Dab tsi yog Cov Cim Sib txawv ntawm Medicare?
Zoo Siab
- Medicare Tshooj A yog dab tsi?
- Medicare Tshooj B yog dab tsi?
- Medicare Tshooj C (Medicare Advantage) yog dab tsi?
- Medicare Tshooj D yog dab tsi?
- Ntawv pov hwm them kho mob Medicare (Medigap) yog dab tsi?
- Cov nqa mus
- Kev pab them nyiaj Medicare tau muab faib ua ntau ntu uas txhua qhov hais txog kev saib xyuas sib txawv.
- Medicare Tshooj A npog rau kev saib xyuas neeg mob thiab feem ntau tsis tau them nqi.
- Medicare Tshooj B pab them rau cov kev kho mob rau sab nrauv thiab muaj tus nqi them nyiaj raws li tau nyiaj ntau.
- Medicare Tshooj C (Medicare Advantage) yog kev tuav pov hwm khoom ntiag tug uas muab cov khoom A thiab B nrog cov txiaj ntsig ntxiv.
- Medicare Tshooj D yog cov khoom pov hwm ntiag tug uas duav cov tshuaj kho mob.
Medicare muab kev pab them nqi kho mob rau cov neeg muaj hnub nyoog 65 xyoos thiab cov neeg xiam oob khab los yog muaj mob. Cov haujlwm nyuaj no muaj ntau ntu, thiab nws cuam tshuam nrog tseemfwv qibsiab thiab tsoomfwv tus tswv tuav haujlwm ua haujlwm ua ke los muab ntau yam kev pabcuam thiab cov khoom lag luam.
Qhov Medicare qub yog tsim ntawm ntu A thiab B. Qhov kev fajseeb no tso cai rau koj mus rau cov kws khomob thiab cov chaw uas lees txais Medicare yam tsis tau txais kev pom zoo lossis pom zoo ua ntej ntawm koj txoj kev npaj khomob. Cov nqi them thiab cov nqi them ua ke, tab sis lawv feem ntau yog cov nyiaj tau los thiab yuav tau txais nyiaj pab.
Medicare Advantage (Tshooj C) cov phiaj xwm yog phiaj xwm kev pov hwm ntiag tug. Cov phiaj xwm no ua ke ntau cov ntsiab lus ntawm Medicare, zoo li ntu A thiab B, nrog rau lwm yam kev pabcuam, xws li tshuaj, kho hniav thiab kho qhov muag. Lawv muab cov kev pab ntau dua, tab sis lawv yuav raug nqi ntau dua thiab tuaj nrog kev txwv network.
Txawm hais tias Medicare ntau txoj kev xaiv ua rau koj hloov tau yooj yim ntawm koj cov kev pab them nqi kho mob, nws kuj txhais tau tias koj yuav tsum tau nkag siab thiab nkag siab ntau cov ntaub ntawv.
Nyeem rau kom paub ib qho zuj zus ntawm qhov sib txawv ntawm Medicare thiab seb lawv yuav pab tau koj li cas.
Medicare Tshooj A yog dab tsi?
Medicare Tshooj A yog ib feem ntawm Medicare qub uas them rau koj cov nqi tsev kho mob thiab lwm cov nqi kho mob sab hauv. Cov neeg feem coob tsis them tus nqi txhua hli rau Ntu A vim tias lawv them rau qhov kev pab cuam los ntawm kev them se thaum lawv xyoo ua haujlwm.
Tshwj xeeb, Medicare Tshooj A yuav them rau:
- pw hauv tsev kho mob
- txwv nyob hauv ib lub tsev laus
- nyob hauv tsev kho mob ncua ntev
- kev saib xyuas hauv tsev tu neeg laus uas tsis siv sijhawm ntev lossis saib xyuas tau
- tsev kho mob
- feem-sijhawm lossis cuam tshuam kev tu mob hauv tsev
Yuav kom ntseeg tau tias Medicare pab them rau koj nyob mus, koj yuav tsum:
- muaj ntawv tso cai ntawm koj tus kws kho mob hais tias koj xav tau kev saib xyuas rau kev muaj mob lossis raug mob
- Nco ntsoov tias lub chaw tu neeg txais Medicare
- Nco ntsoov tias koj muaj sijhawm nyob rau lub sijhawm koj tau txais txiaj ntsig los siv (rau cov chaw tu neeg mob)
- paub meej tias Medicare thiab lub tsev kho mob pom zoo rau vim li cas koj nyob hauv
Raws li Medicare Tshooj A, koj tuaj yeem cia siab them cov nqi hauv qab no rau 2021:
- tsis muaj nqi dab tsi yog tias koj tau ua haujlwm tsawg kawg 40 lub hlis (10 xyoo) hauv koj lub neej thiab them Medicare se (koj yuav them txog $ 471 toj ib hlis yog tias koj ua haujlwm tsawg dua 40 lub hlis)
- $ $ 1,484 rho tawm rau txhua lub sijhawm nyiaj pab
- cov nqi niaj hnub them rau cov hnub so koj pw: $ 0 rau hnub 1 txog 60, $ 371 toj ib hnub rau hnub 61 txog 90, thiab $ 742 nyob rau ib hnub rau 91 thiab dhau ntawd
- tag nrho cov nqi yog tias koj nyob hauv tsev khomob ntau dua 90 hnub hauv ib lub sijhawm nyiaj pab thiab koj tau dhau sijhawm 60 hnub nyob mus ib txhis
Medicare Tshooj B yog dab tsi?
Medicare Tshooj B yog ib feem ntawm Medicare qub uas them rau cov nqi koj cov nqi khomob sab nrauv. Koj yuav them tus nqi them txhua hli rau qhov kev pov hwm no raws koj qib nyiaj tau los.
Medicare Tshooj B yuav them rau tus nqi ntawm cov khoom xws li:
- mus ntsib kws kho mob
- kev khomob thiab kev khomob uas tsim nyog
- cov kev pab tiv thaiv kev saib xyuas
- tsheb thauj neeg mob ceev ceev
- qee qhov khoom siv kho mob
- kev mus cuag thiab pw kho mob hlwb
- qee cov tshuaj siv sab nrauv
Txhawm rau kom paub tseeb tias Medicare Tshooj B npog koj lub sijhawm teem, kev pabcuam, lossis khoom siv khomob, nug saib koj tus kws khomob lossis chaw pabcuam lees txais Medicare.Koj kuj tseem tuaj yeem siv qhov twj pab them kev kho mob Medicare los txiav txim siab seb qhov teem caij lossis kev pab cuam puas duav.
Raws li Medicare Tshooj B, koj tuaj yeem cia siab them cov nqi hauv qab no rau 2021:
- tus nqi tsawg kawg yog $ 148.50 tauj ib hlis (qhov nyiaj no nce yog koj tus neeg khwv tau siab dua $ 88,000 toj xyoo lossis $ 176,000 toj xyoo rau cov txij nkawm)
- ib $ 203 yus them yus rau lub xyoo
- 20 feem pua ntawm cov nyiaj Medicare uas pom zoo tom qab koj them tawm tau tsim nyog rau lub xyoo
Medicare Tshooj C (Medicare Advantage) yog dab tsi?
Medicare Tshooj C (Medicare Advantage) yog cov khoom pov hwm kev ntiag tug uas muab tag nrho cov kev pab them nqi ntawm Medicare seem A thiab B, ntxiv rau cov kev pabcuam ntxiv.
Feem ntau ntawm cov phiaj xwm no muaj kev pab them cov tshuaj sab nrauv thiab sab nrauv. Cov txiaj ntsig zoo ib yam li kho hniav thiab kho qhov muag kuj ntxiv tau ib yam thiab.
Koj tuaj yeem kho koj lub phiaj xwm Medicare Advantage raws li qhov chaw ua hauj lwm uas tswj hwm koj txoj phiaj xwm muab thiab koj xav them dab tsi.
Medicare yuav them tus nqi muab them txhua hli rau koj qhov chaw muab kev pab Medicare Advantage los muab kev koom tes pab them rau.
Medicare Part C cov phiaj xwm feem ntau yog poob rau hauv qee cov kev sib txawv:
- Lub Koomhaum Saib Xyuas Kev Noj Qab Haus Huv (HMO) cov phiaj xwm xav tau kom koj tau txais kev saib xyuas tsis kub tsis tu los ntawm cov kws muab kev pab tshwj xeeb hauv koj txoj phiaj xwm kho mob.
- Cov Phiaj Xwm Kev Zov Me Nyuam (PPO) cov phiaj xwm tso cai rau koj siv cov chaw muab kev pab tsis hais nyob rau sab hauv lossis sab nraud ntawm koj cov koom tes, tab sis koj them tsawg dua rau kev kho mob hauv koom nrog.
- Cov Kev Npaj Rau Tus Kheej Tus Nqi Siv Nyiaj (PFFS) tseem yuav cia koj mus ntsib cov chaw muab kev pab uas nyob hauv lossis sab nraud ntawm lub hom phiaj (network); txawm li cas los xij, txoj kev npaj ua tus nqi teev tus nqi uas nws yuav them rau nws cov tswvcuab kev pabcuam thiab koj feem yuav yog.
- Cov Ntawv Xav Tau Tshwj Xeeb (SNPs) yog Medicare Advantage cov kev npaj tsim rau cov neeg muaj qee yam kab mob lossis cov mob. Cov phiaj xwm no tsim cov kev pabcuam thiab pab them rau koj cov xwm txheej tshwj xeeb.
Medicare Tshooj C tus nqi sib txawv nyob ntawm hom phiaj xwm thiab cov chaw muab kev pov hwm koj xaiv.
Medicare Tshooj D yog dab tsi?
Medicare Tshooj D yog phiaj xwm uas muaj kev pab them cov tshuaj noj.
Nov yog qhov kev xaiv Medicare, tab sis yog tias koj tsis rau npe thaum koj tsim nyog ua ntej, koj yuav them cov nqi nplua thaum koj kos npe tom qab. Cov kev rau txim no yuav siv tau ntev li koj tau muaj hom phiaj siv tshuaj thiab yuav muab ntxiv rau tus nqi ntawm koj tus nqi txhua hli.
Kev yuav tshuaj noj yuav tsum yog nyob ntawm theem qauv teev tseg los ntawm Medicare. Tab sis cov phiaj xwm sib txawv tuaj yeem xaiv cov tshuaj uas lawv teev rau hauv lawv cov npe tshuaj, lossis cov qauv. Feem ntau cov kev pab them tshuaj yuav pab them los ntawm:
- cov qauv tshuaj, uas yog cov npe tshuaj uas tau npaj nyob hauv hom phiaj - feem ntau muaj tsawg kawg yog ob qho kev xaiv rau txhua chav kawm tshuaj lossis pawg
- cov tshuaj kho tsis raug uas yuav muab hloov rau cov tshuaj muaj npe nrog cov nyhuv tib yam
- cov kev pab cuam uas muaj ntau theem kev noj tshuaj (feem ntau nkaus xwb, feem ntau ntxiv cov npe lag luam, thiab lwm yam) rau ntau cov nqi them uas nce nrog koj cov nqi tshuaj
Tus nqi ntawm Medicare Part D cov kev pab them nqi nyob ntawm saib koj xaiv hom kev kho mob twg thiab cov tshuaj uas koj xav tau. Koj tuaj yeem sib piv cov nqi ntawm ntau txoj kev pab them tshuaj yuav tshuaj online los nyem ntawm no.
Ntawv pov hwm them kho mob Medicare (Medigap) yog dab tsi?
Kev tuav pov hwm them nyiaj Medicare, lossis Medigap, cov phiaj xwm yog cov khoom pov hwm ntiag tug txhais tau los pab them cov nqi tsis them rau los ntawm Medicare seem A, B, C, lossis D. Cov phiaj xwm no yog xaiv tau.
Cov kev npaj khomob Medigap tuaj yeem pab them rau Medicare cov nuj nqis xws li:
- nqi them nyiaj
- npib nyiaj suav
- tshem tawm
Qee qhov kev hloov pauv tau hloov pauv mus rau Medigap program xyoo 2020.
Cov kev npaj khomob Medigap tuaj yeem siv tsis tau them rau Medicare Tshooj B uas yus them yus. Qhov no txhais tau hais tias ob hom Medigap cov phiaj xwm - Plan C thiab Plan F - nres muag rau cov tswv cuab tshiab thaum Lub Ib Hlis 1, 2020. Cov neeg uas twb tau txais cov phiaj xwm no lawm, txawm li cas los xij, muaj peev xwm khaws tau lawv cov nyiaj pov hwm.
Cov kev pab them nqi kho mob Medigap yuav tsis them tag nrho cov nqi yuav nyiaj, tab sis koj tuaj yeem nrhiav qhov uas zoo tshaj plaws rau koj cov kev xav tau nyiaj txiag thiab kev noj qab haus huv. Koj muaj ntau txoj phiaj xwm thiab qib kev pab them nyiaj rau xaiv los ntawm.
Nov yog tus txheej txheem cej luam ntawm txhua yam ntawm 10 daim Medigap cov phiaj xwm duav tau:
| Medigap txoj kev npaj | Cov kev pab cuam |
|---|---|
| Daim phiaj A | Medicare Part A kev pab them nqi thiab cov nqi kho mob 365 hnub uas raug saib xyuas tom qab Medicare cov txiaj ntsig tag tag, Feem B tiv nqi lossis them tus nqi them, thawj 3 txuas ntxiv ntawm kev ntxiv ntshav, thiab saib xyuas cov tsev kho mob npib los them lossis nqi them |
| Daim phiaj B | Medicare Tshooj A pab them nqi kho mob thiab cov nqi ntawm 365 hnub kev saib xyuas tom qab Medicare cov txiaj ntsig tag nrho, Feem B them nqi lossis them nqi them, thawj 3 txuas ntxiv ntawm kev ntxiv ntshav, kev saib xyuas mob pw tom tsev kho mob lossis nqi them them nqi, thiab koj Tshooj A rho tawm |
| Txoj Kev Npaj C | Medicare Seem A Kev pab them nqi thiab cov nqi 365 hnub tsim nyog saib xyuas tom qab Medicare cov txiaj ntsig tag nrho, Phaj B B tus nqi them lossis nqi them, thawj 3 txuas ntxiv ntawm kev ntxiv ntshav, kev saib xyuas mob ntawm cov tsev kho mob lossis nqi them them nqi, nqi khomob hauv tsev laus, koj feem A tau them tawm , koj Tshooj B txiav tawm * *, thiab kev tshaj tawm txawv teb chaws mus txog 80% |
| Daim phiaj D | Medicare Seem A Kev pab them nqi thiab cov nqi 365 hnub tsim nyog saib xyuas tom qab Medicare cov txiaj ntsig tag nrho, Phaj B B tus nqi them lossis nqi them, thawj 3 txuas ntxiv ntawm cov ntshav ntxiv, saib xyuas cov tsev kho mob npib lossis nqi them, nqi them rau cov chaw tu neeg mob, koj Ntu A yus them yus, thiab kev ua lag luam tawm txawv teb chaws mus txog 80% |
| Daim phiaj F | Medicare Seem A Kev pab them nqi thiab cov nqi 365 hnub tsim nyog saib xyuas tom qab Medicare tau txais txiaj ntsig, Phaj B B tus nqi them lossis nqi them them, thawj 3 txuas ntxiv ntawm cov ntshav hloov mus rau hauv tsev kho mob, chaw saib xyuas neeg mob lossis them tus nqi them, nqi them rau cov chaw kws tshaj lij, koj feem A Yuav them yus, koj feem B rho tawm tau *, Ntu B cov nuj nqis uas koj tus kws kho mob tsub dhau qhov Medicare tso cai (kev tsub ntxiv), thiab kev tshaj tawm txawv teb chaws mus txog 80% |
| Daim phiaj G | Medicare Seem A Kev pab them nqi thiab cov nqi 365 hnub tsim nyog saib xyuas tom qab Medicare tau txais txiaj ntsig, Phaj B B tus nqi them lossis nqi them them, thawj 3 txuas ntxiv ntawm cov ntshav hloov mus rau hauv tsev kho mob, chaw saib xyuas neeg mob lossis them tus nqi them, nqi them rau cov chaw kws tshaj lij, koj feem A rho tawm tau, Ntu B cov nuj nqis uas koj tus kws kho mob tsub dhau qhov uas Medicare tso cai (ntau dhau tus nqi), thiab kev tshaj tawm txawv teb chaws nce txog 80% |
| Npaj K | Medicare Part A pab them nqi kho mob thiab tus nqi ntawm 365 hnub tsim nyog saib xyuas tom qab Medicare cov txiaj ntsig tag, 50% ntawm Tshooj B feem them nqi lossis them nqi them, 50% ntawm tus nqi ntawm thawj 3 pints ntawm cov ntshav ntxiv, 50% ntawm kev saib xyuas lub tsev khomob. lossis them ib qho nqi them, 50% ntawm cov nyiaj fajseeb khomob rau cov kws tu neeg mob, 50% koj feem A rho tawm - nrog ib tus nqi nyiaj dhau $ 6,220 rau 2021 |
| Daim phiaj L | Medicare Part A kev pab them nqi thiab cov nqi 365 hnub tsim nyog saib xyuas tom qab Medicare cov txiaj ntsig tag, 75% ntawm Tshooj B feem them nqi lossis them nqi them, 75% ntawm tus nqi ntawm thawj 3 txuas ntawm cov ntshav ntxiv, 75% ntawm lub tsev kho mob lossis them ib qho nqi them, 75% ntawm npib nyiaj them nqi rau cov kws tu neeg mob, 75% ntawm Feem Ntu Ib feem yus them tawm - nrog tus nqi tsuas yog $ 3,110 rau 2021 |
| Daim phiaj M | Medicare Tshooj A sib pab them nqi thiab tus nqi them 365 hnub kev saib xyuas tom qab Medicare tau txais txiaj ntsig, Phaj B B tus nqi them lossis nqi them, thawj 3 txuas ntxiv ntawm kev hloov ntshav, kev saib xyuas kab mob kev pab them nqi lossis nqi luam, nqi them rau cov chaw tu neeg mob, 50% ntawm koj Tshooj Seem uas txiav tawm tau, thiab kev tshaj tawm txawv teb chaws mus txog 80% |
| Daim phiaj N | Medicare Seem A Kev pab them nqi thiab cov nqi 365 hnub tsim nyog saib xyuas tom qab Medicare tau txais txiaj ntsig, Phaj B B tus nqi them lossis nqi them them, thawj 3 txuas ntxiv ntawm cov ntshav hloov mus rau hauv tsev kho mob, chaw saib xyuas neeg mob lossis them tus nqi them, nqi them rau cov chaw kws tshaj lij, koj feem A yus them yus, thiab kev ua lag luam tawm txawv teb chaws mus txog 80% |
* Tomqab lub Ib Hlis 1, 2020, cov neeg uas tau tshiab rau Medicare siv tsis tau Medigap npaj los them rau Medicare Tshooj B uas yus them yus. Tab sis yog tias koj twb rau npe rau Medicare lawm thiab koj daim phiaj them nyiaj tam sim no them nws, koj tuaj yeem khaws qhov phiaj xwm ntawd thiab tau txais txiaj ntsig.
Cov nqa mus
Nws tuaj yeem siv sijhawm thiab siv zog los yoo hla ntau hom phiaj xwm Medicare. Tab sis cov kev xaiv no muab ntau txoj kev xaiv rau koj thaum hais txog kev pov hwm thiab tus nqi ntawm koj txoj kev kho mob.
Thaum koj tsim nyog tau txais Medicare thawj zaug, nco ntsoov xyuas txhua feem ntawm nws kom paub qhov zoo tshaj plaws rau koj thiab zam kev nplua tom qab.
Kab lus no tau raug hloov kho thaum Lub Kaum Ib Hlis 17, 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.
Nrov Rau Ntawm Qhov Chaw
Tshuaj yeeb dej caw - nqus tau pa