Tus Sau: Louise Ward
Hnub Kev Tsim: 10 Lub Ob Hli Ntuj 2021
Hloov Hnub: 24 Lub Kawm Ob Hlis Ntuj 2024
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Medicare Qhov Tsim Nyog Tau Txais Kev Pab Tshwj Xeeb Xav Tau Yog Dab Tsi? - Noj Qab Haus Huv
Medicare Qhov Tsim Nyog Tau Txais Kev Pab Tshwj Xeeb Xav Tau Yog Dab Tsi? - Noj Qab Haus Huv

Zoo Siab

  • Qhov Medicare Dual Muaj Peev Xwm Tshwj Xeeb Xav Tau Tshwj Xeeb (D-SNP) yog Medicare Advantage txoj kev npaj tsim los muab kev pab them nqi tshwj xeeb rau cov tib neeg uas muaj npe rau Medicare (ntu A thiab B) thiab Medicaid.
  • Cov phiaj xwm no pab cov neeg uas xav tau kev pab ntau tshaj them cov nqi hauv hnab tshos uas tej zaum lawv yuav raug saib xyuas raws li Medicare cov kev pab ib txwm muaj.

Yog tias koj muaj hnub nyoog tshaj 65 xyoos lossis muaj qee yam mob - thiab muaj nyiaj tsis txaus los them rau kev saib xyuas koj - koj yuav poob rau hauv ib pawg uas xaiv los tau ob qho kev pabcuam nyiaj txiag kas phais pov hwm kev noj qab haus huv thiab tsoomfwv. Qhov tseeb, ze li ntawm 12 lab tus neeg Asmeskas muaj cai tau txais ob qho Medicare thiab Medicaid, los ntawm lawv hnub nyoog thiab kev noj qab haus huv. Yog tias koj yog ib tus ntawm lawv, koj yuav tsim nyog rau D-SNP.

Nyeem rau kom paub seb D-SNP yog dab tsi thiab seb koj puas tsim nyog rau ib qho.

Txoj Kev Xav Tau Qhov Xav Tau Tshwj Xeeb Tshwj Xeeb Medicare (D-SNP) yog dab tsi?

Qhov Medicare Special Needs Plan (SNP) yog ib hom phiaj xwm Medicare Advantage (Tshooj C) uas muab hom kev pab them Medicare txuas ntxiv mus. Cov phiaj xwm ntiag tug no pab tswj kev saib xyuas thiab cov txiaj ntsig nruab nrab ntawm Medicare, uas yog tsoomfwv txoj haujlwm pabcuam, thiab Medicaid, uas yog lub xeev txoj haujlwm.


D-SNPs yog qhov nyuaj tshaj plaws ntawm SNPs uas hais txog ob qho kev pov hwm thiab kev tsim nyog tau txais, tab sis lawv muab cov txiaj ntsig zoo tshaj plaws rau cov neeg muaj kev xav tau ntau tshaj plaws.

Yuav kom tsim nyog rau D-SNP, koj yuav tsum ua pov thawj tias koj tsim nyog. Koj yuav tsum xub muaj npe rau hauv Medicare thiab tag nrho koj lub xeev qhov kev pab cuam Medicaid, thiab koj yuav tsum muaj ntawv pov thawj them rau cov no.

Tsim nyob rau xyoo 2003 los ntawm Congress, Medicare SNPs muaj rau cov neeg uas twb muaj Medicare feem A thiab B. SNPs yog ib hom Medicare Part C (Advantage) txoj kev npaj tswj los ntawm tsoomfwv thiab muaj los ntawm cov tuam txhab muag kev pov hwm. Lawv muab ntau yam hauv Medicare: Tshooj A rau kev fajseeb khomob hauv tsev khomob, Phaj B rau kev khomob sab nrauv, thiab Tshooj D kom pab them cov tshuaj kho mob.

Tsis yog txhua lub xeev muaj Medicare SNPs. Raws li xyoo 2016, 38 lub xeev ntxiv rau Washington, D.C., thiab Puerto Rico muab D-SNPs.

kev kho mob cov phiaj xwm tshwj xeeb

Cov SNP tau faib ua peb pab raws li cov neeg uas tsim nyog rau lawv.


  • Dual Kev Tsim Nyog Qhov Xav Tau Tshwj Xeeb Cov phiaj xwm (D-SNPs). Cov phiaj xwm no yog rau cov neeg uas tsim nyog rau ob qho Medicare thiab lawv lub xeev qhov kev pab cuam Medicaid.
  • Tej Yam Yuav Tau Muaj Ntev Tshwj Xeeb Cov Phiaj Xwm (C-SNPs). Cov phiaj xwm Advantage no tau tsim rau cov neeg muaj kab mob kev nkeeg ntev ntev xws li lub plawv tsis ua haujlwm, mob qog nqaij hlav, mob raum ntu kawg, mob ntshav cawv thiab quav cawv, HIV, thiab ntau dua.
  • Cov Tswv Yim Tshwj Xeeb Cov Tswv Yim (I-SNPs). Cov phiaj xwm Advantage no tau tsim los rau cov neeg uas xav tau nyob hauv ib lub tuam tsev lossis chaw tu neeg ntev ntev dua 90 hnub.

Leej twg thiaj muaj feem tau txais Medicare Dual Muaj Cai Tau Txais SNPs?

Yuav kom txiav txim siab rau ib qho ntawm SNPs, koj yuav tsum xub nkag rau Medicare ntu A thiab B (Medicare qub), uas them cov nqi pw tsev kho mob thiab lwm cov kev kho mob.

Muaj ntau yam ntawm D-SNPs muaj. Qee qhov yog Cov Haujlwm Pabcuam Cov Noj Qab Haus Huv (HMO), thiab qee qhov yuav yog Cov Chaw Xav Tau Kev Npaj Ua Haujlwm (PPO). Cov phiaj xwm sib txawv raws li cov tuam txhab kev pov hwm koj xaiv thiab thaj chaw koj nyob. Txhua qhov kev zov me nyuam yuav muaj cov nqi sib txawv.


Koj tuaj yeem hu 800-MEDICARE kom tau txais xov xwm ntau ntxiv lossis nug txog D-SNPs thiab lwm cov txiaj ntsig Medicare.

Tsim nyog rau Medicare

Koj tsim nyog rau Medicare thaum hnub nyoog 65 lossis tshaj saud. Koj muaj 3 lub hlis ua ntej thiab tom qab lub hlis uas koj muaj 65 xyoos los teev npe rau kev pab them kho mob Medicare thawj zaug.

Koj kuj tsim nyog rau Medicare, tsis hais hnub nyoog li cas, yog tias koj muaj ib qho mob uas tsim nyog lossis xiam oob khab, xws li mob raum ntu kawg lossis mob leeg mob amyotrophic lateral sclerosis, lossis yog koj tau muaj hom kev pab nyiaj Xaus Saus rau 24 lub hlis lossis ntau dua.

Yog tias koj tsim nyog, koj tuaj yeem tso npe rau hauv D-SNP thaum lub sijhawm tsim nyog tau txais kev pab Medicare, tsim nyog tsuav D-SNP muaj nyob hauv koj thaj chaw.

lub sij hawm rau npe yuav tshuaj
  • Pib sau npe. Lub sijhawm no pib 3 lub hlis ua ntej koj 65 xyoos thiab ncua kom txog 3 lub hlis tom qab koj 65 xyoos.
  • Medicare Advantage nkag. Qhov no yog txij lub Ib Hlis 1 txog Lub Peb Hlis 31. Lub sijhawm no, koj tuaj yeem tso npe nkag lossis hloov koj qhov phiaj xwm Medicare Advantage. Koj yuav tsis tau hloov ntawm thawj qhov Medicare mus rau ib qho Advantage phiaj xwm nyob rau lub sijhawm no; koj tsuas pub ua thaum qhib rau npe nkag xwb.
  • Kev tso npe rau Medicare dav dav. Lub sijhawm no yog pib txij lub Ib Hlis 1 txog Lub Peb Hlis 31. Yog tias koj tsis tau tso npe rau Medicare thawj lub sijhawm thaum koj nkag rau npe nkag, koj tuaj yeem tso npe thaum lub sijhawm no.
  • Qhib kev rau npe nkag. Nov yog txij Lub Kaum Hlis 15 txog Kaum Ob Hlis 7. Txhua tus uas muaj cai rau Medicare tuaj yeem sau npe lub sijhawm no yog tias lawv tsis tau muaj. Koj tuaj yeem hloov los ntawm Medicare qub mus rau ib qho phiaj xwm Advantage, thiab koj kuj tuaj yeem hloov lossis tso koj qhov Advantage tam sim no, Ntu D, lossis Medigap lub sijhawm no.
  • Lub sijhawm sau npe tshwj xeeb. Cov no muaj nyob thawm xyoo thiab nyob ntawm qhov hloov pauv koj qhov xwm txheej, xws li kev tsim nyog tshiab rau Medicare lossis Medicaid, kev hloov chaw, kev hloov pauv ntawm koj li kev mob nkeeg, lossis kev tsum tsis ua raws li koj txoj kev npaj tam sim no.

Tsim nyog rau Medicaid

Kev tsim nyog rau Medicaid yog saib raws ntau yam, nrog rau koj cov nyiaj tau, kev noj qab haus huv, thiab seb koj puas muaj feem tau txais Cov Nyiaj Tau Los Ntxiv Cov Nyiaj Tau Los. Txhawm rau tshawb xyuas seb koj puas tsim nyog tau txais kev pab them kho mob Medicaid hauv koj lub xeev thiab kom tau txais kev pom zoo ntawm koj txoj kev tsim nyog, tiv tauj koj lub chaw haujlwm Medicaid hauv xeev.

Koj yuav teev npe li cas nyob rau hauv Qhov Muaj Kev Nyab Xeeb Ob Leeg (SNP)?

Txawm li cas los xij, qee zaum, koj yuav cuv npe rau Medicare ntu A thiab B thaum koj muaj 65 xyoos. Tab sis koj yuav tsis cia npe rau hauv D-SNP vim tias nws yog hom phiaj ntawm Medicare Advantage (Tshooj C) Txoj Kev Npaj.

Koj tuaj yeem yuav Medicare Advantage cov kev npaj, suav nrog D-SNPs, thaum lub sijhawm nkag rau Medicare-pom zoo: lub sijhawm Medicare Advantage rau npe txij lub Ib Hlis 1 txog Lub Peb Hlis 31, qhib kev cuv npe thaum Lub Kaum Hli 15 txog Kaum Ob Hlis 7, lossis lub sijhawm tshwj xeeb yog tias koj muaj hloov pauv ntawm koj tus kheej li xwm txheej.

Txhawm rau teev npe rau txhua qhov phiaj xwm Medicare Advantage, suav nrog D-SNPs, ua raws cov theem hauv qab no:

  • Xaiv lub phiaj xwm hauv koj thaj tsam (saib Medicare cov phiaj xwm nrhiav cov phiaj xwm nyob rau hauv koj li ZIP).
  • Txhawm rau sau npe online los yog thov ib daim ntawv foos los ntawm kev xa ntawv, mus saib tuam txhab ntawv pov hwm lub vev xaib rau txoj kev npaj ua koj xaiv.
  • Hu 800-MEDICARE (800-633-4227) yog tias koj xav tau kev pab.
cov ntaub ntawv koj yuav xav tau tso npe rau hauv D-SNP
  • koj daim npav Medicare
  • hnub uas koj tau pib Medicare feem A thiab / lossis B kev pab them nqi
  • ntawv pov thawj rau kev pab them nqi kho mob Medicaid (koj daim npav Medicaid lossis ib tsab ntawv ntawm nom tswv)

Qhov Dual Raug Tsim Nyog SNP yog dab tsi?

D-SNPs yog Medicare Advantage cov phiaj xwm, yog li lawv them tag nrho cov kev pab tib yam li lwm cov phiaj xwm Medicare Advantage. Cov no suav nrog:

  • $ 0 txhua hli nqi them
  • pab saib xyuas kev khomob
  • Medicare Tshooj D
  • qee cov khoom siv tshuaj thiab cov tshuaj noj
  • kev thauj mus los rau cov kev kho mob
  • ceev faj
  • pom kev zoo thiab kev hnov ​​lus
  • kev ua si qoj thiab kev tawm dag zog

Nrog rau feem ntau Medicare Advantage cov phiaj xwm, koj them ib feem ntawm koj cov phiaj xwm nqi tawm hauv hnab tshos. Nrog D-SNP, Medicare thiab Medicaid them feem ntau lossis tag nrho cov nqi.

Medicare them ib feem ntawm koj cov nqi kho mob ua ntej, ces Medicaid them rau ib qho nqi uas yuav seem. Medicaid yog lub npe hu ua “tus kawg them nyiaj” rau tus nqi uas tsis duav lossis tsuas yog kho tau los ntawm Medicare.

Thaum tseem hwv txoj cai lij choj teev Medicaid cov qauv nyiaj tau los, txhua lub xeev nyias muaj nyias kev tsim nyog tau txais Medicaid thiab kev pab them. Cov kev pab them nqi kho mob sib txawv raws xeev, tab sis muaj qee cov phiaj xwm uas suav tag nrho Medicare thiab Medicaid cov txiaj ntsig.

Qhov Double Tsim Nyog Tau SNP yog li cas?

Feem ntau, nrog phiaj xwm Xav Tau Tshwj Xeeb (SNP), koj yuav them feem sib luag rau cov uas koj yuav them raws li Medicare Advantage txoj phiaj xwm. Tus nqi them, cov nqi them, cov nqi them ua ntej, thiab rho tawm yuav txawv nyob ntawm txoj kev npaj koj xaiv. Nrog rau D-SNP, koj cov nqi tsawg dua vim tias koj txoj kev noj qab haus huv, xiam oob qhab, lossis nyiaj txiag tau tsim nyog koj tau txais kev txhawb nqa ntxiv los ntawm tseemfwv qib siab thiab tsoomfwv.

Cov nqi sib txawv rau D-SNPs nyob rau xyoo 2020

Hom kev siv nyiajNtau ntawm tus nqi
Tus nqi txhua hli$0
txhua xyoo hauv cov kws kho mob tau them tawm $0–$198
kws kho mob tus nqi them uantej$0
tus kws tshwj xeeb nqi sab nraud $0–$15
thawj kws kho mob npib (yog tias tsim nyog)0%–20%
tshwj xeeb npias (yog tias tsim nyog) 0%–20%
tshuaj txiav tawm$0
tawm ntawm hnab tshos max (hauv network)$1,000–
$6,700
tawm ntawm hnab tshos max (tawm ntawm lub network, yog tsim nyog)$6,700

Cov nqa mus

  • Yog tias koj muaj kev xav tau kev noj qab haus huv lossis kev xiam oob qhab thiab koj cov nyiaj tau los tsawg, koj tuaj yeem tsim nyog tau txais kev pabcuam hauv tseemfwv qib siab thiab hauv xeev.
  • Cov phiaj xwm Xav Tau Tshwj Xeeb Tshwj Xeeb (D-SNPs) yog ib hom phiaj xwm Medicare Advantage uas them rau koj cov tsev kho mob, pab kho mob sab nrauv, thiab ntawv sau yuav tshuaj; cov nqi ntawm cov phiaj xwm tau them los ntawm tsoomfwv thiab lub xeev cov nyiaj.
  • Yog tias koj tsim nyog rau ob qho Medicare thiab koj lub xeev qhov kev pab cuam Medicaid, koj yuav muaj cai tau txais kev kho mob qis lossis tsis tau them nqi li D-SNP.

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