Medicare a California: Abin da kuke Bukatar Ku sani

Wadatacce

• Sashin Kiwon Lafiya A
• Sashin Kiwon Lafiya na B
• Kashi na Medicare C (Amfanin Medicare)
• Sashin Kiwon Lafiya na D
• Inshorar ƙarin inshora (Medigap)
• Menene kwanakin ƙarshe na rajista don sassan Medicare da tsare-tsaren su?
• Takeaway

Medicare shiri ne na kiwon lafiya na tarayya wanda ake amfani dashi da farko mutane masu shekaru 65 da sama da shekaru. Mutanen kowane zamani da ke da nakasa da waɗanda ke da cutar koda ta ƙarshe (ESRD) ko amyotrophic lateral sclerosis (ALS) suma suna iya karɓar Medicare.

Idan kana zaune a California kuma ka cika buƙatun Medicare, ka cancanci asalin Medicare (ɓangarorin A da B) da Medicare Sashe na D, komai inda kake a jihar. Kasancewar Medicare Part C (Medicare Advantage) ya banbanta a wasu yankuna na California fiye da yadda yake a yawancin sauran jihohi.

Cancantar Medicare Part C a cikin California ya dogara da gundumar da lambar ZIP na gidan zama na farko.

Sashin Kiwon Lafiya A

Sashi na A Medicare kuma ana sanshi da inshorar asibiti. Sashi na A ya shafi kulawar marasa lafiya na asibiti, kulawar asibiti, wasu hidimomin kiwon lafiya na gida, da iyakantattun tsayawa da ayyuka a cikin cibiyar kula da jinya (SNF).

Idan ku ko matar ku sun yi aiki kuma sun biya harajin Medicare aƙalla shekaru 10, tabbas za ku cancanci samun Partangaren A kyauta kyauta ba tare da wata wata ba. Kodayake baka cancanci sashi na A ba kyauta ba, zaka iya siyan Sashi na A (jigo na A).

Sashin Kiwon Lafiya na B

Sashe na B na Medicare ya ƙunshi ayyukan da ake buƙata na likita, kamar alƙawarin likita da sabis na motar asibiti. Hakanan ya shafi kulawa ta rigakafi, kamar allurai masu yawa. Tare da Sashi na A, Sashin Kiwon Lafiya na B ya kasance asalin Medicare. Dole ne ku biya bashin kowane wata don Medicare Sashe na B

Kashi na Medicare C (Amfanin Medicare)

Ana siyan Medicare Part C ta hannun inshora masu zaman kansu waɗanda Medicare ta amince dasu. Ta hanyar doka, shirin Medicare Part C dole ne ya rufe aƙalla kamar asalin sassan Medicare A da B, suyi. Yawancin tsare-tsaren Sashi na C sun ƙunshi ƙarin ayyuka fiye da asalin Medicare na bayarwa, amma galibi suna buƙatar yin amfani da takamaiman cibiyar sadarwar likitoci. Wasu shirye-shiryen Medicare Part C sun haɗa da ɗaukar maganin magani, amma wasu basuyi.

Babu sashin Medicare Sashe na C a ko'ina cikin California. Wasu ƙananan hukumomi suna da damar yin amfani da tsare-tsare da yawa. Sauran kananan hukumomi suna da damar yin amfani da wasu 'yan kalilan. Kimanin ƙananan hukumomi 115 a California, kamar Calaveras County, suna yi ba sami dama ga kowane shirin Amfani da Medicare.

Shigar da lambar ZIP dinka anan don ganin akwai shirin Medicare a yankinku.

Kamfanoni da yawa suna ba da manufofin Amfani a sassan California. Sun hada da:

• Aetna Medicare
• Tsarin Lafiya jeri
• Waƙar Blue Cross
• Blue Cross na Kalifoniya
• Sabon Sabuwar Ranar
• Tsarin Kula da Kiwon Lafiya na tsakiya
• Tsarin Kiwon Lafiyar Kula da wayo
• Jihar Golden
• Health Net Community Solutions, Inc.
• Lafiya na California
• Humana
• Tsarin Lafiya na Imperial na California, Inc.
• Kaiser Dindindin
• Tsarin Kiwan Lafiya
• UnitedHealthcare
• WellCare

Yawancin tsare-tsaren da aka bayar sune Tsarin Kula da Kiwon Lafiya (HMO) wanda zai fara akan farashin $ 0 na wata-wata. Matsakaicin tsadar kuɗaɗen aljihu da ake buƙatar ku biya duk shekara na iya bambanta ƙwarai game da waɗannan tsare-tsaren. Shirye-shiryen HMO galibi suna buƙatar ku biya kuɗi a kowane ziyarar likita.

Sauran nau'ikan shirye-shiryen Amfanin Medicare sun hada da tsare-tsaren Masu Ba da Agaji (PPO). Wasu daga waɗannan na iya samun mafi girma na kowane wata sama da HMOs ban da kuɗin waje na aljihu da kuma biyan kuɗi. Yana da mahimmanci a sake nazarin shirye-shiryen da kuke la'akari, saboda sun bambanta ba kawai cikin farashi ba har ma da sabis da ɗaukar hoto da aka bayar.

Sashin Kiwon Lafiya na D

Kashi na Medicare wani bangare ne na Medicare wanda ke rufe magungunan likitanci. Ana nufin amfani dashi tare da Medicare na asali (sassan A da B). Idan kuna da shirin Amfani wanda ya hada da magunguna, ba kwa buƙatar siyan Sashin Sashi na D shima.

Idan ba ku da ɗaukar magungunan magani ta hanyar wani tushe, kamar inshorar lafiya da kuka samu a wurin aiki, yana da mahimmanci ku shiga cikin Medicare Part D lokacin da kuka fara cancanta ga Medicare. Idan ba ka yi ba, maiyuwa ne ka biya mafi girman ƙima a matsayin azabar kowane wata na tsawon lokacin aikinka na Part D.

Kamfanin inshora mai zaman kansa ne ke bayar da Medicare Part D. Akwai shirye-shiryen Sashe na D a ko'ina cikin duk jihar California. Wadannan tsare-tsaren sun banbanta dangane da magungunan da suke rufewa, da kuma farashin su.

Tare da zaɓuɓɓuka da yawa, yin rajista a cikin Medicare na iya rikicewa. Waɗannan ƙungiyoyi na iya ba da bayanin da kuke buƙatar zaɓar da yin rajista a cikin mafi kyawun shirin Medicare don ku idan kuna zaune a California.

• Ma'aikatar Kula da tsufa ta Jihar California
• Ma'aikatar Inshora ta California
• HICAP (Shirin Inshorar Kula da Lafiya da Ba da Shawara)
• Shirye-shiryen Taimakon Inshorar Lafiya na Jiha (SHIP)

Inshorar ƙarin inshora (Medigap)

An tsara inshorar ƙarin inshora ko Medigap don taimaka maka biya abubuwan da asalin Medicare bai rufe ba. Waɗannan ƙididdigar sun haɗa da biyan kuɗi, asusun ajiyar kuɗi, da ragi. A cikin Kalifoniya, kuna iya sayan ɗayan nau'ikan nau'ikan 10 na daidaitattun tsare-tsare waɗanda ake samu a cikin yawancin ƙasar.

Waɗannan tsare-tsaren daidaitattun an tsara su ta haruffa haruffa: A, B, C, D, F, G, K, L, M, da N. Kowane shiri ya bambanta dangane da abubuwan da yake cirewa, da tsada, da ɗaukar hoto. A cikin California, akwai masu inshora da yawa waɗanda ke rufe wasu ko duk waɗannan tsare-tsaren. Kudin su a cikin tsare-tsaren yakan zama iri ɗaya ko kama ɗaya.

Wasu kamfanonin da ke ba da Medigap a California sun haɗa da:

• Aetna
• Anthem Blue Cross - California
• Garkuwan Blue na California
• Cigna
• Hadadden Kamfanin Inshora na Amurka
• Renceungiyar Everence Inc.
• Jihar Aljanna
• Global Life da Kamfanin Inshorar Hadari
• Gidan Lafiya
• Humana
• Mutual na Omaha
• Mai Kula da Kasa
• Kamfanin Inshorar Kiwon Lafiya na Kasa
• Oxford
• Sentinel Tsaro
• Gona na Jiha
• Kuɗaɗen Kuɗi don Luterans
• USAA
• Americanasar Amurka
• UnitedHealthcare

Wasu tsare-tsaren kuma suna buƙatar ku biya kashi ɗaya cikin ɗari na farashin ayyukan da aka rufe ƙarƙashin Sashe na B, haɗe da Aangare na A.

Akwai lokacin yin rajista na tsawon watanni 6 lokacin da zaka sami Medigap. Wannan lokacin yakan fara ne a ranar haihuwar ka na 65 kuma yayi daidai da rajistar ka a cikin Sashin Kiwon Lafiya na B.

A mafi yawancin ƙasar, wannan shine kawai lokacin da zaku iya yin rajista a cikin shirin Medigap kuma a tabbatar muku da samun sa, komai nau'in lafiyar ku.

Koyaya, a cikin California, an baku damar canzawa zuwa wani shirin na Medigap daban tare da batun tabbaci yayin kwanaki 30 masu biyo bayan ranar haihuwar ku a kowace shekara, idan har sabon shirin ya baku daidaito ko ƙarami fiye da shirin Medigap ɗinku na yanzu.

Menene kwanakin ƙarshe na rajista don sassan Medicare da tsare-tsaren su?

Ayyadaddun lokacin yin rajistar Medicare a Kalifoniya iri daya ne da na sauran kasar, ban da Medigap, wanda ke da karin lokutan yin rajista.

Takeaway

Medicare shirin inshora ne na tarayya wanda yake a California don waɗanda suka cancanci. Ba a samun fa'idar Medicare (Sashin Kiwon Lafiya na C) a cikin kowane zip code a cikin jihar. Koyaya, Medicare na asali (sassan A da B), da Medicare Sashi na D da Medigap suna nan a kowane yanki da lambar ZIP.

An sabunta wannan labarin a ranar Oktoba 6, 2020 don yin tunani game da 2021 bayanin Medicare.

Bayanin da ke wannan gidan yanar gizon na iya taimaka muku wajen yanke shawara na kanku game da inshora, amma ba a nufin ba da shawara game da sayan ko amfani da kowane inshora ko samfuran inshora. Media na Lafiya ba ya canza kasuwancin inshora ta kowace hanya kuma ba shi da lasisi a matsayin kamfanin inshora ko mai samarwa a cikin kowane ikon Amurka. Media na Lafiya ba ya ba da shawara ko amincewa da wani ɓangare na uku da zai iya ma'amala da kasuwancin inshora.