Medicare

Mwachidule cha Medicare Choyenerera ndi Ubwino

Medicare ndi pulogalamu ya federal yomwe imapereka chithandizo chamankhwala kwa anthu akuluakulu komanso anthu omwe ali ndi zolemala. Anthu okhala m'mayiko a US omwe amakumana ndi msinkhu komanso / kapena kulemala angalandire. Pulogalamuyi ikukwaniritsa zosowa za anthu oposa 56 miliyoni a ku America. Ndi ana pafupifupi 10,000 omwe amakhala ndi zaka 65 tsiku lililonse kupyolera mu 2030, chiwerengero cha anthu omwe ali pa Medicare chikupitiriza kukula.

Pulezidenti Lyndon Johnson adasindikizidwa ndi lamulo mu 1965, Medicare poyamba anali ndi magawo awiri. Zotchulidwa kuti monga Original Medicare, Part A ndi Part B zinapereka chithandizo chamankhwala kuchipatala komanso odwala matenda opatsirana. Kuchokera nthawi imeneyo, pulogalamuyi yaonjezereka kuti ikhale ndi mbali "zambiri" ndipo, ndizo, phindu. Kumvetsetsa mbali za Medicare ndi momwe amagwirira ntchito pamodzi kudzakuthandizani kulemba Medicare m'njira yomwe idzakwaniritse chisamaliro chomwe mumalandira.

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Medicare Part A: Chipatala

Malo okhala kuchipatala angakhale okwera mtengo. Mu 2011, chipatala chachikulu chimakhala madola 12,600 kwa anthu a zaka zapakati pa 65 ndi 84. Chifukwa cha Medicare, boma linalipira madola 11,900 kwa iwo okhala.

Gawo A ndi inshuwalansi ya chipatala. Amalipira ndalama zothandizira kuchipatala, chisamaliro cha kuchipatala, malo osungirako anzeru amatha , malo osungirako zipatala amakhala, komanso zina zothandizira zaumoyo. Musaganize kuti izi zikutanthauza kuti zonse zidzapidwa nthawi yaitali. Medicare ili ndi malamulo okhwima omwe amaletsa nthawi yayitali kuti iyambe ntchito izi, ngati zili choncho.

Medicare Part B: Medical Surgery

Chiwerengero cha chithandizo chamankhwala omwe mumalandira chidzakhala chiri kuchipatala, kutanthauza chipatala.

Izi zikhoza kukhala ku ofesi ya chipatala, labotale, malo osungirako zamagetsi kapena malo ena alionse . Ngakhale ngati chithandizo chikuperekedwa kuchipatala, monga kutenga X-ray kuchipatala cha radiology, Medicare sichisamalira kuchipatala pokhapokha mutaloledwa kukhala odwala.

Gawo B ndi inshuwalansi yanu ya zachipatala. Amapereka maulendo osiyanasiyana a zachipatala kuphatikizapo maulendo a dokotala, maulendo a ambulansi , khansara ndi zowonongeka zina, matenda a shuga, zipangizo zamankhwala zolimba, zojambula zojambula, ma laboratory, mankhwala ochepa , katemera , maulendo abwino , ndi zina zambiri.

Medicare Part C: Medicare Phindu

Medicare Advantage , yemwe poyamba ankadziwika kuti Medicare + Choice, ndi njira ina yowonjezera ku Medicare yomwe inaphatikizidwa ku pulogalamuyi mu 1997. Mungathe kusankha Choyamba Medicare (Gawo A ndi B) kapena Gawo C. Boma silikulolani kuti mukhale awiri .

Mapulani a Medicare Advantage amaperekedwa ndi makampani odzipangira inshuwalansi omwe asayina malonda ndi boma la federal.

Zolingazi zimagwirizana kuti ziphimbe chirichonse chomwe Original Medicare amachita koma ikhozanso kupereka zina zowonjezera.

Mu 2016, anthu oposa 18 miliyoni a ku America adasankha mapulani a Medicare Advantage pa Oyambirira Medicare kuti atsimikizire kuti apitiriza kufotokozera ntchito zomwe akufunikira. Mapulani a Medicare Advantage amadza ndi ndalama zambiri kwa opindula omwe nthawi zambiri amalipira malipiro apamwamba pamwezi kuposa momwe amachitira pa Medicare Yoyamba.

Medicare Part D: Kugwiritsa Ntchito Mankhwala Osokoneza Bongo

Census Bureau ya ku United States inanena kuti anthu ambiri a ku America adadzaza malamulo 12.2 mu 2013. Chiwerengero chimenecho chinawonjezeka kufika pa makalata 27.8 pachaka kwa iwo oposa zaka 65. N'zosavuta kuona momwe ndalama zogwiritsira ntchito mankhwala mofulumira zikhoza kuwonjezera.

Gawo D ndikulandila mankhwala osokoneza bongo omwe adasindikizidwa kukhala lamulo mu 2003 pansi pa Purezidenti George W. Bush koma inayamba mu 2006. Mofananamo Medicare Advantage, mapulaniwa akuyendetsedwa ndi makampani a inshuwalansi okhaokha koma ayenera kutsata ndondomeko zomwe boma limapereka. Ndondomeko iliyonse idzakhala ndi mankhwala osiyana siyana ndipo aliyense wothandizidwa ndi Medicare ayenera kusankha njira yabwino yowonjezera zosowa zawo.

Palibe ndondomeko imodzi yomwe imagwiritsa ntchito mankhwala onse.

Mapulani a Supplementary Medicare: Medigap

Kwa iwo amene akufuna kuwonjezeredwa kwina, Medicare Supplement Plan, yomwe imadziwikanso ngati ndondomeko ya Medigap , ikhoza kukhala chinthu choyenera kuganizira. Mapulani awa sali mbali ya pulogalamu ya Medicare, ngakhale Centers for Medicare ndi Medicaid Services (CMS) ikuyimira zomwe amaika. Mapulani a Medigap ali ofanana kudera lonse ndi ma Massachusetts, Minnesota, ndi Wisconsin.

Mapulani a Medigap samapindulitsa kwambiri ku chidziwitso cha Medicare. Chimene iwo amachita ndi kuthandiza kulipira ndalama zomwe Medicare amazisiya pa tebulo, monga zoperekera ndalama, ndalama zothandizira, komanso mapepala. Iwo angawonjezere ngakhale kufotokoza pamene mukuyenda kutsidya kwa nyanja. Zolingazi zimaperekedwa ndi a inshuwalansi zapadera ndipo zingagwiritsidwe ntchito pokhapokha ndi Original Original Medicare, osati madongosolo a Medicare Advantage.

Nthawi yolembera ku Medicare

Nthawi Yoyamba Kulembetsa (IEP) ya Medicare imayambira miyezi itatu isanakwane ndipo imathera miyezi itatu pambuyo pa kubadwa kwanu kwachisanu ndi chimodzi. Anthu omwe ali ndi Inshuwalansi Yopumidwa Yachikhalidwe (SSDI) amatha kukhala ndi Medicare m'mwezi wa 25 wa ma SSDI ndipo amalowa nawo pulogalamu ya Social Security.

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Anthu ena akhoza kukhala oyenerera nthawi yolembera chifukwa cha mbiri yawo ya ntchito kapena inshuwalansi yaumoyo yomwe ali nayo.

Pali nthawi yolembera chaka chilichonse kwa anthu omwe akufuna kusintha chithandizo chawo cha Medicare. Kodi mukufuna kusintha kuchokera ku Original Medicare kumapulani a Medicare Advantage kapena mosiyana? Kapena mukufuna kusintha kuchokera pa pulani imodzi ya Medicare kupita kumalo ena? Ino ndiyo nthawi yochitira izo. Nthawi yolembera imapezeka chaka chilichonse kuyambira pa October 15 mpaka 7 December.

Sikuti aliyense ayenera kulemba mbali iliyonse ya Medicare, koma kusayina pa nthawi kungatenge mtolo pamalipiro ochedwa ngati mutasankha kulembetsa. Malipiro omalizira a Gawo A akadatha zaka, koma Gawo B ndi gawo D zilango zomalizira zingakhalepo ngati muli ndi Medicare. Kwa mbiriyi, kusankha ndondomeko ya Medicare Advantage mmalo mwa Original Medicare sikudzakutulutsani kulipira Chigawo A ndi Part B.

Kodi Mankhwala Ambiri Amafunika Bwanji?

Medicare kaŵirikaŵiri imatchedwa mankhwala ovomerezeka, koma siufulu. Ngakhale zingakhale zotsika mtengo kusiyana ndi inshuwalansi yapadera, ambiri a ku America akuvutika kuti athe kupeza chithandizo chamankhwala. Kwa iwo omwe amakwaniritsa zofunikira zina zamtengo wapatali ndi zopeza, pali mapulogalamu a Medicare omwe angathandize kusunga ndalama.

• Gawo A: Kulipira kwa mwezi kwa Gawo A ndi kwaulere kwa anthu omwe agwira ntchito zoposa makumi anayi (zaka 10) za ntchito ya Medicare-taxed. Okwatirana awo , ndipo nthawi zina awo omwe kale anali okwatirana ndi amasiye, amalephera kulandira malipiro aulere. Iwo amene agwira ntchito zochepa kuposa izo adzalipira mazana a madola mwezi uliwonse. Kwa 2016, izi zimakhala madola 226 pamwezi pa 30-39 kwa $ 411 pamwezi zosachepera 30 peresenti ya ntchito. Gawo Lonjezereka A ndalama zimaphatikizapo $ 1,288 deductible mu 2016 pa chipatala chilichonse, malipiro a chipatala amakhala motalika kuposa masiku 60, ndipo malipiro a chithandizo cha unamwino amatha kukhala masiku oposa 20.
• Gawo B: Aliyense amapereka malipiro pamwezi pa Gawo B, ndipo pamene mumapeza zambiri mumalipira. Medicare ikuyang'ana pa ma msonkho anu a msonkho kuchokera zaka ziwiri zapitazo kuti mudziwe mtengo wa malipiro anu. Palinso nthawi imodzi yomwe imadulidwa kuti mulipirire chaka chilichonse musanapindule ($ 166 mu 2016). Kuwonjezera pa kuyesedwa koyeso, kulandiridwa kwa maulendo a Medicare ndi maulendo apachaka a maulendo apachaka ndi aulere ngati dokotala wanu akugwirizana ndi madokotala a Medicare. Muyenera kuyembekezera kulipira chitsimikizo cha 20 peresenti pazinthu zilizonse za B B zomwe mumalandira.
• Gawo C (Medicare Advantage) ndi Gawo D: Ndalama zapadera, zopatsa ndalama, komanso zopereka za Medicare Advantage ndi ndondomeko ya Gawo D zidzakhala zosiyana malinga ndi kampani ya inshuwalansi yapadera yomwe imapereka dongosolo. Komabe, ngati ndalama zanu zoposa ndalama zina, CMS imafuna kuti mumalipire ndalama zodziwika kuti Mwezi Wodzikongoletsa wa Mwezi uliwonse (IRMAA) kuwonjezera pa mapepala anu a Pakati pa D. Lamuloli lidzawonjezedwanso ngati muli pa dongosolo la Medicare Advantage lomwe likuphatikizapo kulandira mankhwala osokoneza bongo. IRMAA imalipidwa mwachindunji kwa boma, osati kwa kampani ya inshuwalansi yapadera yomwe imakonzekera dongosolo lanu.

Kumene Mungapeze Thandizo

Medicare ndi pulogalamu yovuta ndi malamulo osintha. Izo zati, izo zingakhoze kukhala zovuta kudziwa momwe angapitirire. Mutha kuitanitsa thandizo la pulogalamu ya inshuwalansi ya umoyo wanu ngati muli ndi mafunso kapena nkhawa zokhudzana ndi chithandizo cha Medicare. Awa ndiwo mapulogalamu ogwira ntchito odzipereka omwe amalandira thandizo kuchokera ku boma la federal kuti likutsogolereni. Mwinanso, mungathe kukonza akatswiri apadera kuti akuthandizeni pazochitika zilizonse zomwe mungakhale nazo.

> Zotsatira:

> Medicare Phindu. Webusaiti ya Henry J. Kaiser Family Foundation. http://kff.org/medicare/fact-sheet/medicare-advantage/. Idasindikizidwa pa June 29, 2015.

> Medicare Kulembetsa Dashboard. Maofesi a webusaiti ya Medicare ndi Medicaid Services. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/CMSProgramStatistics/Dashboard.html. Idasinthidwa mu June 2016.

> Mankhwala Ogwiritsira ntchito ndi Kusinthanitsa Ndalama za Zaumoyo. IMS Institute for Healthcare Informatics website. http://www.imshealth.com/en/thought-leadership/ims-institute/reports/use-of-medicines-in-the-us-2013. Published April 2014.

> Pfuntner A, Wier LM, Steiner C. Ndondomeko za Chipatala Zimakhala ku United States, 2011. Mphindi Yachidule ya HCUP # 168. Bungwe la Health Research Research ndi Quality . http://www.hcup-us.ahrq.gov/reports/statbriefs/sb168-Hospital-Costs-United-States-2011.pdf. Idasindikizidwa December 2013.

> Kodi Medicare Supplement Inshuwalansi (Medigap)? Webusaiti ya Medicare.gov. https://www.medicare.gov/supplement-other-insurance/medigap/whats-medigap.html.