Ke mefuta efe e fapaneng ea Medicare?
Litaba
- Medicare Karolo ea A ke eng?
- Medicare Karolo ea B ke eng?
- Medicare Part C (Medicare Advantage) ke eng?
- Medicare Karolo ea D ke eng?
- Medicare ea tlatsetso ea inshorense (Medigap) ke eng?
- Tsela
- Koahelo ea Medicare e arotsoe likarolo tse 'maloa tseo e' ngoe le e 'ngoe e koahelang karolo e fapaneng ea tlhokomelo.
- Karolo ea Medicare Karolo ea A e akaretsa tlhokomelo ea bakuli ba kenang malapeng 'me hangata ha e lefelloe.
- Medicare Karolo ea B e akaretsa tlhokomelo ea bakuli ba kantle ho naha ebile e na le moputso o thehiloeng ho chelete.
- Medicare Karolo ea C (Medicare Advantage) ke sehlahisoa sa poraefete sa inshorense se kopanyang likarolo tsa A le B le melemo e meng.
- Medicare Karolo ea D ke sehlahisoa sa poraefete sa inshorense se koahelang litlhare tsa ngaka.
Medicare e fana ka tšireletso ea bophelo bo botle ho batho ba ka holimo ho lilemo tse 65 le ba nang le bokooa kapa maemo a itseng a bophelo bo botle. Lenaneo lena le rarahaneng le na le likarolo tse ngata, mme le kenyelletsa mmuso oa koporasi le ba inshorense ba ikemetseng ba sebetsang 'moho ho fana ka lits'ebeletso le lihlahisoa tse fapaneng.
Original Medicare e entsoe ka likarolo tsa A le B. Ts'oaetso ena e u lumella ho ea ho lingaka le lits'ebeletso tse amohelang Medicare ntle le ho fumana tumello kapa tumello pele ho moralo oa hau. Li-premium le li-copayments lia sebetsa, empa hangata li thehiloe holima chelete mme li ka fuoa thuso.
Merero ea Medicare Advantage (Karolo ea C) ke merero ea inshorense ea poraefete. Merero ena e kopanya likarolo tse ngata tsa Medicare, joalo ka likarolo tsa A le B, le lits'ebeletso tse ling, joalo ka lengolo la ngaka, meno le ho koahela pono. Ba fana ka lits'ebeletso tse ngata, empa ba kanna ba bitsa chelete e ngata mme ba tla le lithibelo tsa marang-rang.
Le ha likhetho tse ngata tsa Medicare li u fa phetoho maemong a hau a tlhokomelo ea bophelo bo botle, ho boetse ho bolela hore o tlameha ho tsamaea le ho utloisisa tlhaiso-leseling e ngata.
Bala ho bala ka botlalo ka likarolo tse fapaneng tsa Medicare le hore na li ka u thusa joang.
Medicare Karolo ea A ke eng?
Medicare Karolo ea A ke karolo ea Medicare ea mantlha e koahelang litšenyehelo tsa sepetlele le tlhokomelo e 'ngoe ea bakuli. Batho ba bangata ha ba lefe sekhahla sa khoeli le khoeli bakeng sa Karolo ea A hobane ba lefelletse lenaneo ka lekhetho nakong ea lilemo tsa bona tsa ho sebetsa.
Ka ho khetheha, Karolo ea A ea Medicare e tla akaretsa:
- ho lula sepetlele
- ho lula nakoana setsing sa booki se nang le boiphihlelo
- lula sepetlele sa tlhokomelo ea nako e telele
- tlhokomelo ea lehae la maqheku e seng ea nako e telele kapa ea tlhokomelo
- tlhokomelo ea bakuli
- Tlhokomelo ea bophelo ba nakoana malapeng
Ho etsa bonnete ba hore Medicare e koahela nako ea hau ea bolulo, o tlameha ho:
- ba le taelo ea semmuso e tsoang ho ngaka e bolelang hore o hloka tlhokomelo ea bokuli kapa kotsi
- etsa bonnete ba hore setsi se amohela Medicare
- netefatsa hore o na le matsatsi a setseng nakong ea melemo ea hau ea ho a sebelisa (bakeng sa bolulo bo nang le tsebo ba baoki)
- netefatsa hore Medicare le setsi se amohela lebaka la ho lula ha hao
Tlas'a Medicare Karolo ea A, u ka lebella ho lefa litšenyehelo tse latelang ka 2021:
- ha ho na tefo haeba u sebelitse bonyane likotara tse 40 (lilemo tse 10) bophelong ba hau 'me u lefa makhetho a Medicare (u tla lefa ho fihlela ho $ 471 ka khoeli haeba u sebelitse ka tlase ho likotara tse 40)
- $ 1,484 e theoleloang nako ka 'ngoe ea melemo
- Litsenyehelo tsa letsatsi le letsatsi tsa lichelete tsa ts'epo li ipapisitse le bolelele ba nako ea ho lula sepetlele: $ 0 matsatsi a 1 ho isa ho 60, $ 371 ka letsatsi matsatsi a 61 ho isa ho 90, le $ 742 ka letsatsi matsatsi a 91 le ho feta
- Litsenyehelo tsohle haeba u le sepetlele matsatsi a fetang 90 ka nako e le 'ngoe ea melemo' me u se u fetile matsatsi a 60 ao u a bolokileng a bophelo bohle
Medicare Karolo ea B ke eng?
Medicare Karolo ea B ke karolo ea Medicare ea mantlha e koahelang litšenyehelo tsa tlhokomelo ea hau ea bakuli ba kantle. U tla lefa tefo ea khoeli le khoeli bakeng sa tšireletso ena ho latela boemo ba lekeno la hau.
Medicare Karolo ea B e tla koahela litšenyehelo tsa lintho tse kang:
- maeto a lingaka
- phepelo ea bongaka le lits'ebeletso tse hlokahalang
- litšebeletso tsa tlhokomelo ea thibelo
- lipalangoang tsa ambulense tsa tšohanyetso
- lisebelisoa tse ling tsa bongaka
- litšebeletso tsa bophelo bo botle ba kelello ba bakuli ba ka hare le ba malapeng
- meriana e meng ea kalafo ea bakuli ba kantle
Ho etsa bonnete ba hore Medicare Part B e akaretsa kopano ea hau, ts'ebeletso, kapa lisebelisoa tsa bongaka, botsa hore na ngaka ea hau kapa mofani oa litšebeletso o amohela Medicare.U ka sebelisa sesebelisoa sa tšireletso sa Medicare ho bona hore na kopano ea hau kapa tšebeletso ea hau ea koaheloa.
Tlas'a Medicare Karolo ea B, u ka lebella ho lefa litšenyehelo tse latelang ka 2021:
- moputso oa bonyane $ 148.50 ka khoeli (chelete ena e ea eketseha haeba moputso oa hau o le kaholimo ho $ 88,000 ka selemo kapa $ 176,000 ka selemo bakeng sa banyalani)
- $ 203 e ka theoleloang selemo
- Karolo ea 20 lekholong ea chelete e amoheloang ke Medicare ka mor'a hore chelete ea hau e fumanoe e fihletsoe selemo
Medicare Part C (Medicare Advantage) ke eng?
Medicare Part C (Medicare Advantage) ke sehlahisoa sa inshorense se ikemetseng se u fang karolo eohle ea likarolo tsa Medicare A le B, hammoho le lits'ebeletso tse ling.
Boholo ba merero ena e fana ka tšireletso ea ngaka ho kenyelletsa litšebeletso tsa bakuli le bakuli ba kantle. Melemo e kang ho koahela meno le pono e ka eketsoa hape.
U ka etsa moralo oa hau oa Medicare Advantage ho latela seo k'hamphani e tsamaisang moralo oa hau e fanang ka sona le seo u batlang ho se lefa.
Medicare e tla lefa chelete e behiloeng khoeli le khoeli ho mofani oa moralo oa hau oa Medicare Advantage ho kenya letsoho ho arolelanoeng ha litaba tsa hau.
Merero ea Medicare Part C hangata e oela likarolong tse fapaneng tse fapaneng:
- Merero ea Mokhatlo oa Tlhokomelo ea Bophelo (HMO) e hloka hore o fumane tlhokomelo e se nang maemo a tšohanyetso ho tsoa ho bafani ba khethehileng ka har'a marang-rang a moralo oa hau.
- Merero ea Mokhatlo oa Mofani oa Mofani ea khethiloeng (PPO) e u lumella ho sebelisa bafani ka hare kapa ka ntle ho marang-rang a hau, empa u lefa chelete e fokolang bakeng sa tlhokomelo ea inthanete.
- Merero ea poraefete bakeng sa tšebeletso (PFFS) e boetse e u lumella ho bona bafani ba thepa ba kahare kapa kantle ho marang-rang a moralo; leha ho le joalo, moralo o beha litefiso tsa hore na o tla patalla litšebeletso tsa litho tsa ona le hore na karolo ea hau e tla ba eng.
- Merero e khethehileng ea Litlhoko (SNPs) ke merero ea Medicare Advantage e etselitsoeng batho ba nang le mafu kapa maemo a itseng. Merero ena e hlophisa litšebeletso le ho fana ka litaba maemong a hau.
Litšenyehelo tsa Medicare Part C lia fapana ho latela mofuta oa moralo le mofani oa inshorense eo u mo khethang.
Medicare Karolo ea D ke eng?
Medicare Karolo ea D ke moralo o fanang ka tšireletso bakeng sa meriana ea ngaka.
Ena ke lenaneo la boikhethelo la Medicare, empa haeba u sa ngolise ha u qala ho tšoaneleha, u ka lefa likotlo ha u ingolisa hamorao. Likotlo tseo li tla sebetsa ha feela u ntse u e-na le moralo oa sethethefatsi 'me li tla eketsoa ho theko ea tefo ea hau ea khoeli le khoeli.
Koaelo ea meriana ea ngaka e tlameha ho fanoa ka boemo bo tloaelehileng bo behiloeng ke Medicare. Empa meralo e fapaneng e ka khetha meriana eo ba e thathamisang lenaneng la bona la lithethefatsi, kapa lifomong. Boholo ba merero ea meriana ea ngaka e koahetse meriana ka:
- formulary, e leng lenane la meriana ea ngaka e koahetsoeng morerong - hangata ka bonyane likhetho tse peli bakeng sa sehlopha ka seng sa sehlopha sa lithethefatsi
- meriana e tloaelehileng e ka 'nang ea nkeloa sebaka ke meriana ea mabitso a nang le phello e tšoanang
- Mananeo a tiered a fanang ka mefuta e fapaneng ea meriana (generic feela, generic plus brand brand, joalo-joalo) bakeng sa litefiso tse ngata tsa litefiso tse eketsehang ka litheko tsa hau tsa meriana
Litsenyehelo tsa merero ea Medicare Part D li ipapisitse le moralo oo u o khethang le meriana eo u e hlokang. U ka bapisa litšenyehelo tsa meralo e fapaneng ea meriana ea ngaka ea Medicare inthaneteng ka ho tobetsa mona.
Medicare ea tlatsetso ea inshorense (Medigap) ke eng?
Medicare inshorense ea tlatsetso, kapa Medigap, merero ke lihlahisoa tsa inshorense tsa poraefete tse reretsoeng ho thusa ho koahela litšenyehelo tse sa lefelloeng ke likarolo tsa Medicare A, B, C, kapa D. Merero ena ke ea boikhethelo.
Merero ea Medigap e ka thusa ho koahela litšenyehelo tsa Medicare tse kang:
- likopi
- lichelete tsa lichelete
- tse fokotsoang
Liphetoho tse 'maloa tse kholo li entsoe lenaneong la Medigap ka 2020.
Merero ea Medigap e ke ke ea hlola e sebelisoa ho patalla Medicare Part B e theotsoeng. Sena se bolela hore mefuta e 'meli ea merero ea Medigap - Moralo oa C le Moralo oa F - e emisitse ho rekisetsoa litho tse ncha ho tloha ka la 1 Pherekhong 2020. Batho ba seng ba ntse ba na le merero ena, leha ho le joalo, ba khona ho boloka litaba tsa bona.
Merero ea Medigap e kanna ea se koahele litšenyehelo tsohle tse tsoang ka pokothong, empa u ka fumana e lumellanang hantle le litlhoko tsa hau tsa lichelete le tsa bophelo bo botle. U na le merero le manane a fapaneng ao u ka khethang ho ona.
Mona ke kakaretso ea merero e 10 ea Medigap e koahelang:
Morero oa Medigap | Boitsebiso |
---|---|
Moralo oa A | Karolo ea Medicare Karolo ea chelete ea tšepe le litšenyehelo tsa matsatsi a 365 ka mor'a hore melemo ea Medicare e fele, Karolo ea B ea chelete kapa likoloto, lipepa tse tharo tsa pele tsa tšelo ea mali, le chelete ea tlhokomelo ea tlhokomelo ea bakuli ba bolulo. |
Moralo B | Medicare Part A coinsurance le litšenyehelo tsa tlhokomelo ea matsatsi a 365 kamora hore melemo ea Medicare e fele, Karolo ea B ea chelete kapa likopi tsa pele, lipente tsa pele tse tharo tsa tšelo ea mali, chelete ea tlhokomelo ea bakuli ba tlhokomelo ea bakuli ba bolulo kapa likopi, le karolo ea hau ea A e ka theoleloa |
Moralo C | Karolo ea Medicare Karolo ea lichelete le litšenyehelo tsa matsatsi a 365 ka mor'a hore melemo ea Medicare e fele, Karolo ea B ea chelete kapa likoloto, lipontšo tse tharo tsa pele tsa tšelo ea mali, chelete ea tlhokomelo ea bakuli ba tlhokomelo ea tlhokomelo ea tlhokomelo ea malapeng kapa likopayment, setsi sa booki se nang le boiphihlelo, karolo ea hau e theoleloang , Karolo ea hau ea B e theotsoe *, le phapanyetsano ea maeto a kantle ho naha ho fihlela ho 80% |
Moralo D. | Karolo ea Medicare Karolo ea chelete ea tšepe le litšenyehelo tsa matsatsi a 365 ka mor'a hore melemo ea Medicare e fele, Karolo ea B ea chelete kapa likoloto, lipontšo tsa pele tse tharo tsa tšelo ea mali, chelete ea tlhokomelo ea bakuli ba tlhokomelo ea tlhokomelo ea tlhokomelo ea tlhokomelo ea tlhokomelo ea malapeng kapa li-copayment, li-coinsurance bakeng sa litsi tsa booki tse nang le boiphihlelo, Karolo ea hau ea A deductible, le phapanyetsano ea maeto a kantle ho naha ho fihlela ho 80% |
Moralo oa F | Karolo ea Medicare Karolo ea chelete ea tšepe le litšenyehelo tsa matsatsi a 365 ka mor'a hore melemo ea Medicare e fele, Karolo ea B ea chelete kapa likoloto, lipontšo tsa pele tse tharo tsa tšelo ea mali, chelete ea tlhokomelo ea bakuli ba tlhokomelo ea tlhokomelo ea tlhokomelo ea tlhokomelo ea tlhokomelo ea malapeng kapa li-copayment, li-coinsurance bakeng sa litsi tsa booki tse nang le boiphihlelo, Karolo ea hau ea A khaoha, Karolo ea hau ea B e theoleloa, Karolo ea B e lefella mofani oa hau chelete ho feta seo Medicare e se lumellang (litefiso tse fetelletseng), le phapanyetsano ea maeto a kantle ho naha ho fihlela ho 80% |
Moralo oa G | Karolo ea Medicare Karolo ea chelete ea tšepe le litšenyehelo tsa matsatsi a 365 ka mor'a hore melemo ea Medicare e fele, Karolo ea B ea chelete kapa likoloto, lipontšo tsa pele tse tharo tsa tšelo ea mali, chelete ea tlhokomelo ea bakuli ba tlhokomelo ea tlhokomelo ea tlhokomelo ea tlhokomelo ea tlhokomelo ea malapeng kapa li-copayment, li-coinsurance bakeng sa litsi tsa booki tse nang le boiphihlelo, Karolo ea hau ea A khaoha, Karolo ea B e lefella mofani oa hau chelete ho feta seo Medicare e se lumellang (litefiso tse fetelletseng), le phapanyetsano ea maeto a kantle ho naha ho fihlela ho 80% |
Moralo oa K | Karolo ea Medicare Karolo ea lichelete le litšenyehelo tsa tlhokomelo ea matsatsi a 365 kamora hore melemo ea Medicare e felile, karolo ea 50 lekholong ea PartURE ea chelete ea tšepe kapa li-copayment, 50% ea litšenyehelo tsa liponto tse 3 tsa pele tsa tšelo ea mali, 50% ea chelete ea tlhokomelo ea tlhokomelo ea bakuli kapa li-copayment, 50% ea lichelete tsa tšepe bakeng sa litsi tsa booki tse nang le boiphihlelo, karolo ea 50 lekholong ea Karolo ea hau e fokotsoang - ka moeli o kantle ho pokotho oa $ 6,220 bakeng sa 2021 |
Moralo L | Karolo ea Medicare Karolo ea lichelete le litšenyehelo tsa tlhokomelo ea matsatsi a 365 kamora hore melemo ea Medicare e felile, karolo ea 75 lekholong ea karolo ea B ea chelete ea tšepe kapa li-copayment, 75% ea litšenyehelo tsa liponto tse 3 tsa pele tsa tšelo ea mali, 75% ea tlhokomelo ea chelete ea tlhokomelo ea bakuli kapa li-copayment, 75% ea chelete ea lichelete bakeng sa litsi tsa booki tse nang le boiphihlelo, karolo ea 75 lekholong ea karolo ea hau ea A e tlosoa - ka moeli o kantle ho pokotho oa $ 3,110 bakeng sa 2021 |
Moralo oa M | Karolo ea Medicare Karolo ea chelete ea tšepe le litšenyehelo tsa tlhokomelo ea matsatsi a 365 kamora hore melemo ea Medicare e felile, Karolo ea B chelete ea ts'episo kapa li-copayment, lipente tsa pele tse tharo tsa tšelo ea mali, chelete ea tlhokomelo ea tlhokomelo ea bakuli ba liphallelo kapa likopi tsa chelete, ts'ehetso ea chelete bakeng sa litsi tsa booki tse nang le boiphihlelo, 50% ea Karolo ea hau e huloang, le phapanyetsano ea maeto a kantle ho naha ho fihlela ho 80% |
Morero N | Karolo ea Medicare Karolo ea chelete ea tšepe le litšenyehelo tsa matsatsi a 365 ka mor'a hore melemo ea Medicare e fele, Karolo ea B ea chelete kapa likoloto, lipontšo tsa pele tse tharo tsa tšelo ea mali, chelete ea tlhokomelo ea bakuli ba tlhokomelo ea tlhokomelo ea tlhokomelo ea tlhokomelo ea tlhokomelo ea malapeng kapa li-copayment, li-coinsurance bakeng sa litsi tsa booki tse nang le boiphihlelo, Karolo ea hau ea A deductible, le phapanyetsano ea maeto a kantle ho naha ho fihlela ho 80% |
* Kamora la 1 Pherekhong 2020, batho ba sa tsoa qala ho tseba Medicare ba ke ke ba sebelisa meralo ea Medigap ho patala Medicare Part B e tlosoang. Empa haeba u se u ngolisitse ho Medicare 'me moralo oa hau oa e lefa hona joale, u ka boloka moralo oo le molemo.
Tsela
Ho ka nka nako le boiteko ho lekola mefuta e mengata ea merero ea Medicare. Empa likhetho tsena li u fa likhetho tse ngata ha ho tluoa ho fana ka litaba le litšenyehelo tsa tlhokomelo ea hau ea bophelo bo botle.
Ha o qala ho tšoaneleha bakeng sa Medicare, etsa bonnete ba hore o lekola likarolo tsohle tsa eona ho fumana tse u loketseng hantle le ho qoba likotlo hamorao.
Sengoliloeng sena se ntlafalitsoe ka la 17 Pulungoana 2020 ho hlahisa leseli la 2021 la Medicare.
Tlhahisoleseling e fumanehang webosaeteng ena e ka u thusa ho iketsetsa liqeto ka inshorense, empa ha ea etsetsoa ho fana ka likeletso mabapi le ho reka kapa ho sebelisa inshorense kapa lihlahisoa tsa inshorense. Healthline Media ha e sebetse khoebong ea inshorense ka tsela efe kapa efe ebile ha e na laesense ea ho ba k'hamphani ea inshorense kapa moetsi oa matla afe kapa afe a U.S. Healthline Media ha e khothaletse kapa ho ts'ehetsa batho ba boraro ba ka etsang khoebo ea inshorense.