Kumvetsa Ma Medigap Policy ndi Supplemental Inshuwalansi
Choyamba Medicare (chomwe chimaphatikizapo Gawo A A Inshuwalansi ya Chipatala ndi Gawo B Inshuwalansi ya Zamankhwala ) amalipira ambiri, koma osati onse, ntchito zokhudzana ndi thanzi komanso mankhwala. Mukhoza kugula inshuwalansi kuti mupeze "mipata" yomwe simukulipirako ndi Medicare, monga mapepala, ndalama zothandizira, komanso zopereka ndalama. Izi zingawonjezere ndalama zambiri , makamaka ngati mwakhala kuchipatala kapena mukusowa ntchito zothandizira anthu okalamba.
Ndondomeko zina za Medigap zidzalipiranso zithandizo zamankhwala kunja kwa United States ndi zina zothandizira zowonjezera zomwe sizinapangidwe ndi Medicare.
Inshuwalansi ya Medigap (yomwe imatchedwanso Medicare Supplement Inshuwalansi) ndi yodzipereka ndipo muli ndi udindo pa premium kapena pachaka premium. Medicare salipira malipiro anu kuligula ndondomeko ya Medigap.
Kodi Malamulo a Medigap Amagwira Ntchito Motani?
Ngati muli mu Medicare Yoyamba (Mbali A ndi B) ndipo muli ndi ndondomeko ya Medigap, oyamba Medicare amalipira gawo lake la ndalama zomwe amagwiritsidwa ntchito ndi Medicare chifukwa cha ndalama zanu zothandizira. Ndiye ndondomeko yanu ya Medigap imapereka gawo lake la mtengo.
Mwachitsanzo: Alice G ali ndi matenda a shuga a mtundu wa 2 ndipo amachezera dokotala wake woyang'anira chisamaliro chaka chilichonse miyezi itatu kapena inayi kuti azisamalidwa. Malinga ake a Medigap akuphatikizapo Mapulani a B B, koma osati a Plan B omwe amachotsedwa . Kumayambiriro kwa chaka, amalipiritsa ndalama zokwana madola 155 oyendetsa kuchipatala. Pambuyo pake, Medicare amalipira 80% ya maulendo ovomerezeka a Medicare ndi maulendo ake a Medigap ndi ndondomeko yake ya Medigap imapereka 20% otsala - popeza Medicare ikuvomereza ku ofesi ku ofesi ya $ 65, Medicare imalipira $ 52 ndipo Medigap amapereka $ 13.
Malamulo a Medigap amagulitsidwa ndi makampani a inshuwalansi. Ndondomekozi zikufunika kuti zidziwike ngati Medicare Supplement Inshuwalansi . Ndipo, ndondomeko iliyonse iyenera kutsata malamulo a feduro ndi a boma okonzedwa kuti ateteze ogula.
Makampani a inshuwalansi a Medigap angokugulitseni malingaliro ofanana a Medigap omwe amapezeka ndi makalata A kupyolera mwa L.
Ndondomeko iliyonse ya Medigap iyenera kupereka phindu lofanana, ngakhale kuti kampani ya inshuwalansi ikugulitsa. Choncho, Medigap Plan F ili ndi phindu lofanana ngakhale pampani kapena inshuwalansi.
Ndemanga ya Medigap kuchokera kwa Mike Mike: Sizinthu zonse zomwe zikupezeka m'madera onse. Ndipo, atatu akuti - Massachusetts, Minnesota ndi Wisconsin - ali ndi malingaliro awo a Medigap omwe ali osiyana ndi ndondomeko ya Medigap.
Kodi Medigap Inshuwalansi Yambiri Ngati?
Kodi mumalipiritsa ndalama zotani pa ndondomeko ya Medigap kumadalira ndondomeko yomwe mumasankha ndi kampani imene mumagwiritsa ntchito inshuwalansi.
Zolinga zonse (A kupyolera mu L) zimapereka phindu losiyana ndipo ndalama zimasiyana ndi kuchuluka kwake. Kawirikawiri, ndondomeko A, yomwe imapereka madalitso ochepa omwe ali ndi malipiro apamwamba kwambiri. Mapulani a Medigap omwe amapereka zowonjezera, monga Plan J, kawirikawiri amakhala ndi apamwamba. Malinga ndi Medicare Rights Center, mapulani a Medigap omwe ndi otchuka kwambiri ndi C ndi F, chifukwa amapindulitsa kwambiri ndipo ndi otsika mtengo kuposa zolinga zambiri.
Ngakhale Medicare ikufotokoza zomwe Medigap imapereka, sizikulamulira zomwe kampani ya inshuwalansi ikhoza kulipira. Makampani apakampani a inshuwalansi okhawo amatha kulipira ndalama zosiyana zofanana ndi momwe Medigap imayambira.
Mwachitsanzo: Ku New York City, kuyambira mwezi wa December 2009, msonkho wamwezi uliwonse wa Medigap Plan C unachokera pa $ 232 mpaka kufika pa $ 337. Izi zikhoza kukhala kusiyana kwa pachaka kwa $ 1260!
Mitundu Yabwino Yanji Kodi Malamulo a Medigap Amapereka?
Medigap amapanga A kudzera mwa J ayenera kuphatikizapo zotsatirazi:
- Inpatient Hospital Care: Akuphimba Medicare Part A ndalama zothandizira (koma osati Gawo A pachaka deductible) kuphatikizapo kulandila kwa masiku 365 pambuyo pa kulandira thandizo kwa Medicare kumatha.
- Ndalama Zamankhwala: Amagwiritsira ntchito Medicare Part B yothandizira (koma osati gawo la B) loperekedwa pachaka) kapena ndalama zothandizira kuchipatala. Gawo B ndalama zambiri ndi 20 peresenti ya ndalama zomwe amagwiritsidwa ntchito ndi Medicare.
- Magazi: Aphimba mapulogalamu atatu oyambirira a magazi omwe mukufunikira chaka chilichonse.
Malingana ndi momwe Medigap mungasankhire, mungapeze ndalama zowonjezerapo komanso ndalama zomwe Medicare sizikuphimba, kuphatikizapo:
- Chipatala cha pachaka chakale (mapulani a B ku L)
- Unamwino wodziwa bwino umoyo umalimbikitsa (mapulani C mpaka L)
- Gawo B pachaka lopangidwa (mapulani C, F ndi J)
- Kusamalira mwadzidzidzi paulendo wakunja (mapulani C mpaka J)
- Kusamalidwa pakhomo pakhomo (mapulani D, G, I ndi J)
- Kusamala kosamaliridwa kumene sikuperekedwa ndi Medicare (mapulani E ndi J)
- Medicare Part B owonjezera madokotala (ndondomeko F, G, I ndi J) - malipiro ochulukirapo ndi ndalama pamwamba pa ndalama zavomerezedwa ndi Medicare kuti dokotala yemwe sagwira nawo ntchito ya Medicare akhoza kulipira.
Cholinga cha Medigap kuchokera kwa Dr. Mike: Medigap Amapanga L ndi K amapereka chithandizo cha Medicare Part A okhudzidwa ndi ndalama, ndalama, komanso ndalama zothandizira Medicare Part B, chisamaliro cha kuchipatala, anamwino ogwira ntchito zamwino, ndi chithandizo cha mankhwala a Medicare. Mapulani awa ali ndi zofunikira zogawirana mtengo kusiyana ndi Mapulani A kupyolera mwa J ndipo mukuyenera kukwaniritsa malire omwe amatha kupitirira $ 4500.
Kuyambira pa June 1, 2010, mtundu wa malingaliro a Medigap omwe mungagule udzasintha. Mapulani E, H, I, ndi J sadzagulitsanso (ngati mwalembedwera kale mu chimodzi mwa mapulani awa, mukhoza kusunga ndondomeko yanu). Mapulani awiri atsopano a Medigap (M ndi N) adzaperekedwa.
Kodi Ndikufunikira Ndondomeko ya Medigap ngati ndalowa m'ndandanda ya Medicare Advantage Plan?
Malingana ngati mulembedwera mu Mapulani a Medicare Advantage , simukusowa kugula ndondomeko ya Medigap. Ndipotu, sikuletsedwa kuti wina akugulitseni ndondomeko ya Medigap ngati muli pulogalamu yabwino. Mapindu omwe amaperekedwa ndi ndondomeko ya Medigap akugwiritsidwa ntchito ndi ndondomeko yanu yopindulitsa ndipo Medigap yowonjezerapo siilipilira ndalama zomwe mukupindula nazo, ndalama zanu, kapena ndalama zanu.
Kodi Ndingaphunzire Kuti Kuwonjezera Pogwiritsa Ntchito Medigap?
Musanagule ndondomeko ya Medigap, nkofunika kuti mumvetse malamulo a Medicare's Medigap, ufulu wanu, komanso mwayi wa Medigap womwe ulipo mdziko lanu. Zotsatira zotsatirazi ndi malo abwino oyamba:
- Kusankha Mfundo ya Medigap: Buku lochokera ku Medicare
- Supplemental Inshuwalansi ya Chiyambi Cha Medicare: Chidziwitso chokhudzana ndi kufotokoza kwa Medigap kuchokera ku Medicare Rights Center
- State Health Insurance Assistance Program: pulogalamu yomwe imapereka uphungu ndi thandizo limodzi kwa anthu omwe ali ndi Medicare