Ndeipi NdeYakanakisa Medicare Kubatsira Kuronga Iwe?

Zvemukati

• Nzira dzokusarudza rakanakisa chirongwa chezvaunoda
• Tsvagurudzo yeCMS nyeredzi ratings
• Ziva zvaunokoshesa
• Sarudza zvido zvako zvehutano zvakasarudzika
• Kurukurai kuti mungakwanise kubhadhara marii
• Wongorora zvimwe zvakanaka zvaungave uinazvo kare
• Funga kusaina kuMedicare Chikamu D kutanga
• Kutora

Kana iwe uchitsvaga uchitenderedza chirongwa cheMedicare Advantage gore rino, unogona kunge uchishamisika kuti nderipi zano rakanakira iwe. Izvi zvinoenderana nemamiriro ako ega, zvido zvekurapa, marii yaunokwanisa kutenga, uye zvimwe zvinhu.

Kune maturusi anowanikwa ekukubatsira iwe kuti uwane zvirongwa zveMedare zvinobatsira munzvimbo yako zvinogona kuzadzisa zvese zvaunoda zvehutano.

Ichi chinyorwa chichaongorora maitiro ekuona rakanakisa Medicare Advantage chirongwa cheako mamiriro, pamwe nemazano ekuti unganyore sei muMedicare.

Nzira dzokusarudza rakanakisa chirongwa chezvaunoda

Nezvese shanduko dziri kuitwa kune iyo Medicare zvirongwa pamusika, zvingave zvakaoma kudzikisira pasi rakanakisa chirongwa chako. Hezvino zvinhu zvishoma zvekutarisa muhurongwa hweMedicare Advantage:

• mari inokodzera bhajeti yako uye zvaunoda
• rondedzero ye-in-network vanopa iyo inosanganisira chero chiremba (s) waungade kuchengeta
• kufukidza kwemasevhisi nemishonga yaunoziva iwe yauchazoda
• CMS nyeredzi chiyero

Verenga pamusoro kuti udzidze zvimwe zvaungafunge nezvazvo pakutenga zvirongwa zveMedicare Advantage munzvimbo yako.

Tsvagurudzo yeCMS nyeredzi ratings

Iwo maCentre eMedicare & Medicaid Services (CMS) akashandisa mashanu-Nyeredzi Kuyera Sisitimu kuyera mhando yehutano nemishonga yemishonga inopihwa neMedare Chikamu C (Kubatsira) uye Chikamu D (chirongwa chemushonga). Gore rega rega, iyo CMS inoburitsa idzi nyeredzi ratings uye yakawedzera data kune veruzhinji.

Medicare Kubatsira uye Chikamu D zvirongwa zvinoyerwa nezvakasiyana zvinhu, zvinosanganisira:

• kuwanikwa kwehutano kuongororwa, kuongororwa, uye majekiseni
• manejimendi ehupenyu husingaperi mamiriro
• chiitiko chenhengo nechirongwa chehutano
• kuronga mashandiro uye zvichemo zvemitezo
• kuwanikwa kwevatengi uye ruzivo
• mutengo wemishonga, chengetedzo, uye kurongeka

Imwe neimwe Medicare Chikamu C uye D chirongwa chinopihwa chiyero chechimwe nechimwe chezvikamu izvi, imwe chete nyeredzi chiyero cheChikamu C uye D, uye huwandu hwehurongwa.

Kuyerwa kweCMS kunogona kuva nzvimbo yakanaka yekutanga kana uchitenga kutenderedza kune yakanakisa chirongwa cheMedare Kubatsira mudunhu rako. Funga nezvekutsvaga izvi zvirongwa kuti uwane rumwe ruzivo nezve chii kufukidzwa kunosanganisirwa uye kuti zvinoda marii.

Kuti uone zvese zviripo Medicare Chikamu C uye D 2019 nyeredzi ratings, shanyira CMS.gov uye utore iyo 2019 Chikamu C uye D Medicare Star Ratings Dhata.

Ziva zvaunokoshesa

Zvirongwa zvese zveMedare zvinobatsira zvinovhara zvinovharwa neMedicare zvekutanga - izvi zvinosanganisira kufukidza kuchipatara (Chikamu A) uye nekurapwa (Chikamu B).

Paunosarudza chirongwa cheMedicare Advantage, iwe unotanga kufunga nezvekuti ndeupi rudzi rwekuvhara kwaunoda kuwedzera mukufukidzwa pamusoro.

Mazhinji zvirongwa zveMedare zvinobatsira zvinopa imwe, kana isiri yese, yeaya mamwe marudzi ekufukidza:

• kunyorerwa zvinodhaka
• kuvhara mazino, kusanganisira bvunzo dzegore uye maitiro
• kufukidzwa kwechiono, kusanganisira bvunzo dzegore uye zvigadzirwa zvekuona
• kufukidzwa kwekunzwa, kusanganisira bvunzo nemidziyo yekunzwa
• kugwinya nhengo
• kutakura kwekurapa
• zvimwe zvekuchengetedza hutano

Kutsvaga iyo yakanakisa Medicare Kubatsira chirongwa kunoreva kugadzira cheki rondedzero yemasevhisi aunoda kugashira kufukidzwa. Iwe unogona ipapo kutora yako yekuvhara yekutarisa kune iyo Tsvaga iyo Medicare 2020 Chirongwa chishandiso uye enzanisa zvirongwa zvinofukidza izvo zvaunoda.

Kana iwe ukawana chirongwa chinotaridzika kunge chakanakira iwe, usatya kutyaidzira kambani kuti ibvunze kana ivo vachipa chero chekuwedzera kufukidza kana zvigadzirwa.

Sarudza zvido zvako zvehutano zvakasarudzika

Pamusoro pekuziva izvo zvaunoda muhurongwa hwekuchengetedza hutano, zvakakoshawo kuti uone zvaunoda kune yako yenguva-refu zvehutano zvinodiwa.

Kana iwe uine chirwere chisingaperi kana kufamba kazhinji, izvi zvinhu zvinogona kutamba chinzvimbo murudzi rwehurongwa hwauchazoda. Zvirongwa zvakasiyana zvinopa mabhenefiti akasiyana zvichienderana nemamiriro ako pachako.

Mukati meiyo CMS ratidziro system, iwe unogona kuwana kuti ndeapi marongero akayerwa zvakanyanya kune akasiyana ehupenyu husingaperi mamiriro. Zvirongwa zvinoyerwa pahunhu hwavo hwekuchengeta osteoporosis, chirwere cheshuga, shuga yakakwira muropa, BP, chirwere cheitsvo, rheumatoid arthritis, mamiriro echiropa, nekuchengetwa kwevanhu vakuru (kudonha, mishonga, kurwadziwa kusingaperi).

Rudzi rweMedicare Advantage chirongwa chauinacho chakakoshawo. Kune mashanu marudzi ezvirongwa zvehurongwa iwe zvaunoda kufunga kana uchitsvaga chirongwa:

• Hutano Kuchengetedza Sangano (HMO) zvirongwa. Aya marongero anotarisana zvakanyanya mu-network hutano hutano mabasa.
• Anosarudzika Provider Sangano (PPO) zvirongwa. Aya marongero anobhadharisa mitero yakasiyana zvichienderana nekuti masevhisi ari mumambure kana kunze kwenetiweki. ("Netiweki" iboka revapi vanoita chibvumirano chekupa masevhisi kukambani yeinishuwarenzi uye kuronga.) Izvi zvinogona kupa dzimwe nzira dzekutambira kunze kwe-network.
• Yakavanzika Mari-yeBasa (PFFS)zvirongwa. Aya marongero anotendera iwe kuti ugamuchire rubatsiro kubva kune chero Medicare anotenderwa mupi uyo achagamuchira iyo yakatenderwa mari kubva kuchirongwa chako.
• Zvirongwa Zvakakosha Zvezvinodiwa (SNP). Aya marongero anopa rumwe rubatsiro kune zvekurapa zvinodhura zvine hukama neakasarudzika mamiriro ehutano.
• Medicare Medical Kuchengetedza Akaunti (MSA)zvirongwa. Aya marongero anosanganisa chirongwa chehutano icho chine yakakwira inodonhedzwa neyekurapa yekuchengetedza account.

Chirongwa chega chega chinopa sarudzo kuti uwane zvido zvako zvehutano. Kana iwe uine mamiriro ehutano husingaperi, SNPs yakagadzirirwa kubatsira kudzikisira imwe yemitengo yenguva refu. Kune rimwe divi, chirongwa che PFFS kana MSA chinogona kubatsira kana iwe uchifamba uye uchida kuona vekunze-ve-network vanopa.

Kurukurai kuti mungakwanise kubhadhara marii

Chimwe chezvinhu zvakakosha zvekutarisa kana uchisarudza chakanakisa chirongwa cheMedare Kubatsira ndechekuti ingakudhurira zvakadii. Iyo Tsvaga iyo Medicare Chirongwa chishandiso inonyora inotevera mutengo ruzivo nezvirongwa:

• mwedzi wepamberi
• Chikamu B chekutanga
• mu-network gore rega rinobviswa
• mushonga unobviswa
• mukati- nekunze-kwe-network kunze-kwehomwe max
• copays uye coinsurance

Mari idzi dzinogona kubva pamadhora 0 kusvika pamadhora chiuru nemazana mashanu uye pamusoro, zvinoenderana nedunhu repamba, mhando yechirongwa, uye chirongwa chinobatsira.

Kuti uwane yekutanga fungidziro yemari yako yegore, funga iyo premium, inobviswa, uye kunze-kwehomwe max.Chero ipi inobviswa yakanyorwa ndiyo huwandu hwauchakwereta kunze-kwehomwe inishuwarenzi yako isati yatanga kubhadhara. Chero chekunze-kwehomwe max chakanyorwa ndiyo yakanyanya mari iyo yauchabhadhara masevhisi mukati megore.

Paunenge uchifungidzira yako Yakanakira hurongwa hwehurongwa, funga izvi zvinodhura uye kangani iwe zvauchazadza kuzadza mishonga yemishonga kana kushanyira hofisi.

Kana iwe uchida nyanzvi kana kunze-kwe-network kushanya, sanganisira izvo zvingangoita mari mukufungidzira kwako futi. Usakanganwa kufunga kuti yako mari inogona kunge yakaderera kana iwe uchigamuchira chero rubatsiro rwemari kubva kuhurumende.

Wongorora zvimwe zvakanaka zvaungave uinazvo kare

Kana iwe uchinge watogashira mamwe marudzi ebatsiro ehutano, izvi zvinogona kukonzeresa kuti ndeupi rudzi rweMedicare Advantage chirongwa chauchazoda.

Semuenzaniso, kana iwe watogamuchira iyo yekutanga Medicare uye wakasarudza kuwedzera Chikamu D kana Medigap, zvakawanda zvako zvaunoda zvinogona kunge zvatovharwa.

Zvisinei, iwe unogona kugara uchiita kufukidza kufukidza kuti uone kana chirongwa cheMedicare Chakanakira chinga shande zvirinani kana kuve chinodhura kwauri.

Maitiro ekunyoresa eMedare anogona kutanga kutanga mwedzi mitatu usati iwe kana mudiwa wako atendeuka makore makumi matanhatu nemashanu ekuberekwa. Ino inguva yakanakisa yekunyorera, sezvo ichave ichisimbisa kuti iwe unogashira kufukidzwa neako makumi matanhatu neshanu^th bhavhdhe.

Iwe unogona kumirira kunyorera Medicare kusvikira mwedzi wemakumi matanhatu neshanu^th zuva rekuzvarwa kana mwedzi mitatu inotevera zuva rekuzvarwa kwako. Nekudaro, kufukidza kunogona kunonoka kana iwe ukamirira, saka edza kunyorera kutanga.

Heano mamwe akakosha ekukumbira ruzivo iwe auchazofanira kuve nawo parutivi kunyorera Medicare:

• nzvimbo uye zuva rekuzvarwa
• Nhamba yeMedicaid
• yazvino inishuwarenzi yehutano

Paunenge uchinge uine ruzivo rwakakodzera rwanyorwa pamusoro, enda kumusoro kune webhusaiti reSocial Security kuti unyore. Kamwe kana iwe kana chako cheMedicare chikumbiro chikagadziriswa uye chichigamuchirwa, unogona kutanga kutenga uchitenderedza chirongwa cheMedicare Advantage kuti chienderane nezvaunoda.

Funga kusaina kuMedicare Chikamu D kutanga

Chinhu chakakosha kucherechedza ndechekuti kana iwe watove wakanyoreswa muMedare zvikamu A uye B asi usina kunyoreswa muChikamu C, Chikamu D, kana imwewo mishonga yekunyorera zvinodhaka, unogona kusangana nechirango chekunonoka kunonoka.

Iyi chirango inorova mukati kana iwe usina kunyoreswa mukati memazuva makumi matanhatu nematanhatu ekutanga kwako kunyoresa nguva. Kunyoresa uku kunowanzo kuve makore ako makumi matanhatu nemashanu ekuberekwa, asi zvinogona kunge zvakatangira kare kana uri pahurema kana ukasangana nezvimwe zvinodiwa.

Kana iwe ukatambira iyo yekupedzisira chirango, inozoiswa kune yako Chikamu D yemwedzi weprimiyamu zvachose.

Kana iwe uchinetseka kuwana chikamu Chikamu C, usamirira kuti utenge kufukidza Chikamu D, kana kuti unoisa panjodzi yekuve nechirango chePlan D zvachose.

Kutora

Pane zvakawanda zvinhu zvinogona kukanganisa iyo Medicare Advantage chirongwa chaunosarudza. Funga nezve iyo CMS nyeredzi ratidziro, zvaunokoshesa uye zvehutano zvido, kuti yakawanda sei iwe yaunokwanisa kutenga, uye rudzii rweinishuwarenzi yauinayo izvozvi.

Zvakakosha kunyoresa muMedare usati wasvitsa makore makumi matanhatu nemashanu kuti uve nechokwadi chekuti hauendi pasina kufukidzwa kwekurapa. Usakanganwa kuti iwe une simba rekutenga uchitenderedza kuti uwane hwakanakisa chirongwa cheMedicare Advantage chinokwana zvese zvaunoda.

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.