Ndondomeko Zopindulitsa za Medicare: Ndani Amawapatsa ndi Momwe Mungalembetsere

Zamkati

• Kodi Medicare Advantage (Medicare Part C) ndi chiyani?
• Ndani amagulitsa mapulani a Medicare Advantage?
• Kodi Medicare Advantage ndi ndalama zingati?
• Malangizo posankha dongosolo la Medicare Advantage
• Ndani ali woyenera mapulani a Medicare Advantage?
• Nthawi zolembetsa ku Medicare
• Kutenga

Medicare Advantage ndi njira ina ya Medicare yomwe imaphatikizaponso kufotokozera zamankhwala, mano, masomphenya, kumva, ndi zina zathanzi.

Ngati mwalembetsa ku Medicare posachedwa, mwina mungakhale mukuganiza kuti ndani akugulitsa mapulani a Medicare Advantage mdera lanu. Medicare Advantage imaperekedwa ndi makampani abizinesi a inshuwaransi omwe ali ndi mgwirizano ndi Medicare kuti akwaniritse zaumoyo wanu.

Munkhaniyi, tiwunikanso zomwe muyenera kudziwa za Medicare Advantage, momwe mungalembetsere, komanso zomwe muyenera kuyembekezera kuchokera kumakampani omwe amapereka mapulaniwa.

Kodi Medicare Advantage (Medicare Part C) ndi chiyani?

Medicare Advantage, yomwe imadziwikanso kuti Medicare Part C, ndi kufotokozera kwa Medicare komwe makampani ogulitsa inshuwaransi amagulitsa. Kuphatikiza pa kuphimba Medicare Gawo A ndi Gawo B, mapulani ambiri a Medicare Advantage amaphatikizaponso mankhwala akuchipatala, komanso mano, masomphenya, ndi kumva.

Ena mwa Medicare Part C amakonzekera ngakhale kuphimba zofunikira zathanzi monga ziwalo zolimbitsa thupi komanso ntchito zina zakuchipatala.

Mapulani ambiri a Medicare Advantage amakwaniritsa izi:

• chisamaliro cha kuchipatala
• chithandizo chamankhwala kuchipatala
• mankhwala osokoneza bongo
• mano, masomphenya, ndi chisamaliro chakumva
• zina zowonjezera zaumoyo

Madongosolo a Medicare Advantage atha kukhala njira yabwino kwa anthu omwe akufuna zowonjezera zowonjezera kupitilira Medicare magawo A ndi B ndipo onse amakhala pansi pa pulani imodzi.Medicare Part C ndichinthu chodziwika bwino kwa anthu omwe akufuna kusankha pazinthu zosiyanasiyana, monga ma HMO, ma PPO, ndi zina zambiri.

Pomaliza, afotokoza kuti Medicare Advantage itha kukupulumutsirani ndalama poyerekeza ndi Medicare yoyambirira mukafika pazida zamagetsi.

Ndani amagulitsa mapulani a Medicare Advantage?

Mapulani a Medicare Advantage amagulitsidwa ndi makampani ambiri akuluakulu a inshuwaransi, kuphatikizapo:

• Aetna Medicare
• Blue Cross Blue Shield
• Cigna
• Humana
• Kaiser Permanente
• SankhaniHealth
• UnitedHealthcare

Zopereka za Medicare Part C zimasiyana malinga ndi mayiko, ndipo kampani iliyonse ya inshuwaransi ili ndi ufulu wosankha ngati ingagulitse mapulani a Medicare Advantage chaka ndi chaka.

Mwachitsanzo, makampani ena atha kupereka mapulani m'malo osankhidwa ochepa koma mwa ena. Izi zikutanthauza kuti ngakhale mnzanu atalembetsa nawo mapulani a Medicare Advantage mdera lawo, malingaliro omwewo sangaperekedwe komwe mumakhala.

Ngati mukulandira kale ntchito kuchokera kwa wamkulu wa inshuwaransi kudzera kwa abwana anu, mutha kufikira ndikufunsa ngati akugulitsa mapulani a Medicare Advantage.

Njira inanso yowunikirira zopereka zanu zonse ndikugwiritsa ntchito chida chopezera dongosolo chomwe chimaperekedwa ndi Medicare. Chida ichi chimakupatsani mwayi wofufuza ndikuyerekeza mapulani a Medicare Advantage mumzinda wanu, boma, kapena ZIP code.

Kodi Medicare Advantage ndi ndalama zingati?

Mapulani a Medicare Advantage amaphatikizira ndalama zoyambirira za Medicare, komanso mtengo wapaderadera. Palibe mtengo umodzi wokha kulembetsa mu dongosolo la Medicare Advantage chifukwa pali zinthu zambiri zomwe zingakhudze zomwe mudzalipira.

Ndalama zonsezi zimakhudzidwa ndi dziko lomwe mumakhala, mtengo wamoyo wanu, ndalama zanu, komwe mumapita kukalandila chithandizo chamankhwala, momwe mumafunira ntchito kangati, komanso ngati mumalandira thandizo lililonse lazachuma.

Nayi kuwonongeka kwa zomwe mungayembekezere kulipira mu 2021 mukalembetsa mu dongosolo la Medicare Advantage:

• Zolipira. Ngati simukuyenera kulandira Gawo A lopanda premium, gawo lanu la Part A limatha kufika $ 471 pamwezi. Gawo la B B limadula $ 148.50 pamwezi kapena kupitilira apo, kutengera ndalama zomwe mumapeza. Malingaliro ena a Medicare Advantage amalipiritsa ndalama zoyambira pamwezi. Kuphatikiza apo, ngakhale mapulani ena a Medicare Advantage ndiopanda premium, ena amalipitsanso ndalama zoyambira pamwezi.
• Zodulidwa. Gawo A lili ndi ndalama zochotseredwa $ 1,484 panthawi yopindulitsa. Gawo B lili ndi ndalama zochotseredwa $ 203 pachaka. Ngati dongosolo lanu la Medicare Advantage limakhudza mankhwala omwe mumalandira, mungakhalenso ndi ngongole yothandizidwa ndi mankhwala.
• Zokopa. Dongosolo lililonse la Medicare Advantage lidzakhala ndi ndalama zokwanira zolipirira oyendera madokotala ndi akatswiri. Ndalamazi zimatha kusiyanasiyana kutengera dongosolo lanu komanso ngati mukulandira ntchito kuchokera kwa omwe ali mu netiweki kapena kunja kwa netiweki.
• Coinsurance. Gawo A chitsimikizo limatha ndalama zochepa $ 0 kapena $ 742 patsiku, kutengera kutalika kwa nthawi yomwe mukukhala kuchipatala. Gawo B ndalama zowonjezera ndi 20 peresenti ya chithandizo chamankhwala chovomerezeka ndi Medicare pambuyo poti deductible ikwaniritsidwa.

Malangizo posankha dongosolo la Medicare Advantage

Pofunafuna dongosolo labwino kwambiri la Medicare Advantage pazosowa zanu, ganizirani izi:

• mtundu wokhudzana ndi zomwe mukufuna, zomwe zingakhudze mtundu wamapulani omwe mungasankhe komanso mtundu wanji wa mapulani omwe mungafune
• kuchuluka kwa kusinthasintha komwe kumafuna, komwe kungakuthandizeni kudziwa mtundu wamapulani a Advantage omwe mungalembetse
• ndalama zomwe mumatha mwezi uliwonse pachaka komanso pachaka zomwe mungathe kuthana nazo, zomwe zimaphatikizapo ndalama zoyambira, zochotseredwa, ndalama zolipirira, ndalama zandalama, ndalama zamankhwala zomwe mumalandira, komanso kuchuluka kwakatundu
• mumafuna chisamaliro kangati komanso mtundu wanji wa chisamaliro chomwe mungafune, chomwe chingakuthandizeni kulembetsa dongosolo lomwe limakwaniritsa zosowa zanu zachuma komanso zamankhwala

Mutaganizira zinthu zonse zomwe zikukhudzana ndi vuto lanu, mutha kugwiritsa ntchito kupeza chida chadongosolo cha Medicare kuti mupeze dongosolo lenileni la Medicare Advantage lomwe lingakuthandizeni kwambiri.

Ndani ali woyenera mapulani a Medicare Advantage?

Aliyense amene adalembetsa ku Medicare Part A ndi Part B ali woyenera kulembetsa ku Medicare Advantage.

Mu 2021, anthu omwe ali ndi matenda opatsirana a endal (ESRD) ali oyenera kulembetsa mapulani osiyanasiyana a Medicare Advantage chifukwa cha lamulo lomwe Congress idapereka. Lamuloli lisanachitike, mapulani ambiri sangavomereze kapena kukuchepetsani ku Chronic Condition SNP (C-SNP) mukadapezeka ndi ESRD.

Nthawi zolembetsa ku Medicare

Mukakhala okonzeka kulembetsa dongosolo la Medicare Advantage, muyenera kuyang'anitsitsa masiku omaliza awa:

Kutenga

Makampani ambiri akuluakulu a inshuwaransi kuzungulira United States amagulitsa mapulani a Medicare Advantage. Mapulani a Medicare Part C sakhala okhazikika ndipo amasiyana mayiko ndi mayiko komanso pakati pa makampani.

Mukalembetsa ku Medicare Advantage, mutha kuyembekezera kulipira ndalama zonse zoyambirira za Medicare kuphatikiza mtengo uliwonse wa Medicare Advantage.

Musanalembetse ku Medicare Part C, onetsetsani kuti mukuwunikiranso zomwe muli nazo kuti musankhe njira yabwino pazosowa zanu zachuma komanso zamankhwala.

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.