Menene Tsarin Biyan Bukatun Musamman na Medicare Dual?

Wadatacce

• Menene Tsarin Buƙatun Musamman na Musamman na Medicare Dual (D-SNP)?
• Wanene ya cancanci Medicare Dual Cancantar SNPs?
• Cancantar don Medicare
• Cancanta don Medicaid
• Ta yaya ake yin rajista a cikin Dual Cancantar SNP?
• Menene Dual Cancantar SNP ya rufe?
• Menene farashin SNP mai cancanta?
• Kudin kuɗi na D-SNPs a cikin 2020
• Takeaway

• Tsarin Buƙatu na Musamman na Musamman na Duka (D-SNP) shine Tsarin Amfani da Medicare wanda aka tsara don samar da ɗaukar hoto na musamman ga mutanen da suka yi rajista a duka Medicare (sassan A da B) da Medicaid.
• Waɗannan tsare-tsaren suna taimaka wa mutane da buƙatu mafi girma su rufe aljihunan aljihun da wataƙila za su iya ɗaukar nauyinsu a ƙarƙashin shirye-shiryen Medicare na gargajiya.

Idan ka wuce shekaru 65 ko kuma kana da wasu halaye na kiwon lafiya - kuma suna da karancin kuɗi don biyan kulawarku - ƙila ku faɗa cikin rukunin zaɓaɓɓu waɗanda suka cancanci duka shirye-shiryen inshorar lafiyar jama'a na tarayya da na jihohi. A zahiri, kusan Amurkawa miliyan 12 suna da haƙƙin aikin bayar da magani da na Medicaid, dangane da shekarunsu da yanayin lafiyar su. Idan kana ɗaya daga cikinsu, zaka iya cancanta don D-SNP.

Karanta don koyon menene D-SNP kuma shin kun cancanci ɗayan.

Menene Tsarin Buƙatun Musamman na Musamman na Medicare Dual (D-SNP)?

Tsarin Buƙatu na Musamman na Medicare (SNP) wani nau'in Tsarin Amfani ne na Medicare (Sashe na C) wanda ke ba da nau'ikan ƙaddamar da aikin Medicare. Waɗannan tsare-tsaren masu zaman kansu suna taimakawa daidaita daidaito da fa'idodi tsakanin Medicare, wanda shine tsarin tarayya, da Medicaid, wanda shine shirin jihar.

D-SNPs sune mafi rikitarwa na SNPs dangane da ɗaukar hoto da buƙatun cancanta, amma suna ba da fa'idodi mafi mahimmanci ga mutanen da suke da buƙatu mafi girma.

Don cancanta ga D-SNP, dole ne ku tabbatar da cewa kun cancanci. Dole ne a fara sanya ku a cikin duka Medicare da kuma shirin Medicaid na jihar ku, kuma dole ne ku sami damar yin rubutun wannan ɗaukar hoto.

An ƙirƙira shi a cikin 2003 ta Majalisa, ana samun Medicare SNPs ga waɗanda suka riga suna da sassan Medicare A da B. SNPs nau'ikan shirin Medicare Sashe na C (Amfani) wanda gwamnatin tarayya ta tsara kuma aka bayar da kamfanonin inshora masu zaman kansu. Suna haɗuwa da abubuwa da yawa na Medicare: Sashe na A ɗaukar hoto don asibiti, Partauke da Sashi na B don sabis na marasa lafiya, da kuma Sashi na D don maganin magani.

Ba duk jihohi ke ba da Medicare SNPs ba. Tun daga 2016, jihohi 38 da Washington, DC, da Puerto Rico sun ba D-SNPs.

SNPs sun kasu kashi uku dangane da nau'in mutanen da suka cancanta dasu.

• Shirye-shiryen Musamman Masu cancanta Duka Shirye-shiryen (D-SNPs). Wadannan tsare-tsaren na mutanen da suka cancanci duka Medicare da shirin Medicaid na jiharsu.
• Shirye-shiryen Buƙatu na Musamman na Musamman (C-SNPs). Wadannan tsare-tsaren Amfani an kirkiresu ne don mutanen da suke fama da yanayin rashin lafiya kamar rashin ciwan zuciya, kansar, ƙarshen cutar koda, maganin ƙwayoyi da maye, HIV, da ƙari.
• Shirye-shiryen Buƙatun Musamman na itutionasa (I-SNPs). An tsara waɗannan tsare-tsaren Amfani ne don mutanen da suke buƙatar zama a cikin ma'aikata ko kuma wurin kulawa na dogon lokaci na fiye da kwanaki 90.

Wanene ya cancanci Medicare Dual Cancantar SNPs?

Don yin la'akari da kowane ɗayan SNPs, dole ne a fara sanya ku a cikin sassan Medicare A da B (asalin Medicare), waɗanda ke rufe asibiti da sauran ayyukan kiwon lafiya.

Akwai wadatar D-SNPs da yawa. Wasu shirye-shiryen Kulawa da Kulawa da Lafiya (HMO), wasu kuma na iya zama shirye-shiryen masu ba da Agaji (PPO). Shirye-shiryen sun bambanta dangane da kamfanin inshorar da kuka zaɓa da yankin da kuke zaune. Kowane shirin na iya samun farashi daban-daban.

Kuna iya kiran 800-MEDICARE don ƙarin bayani ko yin tambayoyi game da D-SNPs da sauran fa'idodin Medicare.

Cancantar don Medicare

Kun cancanci Medicare a shekara 65 ko sama da haka. Kuna da watanni 3 kafin da kuma bayan watan da kuka cika 65 don yin rajista don ɗaukar nauyin Medicare na farko.

Hakanan kun cancanci Medicare, ba tare da la'akari da shekaru ba, idan kuna da halin cancanta ko nakasa, kamar ƙarshen ƙarshen ƙwayar koda ko amyotrophic layin sclerosis, ko kuma idan kun kasance a cikin Inshorar Rashin Lafiya na Social na watanni 24 ko fiye.

Idan kun cancanci, kuna iya yin rajista a cikin D-SNP yayin lokacin rajistar Medicare mai dacewa, muddin ana bayar da D-SNPs a yankinku.

• Rijista na farko Wannan lokacin yana farawa watanni 3 kafin ranar haihuwar ku ta 65 kuma ya faɗaɗa har zuwa watanni 3 bayan ranar haihuwar ku na 65.
• Rijistar amfani da Medicare Wannan daga 1 ga Janairu zuwa Maris 31. A wannan lokacin, zaku iya shiga ko canza shirin Amfani da Medicare. Kuna iya ba sauyawa daga Asibiti na asali zuwa shirin Amfani a wannan lokacin; kuna iya yin hakan kawai yayin buɗe rajista.
• Janar rajista na Medicare. Wannan lokacin yana daga 1 ga Janairu zuwa 31 ga Maris. Idan baku yi rajistar asalin Medicare ba a lokacin rijistar ku na farko, kuna iya yin rijista yayin wannan.
• Bude rajista. Wannan daga 15 ga Oktoba zuwa Disamba 7. Duk wanda ya cancanci zuwa Medicare zai iya yin rijista a wannan lokacin idan bai rigaya ba. Kuna iya canzawa daga Asibitin Medicare na asali zuwa shirin Amfani, sannan kuma kuna iya canzawa ko barin Amfanin ku na yanzu, Sashi na D, ko shirin Medigap a wannan lokacin.
• Lokaci na yin rajista na musamman. Waɗannan ana samun su a cikin shekara kuma sun dogara ne da canjin yanayin ku, kamar sabon cancanta ga ko dai Medicare ko Medicaid, ƙaura, canjin yanayin lafiyar ku, ko dakatar da shirin ku na yanzu.

Cancanta don Medicaid

Cancantar Medicaid ya dogara da dalilai da yawa, gami da kuɗin shiga, yanayin kiwon lafiya, da kuma ko kun cancanci samun Suparin Tsaro na Tsaro. Don gano ko kana da damar samun tallafin Medicaid a cikin jihar ka da kuma samun tabbaci na cancanta, tuntuɓi ofishin Medicaid na jihar ka.

Ta yaya ake yin rajista a cikin Dual Cancantar SNP?

Kuna iya, a ƙarƙashin wasu yanayi, sanya ku ta atomatik don sassan Medicare A da B lokacin da kuka cika shekaru 65. Amma ba za ku shiga cikin D-SNP ta atomatik ba saboda nau'ikan Tsarin Amfani da Medicare ne (Sashe na C).

Kuna iya siyan tsare-tsaren Amfani na Medicare, gami da D-SNPs, yayin lokutan yin rajista na Medicare: lokacin yin rijistar amfani da Medicare daga Janairu 1 zuwa 31 ga Maris, buɗe rajista daga Oktoba 15 zuwa 7 ga Disamba, ko yayin lokacin yin rajista na musamman idan kuna da canza a cikin halin da kake ciki.

Don yin rajista a cikin kowane Tsarin Amfani da Medicare, gami da D-SNPs, bi waɗannan matakan:

• Zaɓi tsari a yankinku (duba kayan aikin nemo shirin Medicare don tsare-tsare a cikin lambar ZIP ɗin ku).
• Don yin rajista a kan layi ko neman takarda don yin rajista ta hanyar wasiƙa, ziyarci gidan yanar gizon kamfanin inshora don shirin da kuka zaɓa.
• Kira 800-MEDICARE (800-633-4227) idan kuna buƙatar taimako.

• katin likita
• takamaiman ranar da kuka fara sassan Medicare A da / ko B
• tabbacin Medicaid ɗaukar hoto (katin ku na Medicaid ko wasiƙar hukuma)

Menene Dual Cancantar SNP ya rufe?

D-SNPs tsare-tsaren Amfani ne na Medicare, saboda haka suna rufe dukkan ayyuka iri ɗaya kamar sauran tsare-tsaren Amfani da Medicare. Wadannan sun hada da:

• $ 0 na kowane wata
• kula da ayyukan kulawa
• Sashin Kiwon Lafiya na D
• wasu kantuna da magunguna
• sufuri zuwa sabis na likita
• kiwon lafiya
• hangen nesa da fa'idar ji
• dacewa da motsa jiki mambobi

Tare da mafi yawan tsare-tsaren Amfani da Medicare, zaka biya wani ɓangare na kuɗin shirinka daga aljihu. Tare da D-SNP, Medicare da Medicaid suna biyan mafi yawan ko halin kaka.

Medicare ce ta fara biyan wani kaso na kudin likita, sannan Medicaid ta biya duk wani kudin da za'a bari. Medicaid an san shi azaman mai biyan “makoma ta ƙarshe” don farashin da ba a rufe ba ko kuma sashin kula da lafiya ne kawai ke rufe shi.

Yayinda dokar tarayya ke tsara ƙa'idodin samun kuɗin Medicaid, kowace jiha tana da nata cancantar Medicaid da iyakokin ɗaukar hoto. Tsarin ɗaukar hoto ya bambanta da jiha, amma akwai wasu tsare-tsaren da suka haɗa da duk fa'idodin Medicare da Medicaid.

Menene farashin SNP mai cancanta?

Yawancin lokaci, tare da Tsarin Buƙatu na Musamman (SNP), zaku iya biyan kuɗi kwatankwacin abin da za ku biya a ƙarƙashin kowane shirin Amfani da Medicare. Farashin farashi, biyan kudi, bada kudi, da kuma ragin kudi na iya bambanta ya danganta da shirin da kuka zaba. Tare da D-SNP, farashin ku sun yi ƙasa saboda lafiyar ku, nakasar ku, ko halin kuɗin ku sun cancanci ku don ƙarin tallafi daga gwamnatin tarayya da na jihohi.

Kudin kuɗi na D-SNPs a cikin 2020

Takeaway

• Idan kuna da cikakkun bukatun kiwon lafiya ko naƙasa kuma kuɗin ku ya iyakance, ƙila ku cancanci samun tallafin tarayya da na jihohi.
• Shirye-shiryen Buƙatu na Musamman Masu cancanta Dual (D-SNPs) nau'ikan shirin Masarufin Amfani ne wanda ke rufe asibitin ku, kula da marasa lafiya, da kuma takaddun magani; Kudaden da aka kashe a shirin sun hada da kudaden tarayya da na jihohi.
• Idan kun cancanci duka Medicare da shirinku na Medicaid, zaku iya samun damar samun ƙarancin kuɗi ko ƙarancin kuɗi a ƙarƙashin D-SNP.