Shirye-shiryen Magungunan Delaware a cikin 2021

Wadatacce

• Menene Medicare?
• Abin da yake rufewa
• Kudin Medicare
• Waɗanne tsare-tsaren Amfani da Ingancin ne ke cikin Delaware?
• Kungiyar Kula da Kiwon Lafiya (HMO)
• Providungiyar Bayar da Akafi so (PPO)
• Asusun ajiyar lafiya (MSA)
• Kudin Biyan Kuɗi Na Kai (PFFS)
• Tsarin Buƙatu na Musamman (SNP)
• Akwai tsare-tsaren da ke cikin Delaware
• Wanene ya cancanci Medicare a Delaware?
• Yaushe zan iya shiga cikin shirye-shiryen Medicare Delaware?
• Rijistar abubuwan da suka faru
• Shiga shekara-shekara
• Nasihu don yin rajista a cikin Medicare a cikin Delaware
• Delaware Magungunan Medicare
• Ofishin Taimakon Magungunan Delaware (800-336-9500)
• Medicare.gov (800-633-4227)
• Me zan yi a gaba?

Medicare ita ce inshorar lafiya ta gwamnati wacce za ku iya samu lokacin da kuka cika shekara 65. Medicare a cikin Delaware kuma ana samun ta ne ga mutanen da shekarunsu ba su kai 65 ba waɗanda suka cika wasu sharuɗɗa.

Menene Medicare?

Medicare ya hada da manyan sassa hudu:

• Kashi na A: kulawar asibiti
• Sashe na B: kulawar marasa lafiya
• Sashe na C: Amfani da Kulawa
• Sashe na D: magungunan ƙwayoyi

Abin da yake rufewa

Kowane bangare na Medicare ya ƙunshi abubuwa daban-daban:

• Kashi na A ya shafi kulawar da kuka karba a matsayin mara lafiya a asibiti sannan kuma ya hada da kulawar asibiti, takaitaccen bayani game da kulawar jinya na gajeren lokaci (SNF), da wasu ayyukan kula da lafiyar gida na lokaci-lokaci.
• Sashi na B ya shafi kula da marasa lafiya, kamar ziyarar likitoci, ba da kariya, da wasu kayan aikin likita masu karko.
• Sashi na C yana ɗaukar ɗaukar hoto don Sashi na A da Sashi B cikin tsari guda ɗaya wanda zai iya haɗa da wasu fa'idodi, kamar haƙori ko hangen nesa. Waɗannan tsare-tsaren galibi sun haɗa da ɗaukar magungunan ƙwaya kuma.
• Sashi na D yana ɗaukar wasu ko duk kuɗin kuɗin maganin ku na asibiti a waje da asibiti (magani da kuka samu yayin zaman asibiti an rufe shi a ƙarƙashin Sashi na A).

Baya ga manyan sassa huɗu, akwai kuma tsare-tsaren inshora na ƙarin inshora. Sau da yawa ana kiransa Medigap, waɗannan tsare-tsaren suna biyan kuɗi daga aljihu kamar biyan kuɗi da kuma biyan kuɗi wanda ainihin shirin Medicare baya yi kuma ana samun su ta hanyar masu jigilar inshora masu zaman kansu.

Ba zaku iya siyan duka Sashin C da Medigap ba. Dole ne ku zaɓi nau'in ɗaya ko ɗaya.

Kudin Medicare

Shirye-shiryen Medicare a cikin Delaware suna da wasu tsada waɗanda kuka biya don ɗaukar hoto da kulawa.

Kashi na A ana samunsa ba tare da biyan kowane wata ba muddin kai ko mata kun yi aiki na tsawon shekaru 10 ko fiye a cikin aiki kuma sun biya harajin Medicare. Hakanan zaka iya sayan ɗaukar hoto idan baku cika buƙatun cancanta ba.Sauran farashin sun hada da:

• abin cire kudi duk lokacin da aka shigar da kai asibiti
• ƙarin farashin idan asibitin ku ko SNF ɗinku ya daɗe fiye da saitin kwanaki

Kashi na B yana da kudade da yawa da tsada, gami da:

• kyauta na wata-wata
• shekara-shekara wanda ake cirewa
• biyan kuɗaɗe da kashi 20 na kuɗin tsabar kudi bayan an cire kuɗin ku

Kashi na C tsare-tsaren na iya samun kyauta don ƙarin fa'idodi waɗanda ke samuwa ta hanyar shirin. Hakanan kuna biyan kuɗin Sashin B na farko.

Kashi na D farashin kuɗi sun bambanta dangane da ɗaukar hoto.

Madigap farashin kuɗi sun bambanta dangane da shirin da kuka zaɓa.

Waɗanne tsare-tsaren Amfani da Ingancin ne ke cikin Delaware?

Shirye-shiryen Amfanin Medicare an yarda dasu Cibiyoyin Kula da Magunguna da Cutar Medicaid (CMS) kuma ana samun su ta hanyar kamfanonin inshora masu zaman kansu. Fa'idodin sun haɗa da:

• duk amfanin ku daga kowane bangare na Medicare an rufe shi a karkashin tsari guda
• sauran fa'idodin da Medicare na asali ba ya ƙunsa, kamar hakora, gani, ji, hawa zuwa alƙawarin likita, ko isar da abinci na gida
• daga cikin aljihun kuɗi mafi yawa na $ 7,550 (ko ƙasa da haka)

Akwai tsare-tsaren Amfanin Medicare guda biyar a cikin Delaware. Bari muyi la'akari da kowane nau'i na gaba.

Kungiyar Kula da Kiwon Lafiya (HMO)

• Kuna zaɓar mai ba da kulawa na farko (PCP) wanda ke tsara kulawar ku.
• Dole ne ku yi amfani da masu samarwa da kayan aiki a cikin hanyar sadarwar HMO.
• Yawancin lokaci kana buƙatar kulawa daga mai ba ka kulawa na farko (PCP) don ganin ƙwararren masani.
• Kullum ba a rufe kulawa a waje da hanyar sadarwa sai cikin larura.

Providungiyar Bayar da Akafi so (PPO)

• Kulawa daga likitoci ko wurare a cikin tsarin sadarwar PPO an rufe.
• Kulawa a waje da hanyar sadarwar na iya tsada, ko kuma baza'a rufe ta ba.
• Ba kwa buƙatar kulawa don ganin ƙwararren masani.

Asusun ajiyar lafiya (MSA)

• Waɗannan tsare-tsaren sun haɗu da babban shirin rage lafiya da asusun ajiya.
• Medicare tana ba da wasu adadin kuɗi kowace shekara don biyan kuɗin kashewa (kuna iya ƙara ƙarin).
• Za'a iya amfani da MSAs kawai don ƙwararrun kuɗin likita.
• Asusun MSA ba shi da haraji (don ƙwararrun kuɗin likita) kuma suna samun ribar mara haraji.

Kudin Biyan Kuɗi Na Kai (PFFS)

• PFFS shirye-shirye ne ba tare da cibiyar sadarwar likitoci ko asibitoci ba; zaka iya zaɓar zuwa ko'ina wanda ya yarda da shirinka.
• Suna yin shawarwari kai tsaye tare da masu samarwa kuma suna ƙayyade adadin bashin sabis.
• Ba duk likitoci ko wurare bane suka yarda da waɗannan tsare-tsaren ba.

Tsarin Buƙatu na Musamman (SNP)

• An ƙirƙiri SNPs don mutanen da suke buƙatar ƙarin haɗin kai da haɗuwa da wasu ƙwarewa.
• Dole ne ku zama masu cancanta biyu don Medicare da Medicaid, kuna da ɗaya ko fiye da yanayin lafiya, da / ko ku zauna a gidan kula.

Akwai tsare-tsaren da ke cikin Delaware

Waɗannan kamfanonin suna ba da shirye-shirye a cikin ƙananan hukumomi da yawa a Delaware:

• Aetna Medicare
• Cigna
• Humana
• Lafiya Lasso
• UnitedHealthcare

Offeringsididdigar shirin Amfani na Medicare ya bambanta da yanki, don haka shigar da takamaiman lambar ZIP ɗinka yayin neman tsare-tsaren inda kuke zaune.

Wanene ya cancanci Medicare a Delaware?

Don cancanta ga Medicare, dole ne ku kasance:

• Shekaru 65 ko sama da haka
• Ba'amurke ko mazaunin doka na tsawon shekaru 5 ko fiye

Idan kun kasance ƙasa da shekaru 65, zaku iya samun shirin Medicare a cikin Delaware idan kun:

• yi dashen koda ko ƙarshen cutar koda (ESRD)
• suna da amyotrophic lateral sclerosis (ALS)
• sun kasance suna karɓar Social Security ko Railroad Retirement Board tsawon watanni 24

Kuna iya amfani da kayan aikin Medicare don ganin ko kun cancanci.

Yaushe zan iya shiga cikin shirye-shiryen Medicare Delaware?

Don karɓar Medicare ko Amfanin Medicare dole ne ku yi rajista a lokacin da ya dace.

Rijistar abubuwan da suka faru

• Lokacin yin rajista na farko (IEP) shine taga na wata 7 a kusa da ranar haifuwar ku na 65, farawa watanni 3 da suka gabata kuma yana ci gaba har tsawon watanni 3 bayan ranar haihuwar ku. Idan kayi rajista kafin ka cika shekaru 65, ɗaukar hoto zai fara a cikin watan haihuwar ka. Shiga ciki bayan wannan lokacin yana nufin jinkiri a ɗaukar hoto.
• Lokaci na yin rajista na musamman (SEPs) sune lokutan da aka ayyana lokacin da zaka iya yin rijista a waje na buɗe rajista idan ka rasa ɗaukar hoto saboda dalilai daban-daban, gami da rasa shirin mai ɗaukar nauyi na mai ba da aiki ko ƙaura a wajen yankin ɗaukar shirin ka.

Shiga shekara-shekara

• Janar yin rajista(Janairu 1 zuwa Maris 31): Idan baku yi rajista don Medicare ba lokacin IEP ɗin ku, zaku iya yin rajista a cikin Sashe na A, Sashe na B, Sashe na C, da Sashe na D. Kuna iya biyan hukunci don yin rajistar a makare.
• Amfani da Medicare Amfani bude rajista (Janairu 1 zuwa Maris 31): Kuna iya canzawa zuwa wani sabon tsari idan kun kasance a kan Amfani da Medicare ko za ku iya ci gaba da asalin Medicare.
• Bude rajista(Oktoba 15 zuwa Disamba 7): Kuna iya canzawa tsakanin asalin Medicare da Medicare Advantage, ko shiga cikin Sashi na D idan bakayi rajista ba a lokacin IEP ɗin ku.

Nasihu don yin rajista a cikin Medicare a cikin Delaware

Zaɓin tsari mai kyau don ya dogara da dalilai masu zuwa:

• bukatun lafiyar ku
• kudaden da aka tsara
• waɗanne likitoci (ko asibitoci) kuke son gani don kulawa

Delaware Magungunan Medicare

Kuna iya samun amsoshin tambayoyin ku na Medicare Delaware daga waɗannan ƙungiyoyi:

Ofishin Taimakon Magungunan Delaware (800-336-9500)

• Shirin Taimakon Inshorar Lafiya na Jiha (SHIP), wanda a da ake kira ELDERbayani
• ba da shawara kyauta ga mutanen da ke fama da cutar likita
• rukunin yanar gizo na nasiha a duk cikin Delaware (kira 302-674-7364 don neman naka)
• taimakon kuɗi don taimakawa wajen biyan kuɗin Medicare

Medicare.gov (800-633-4227)

• yayi aiki a matsayin shafin yanar gizon Medicare
• ya horar da ma'aikata kan kira don taimakawa amsa tambayoyin ku na Medicare
• yana da kayan aikin nema don taimaka maka samun wadatar Medicare, Sashe na D, da shirye-shiryen Medigap a yankinka

Me zan yi a gaba?

Anan ga matakanku na gaba don nemo mafi kyawun ɗaukar marasa lafiya don biyan bukatunku:

• Ayyade ko kuna son Medicare na asali ko Amfanin Medicare.
• Zaɓi Amfanin Kula da Lafiya ko Manufofin Medigap, idan an zartar.
• Gano lokacin yin rajistar ku da ajalin ku.
• Tattara bayanai kamar jerin magungunan likitancin da kuka sha da kowane irin yanayin kiwon lafiya da kuke dashi.
• Tambayi likitanku idan sun yarda da Medicare, da kuma wacce cibiyar sadarwar Medicare suke.

An sabunta wannan labarin a Nuwamba 10, 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.