Yog Vim Li Cas Qee Qhov Medicare Advantage Cov Kev Npaj Dawb?

Zoo Siab

• Medicare Advantage yog dab tsi?
• Dab tsi yog them rau hauv 'dawb' cov phiaj xwm?
• Puas yog nws 'pub dawb'?
• Cov txiaj ntsig daim phiaj them txhua hli hwm
• Tshooj B hwm txhua hli
• Tej lus ntuas
• Coinsurance / copayments
• Hom phiaj
• Medicare nqi dab tsi?
• Medicare Tshooj A
• Medicare Tshooj B
• Lwm yam kev xaiv
• Koj puas tsim nyog rau Medicare?
• Koj puas tsim nyog rau 'dawb' Advantage cov phiaj xwm?
• Cov nqa mus

Yog tias koj tau nyuam qhuav ncig yuav khoom ntawm Medicare Advantage txoj kev npaj, koj yuav tau pom tias qee qhov phiaj xwm no tau tshaj tawm "dawb."

Qee hom phiaj Advantage hu ua pub dawb vim tias lawv tau them $ 0 txhua hli kom nkag rau hauv txoj phiaj xwm. Qhov no ua rau cov hwm Medicare Advantage muaj pes tsawg lub phiaj xwm txaus nyiam rau cov uas tab tom nrhiav kev txuag nyiaj ntawm Medicare cov nuj nqis txhua hli.

Kab lus no yuav tshawb nrhiav saib cov phiaj xwm Medicare Advantage pub dawb yog dab tsi npog, cov nqi dab tsi ntxiv koj yuav ntsib, thiab leej twg tsim nyog tau txais kev pab Medicare Tshooj C pub dawb.

Medicare Advantage yog dab tsi?

Medicare Advantage, tseem hu ua Medicare Tshooj C, yog muaj los ntawm cov tuam txhab tuav pov hwm ntiag tug rau cov neeg tsim nyog uas xav tau ntau dua cov kev pab them nqi kho mob Original.

Medicare Advantage cov phiaj xwm muab cov kev pab them nqi uas yuav tsum ua nram qab no:

• Pab them hauv tsev kho mob (Medicare Tshooj A). Qhov no suav nrog kev pabcuam ntsig txog tsev kho mob, kev tu mob hauv tsev, kev saib xyuas hauv tsev laus, thiab kev saib xyuas tsev laus.
• Kev pab them nqi kho mob (Medicare Tshooj B). Qhov no hais txog kev tiv thaiv, kuaj mob thiab kho mob.

Ntau tus Advantage phiaj xwm kuj tseem them rau cov kev kho mob ntxiv, xws li:

• Kev pab them tshuaj
• kho hniav, kho qhov muag, thiab hnov ​​pob ntseg
• kev pov hwm kev noj qab haus huv
• lwm cov kev noj qab haus huv perks

Thaum koj xaiv Medicare Advantage txoj kev pab them nqi los ntawm cov tuam txhab ntiag tug, muaj cov phiaj xwm kev xaiv sib txawv los xaiv. Cov phiaj xwm Advantage feem ntau yog:

• Lub Koomhaum Saib Xyuas Kev Noj Qab Haus Huv (HMO) cov phiaj xwm. Cov no tsuas yog pab them nqi los ntawm cov kws kho mob hauv koom pab pawg sib koom tes nkaus xwb.
• Cov Phiaj Xwm Ua Haujlwm Zoo Tshaj Lij (PPO) cov phiaj xwm. Cov no tsub tus nqi sib txawv ntawm cov kev sib txuas hauv-pab pawg thiab sab nraud.

Nws tseem muaj peb lwm cov qauv phiaj xwm rau Medicare Tshooj C cov phiaj xwm:

• Cov Kev Npaj Ua Tus Nqi Them Nyiaj-Rau-Kev Pabcuam (PFFS). Cov no yog cov phiaj xwm them tshwj xeeb uas muab kev pab them nqi yooj yim.
• Cov phiaj xwm Xav Tau Tshwj Xeeb (SNP). Cov no yog cov kev pab them nqi kho mob rau cov neeg muaj mob mus ntev.
• Medicare Cov Txhab Nyiaj Txiag Rau Kev Kho Mob (MSA) cov phiaj xwm. Cov phiaj xwm no ua ke muab kev them nqi kho mob siab txo nrog cov nyiaj khaws tseg kev kho mob.

Dab tsi yog them rau hauv 'dawb' cov phiaj xwm?

Cov phiaj xwm Medicare Advantage Dawb yog Medicare Part C cov phiaj xwm uas them $ 0 nyob rau txhua xyoo.

Piv nrog rau lwm cov phiaj xwm Medicare, cov phiaj xwm Medicare Advantage tsis tau nce qib no yuav tsis tsub nqi ib xyoo ib zaug rau kev nkag rau hauv hom phiaj.

Feem ntau tsis muaj qhov sib txawv ntawm cov kev pab them nqi dawb thiab ib txoj kev them nyiaj. Tsis hais txog nqi dab tsi, feem ntau Medicare Part C cov kev npaj muaj feem A thiab B, tshuaj noj tshuaj, thiab lwm yam kev tiv thaiv ntxiv.

Yog li, vim li cas cov tuam txhab lag luam thiaj muab cov phiaj xwm Medicare hom phiaj siab no? Thaum lub tuam txhab sib cog lus nrog Medicare, nws tau muab cov nyiaj them rau cov nqi A thiab B kev pov hwm.

Yog tias lub tuam txhab tuaj yeem txuag nyiaj lwm qhov, xws li los ntawm kev siv cov koom hauv koom nrog, nws tuaj yeem hla cov nyiaj ntxiv nrog rau cov tswv cuab. Qhov no tuaj yeem ua rau tus nqi them txhua hli dawb.

Cov phiaj xwm Medicare Advantage pub dawb no kuj yog ib txoj kev zoo rau cov tuam txhab tshaj tawm cov kev txuag nyiaj kom zoo rau cov neeg tau txais txiaj ntsig zoo.

Puas yog nws 'pub dawb'?

Txawm hais tias xoom hwm Medicare Advantage cov phiaj xwm kev lag luam muaj lag luam pub dawb xwb los, koj tseem yuav tau them qee qhov nqi sab nrauv sab nraud rau kev pab them.

Cov txiaj ntsig daim phiaj them txhua hli hwm

Yog tias txoj kev pab Medicare Advantage pub dawb, koj yuav tsis tau them qhov nqi txhua hli kom koj rau npe tau.

Tshooj B hwm txhua hli

Feem ntau cov phiaj xwm Medicare Advantage dawb tseem them ib qhov nqi them txhua hli Part B tus nqi. Qee qhov phiaj xwm yuav them tus nqi, tab sis lwm tus yuav tsis kam.

Ntu B tus nqi them txhua hli pib ntawm $ 135.50, lossis siab dua nyob ntawm koj cov nyiaj tau los.

Tej lus ntuas

Nws muaj ob hom kev rho tawm hauv ib xyoos nrog cov phiaj xwm Medicare Advantage feem ntau:

• Cov phiaj xwm nws tus kheej yuav muaj qhov rho tawm txhua xyoo, uas yog cov nyiaj hauv hnab tshos uas koj tau them ua ntej koj cov nyiaj pov hwm them tawm.
• Txoj kev pab them nqi kuj tseem yuav tsub koj cov tshuaj uas txiav tawm ib yam nkaus.

Coinsurance / copayments

Feem ntau ntawm Medicare Advantage cov kev npaj them nqi tsub cov nqi mus ntsib. Kev them nyiaj tus nqi yog tus nqi them kev rho nyiaj hauv hnab tshos koj them txhua zaus koj mus khomob.

Qee qhov phiaj xwm kuj yuav tsub nqi ntxiv tus nqi them ua ntej. Nov yog feem pua ​​ntawm tag nrho cov nqi kho mob uas koj yuav tsum them.

Hom phiaj

Medicare Advantage cov phiaj xwm kuj tseem tuaj yeem sib txawv hauv cov nqi raws lawv cov qauv. Piv txwv, PPO cov phiaj xwm them cov nqi sib ntxiv raws seb tus neeg muab kev pab puas nyob hauv koom nrog lossis muaj kev sib koom tes sib txuas.

Cov nqi no kuj tseem yuav sib txawv nyob rau xyoo. Piv txwv li, PFFS cov phiaj xwm tau ntsib qhov feem pua ​​me me hauv tus nqi txhua xyoo rau ob peb lub xyoo dhau los.

Medicare nqi dab tsi?

Medicare tsis muaj ntawv them nqi kho mob dawb. Muaj ntau cov nqi sib txawv uas cuam tshuam nrog Medicare cov kev pab them nqi.

Ua ntej koj tuaj yeem tso npe rau hauv Medicare Advantage txoj kev npaj, koj yuav tsum muaj Medicare seem thiab kev pab them nqi B. Hauv qab no koj yuav pom cov nqi uas cuam tshuam nrog cov phiaj xwm ntawd.

Medicare Tshooj A

Medicare Tshooj A tsub tus nqi them txhua hli, uas tuaj yeem suav txij li $ 240 txog $ 437. Txawm li cas los xij, ntau tus neeg raug zam los ntawm cov nqi no.

Yog tias koj tau them Medicare se thaum ua haujlwm lossis tau txais (lossis tsim nyog rau) Cov txiaj ntsim kev pab Xaus Saus lossis kev noj qab haus huv ntawm kev tsheb nqaj hlau, koj yuav raug zam.

Medicare Tshooj A tseem yuav tsub tus nqi $ 1,364 rau ib qho txiaj ntsig rau ib lub sijhawm txuas ntxiv rau qhov txiaj ntsig, uas suav txij $ 341 txog $ 682-ntxiv.

Medicare Tshooj B

Medicare Tshooj B tsub tus nqi them txhua hli yog $ 135.50 lossis ntau dua, nyob ntawm koj cov nyiaj tau los txhua xyoo. Koj yuav tsum tshuav nuj nqis no Tshooj B yog ib feem ntawm koj qhov phiaj xwm Medicare Advantage pub dawb tshwj tsis yog tias tau them los ntawm txoj kev npaj them.

Medicare Tshooj B kuj yuav tsub tus nqi $ 185 uas yus them yus tauj ib xyoos, tom qab ntawv taw tes koj yuav tshuav nuj nqis 20 feem pua ​​tus nqi them rau txhua yam kev pab.

Lwm yam kev xaiv

Yog tias koj xaiv nkag rau Medicare txoj kev pab them nqi kho mob xws li Medicare Tshooj D los yog Medigap ua lwm txoj kev pab rau Medicare Advantage, koj yuav tsum them tus nqi txhua hli thiab lwm cov nqi uas cuam tshuam nrog cov phiaj xwm no.

Medicare Tshooj D thiab Medigap cov nqi yog txiav txim los ntawm txoj kev pab them nqi koj xaiv.

Tsis zoo li qhov ntau tshaj plaws ntawm hnab tshos them nrog qhov Medicare Advantage txoj kev npaj, tsis muaj ib qhov txwv rau qhov ntau ntawm cov hnab tshos tawm koj yuav them rau Medicare feem A, B, D, lossis Medigap.

Koj puas tsim nyog rau Medicare?

Koj muaj cai tau txais Medicare raws li cov hauv qab no:

• Koj hnub nyoog 65 lossis laus dua. Txhua tus neeg Asmeskas hnub nyoog 65 lossis laus dua muaj cai tau txais Medicare. Koj tuaj yeem thov Medicare txog 3 lub hlis ua ntej koj hnub yug 65 xyoos.
• Koj muaj mob xiam oob qhab. Txawm hais tias koj muaj hnub nyoog qis dua 65 xyoos, koj tsim nyog muaj npe rau Medicare yog koj tau txais cov nyiaj xiam Xaus Saus. Xaus Saus muab cov txiaj ntsig kev tsis taus rau kwv yees li 14 pawg ntawm kev tsis taus.
• Koj muaj ALS. Yog tias koj muaj ALS thiab tau txais cov txiaj ntsig kev xiam oob qhab, koj yuav tau txais Medicare.
• Koj muaj mob raum ntu kawg. Yog tias koj muaj lub raum tsis ua haujlwm lawm, koj yuav tsim nyog muaj npe rau Medicare. Txawm li cas los xij, nws tseem ceeb kom nco ntsoov tias cov neeg uas muaj tus mob no yuav tsis tsim nyog tau kho rau Medicare Advantage txoj kev npaj.

Qee yam kev ntsuas, xws li tau txais cov txiaj ntsig kev tsis taus rau 24 lub hlis, yuav tso npe koj rau Medicare nyob rau 25 lub hlis. Yog tias qhov xwm txheej no, koj tsis tas yuav kos npe rau koj tus kheej rau Medicare ntu A thiab B.

Txawm li cas los xij, yog tias koj tsim nyog rau Medicare tab sis tsis rau npe nkag, koj yuav tsum tau ua ntawv thov ntawm Xaus Saus lub vas sab.

Koj puas tsim nyog rau 'dawb' Advantage cov phiaj xwm?

Nws tsis muaj cov kev tsim nyog rau phiaj xwm pub dawb Medicare Advantage. Ntau qhov Advantage cov kev pab them nqi pub dawb dawb txhua hli raws li ib feem ntawm lawv cov phiaj xwm phiaj xwm kho mob.

Koj tuaj yeem nrhiav Medicare Part C cov phiaj xwm hauv koj thaj tsam nrog $ 0 hwm los ntawm kev siv Medicare.gov nrhiav tau 2020 qhov phiaj xwm Medicare plan.

Thaum lub sijhawm koj tshawb, koj tuaj yeem siv cov "Sort cov phiaj xwm los ntawm: Tus nqi them qis qis tshaj plaws" rau pom cov nuj nqis Medicare Advantage nyob hauv koj thaj chaw.

Ib txoj hauv kev tseem ceeb los tswj hwm koj cov nuj nqis Medicare yog siv cov peev txheej muaj los pab txo lossis txo koj cov nqi. Cov peev txheej no suav nrog:

• Medicaid. Qhov kev pab no tau pab them cov nqi kho mob rau ntau dua li cov neeg tau nyiaj los tsawg lossis tsis muaj kev pab cuam los them rau cov nqi kho mob.
• Medicare Cov Kev Pab Txuag Nyiaj. Cov phiaj xwm no tuaj yeem pab cov neeg tau txais nyiaj tsawg tau them Medicare Advantage cov nqi them txhua hli, rho tawm, them nyiaj ntxiv, thiab ua kom zoo.
• Pab Nyiaj Xaus Saus. Cov nyiaj pab no muab rau cov neeg uas xiam oob qhab, dig muag, lossis tshaj 65 qhov them txhua hli, uas tuaj yeem pab them cov nqi Medicare.
• Cov kev pab ntxiv. Muaj lwm cov kev pab cuam uas yuav muab kev pab rau cov neeg uas nyob hauv thaj chaw Asmeskas teb lossis cov nqi them tshuaj ntau.

Lwm txoj hauv kev los khaws koj cov nuj nqis Medicare Advantage yog kom saib xyuas Daim Ntawv Pov Thawj Pov Hwm Kev Tiv Thaiv thiab Ntawv Ceeb Toom Txhua Xyoo ntawm cov ntawv ceeb toom kev hloov pauv koj daim phiaj xwm xa koj mus txhua xyoo Qhov no yuav pab koj nyob rau saum toj ntawm ib qho kev hloov nqi lossis tus nqi nce.

Cov nqa mus

Cov phiaj xwm Medicare Advantage Dawb yog cov phiaj xwm kev faj seeb kho mob Medicare uas muaj pab $ 0 txhua hli.

Txawm tias cov phiaj xwm no tau tshaj tawm tsis pub siv, koj tseem yuav tau them tus nqi ntawm cov hnab tshos tus nqi rau lwm cov nqi them, cov nqi txiav tawm, thiab them nyiaj ntxiv.

Yog tias koj tsim nyog rau Medicare thiab tau rau npe rau ntu A thiab B, koj tuaj yeem siv Nrhiav Kev Pab Them Nqi Kho Mob (Medicare) xyoo 2020 los nrhiav cov txiaj ntsig Medicare Advantage nyob hauv koj thaj chaw.

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.