Mishonga yezvirongwa zvekushandisa inouya mune zvinyorwa zvina zvinokosha
Medicare Makomborero Mapurogiramu, kana Medicare Chikamu C, inopa Medicare vanobatsirwa pane imwe nzira yeMedare. Izvo zvirongwa zvinoita kuti varwere vasarudze hurongwa hunogona kupa kuchinja kwavanoda kuitira kuti vatarise zvavanoda. Izvi zvingave zvichifadza sezvo vazhinji vanopiwa Medicare vari pane mari yakasarudzwa.
Medicare Makomborero Mazano Akafukidzirwa Mazano
Medicare Advantage Plan Makambani anofanirwa kutevera imwechete yemitemo inotungamirira chirongwa cheMedare. Medicare zvibvumirano nemasangano ehurumende kana ega ega kupa hutano hwakasiyana-siyana hwehutano hwehutano hunoisa zvikwereti zvakafanana izvo Medicare Chikamu A uye Chikamu B chinovhara.
- Medicare Chikamu A chinonzi inshuwarhu yepatara nokuti inobatsira kubhadhara kuchengetwa kwomurwere anogamuchira muchipatara chirwere chepachipatara, chirwere chakakosha chinosvika, chiremba unyanzvi hwehutano (SNF), hospice, uye kutarisira utano hwepamusha.
- Medicare Chikamu B chikamu cheMedare chinonzi "inshuwarisi" yehutano. Iyi chikamu cheMedare ndeyekusarudzira kune varwere kana vaine makore makumi matanhatu nemashanu, uye vanobhadharwa purogiramu yemwedzi. Chikamu B inosanganisira zvizhinji zvisingabatanidzwi neChikamu A.
Mhando dzeMedare Inobatsira Mazano - Chikamu C
Iko kune marudzi mana akasiyana eMedare Advantage Plans ayo vanobatsirwa vanogona kusarudza kubva. Izvi zvinopesana nezvokuti vanopa mari vanobhadhara sei, uyewo mapepa uye zvimwe zvido zvevarwere.
1. Utano Hwekuchengetedza Utano kana HMO Plans
Medicare HMO zvirongwa zvinoshanda nenzira yakafanana nekutarisira kutarisirwa HMO zvirongwa. Chimiro icho chinonyanya kunyanya neHMO chirongwa ndiyo nzira yekubhadhara kwayo. Ihofisi yezvokurapa inogamuchira mwero wakatarwa, mwedzi mumwe nomumwe nemurwere. Iyi mari inoramba ichifanana zvisinei nokuti vangani vanoshanyira murwere vane, mari yekutengesa mari, kana kunyange kana vasingagamuchiri kutarisirwa zvachose. Mamwe maitiro eHMO ndeaya:
- Kushoma kune in-network providers kunze kwekukurumidza
- Zviratidzo zvinotarisirwa kuona chiremba
- Pamberi pemvumo inotarisirwa kune mamwe mabasa
- Nhengo hadzina deductible uye zvishoma copays
2. Mupi weHurumende Anosarudza kana PPO Plans
Medicare PPO zvirongwa zvakafanana nekuchengetedzwa kwakachengetedzwa PPO Plans. PPOs inobhadhara nemari yekubhadhara-ye-service. Hofisi yekushanyira, maawa ekuongorora mabhii, X-rays, kana mamwe mabasa anobhadharwa maererano nemutambo wemari. Iyi nzira yekubhadhara inobvumira hofisi yezvokurapa kugamuchira kubhadharwa kwakakwana kwechikamu chega chega chekutarisira. Zvimwe zvinhu ndezvi:
- In-network uye kunze kwe-network vanobvumirwa vanobvumirwa, asi varwere vanobhadhara zvishoma apo in-network providers vanoshandiswa
- Hapana kutumira kunodiwa kuti uone nyanzvi
- Pamberi pemvumo inotarisirwa kune mamwe mabasa
- Nhengo dzinogona kunge dziine basa rekudzikinura, zvinyorwa, uye coinsurance
- Inopa zvimwe zvikomborero zvichienzaniswa neMagareti, zvekare pamutengo wekuwedzera
- Inosanganisira gore rega rega-re-rehomwe
3. Pamwe Chete-For-Service kana PFFS Plans
Chinhu chinonyanya kukosha kuziva pamusoro pezvirongwa zveMedricare PFFS ndechokuti vanobvumira vashandi kuti "vaenzanise mari" kusvika 15 kubva muzana pamusoro pemari yekubhadhara chirongwa chebasa. PFFS zvirongwa zvinoshanda zvakafanana nekugadzirisa zvirongwa.
Indemnity inshuwarano zvirongwa zvinokweretesa kuhofisi yezvokurapa inobva pamari-ye-service model. Mune mari-ye-kushanda, hofisi yezvokurapa inobhadharwa mari yakatarwa yega yega yega kana chikwata chebasa rakashandurwa. Hofisi yekushanyira, maawa ekuongorora mabhii, X-rays, kana mamwe mabasa anobhadharwa maererano nemutambo wemari. Iyi nzira yekubhadhara inobvumira hofisi yezvokurapa kugamuchira kubhadharwa kwakakwana kwechikamu chega chega chekutarisira.
4. Zvimwe Zvidikanwi Zvitsva kana SNP
Medicare Special Needs Needs Zvirongwa zvinotarirwa kune vanobatsira vanorarama nezvimwe zvirwere zvisingaperi, zvirwere, kana zvirwere. Batsiro inongowanikwa kuvarwere vano:
- Iva nemamiriro ezvinhu asingazivikanwi kana kuti asingagoni kudzivisa seAIDS / AIDS, chirwere cheshuga, hutano hwepfungwa, congestive moyo kusagadzikana (CHF), kungoti vashoma
- Urarame mumusha wakwegura kana kugamuchira kutarisira kumba
- Gamuchira zvose Medicare neMedicaid zvinobatsira
Zvinotakura
Medicare Kubatsira zvirongwa dzimwe nguva zvinopesana nezvirongwa zvekuchengetedza zvakachengetedzwa nevashandi vehofisi yezvehutano. Zvizhinji zvezvirongwa izvi zvinopiwa kuburikidza nemakambani makuru ehutano inshuwarisi akadai se:
- Aetna
- AARP
- United Health Health
- Blue Cross Blue Shield
- WellCare
Zvakakosha kuti uzive zvirongwa zve Medicare Advantage munharaunda yako uye kuti iwe ungaisa sei zvikwereti kuitira kuti udzivise kunonoka kubhadhara.