Delaware Medicare Cov Tswv Yim Kho Mob hauv 2021

Zoo Siab

• Medicare yog dab tsi?
• Dab tsi nws npog
• Medicare cov nqi
• Cov phiaj xwm Medicare Advantage twg muaj nyob hauv Delaware?
• Lub Koomhaum Saib Xyuas Kev Noj Qab Haus Huv (HMO)
• Lub Koom Haum Cov Chaw Zov Me Nyuam (PPO)
• Cov txhab nyiaj tau pajkasphais kuaj mob (MSA)
• Kev Nto Nqi-rau-Kev Pabcuam (PFFS)
• Txoj Kev Xav Tau Tshwj Xeeb (SNP)
• Muaj cov phiaj xwm hauv Delaware
• Leej twg muaj feem tsim nyog tau txais Medicare hauv Delaware?
• Thaum twg kuv thiaj tuaj yeem teev npe tau hauv Medicare Delaware cov phiaj xwm?
• Cov koom sau npe koom kev kawm
• Kev tso npe txhua xyoo
• Cov lus qhia rau kev cuv npe hauv Medicare hauv Delaware
• Delaware Medicare cov kev pab
• Delaware Medicare Assistance Bureau (800-336-9500)
• Medicare.gov (800-633-4227)
• Kuv yuav ua licas txuas ntxiv mus?

Medicare yog tsoomfwv tswjfwm kev fajseeb khomob uas koj tuaj yeem tau txais thaum koj muaj hnub nyoog 65 xyoos. Medicare hauv Delaware tseem muaj rau cov neeg tsis tau muaj hnub nyoog 65 xyoos uas muaj raws li qee yam.

Medicare yog dab tsi?

Medicare muaj plaub qhov loj:

• Ntu A: Kev saib xyuas mob hauv tsev kho mob
• Tshooj B: Kev saib xyuas sab nraud
• Ntu C: Medicare Advantage
• Ntu D: Cov tshuaj kws kho mob sau tseg

Dab tsi nws npog

Txhua ntu ntawm Medicare muaj ntau yam sib txawv:

• Ntu A pab them kev kho mob uas koj tau mus pw hauv tsev kho mob thiab tseem suav nrog kev saib xyuas hauv tsev kho mob, kev pab them nqi tsawg rau kev saib xyuas cov neeg muaj mob nyob ib ntus (SNF), thiab qee cov kev pab saib xyuas mob hauv tsev ib nrab sijhawm.
• Ntu B hais txog kev saib xyuas mob sab nrauv, xws li mus ntsib kws kho mob, tiv thaiv kev tiv thaiv, thiab qee yam khoom siv kho mob ruaj khov.
• Phaj C yuav them koj cov nyiaj them rau Tshooj A thiab Tshooj B mus rau ib daim phiaj xwm tib si uas yuav suav nrog lwm cov txiaj ntsig, xws li kev pab them kho mob lossis kho qhov muag. Cov phiaj xwm no feem ntau suav nrog them tshuaj siv ib yam nkaus.
• Seem D npog qee lossis tag nrho koj cov nuj nqis tshuaj nyob sab nraum tsev kho mob (tshuaj uas koj tau txais thaum pw hauv tsev kho mob raug tiv thaiv hauv Ntu A).

Ntxiv nrog rau plaub ntu loj, tseem muaj Medicare cov nyiaj pab kas phais. Feem ntau hu ua Medigap, cov phiaj xwm no duav cov nyiaj hauv hnab tshos xws li feem yus them ua ke thiab kev pab them tus nqi uas tus phiaj xwm Medicare qub yeej tsis kam thiab muaj los ntawm cov tuam txhab tuav pov hwm ntiag tug.

Koj tuaj yeem tsis yuav Ob Ntu C thiab Medigap. Koj yuav tsum xaiv hom ib lossis lwm yam.

Medicare cov nqi

Cov phiaj xwm Medicare hauv Delaware muaj qee cov nqi uas koj them rau kev pab them nqi thiab saib xyuas.

Ntu A muaj peev nyiaj yam tsis tau them qhov nqi txhua lub hlis tsuav koj lossis tus txij nkawm tau ua haujlwm rau 10 lossis ntau xyoo hauv kev ua haujlwm thiab them se Medicare. Koj tseem tuaj yeem yuav tau cov kev pab yog tias koj tsis muaj raws li cov cai.Lwm yam nqi nrog:

• txiav tawm tau txhua zaus koj tuaj pw hauv tsev kho mob
• cov nqi ntxiv yog tias koj lub tsev khomob lossis SNF nyob ntev dua li cov sijhawm tau teev tseg

Ntu B muaj ntau tus nqi thiab cov nqi, suav nrog:

• tus nqi txhua hli
• ib qho kev txiav tawm txhua xyoo
• cov nqi them thiab 20 feem pua ​​tus nqi them ua haujlwm tom qab koj them tawm

Ntu C cov phiaj xwm yuav muaj qhov hwm rau cov txiaj ntsig ntxiv uas muaj los ntawm phiaj xwm. Koj tseem them tus nqi B feem hwm.

Ntu D phiaj xwm nqi sib txawv raws cov kev pab them nqi.

Medigap cov nqi sib txawv raws li txoj kev pab them nqi koj xaiv.

Cov phiaj xwm Medicare Advantage twg muaj nyob hauv Delaware?

Medicare Advantage cov kev npaj tau pom zoo los ntawm Lub Chaw rau Medicare thiab Medicaid Cov Kev Pabcuam (CMS) thiab muaj los ntawm cov tuam txhab muag kev pov hwm. Cov txiaj ntsig suav nrog:

• tag nrho koj cov kev pab los ntawm txhua feem ntawm Medicare raug pab them nyob rau hauv ib daim phiaj xwm
• lwm cov txiaj ntsig uas qhov Medicare qub qub tsis suav nrog, xws li kev kho hniav, kho qhov muag, hnov ​​lus, thauj mus rau kev teem caij kho mob, lossis mus noj mov tom tsev
• hnab tshos nyiaj ntau kawg ntawm $ 7,550 (lossis tsawg dua)

Muaj tsib hom phiaj xwm Medicare Advantage nyob hauv Delaware. Cia saib ntawm txhua hom ntxiv.

Lub Koomhaum Saib Xyuas Kev Noj Qab Haus Huv (HMO)

• Koj xaiv thawj tus kws khomob (PCP) uas tswj xyuas koj txoj kev tu mob.
• Koj yuav tsum siv cov chaw muab kev pab thiab chaw kho mob nyob hauv HMO pab pawg.
• Feem ntau koj xav tau kev xa los ntawm koj thawj tus kws khomob (PCP) mus ntsib tus kws tshaj lij.
• Kev saib xyuas sab nraum lub network feem ntau tsis duav tshwj tsis yog thaum muaj xwm ceev.

Lub Koom Haum Cov Chaw Zov Me Nyuam (PPO)

• Kev saib xyuas los ntawm cov kws kho mob lossis cov chaw kho mob hauv cov phiaj xwm PPO network.
• Kev saib xyuas sab nraum lub network yuav raug nqi ntau dua, lossis tej zaum yuav tsis pab them.
• Koj tsis tas yuav xa mus ntsib tus kws kho mob tshwj xeeb.

Cov txhab nyiaj tau pajkasphais kuaj mob (MSA)

• Cov phiaj xwm no ua ke muab kev them nqi kho mob siab thiab rho nyiaj tau ntau.
• Medicare pab muab ib qhov nyiaj ntawm qhov nyiaj txhua xyoo los them rau cov nuj nqis (koj tuaj yeem ntxiv ntxiv).
• MSAs tsuas yog siv rau cov nqi kho mob uas tsim nyog.
• MSA kev khaws nyiaj yog tsis muaj kev sau se dawb (rau cov nqi kho mob uas tsim nyog) thiab tau txais nyiaj tsis muaj paj tsis txaus siab

Kev Nto Nqi-rau-Kev Pabcuam (PFFS)

• PFFS yog cov phiaj xwm tsis muaj kev sib txuas nrog cov kws kho mob lossis tsev kho mob; koj tuaj yeem xaiv mus nyob qhov twg los lees txais koj txoj phiaj xwm.
• Lawv nrog sib tham ncaj qha nrog cov muab kev pab thiab txiav txim siab tias koj tshuav nqi npaum li cas rau cov kev pabcuam.
• Tsis yog txhua tus kws kho mob lossis chaw kho mob lees txais cov phiaj xwm no.

Txoj Kev Xav Tau Tshwj Xeeb (SNP)

• SNPs tau tsim rau cov neeg xav tau kev saib xyuas ntau dua thiab ua tau raws li qee qhov kev tsim nyog.
• Koj yuav tsum muaj cai ob yam rau Medicare thiab Medicaid, muaj ib lossis ob peb yam mob muaj nkeeg, thiab / lossis nyob hauv tsev laus.

Muaj cov phiaj xwm hauv Delaware

Cov tuam txhab no muaj cov phiaj xwm hauv ntau lub nroog hauv Delaware:

• Aetna Medicare
• Cigna
• Neej Neeg Dab
• Lasso Kho Mob
• UnitedHealthcare

Medicare Advantage txoj kev pab them nqi sib txawv nyob rau cheeb nroog, yog li sau koj tus lej ZIP tshwj xeeb thaum tshawb cov phiaj xwm koj nyob.

Leej twg muaj feem tsim nyog tau txais Medicare hauv Delaware?

Yuav kom tsim nyog rau Medicare, koj yuav tsum yog:

• 65 xyoos rov saud
• Tebchaws Meskas ib tus pej xeem lossis neeg muaj cai nyob hauv 5 xyoos lossis tshaj saud

Yog tias koj hnub nyoog qis dua 65 xyoos, koj tuaj yeem tau txais cov phiaj xwm Medicare hauv Delaware yog tias koj:

• muaj raum hloov raum lossis mob raum ntu raum (ESRD)
• muaj amyotrophic lateral sclerosis (ALS)
• tau txais cov txiaj ntsig Xaus Saus lossis Cov Ciav Haujlwm Saib Xyuas Kev So Haujlwm rau 24 lub hlis

Koj tuaj yeem siv Medicare lub cuab yeej los xyuas seb koj puas tsim nyog tau txais.

Thaum twg kuv thiaj tuaj yeem teev npe tau hauv Medicare Delaware cov phiaj xwm?

Txhawm rau kom tau txais Medicare lossis Medicare Advantage koj yuav tsum teev npe kom ncav sijhawm.

Cov koom sau npe koom kev kawm

• Lub sijhawm nkag thaum pib (IEP) yog lub qhov rai 7 hli ib puag ncig koj lub hnub nyoog 65 xyoos, pib 3 lub hlis ua ntej thiab txuas ntxiv rau 3 lub hlis tom qab koj hnub yug. Yog tias koj xee npe ua ntej koj muaj 65 xyoos, qhov kev pab them nyiaj yuav pib hauv koj lub hnub yug. Kev rau npe tom qab lub sijhawm no txhais tau tias yuav tau txais kev duav qeeb.
• Lub sijhawm sau npe tshwj xeeb (SEPs) yog lub sijhawm tau xaiv thaum koj tuaj yeem tso npe tawm sab nraud ntawm qhov qhib nkag yog tias koj poob qhov kev pab them nqi rau ntau yam laj thawj, suav nrog poob chaw ua haujlwm los ntawm lub chaw ua haujlwm lossis hloov chaw sab nraud ntawm koj txoj kev npaj khomob.

Kev tso npe txhua xyoo

• Kev tso npe dav dav(Lub Ib Hlis 1 txog Peb Hlis 31): Yog tias koj tsis tau tso npe rau Medicare lub sijhawm koj qhov IEP, koj tuaj yeem tso npe rau hauv Tshooj A, Ntu B, Ntu C, thiab Tshooj D cov phiaj xwm. Koj yuav raug them tus nqi nplua rau kev kos npe lig.
• Medicare Advantage qhib kev rau npe nkag (Lub Ib Hlis 1 txog Lub Peb Hlis 31): Koj tuaj yeem hloov mus rau txoj phiaj xwm tshiab tau yog tias koj twb tau txais Medicare Advantage lawm lossis koj tuaj yeem txuas ntxiv nrog Medicare qub.
• Qhib kev rau npe nkag(Lub Kaum Hlis 15 txog Kaum Ob Hlis 7): Koj tuaj yeem hloov pauv ntawm thawj Medicare thiab Medicare Advantage, lossis tso npe rau Tshooj D yog tias koj tsis kos npe rau lub sijhawm koj qhov IEP.

Cov lus qhia rau kev cuv npe hauv Medicare hauv Delaware

Xaiv txoj hauv kev kom haum raws li cov ntsiab lus hauv qab no:

• koj li kev noj qab haus huv xav tau
• cov kev siv nyiaj npaj
• cov kws kho mob (lossis tsev kho mob loj) koj xav mus saib xyuas

Delaware Medicare cov kev pab

Koj tuaj yeem nrhiav cov lus teb rau koj cov lus nug Medicare Delaware los ntawm cov koom haum no:

Delaware Medicare Assistance Bureau (800-336-9500)

• Xeev Qhov Nyiaj Pab Nyiaj Pov Hwm Kev Nyab Xeeb (SHIP), yav tas los hu ua ELDERcov ntaub ntawv
• pab tswv yim pub dawb rau cov neeg mob Medicare
• chaw sab laj hauv zos thoob Delaware (hu 302-674-7364 mus nrhiav koj li)
• kev pab nyiaj txiag los pab them rau Medicare

Medicare.gov (800-633-4227)

• ua hauj lwm tam li nom tswv Medicare site
• tau cob qhia cov neeg ua hauj lwm hauv xov tooj los pab teb koj cov lus nug Medicare
• muaj phiaj xwm phiaj xwm phiaj xwm los pab koj kom pom cov kev pab Medicare Advantage, Ntu D, thiab Medigap cov phiaj xwm hauv koj thaj tsam

Kuv yuav ua licas txuas ntxiv mus?

Ntawm no yog koj cov kauj ruam tom ntej los nrhiav kev pab them Medicare zoo tshaj plaws kom tau raws li koj xav tau:

• Kev txiav txim siab seb koj puas xav tau daim Medicare lossis Medicare Advantage qub.
• Xaiv Medicare Advantage los yog Medigap txoj cai, yog tsim nyog.
• Txheeb xyuas koj lub sijhawm nkag thiab hnub kawg.
• Sau cov ntaub ntawv xws li daim ntawv teev cov tshuaj uas koj noj thiab lwm yam mob uas koj muaj.
• Nug koj tus kws kho mob yog tias lawv txais Medicare, thiab lub koom haum Medicare Advantage uas lawv muaj.

Kab lus no tau raug hloov kho thaum Lub Kaum Ib Hlis 10, 2020, kom pom zoo 2021 Cov ntaub ntawv Medicare.

Cov ntaub ntawv ntawm lub vev xaib no tuaj yeem pab koj txiav txim siab tus kheej txog kev tuav pov hwm, tab sis nws tsis yog yuav pab tswv yim txog kev yuav khoom lossis kev siv cov khoom pov hwm lossis kev tuav pov hwm. Healthline Media yuav tsis hloov lag luam ntawm kev tuav pov hwm tsis hais yam twg thiab tsis tau ntawv tso cai raws li cov tuam txhab pov hwm lossis cov neeg tsim khoom hauv ib cheeb tsam ntawm Teb Chaws Asmeskas. Healthline Media tsis tau qhia lossis pom zoo rau ib tog neeg thib peb uas ua lag luam ntawm kev tuav pov hwm.