Momwe Makampani A Inshuwalansi Angagwiritsire Ntchito Ndalama Kwa Boma
Mwinamwake simungamve zitsulo, koma boma la federal likutsimikiza. Makampani a inshuwalansi okhawo angakhale akupindula pa boma pamene akukupatsani zomwe zikuwoneka kuti ndi "zaulere". Ngati munayamba mwakhala mukuyezetsa pakhomo la Medicare kunyumba, mungafune kudziwa momwe kampani yanu ya inshuwalansi ingagwiritsire ntchito mankhwala anu.
Kusiyanitsa pakati pa mankhwala oyambirira a Medicare ndi Medicare Advantage
Poyamba Medicare ndi zomwe mumadziwika kuti Medicare.
Zinakhalapo ndi Social Security Amendments 1965 ndipo amapereka onse inshuwalansi ya chipatala (Part A) ndi inshuwalansi ya mankhwala (Part B) . Mu 2006, Medicare Part D inawonjezeredwa ngati gawo lachidziwitso la Medicare lomwe limapereka mankhwala opatsirana mankhwala .
Izi zikutanthauza zigawo A, B, ndi D, koma nanga bwanji Gawo C?
Apa ndi kumene Medicare Advantage ikugwiritsidwira ntchito. Medicare Part C, aka Medicare Advantage (amene kale anali Medicare + Chosankha), ndi njira ina yopita ku Medicare Yoyamba . Mapulani a Medicare Othandiza akhoza kapena sangaphatikizepo Phindu la Gawo la D.
Ndondomeko zonse za Medicare Advantage zikuphimba zomwe Gawo A ndi gawo B zimachita koma angathe, ngati angasankhe, akupatsani zina zothandiza. Chifukwa chiyani? Chifukwa mmalo moyendetsedwa ndi boma, ndondomeko izi zimayendetsedwa ndi makampani a inshuwalansi.
Momwe Government Government Amachitira ndi Private Inshuwalansi Makampani
Nchifukwa chiyani kampani ya inshuwalansi yaumwini akufuna kulemba anthu pa Medicare?
Mwakutanthawuza, opindula adzakhala ali ndi zaka 65 kapena kuposera kapena ngati ali aang'ono, adzakhala ndi kulemala kwa nthawi yaitali . Ziribe kanthu momwe mukuyang'anirako, iwo ali pachiopsezo chachikulu chokhala ndi mavuto aakulu azachipatala amene angafune ndalama zochuluka zogwiritsira ntchito zaumoyo.
Makampani opindulitsa amapita ku bizinesi ya Medicare chifukwa boma la boma likulipira iwo kuti achite izo.
Boma limalipira iwo ndalama za "ndalama" mwezi uliwonse kuti zikusamalirani. Izi zikutanthawuza kuti pali mlingo woyenera womwe boma limapereka kwa munthu aliyense yemwe akuyimira dongosolo la Medicare Advantage. Ndalama ya kampani ya inshuwalansi imabwezeredwa, komabe imakula kwambiri ndi matenda onse omwe muli nawo. Izi zimachokera pa chiwerengero cha Medicare chowerengetsera ngozi.
Momwe Mankhwala Amagwiritsira Ntchito Ngozi Ntchito
Ndili ndi inshuwalansi yabwino kwambiri kuti mupeze chidziwitso chachipatala cholembedwa bwino chomwe chimatchula zinthu zambiri zachipatala momwe zingathere. Mwa njira iyi, iwo akhoza kupeza malipiro apamwamba omwe amawunikira ku Medicare ndi ndalama zambiri za federal.
Funsoli ndiloti iwo angagwiritse ntchito ndalama zomwezo kuti akusamalireni kapena ngati angasankhe kukweza ndalamazo m'malo mwake.
Zoona zenizeni, a inshuwalansi zapadera sakhala ndi zolembera zachipatala. Zolemba zachipatala zimatetezedwa ndi chipatala chanu, osati kampani ya inshuwalansi. Wa inshuwalansi akhoza kungowona zomwe zimaperekedwa ndi madokotala ndi ena othandizira zaumoyo. Mwachidziwikire, pangakhale zidziwitso zodziwika pa chithunzi chanu chachipatala chomwe sichikakamizidwa mu dongosolo.
Pofuna kuwonjezera ma ARV awo, ama insurer angafune kutumiza dokotala wawo kunyumba kuti adziwe zambiri.
Iwo sangadalire pa chidziwitso choperekedwa pa telefoni. Kuti chidziwitso chiwerengere ku chiwerengero cha mankhwala a Medicare, payenera kukhala ndi maso ndi maso kukumana ndi wothandizira zachipatala.
Kufufuza Kwapakhomo
Kampani yanu ya inshuwalansi ingakufikireni pa ulendo wopita kunyumba. Ikhoza kutchulidwa mwina poyendera mwakuthupi kapena mwamtendere. Mwa njira iliyonse, amalimbikitsa ntchitoyo kuti atsimikizire kuti makasitomala awo ali okhwima ngati angathe ndipo amakhala otetezeka m'nyumba zawo. Chabwino, iwo amapereka kwaulere.
Ndi njira yabwino yogulitsira, ndipo achikulire ambiri amachikonda. Muli ndi ora la nthawi yoyang'anizana ndi dokotala mumalimbikitso a nyumba yanu pomwe mumakhala ndi nthawi yochepa mu ofesi ya dokotala.
Dokotala wochezera amayang'ana mankhwala anu, mbiri yakale ya zachipatala, mbiri ya banja lanu, mbiri yanu ya chikhalidwe, ndipo amachititsa kuyeza kosavuta kokha kuphatikizapo kufufuza kwa magazi . Ngakhale dokotala uyu sangakulandireni kapena akukupatsani mankhwala, zonse zomwe zasonkhanitsidwa zidzagawidwa ndi dokotala wanu wamkulu. Chofunika kwambiri, kwa kampani ya inshuwalansi, deta yosonkhanitsidwa ikhoza kugwiritsidwa ntchito kulimbitsa chiwerengero cha mankhwala a Medicare.
Kodi maulendowa akuwongolera ubwino wa chisamaliro chomwe munthu amalandira pamapeto pake? Izi sizinapezepo kuti ndizochitika. Zomwe adasonyezedwa kuti achite, ndikuwongolera kukhulupirika kwa membala ku chipani cha inshuwaransi. Zochulukirapo, iwo awonjezeka kwambiri federal ndalama pa Medicare.
Ndalama Yeniyeni ya Mankhwala Othandiza
Kaya mumapita njira yoyamba ya Medicare kapena Medicare Advantage, mulibe chikole kuti mulipire gawo la A ndi B premiums B ku boma. Mwamwayi, anthu ambiri akhoza kupeza gawo la A Awo kwaulere . Ngati mutasankha ndondomeko ya Medicare Advantage, mukhoza kulipiritsa mwezi uliwonse ku kampani ya inshuwalansi. Ochepa kwambiri a Medicare Advantages plans akupezeka popanda phindu, ngakhale alipo owerengeka.
Ngakhale ngati mapikidwe anu a Medicare ali apamwamba, dongosolo lanu la Medicare Advantage lidzakuchitirani chimodzimodzi. Kampani yanu ya inshuwalansi imapeza ndalama zowonjezera koma ndalama sizinalembedwe kwa inu. Kampaniyo imayisunga iyo ndipo potsirizira pake imasankha momwe ingayigwiritsire ntchito.
Zikuoneka kuti mapulani a Medicare Advantage anagonjetsa boma pafupifupi $ 70 biliyoni kuchokera mu 2008 mpaka 2013 pogwiritsa ntchito ziwerengero zoopsa za Medicare zokhazokha. Ngati chikhalidwechi chikupitirira, solvency ya Medicare (yomwe Medicare Trust idzakhalapo kwa nthawi yayitali) ingakhale pangozi.
Funso liripobe: Kodi Medicare Advantage ndi yopindulitsa kwambiri kuchokera ku kulingalira kwa ndalama? Mu 2012, Commonwealth Fund inapeza kuti 75 peresenti ya madongosolo a Medicare Advantage ankagwiritsa ntchito zambiri pa chisamaliro kuposa Original Medicare. Mankhwala a Medicare Advantage m'mizinda ina, komabe, adapambana kwambiri kuti asunge mtengo wotsika kuposa Medicare wamba.
Kodi tingathe kupereka Medicare kwa makampani a inshuwalansi ngati akupitiriza kuika phindu pamaso pa anthu?
> Zotsatira:
> Kodi Medicare Zopindulitsa Zidapanda Kuwonjezera pa Mankhwala Achikhalidwe? Tsamba la Commonwealth Fund. http://www.commonwealthfund.org/publications/issue-briefs/2016/jan/does-medicare-advantage-cost-less. Lofalitsidwa pa January 28, 2016.
> Kodi madongosolo a Medicare Advantage amapanga bwanji? Webusaiti ya Medicare.gov. Chiwongoladzanja
> Medicare Phindu. Webusaiti ya Henry J. Kaiser Family Foundation. http://kff.org/medicare/fact-sheet/medicare-advantage/. Lofalitsidwa May 11, 2016.
> Shulte F, Donald D, Durkin E. Chifukwa Mankhwala Othandiza Amtengo Wapatali Obwezera Ngongole Mabiliyoni Osati. Msonkhanowo wa webusaiti yathu yotetezeka. Chiwongoladzanja: Idasindikizidwa pa June 4, 2014.
> Kumvetsetsa Kusintha kwa Ngozi ku Medicare Phindu. Webusaiti ya Better Medicare Alliance. http://bettermedicarealliance.org/sites/default/files/Understanding_Risk_Adjustment_in_Medicare_Advantage_February_2016.pdf. Lofalitsidwa February 2016.