California Medicare Zvirongwa muna 2021

Zvemukati

• Chii chinonzi Medicare?
• Chikamu A (inpatient uye chipatara kufukidzwa)
• Chikamu B (kunze kwekurapa uye kwekurapa kufukidza)
• Chikamu D (inonyorwa mishonga yekuvhara)
• Medicare Kubatsira
• Ndeapi maMedare Ekubatsira zvirongwa aripo muCalifornia?
• HMO
• PPO
• SNP
• Vanopa muCalifornia
• Ndiani anokodzera Medicare muCalifornia?
• Ndirini pandinogona kunyoresa muMedare muCalifornia?
• Pakutanga kufukidza kunyoresa nguva
• Nguva yesarudzo yegore negore
• Medicare Kubatsira kuvhura kunyoresa
• Kazhinji kunyoresa nguva
• Nguva dzakakosha dzekunyora
• Matipi ekunyoresa muMedare muCalifornia
• California Medicare zviwanikwa
• Hutano Inishuwarenzi Counselling & Advocacy Chirongwa (HICAP)
• Medicare
• Mushandi-anotsigirwa kufukidza
• Chii chandinofanira kuita zvinotevera?

Chii chinonzi Medicare?

Medicare inishuwarenzi yehutano inovhara kuvanhu vane makore makumi matanhatu nemashanu zvichikwira. Iwe unogona zvakare kuve unokodzera Medicare kana iwe uri pasi pemakore makumi matanhatu nemashanu ekuberekwa uye uri kurarama nehumwe hurema kana mamiriro ehutano.

Medicare inoronga muCalifornia inosanganisira:

• chepakutanga Medicare: chirongwa cheinishuwarenzi chehutano inofambiswa neCenters yeMedicare & Medicaid Services (CMS)
• Medicare Kubatsira: zvirongwa zvinopihwa kuburikidza nemakambani einishuwarenzi akazvimirira ayo anobvumirana neCMS
• Medicare mishonga yemishonga inorongwa: inishuwarenzi inoronga iyo inovhara mishonga yemishonga inodhura

Chikamu A (inpatient uye chipatara kufukidzwa)

Chikamu A chinofukidza kuchengetwa kwaunogashira iwe uchigara muzvipatara, zvakakosha kuwana zvipatara, uye imwe nguva shoma munzvimbo dzine hunyanzvi dzevanamukoti Vanhu vazhinji havabhadhare mari yemwedzi pamwedzi yezvikamu zvePart A, asi pane chinobviswa kana iwe uchigamuchirwa muchipatara.

Chikamu B (kunze kwekurapa uye kwekurapa kufukidza)

Chikamu B chinovhara kuchengetedza kunze kwechipatara kune zvinhu zvakaita se:

• kushanya kwavanachiremba
• kuongororwa kuongororwa
• lab miedzo
• midziyo yezvokurapa yakasimba

Iwe uchabhadhara imwezve yekuwedzera yezvikamu zveBato B. Maprimiyamu akaiswa neCMS uye anochinja gore rega rega zvichibva pamutengo wehutano wehutano.

Chikamu D (inonyorwa mishonga yekuvhara)

Wese munhu ari paMedare anokodzera (Chikamu D), asi iwe unofanirwa kuitora kuburikidza neyega inshuwarisi. Izvo zvakakosha kuenzanisa aya marongero nekuti mutengo uye kufukidza zvinosiyana.

Medicare Kubatsira

Medicare Advantage mapurani (Chikamu C) inopihwa kuburikidza neveinishuwarenzi vega avo vanounganidza kufukidzwa kwako kwese kwezvikamu A neB, uye dzimwe nguva kunyorerwa mishonga yemishonga, muchirongwa chimwechete Nezvirongwa zveMedicare Advantage, iwe uchiri kubhadhara iyo Medicare Chikamu B premium.

Medicare Advantage zvirongwa zvinofanirwa kufukidza zvakafanana zvinhu seMedicare zvikamu A uye B, asi vamwe vane yekuwedzera kufukidzwa (uye imwezve yekuwedzera) yezvinhu zvakaita se:

• mazino kana ekuona masevhisi
• kumba kwewiricheya ramps
• kuendesa kudya
• kutakurwa kuenda uye kubva kunzvimbo dzekurapa

Ndeapi maMedare Ekubatsira zvirongwa aripo muCalifornia?

MuCalifornia, Medicare Advantage zvirongwa zvinowira muzvikamu zvitatu: Hutano Hwekuchengetedza Masangano (HMOs), Vanosarudzwa Vanopa Masangano (PPOs), uye Special Needs Zvirongwa (SNPs).

HMO

Uine HMO, unosarudza chiremba wekutanga anotarisira kutarisira kwako uye anokuendesa kune nyanzvi sezvazvinodiwa. Mazhinji zvirongwa zvinoda kuti iwe uwane rubatsiro kubva kune vanopa mune iyo HMO network.

Kuchengetedza kunze kweiyo HMO network kazhinji haina kuvharwa kunze kwekunge kuri kurapwa kwekukurumidzira, kunze-kwenzvimbo kutarisirwa nekukurumidza, kana kunze kwenzvimbo dialysis.

Zvimwe zvirongwa zveHMO zvinoda kuti iwe utenge yakaparadzaniswa inovharirwa mishonga (Chikamu D).

Kuwanikwa kwezvirongwa zveHMO muCalifornia zvinosiyana nedunhu, uye hazviwanikwe kwese kwese.

PPO

Uine PPO, unogona kuwana rubatsiro kubva kunetiweki dzevanachiremba nenzvimbo dzinopa masevhisi akafukidzwa pasi pechirongwa chako.

Iwe unogona zvakare kuwana kutarisirwa kubva kune wekurapa kunze kwenetiweki yako, asi yako yekunze-kwehomwe mari inowanzo kuve yakakwira.

Mazhinji maPPO haadi kuendeswa kunoona nyanzvi.

California haina chero nyika yose Medicare Advantage PPO zvirongwa, asi makumi maviri nematatu madunhu ane emuno PPO zvirongwa zviripo.

SNP

SNPs inowanikwa kune vanhu vanoda nhanho yepamusoro yekutarisirwa kwakarongeka uye manejimendi ekuchengetedza. Unogona kukwanisa kuwana SNP kana iwe:

• vane chirwere chisingaperi kana chinoremadza, senge chirwere cheshuga kana kusingaperi kwemoyo kutadza
• vari "vaviri vanokodzera" kune vese Medicare neMedicaid
• kugara mumusha unochengeterwa vakwegura kana sisitimu yakafanana kana kugara pamba asi uwane chiyero chakafanana chekuchengetwa semumwe munhu mumusha unochengeterwa vakwegura

Vanopa muCalifornia

Aya makambani anopa Medicare Advantage zvirongwa muCalifornia:

• Aetna Medicare
• Kurongedza Hutano Hurongwa
• Nhetembo Bhuruu Muchinjikwa
• Bhuruu Muchinjikwa weCalifornia
• Zuva idzva
• Central Hutano Medicare Chirongwa
• Clever Kuchengeta Hutano Chirongwa
• Goridhe State
• Hutano Net Nharaunda Solutions, Inc.
• Hutano Net yeCalifornia
• Humana
• Imperial Hutano Chirongwa cheCalifornia, Inc.
• Kaiser Permanente
• Shandisa Health Plan
• UnitedHealthcare
• WellCare

Haasi ese anotakura anopa zvirongwa mudunhu rese, saka sarudzo dzauinadzo dzinosiyana zvichienderana nedunhu rako rekugara.

Ndiani anokodzera Medicare muCalifornia?

Vagari veCalifornia vanokodzera zvirongwa zveMedare uye zveMedare kana:

• uri mugari wemuUnited States kana mugari zviri pamutemo kwemakore mashanu apfuura kana anopfuura
• une makore makumi matanhatu nemashanu zvichikwira, uye iwe kana murume / mukadzi kana mukasangana nezvinodiwa zvebasa mune rinotsigirwa neMedare

Vanhu vari pasi pemakore makumi matanhatu nemashanu vanogona kukodzera kana:

• une hurema uye unogashira Social Security Disability Insurance (SSDI) kana Railroad Retirement Board kuremerwa kubhadhara
• une amyotrophic lateral sclerosis (ALS) kana yekupedzisira nhanho chirwere (ESRD)

Kana iwe uchiri nemibvunzo nezvekuti iwe unokodzera here, unogona kushandisa Medicare's online kukodzera chishandiso.

Ndirini pandinogona kunyoresa muMedare muCalifornia?

Pakutanga kufukidza kunyoresa nguva

Yekutanga yekuvhara nguva yekunyoresa (EIP) inguva yemwedzi minomwe inotanga mwedzi mitatu usati wasvika makore makumi matanhatu nemashanu ekuberekwa uye inopera mwedzi mitatu mushure mekusvitsa makore makumi matanhatu nemashanu ekuberekwa. Kana iwe ukanyoresa, kufukidza kwako kunotanga kwekutanga kwemwedzi iwe waunosvitsa makore makumi matanhatu nemashanu ekuberekwa.

Kana iwe ukanonoka kunyoresa kusvika pamwedzi kana kana mushure mekuzvarwa kwako, unogona kunge uine gap muinishuwarenzi yako yehutano.

Nguva yesarudzo yegore negore

Iwe unogona kunyoresa muMedicare Advantage zvirongwa pakati Gumiguru 15 naDecember 7 gore rega rega. Kuvhara kunotanga muna Ndira 1.

Medicare Kubatsira kuvhura kunyoresa

Kana iwe watove pachirongwa cheMedicare Advantage uye uchida kuchinjira kune imwe chirongwa cheMedare Kubatsira kana kuenda kune yekutanga Medicare, unogona kuzviita pakati Ndira 1 uye Kurume 31 gore rega rega.

Kazhinji kunyoresa nguva

Kunyoresa kwakawanda kuri pakati Ndira 1 uye Kurume 31 gore rega rega. Kana iwe uine Medicare Chikamu A uye uchida kunyoresa muChikamu B, chirongwa cheMedicare Advantage, kana chikamu cheD chikamu D unogona kuzviita panguva ino. Kuvhara kunoshanda Chikunguru 1.

Nguva dzakakosha dzekunyora

Nguva dzekunyoresa dzakasarudzika dzinokutendera kuti unyore kunze kwenguva dzakajairika dzekunyoresa pasi pemamiriro akakosha. Semuenzaniso, iyo yakakosha kunyoresa nguva inokutendera iwe kunyoresa muchirongwa chitsva pasina chirango kana iwe ukarasikirwa newaunoshandira-anotsigirwa inishuwarenzi chirongwa uye unoda kunyoresa muChikamu B, kana kubuda munzvimbo yako yazvino chirongwa chebasa nzvimbo.

Matipi ekunyoresa muMedare muCalifornia

Medicare uye Medicare Advantage zvirongwa muCalifornia zvinogona kuvhiringidza, saka usati wasaina zvakakosha kuongorora sarudzo dzako uye enzanisa zvinhu zvakaita se:

• mari
• kufukidza
• vanopa uye zvivakwa muhurongwa hwechirongwa
• CMS nyeredzi ratings yeChikamu C uye Chikamu D zvirongwa

Kana iwe uchida rubatsiro kuona kuti ndeapi marongero akanakira zvaunoda kana iwe uine mibvunzo nezvezviripo sarudzo, pane zvakawanda zviwanikwa zvekukubatsira iwe.

California Medicare zviwanikwa

Hutano Inishuwarenzi Counselling & Advocacy Chirongwa (HICAP)

Dhipatimendi reCalifornia reAging rinopa zano reMedare kuburikidza neHICAP. Vanopa:

• ruzivo rwekunyora kweMedare
• tsananguro dzeZvikamu A, B, uye C, uye maitiro ekuziva kuti ndechipi chinyorwa chaunoda
• mhinduro kumibvunzo nezve Chikamu D chinyoreso chinodhakwa chinodhaka, mutengo, uye kukodzera

HICAP yakavanzika uye yemahara kune chero munhu anokodzera Medicare kana kuda kuve anokodzera. Unogona kutsvaga emuno HICAP masevhisi nedunhu kana kufona 800-434-0222.

Medicare

Bata Medicare zvakananga kuti ubatsirwe nekunyoresa kana kuronga mibvunzo nekufona 800-MEDICARE (800-633-4227) kana kushanyira Medicare.gov. Iwe unogona zvakare kufonera renharaunda yeCMS hofisi muSan Francisco pa 415-744-3501.

Mushandi-anotsigirwa kufukidza

Kana uine zvauri kunetseka kana uchida kubatsirwa neMedare California kufukidzwa kunotengwa kuburikidza nemushandirwi, bata California Dhipatimendi reManaged Health Care pa888-466-2219 kana email [email protected].

Chii chandinofanira kuita zvinotevera?

Paunenge wagadzirira kusaina Medicare muCalifornia:

• sarudza kuti ndeipi kufukidza iwe yaunoda uye tsvaga aripo marongero, sarudzo dzekuvhara, uye mutengo
• bata HICAP kana Medicare kana iwe uine mibvunzo nezve kukodzera kana kufukidzwa
• tsvaga kuti rinotevera rinyore nguva

Ichi chinyorwa chakagadziridzwa muna Gumiguru 5, 2020 kuratidza 2021 Medicare ruzivo.

Ruzivo ruri pane ino webhusaiti runogona kukubatsira mukuita sarudzo pachako nezve inishuwarenzi, asi haina kuitirwa kupa zano maererano nekutenga kana kushandiswa kweinishuwarenzi kana zvigadzirwa zveinishuwarenzi. Healthline Media haifambise bhizinesi reinishuwarenzi munzira ipi neipi uye haina kupihwa rezenisi sekambani yeinishuwarenzi kana mugadziri mune chero hutongi hweU.S. Healthline Media haina kukurudzira kana kutsigira chero mapato echitatu anogona kuita bhizinesi reinishuwarenzi.