Ayi, Medicare yachikhalidwe sichimaphatikizapo zopindulitsa zomwe si zachipatala monga makhadi a golosale kapena umembala wa masewera olimbitsa thupi – InsuranceNewsNet

Nthawi yotsegulira ya Medicare yokonzekera 2022 October 15zidzapita December 7. Zotsatsa ndi zotsatsa zayamba kale kutulutsa mapulani a Medicare, kuphatikiza omwe amati akupereka a $900 ogula ndi omwe amati amapereka umembala waulere wa masewera olimbitsa thupi.

Owerenga angapo a VERIFY adatumiza maimelo ndikutumizirana mameseji VERIFY kufunsa ngati zabwinozi ndi zenizeni. Joyce anafunsa, mwachitsanzo, “Kodi olandira Medicare amayenerera $900.00 Mumapindu a zakudya? “

funso

Kodi olandira Medicare achikhalidwe ali oyenera kulandira mapindu aulere omwe siachipatala?

Magwero

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Medicare ndi Medicaid Services Centers (CMS)

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Malingaliro a kampani Health Network GroupNdi msika wodziyimira pawokha wa inshuwaransi yazaumoyo

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Makampani a inshuwaransi yazaumoyo kuphatikiza ClearMatch Medicare, Alfalfa thanzi Ndipo the Blue Shield California

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Consumer Reports, bungwe lopanda phindu lolimbikitsa ogula

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Kaiser Family Foundation (KFF), bungwe lopanda phindu lomwe limayang’ana kwambiri kafukufuku wazachipatala

yankho

Ayi, olandira Medicare achikhalidwe sakuyenera kulandira mapindu aulere osakhala achipatala. Izi ndi gawo la mapulani a Medicare Advantage omwe amayendetsedwa ndi makampani apadera.

zomwe tapeza

Zopindulitsa zambiri zomwe si zachipatala zimaperekedwa kudzera mu mapulani achinsinsi a Medicare Advantage, omwe ndi osiyana ndi dongosolo loyambirira la Medicare loperekedwa ndi boma la federal.

The Medicare ndi Medicaid Services Centers (CMS) Conventional Medicare, pulani yayikulu yoyendetsedwa ndi boma la federal, imatcha Medicare yoyambirira. Imayendera zipatala ndi ma ofesi a dotolo. Choyambirira chimakhudzanso ntchito zochizira kapena kuzindikira matenda, kuphatikiza maopaleshoni osadzikongoletsa ndi ntchito zopewera matenda, kuphatikiza katemera wa chimfine. Sichimaphimba mankhwala olembedwa mwachisawawa, koma olembetsa a Original Medicare atha kuwonjezera chithandizo chawo ndi ndondomeko ya mankhwala omwe amaperekedwa ndi kampani ya inshuwalansi.

Boma la federal limapanga mgwirizano ndi makampani a inshuwalansi apadera kuti agwiritse ntchito mapulani a Medicare Advantage. Boma la federal likufuna kuti mapulaniwa apereke ntchito zomwezo monga Medicare yoyamba-kupatulapo zochepa monga mayesero a zachipatala ndi chisamaliro chachipatala-ndipo amalola kuti mapulaniwa apereke chithandizo chowonjezera kapena zopindulitsa.

“Ndi dongosolo la Medicare phindu, mukhoza kukhala ndi chithandizo cha zinthu zomwe Medicare yoyambirira sichikuphimba, monga mapulogalamu olimbitsa thupi (mamembala a masewera olimbitsa thupi kapena kuchotsera),” CMS ikutero. “Mapulani amathanso kupindula zambiri. Mwachitsanzo, mapulani ena angapereke chithandizo cha mautumiki monga mayendedwe opita kukaonana ndi dokotala, mankhwala osagwiritsidwa ntchito ndi Gawo D, ndi ntchito zomwe zimalimbikitsa thanzi lanu ndi thanzi lanu.”

“Ntchito zomwe zimalimbikitsa thanzi lanu ndi thanzi lanu” zimaphatikizansopo zakudya zomwe zimalimbikitsa zakudya zathanzi. Medicare Yoyamba Imati Simabisa Zogula kapena Zogulitsa Malingaliro a kampani Health Network GroupNdi msika wodziyimira pawokha wa inshuwaransi yazaumoyo.

Makampani ambiri a inshuwaransi yazaumoyo amaphatikiza zopindulitsa pazakudya m’mapulani awo a Medicare Advantage, kuphatikiza ClearMatch Medicare, Alfalfa thanzi Ndipo the Blue Shield California. Onse atatu amazindikira kuti gawoli ndi gawo chabe la mapulani ena, ndipo limapezeka kwa anthu omwe ali ndi matenda osatha. Zolinga zonse zimangotengera zakudya zathanzi kapena zopatsa thanzi, ndipo sizingagwiritsidwe ntchito pazakudya zonse. chishango cha buluu nenani chidwi chawo $25 mwezi, womwe ndi wofanana ndi pafupifupi 300 dollars chaka.

Kaiser Family Foundation (KFF), bungwe lopanda phindu lomwe limachita kafukufuku wazachipatala, likuti 98% ya mapulani a Medicare Advantage payekha amaphatikiza zolimbitsa thupi, zomwe zimaphatikizapo umembala wa masewera olimbitsa thupi. KFF idapeza kuti 71% ya mapulani a Medicare Advantage amapereka phindu lazakudya. Ubwino Wocheperako wa Medicare ndi monga mayendedwe, kutema mphini, ntchito zothandizira kunyumba, ndi zida zotetezera ku bafa.

Pali mapulani osiyanasiyana a Medicare Advantage, ena omwe angakhale otsika mtengo komanso opindulitsa kwa inu kuposa Medicare yoyambirira. Koma zimatengera zomwe mukufuna komanso komwe mukukhala, kotero ndizotheka kuti Medicare yoyambirira idzakhala yotsika mtengo kwa inu m’malo mwake.

Consumer Reports, bungwe lolimbikitsa ogula lopanda phindu, likuti mapulani a Medicare nthawi zambiri amakhala abwino kwa achikulire athanzi m’matauni ndi akumidzi. Koma anthu omwe ali ndi matenda aakulu kapena osowa thanzi labwino, ndi anthu omwe amakhala kumidzi, akhoza kukhala bwino ndi Original Medicare malingana ndi mapulani a Medicare Advantage omwe alipo.

KFF yapeza kuti pafupifupi anthu onse omwe ali pa mapulani a Medicare Advantage amalipira ndalama zochepa kuti agone m’chipatala masiku atatu kusiyana ndi anthu omwe ali pa Medicare yoyambirira. Koma idapezanso kuti opitilira theka la omwe adalembetsa ku Medicare Advantage amayamba kulipira ndalama zambiri kuposa omwe adalembetsa ku Medicare kamodzi kuchipatala kumatha masiku asanu ndi awiri.

Muyenera kufufuza ndondomeko yomwe ili yabwino kwa inu, komanso ngati zopindulitsa za ndondomeko ya Medicare Advantage zidzakupulumutsirani ndalama pakati pa malipiro ndi ndalama zotuluka m’thumba. Pulogalamu yanu yothandizira inshuwaransi yazaumoyo ikhoza kukupatsani chidziwitso ndi kulembetsa kukuthandizani kusankha dongosolo lomwe lingakhale labwino kwa inu.

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