku Medicare sangagwiritse ntchito njira za Medigap kulipira chindapusa cha Medicare Part B. Koma ngati mwalembetsa kale ku Medicare ndipo dongosolo lanu likulipira, mutha kusunga ndalamazo ndi phindu lake.

Kutenga

Zingatenge nthawi ndi khama kuti mufufuze mitundu yambiri yamalingaliro a Medicare. Koma zosankhazi zimakupatsani zisankho zambiri pankhani yophimba ndi mtengo wamankhwala anu.

Mukayamba kulandira Medicare, onetsetsani kuti mwawunikanso ziwalo zake zonse kuti mupeze zoyenera ndikupewa zilango pambuyo pake.

Nkhaniyi idasinthidwa pa Novembala 17, 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.