Kodi ndichifukwa chiyani ma Medicare Advantage Plans ndi aulere?

Zamkati

• Kodi Medicare Advantage ndi chiyani?
• Nchiyani chomwe chimaphimbidwa mu mapulani 'aulere'?
• Kodi ndi 'zaulere'?
• Ndondomeko ya phindu pamwezi uliwonse
• Gawo B mwezi uliwonse
• Zodulidwa
• Coinsurance / zopereka
• Mtundu wa mapulani
• Kodi mtengo wa Medicare ndi chiyani?
• Medicare Gawo A
• Medicare Gawo B
• Zosankha zina
• Kodi mukuyenera kulandira Medicare?
• Kodi mukuyenererana ndi mapulani a'ulere '?
• Kutenga

Ngati mwakhala mukugula malonda posachedwa panjira ya Medicare Advantage, mwina mwazindikira kuti zina mwazinthuzi zimalengezedwa kuti ndi "zaulere."

Malingaliro ena a Advantage amatchedwa aulere chifukwa amapereka $ 0 pamwezi pamwezi kuti alembetsedwe. Izi zimapangitsa zero premium Medicare Advantage kukonzekera zopereka zabwino kwa iwo omwe akufuna kupulumutsa ndalama pamwezi pamtengo wa Medicare.

Nkhaniyi ifufuza momwe mapulani a Medicare Advantage aulere awa akukhudzira, ndi zina zotani zomwe mungakumane nazo, ndi omwe ali oyenera kulandira pulogalamu yaulere ya Medicare Part C.

Kodi Medicare Advantage ndi chiyani?

Medicare Advantage, yotchedwanso Medicare Part C, imaperekedwa ndi makampani a inshuwaransi apadera kwa anthu oyenerera omwe akufuna zochulukirapo kuposa Medicare Original.

Mapulani a Medicare Advantage amapereka zofunikira zotsatirazi:

• Kupezeka kwachipatala (Medicare Part A). Izi zimakhudza ntchito zokhudzana ndi zipatala, chithandizo chamankhwala kunyumba, chisamaliro cha okalamba, ndi chisamaliro cha odwala.
• Kuphunzira zamankhwala (Medicare Part B). Izi zimakhudza kupewa, kuzindikira, komanso kuchiza matenda.

Mapulani ambiri a Advantage amakhudzanso zosowa zina zamankhwala, monga:

• Kuphunzira mankhwala osokoneza bongo
• mano, masomphenya, ndi kumva kumva
• kulimbitsa thupi
• zina zaumoyo

Mukasankha dongosolo la Medicare Advantage kuchokera ku kampani yabizinesi, pali njira zingapo zomwe mungasankhe. Zambiri Zopindulitsa ndi izi:

• Mapulani a Health Maintenance Organisation (HMO). Izi zimafotokoza ntchito kuchokera kwa omwe ali ndi intaneti komanso omwe amapereka okha.
• Mapulani a Preferred Provider Organisation (PPO). Izi zimalipira mitengo yosiyanasiyana yama intaneti ndi ma network.

Palinso mapulani ena atatu a mapulani a Medicare Part C:

• Ndondomeko za Fizi-for-Service (PFFS). Awa ndi mapulani apadera olipirira omwe amapereka chithandizo chosavuta cha omwe amapereka.
• Mapulani a Zosowa Zapadera (SNP). Izi ndizo njira zothandizira anthu omwe ali ndi matenda a nthawi yaitali.
• Mapulani a Medicare Medical Savings Account (MSA). Mapulaniwa amaphatikiza dongosolo labwino la kuchotsera ndi akaunti yosungira zamankhwala.

Nchiyani chomwe chimaphimbidwa mu mapulani 'aulere'?

Mapulani aulere a Medicare Advantage ndi mapulani a Medicare Part C omwe amapereka $ 0 pachaka.

Poyerekeza ndi mapulani ena a Medicare, mapulani awa a zero premium Medicare Advantage salipira ndalama pachaka kuti alembetsedwe.

Palibe kusiyana kulikonse pakubisa pakati pa pulani yaulere ndi pulani yolipira. Mosasamala mtengo, madongosolo ambiri a Medicare Part C amapereka magawo A ndi B, mankhwala akuchipatala, ndi zina zowonjezera.

Ndiye, ndichifukwa chiyani makampani amapereka mapulani a zero premium Medicare? Kampani ikamachita mgwirizano ndi Medicare, imapatsidwa ndalama zokwanira kulipirira inshuwaransi ya A ndi B.

Ngati kampaniyo ikhoza kusunga ndalama kwina kulikonse, monga kugwiritsa ntchito ma netiweki apaintaneti, itha kupereka ndalama zowonjezerazo kwa mamembala. Izi zitha kubweretsa kukulitsa kwaulere pamwezi.

Mapulani aulere awa a Medicare Advantage ndi njira yothandizanso kuti makampani alengeze zosungitsa zokongola kwa omwe atha kupindula nawo.

Kodi ndi 'zaulere'?

Ngakhale mapulani a zero premium Medicare Advantage amagulitsidwa ngati aulere, mudzafunikirabe kulipira ndalama zakuthumba kuti mulipirire.

Ndondomeko ya phindu pamwezi uliwonse

Ngati dongosolo la Medicare Advantage ndi laulere, simuyenera kulipira ndalama pamwezi kuti mulembetsedwe.

Gawo B mwezi uliwonse

Mapulogalamu ambiri a Medicare Advantage amalipirabe gawo lililonse mwezi uliwonse Gawo B. Zolinga zina zimalipira ndalamazi, koma ena sangatero.

Gawo B pamwezi woyamba umayamba pa $ 135.50, kapena kupitilira kutengera zomwe mumapeza.

Zodulidwa

Pali mitundu iwiri ya zotulutsidwa pachaka zomwe zimagwirizanitsidwa ndi mapulani ambiri a Medicare Advantage:

• Dongosolo lokha limatha kuchotsedwa pachaka, zomwe ndi ndalama zomwe mumalipira musanapereke inshuwaransi yanu.
• Dongosololi lingakulipitseninso mankhwala ochotsera mankhwala.

Coinsurance / zopereka

Mapulogalamu ambiri a Medicare Advantage amalipiritsa ndalama zolipirira alendo. Ndalama zolipirira ndi ndalama zomwe mumalipira mthumba mukalandira chithandizo chamankhwala.

Zina mwazinthu zingathenso kulipiritsa ndalama. Izi ndi kuchuluka kwa ndalama zonse zomwe mumayenera kulipira.

Mtundu wa mapulani

Madongosolo a Medicare Advantage amathanso kusiyanasiyana pamitengo kutengera kapangidwe kake. Mwachitsanzo, mapulani a PPO amalipiritsa ndalama zingapo zolipira kutengera ngati omwe amakupatsani ali mu netiweki kapena kunja kwa netiweki.

Izi zimatha kusiyanasiyana chaka ndi chaka. Mwachitsanzo, mapulani a PFFS akumana ndi kuwonjezeka kocheperako kwakuchepa kwa ndalama chaka chilichonse pazaka zingapo zapitazi.

Kodi mtengo wa Medicare ndi chiyani?

Medicare si inshuwaransi yaulere yaulere. Pali zolipira zambiri zomwe zimakhudzana ndi kufalitsa kwa Medicare.

Musanalembetse dongosolo la Medicare Advantage, muyenera kukhala ndi magawo a Medicare ndi B. Pansipa mupeza mtengo wogwirizana ndi mapulani amenewo.

Medicare Gawo A

Medicare Part A imalipira ndalama pamwezi, zomwe zimatha kuyambira $ 240 mpaka $ 437. Komabe, anthu ambiri samasulidwa pamalipiro awa.

Ngati mudalipira misonkho ya Medicare pomwe mukugwira ntchito kapena kulandira (kapena mukuyenera) Social Security kapena mapindu opuma pantchito njanji, mwina simukhululukidwa.

Medicare Part A imaperekanso ndalama zokwana $ 1,364 zochotseredwa panthawi iliyonse yopindulitsa kuphatikiza ndalama zolipirira ndalama, zomwe zimayambira $ 341 mpaka $ 682-kuphatikiza.

Medicare Gawo B

Medicare Part B imalipira $ 135.50 kapena kupitilira mwezi pamwezi, kutengera ndalama zomwe mumapeza pachaka. Muyenera kukhala ndi ngongole ya Part B iyi ngati gawo la pulogalamu yanu yaulere ya Medicare Advantage pokhapokha itakonzedwa.

Medicare Part B imalipitsanso $ 185 yochotseredwa pachaka, pambuyo pake mudzakhala ndi ngongole ya 20% yothandizira pantchito zonse.

Zosankha zina

Ngati mungasankhe kulembetsa nawo pulogalamu yothandizira ya Medicare ngati Medicare Part D kapena Medigap ngati njira ina ya Medicare Advantage, mudzakhala ndi ngongole ya mwezi ndi mwezi komanso zolipira zina zokhudzana ndi mapulaniwa.

Ndalama za Medicare Part D ndi Medigap zimatsimikizika ndi dongosolo lomwe mungasankhe.

Mosiyana ndi kuchuluka kwa ndalama zomwe muli nazo zomwe zili ndi pulani ya Medicare Advantage, palibe malire pamtengo wotuluka muthumba womwe mungalipire ku Medicare magawo A, B, D, kapena Medigap.

Kodi mukuyenera kulandira Medicare?

Mukuyenera kulandira Medicare potsatira izi:

• Ndinu wazaka 65 kapena kupitirira. Anthu onse aku America 65 kapena kupitilira apo ali oyenera kulandira Medicare. Mutha kulembetsa ku Medicare mpaka miyezi itatu musanathe zaka 65.
• Muli ndi chilema. Ngakhale mutakwanitsa zaka 65, ndiye kuti mukuyenera kulandira Medicare mukalandira ndalama zothandizidwa ndi Social Security. Social Security imapereka maubwino olumala pamitundu pafupifupi 14 ya olumala.
• Muli ndi ALS. Ngati muli ndi ALS ndipo mukulandira phindu lolemala, ndiye kuti ndinu oyenera kulandira Medicare.
• Mutha kudwala matenda aimpso. Ngati mukulephera impso, mukuyenera kulandira Medicare. Komabe, nkofunika kuzindikira kuti anthu omwe ali ndi vutoli sakuyenera kupititsa patsogolo dongosolo la Medicare Advantage.

Njira zina, monga kulandira maubwino olumala kwa miyezi 24, zingakulembetseni ku Medicare pa mwezi wa 25. Ngati ndi choncho, simuyenera kulembetsa nawo gawo la Medicare A ndi B.

Komabe, ngati mukuyenera kulandira Medicare koma osangolembetsa zokha, muyenera kulembetsa patsamba la Social Security.

Kodi mukuyenererana ndi mapulani a'ulere '?

Palibe ziyeneretso za mapulani aulere a Medicare Advantage. Mapulani ambiri a Advantage amapereka kwaulere pamwezi pamwezi monga gawo la maperekedwe awo azaumoyo.

Mutha kupeza mapulani a Medicare Part C mdera lanu ndi $ 0 premium pogwiritsa ntchito Medicare.gov's Pezani chida cha 2020 Medicare.

Pakusaka kwanu, mutha kugwiritsa ntchito "Sort mapulani ndi: Ochepa kwambiri pamwezi" kuti muwone mapulani a zero premium Medicare Advantage mdera lanu.

Njira imodzi yofunika kwambiri yosungitsira mtengo wanu wa Medicare ndikugwiritsa ntchito zomwe zilipo kuti zikuthandizireni kapena kuchepetsa mtengo wanu. Izi ndi monga:

• Mankhwala. Pulogalamuyi yathandizira kulipira ndalama zamankhwala kuposa anthu omwe amalandila ndalama zochepa kapena alibe ndalama zolipira kuchipatala.
• Mapulogalamu Osungira Mankhwala. Mapulogalamuwa atha kuthandiza omwe amalandila ndalama zochepa kuti azilipira chindapusa cha Medicare Advantage, zochotseredwa, zolipiritsa, komanso chitsimikizo cha ndalama.
• Zowonjezera Chitetezo Chachikhalidwe. Izi zimapatsa anthu olumala, akhungu, kapena opitilira 65 kulipira mwezi uliwonse, zomwe zingathandize kulipira ndalama za Medicare.
• Zowonjezera zowonjezera. Palinso mapulogalamu ena omwe atha kuthandiza anthu omwe amakhala m'malo ena aku U.S. kapena omwe amamwa ndalama zambiri pamankhwala osokoneza bongo.

Njira yina yosungira ndalama zanu za Medicare Advantage ndikumvetsera Umboni Wokhutira ndi Chidziwitso Chachaka cha Zosintha zomwe dongosolo lanu limakutumizirani chaka chilichonse. Izi zikuthandizani kuti mukhale pamwamba pazosintha mitengo iliyonse kapena zolipiritsa.

Kutenga

Mapulani aulere a Medicare Advantage ndi mapulani a inshuwaransi a Medicare omwe amapereka $ 0 pamwezi pamwezi.

Ngakhale mapulaniwa amalengezedwa ngati aulere, mufunikirabe kulipira ndalama zotulutsira mthumba za ma premiums ena, zochotseredwa, ndi zopereka.

Ngati mukuyenerera Medicare ndipo mwalembetsa mu gawo A ndi B, mutha kugwiritsa ntchito Chida cha 2020 Medicare kuti mufufuze mapulani a zero premium Medicare Advantage mdera lanu.

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.