He aha ke ʻano pono pono Medicare Dual Eligible?

Anter

• He aha kahi Medicare Dual Eligible Pono Pono Pono (D-SNP)?
• ʻO wai ka mea i kūpono no Medicare Dual Eligible SNPs?
• Ke kūpono no Medicare
• Ke kūpono no Medicaid
• Pehea ʻoe e kākau inoa ai i kahi Dual Eligible SNP?
• He aha ka uhi a Dual Eligible SNP?
• He aha ke kumu kūʻai o kahi Dual Eligible SNP?
• Nā kumukūʻai maʻamau no nā D-SNPs ma 2020
• ʻO ka lawe lawe ʻana

• ʻO kahi Medicare Dual Eligible Special Needs Plan (D-SNP) kahi hoʻolālā Medicare Advantage i hoʻolālā ʻia e hāʻawi i kahi uhi kūikawā no nā poʻe i hoʻopaʻa inoa ʻia i nā Medicare (ʻāpana A a me B) a me Medicaid.
• Kōkua kēia mau hoʻolālā i ka poʻe me nā pono nui e uhi i nā koina mai waho o ka ʻeke a lākou paha ke kuleana ma lalo o nā papahana Medicare kuʻuna.

Inā ʻoi aku ʻoe i ka makahiki 65 a i ʻole he ʻano olakino - a he palena kālā kāu e uku ai no kāu mālama ʻana - e hāʻule paha ʻoe i kahi hui i koho ʻia no nā papahana ʻinikua olakino pekelala a mokuʻāina hoʻi. ʻO ka ʻoiaʻiʻo, ʻaneʻane he 12 miliona mau ʻAmelika i kuleana i ka Medicare a me Medicaid uhi ʻia, e pili ana i ko lākou mau makahiki a me nā kūlana olakino. Inā ʻo ʻoe kekahi o lākou, kūpono paha ʻoe no kahi D-SNP.

E heluhelu e aʻo ai he aha ka D-SNP a inā kūpono ʻoe i hoʻokahi.

He aha kahi Medicare Dual Eligible Pono Pono Pono (D-SNP)?

ʻO kahi Plan Medicare Special Needs Plan (SNP) kahi ʻano Medicare Advantage (ʻĀpana C) hoʻolālā e hāʻawi i kahi ʻano o ka uhi Medicare hoʻonui ʻia. Kōkua kēia mau hoʻolālā pilikino i ka hoʻopili ʻana i ka mālama a me nā pono ma waena o Medicare, he papahana pekelala ia, a me Medicaid, kahi papahana mokuʻāina.

ʻO nā D-SNP ka mea paʻakikī o nā SNP e pili ana i nā ʻaoʻao ʻelua a me nā pono e pono ai, akā hāʻawi lākou i nā keu pono piha loa no ka poʻe me ka pono kiʻekiʻe loa.

I mea e kūpono ai no kahi D-SNP, pono ʻoe e hōʻoia i kou kuleana. Pono ʻoe e kau inoa mua ma ka Medicare a me ka papahana Medicaid o kou mokuʻāina, a pono ʻoe e hiki ke palapala i kēlā uhi.

Hana ʻia i ka makahiki 2003 e ka ʻAhaʻōlelo, loaʻa nā Medicare SNP i ka poʻe i loaʻa nā ʻaoʻao Medicare A a me B. SNP kekahi ʻano o ka papahana Medicare Part C (Advantage) i hoʻoponopono ʻia e ke aupuni pekelala a hāʻawi ʻia e nā ʻoihana ʻinikua pilikino. Hoʻohui lākou i nā mea he nui o Medicare: Māhele A ʻāpana no ka haukapila, ʻāpana B uhi no nā lawelawe olakino waho, a me ka ʻaoʻao D no ka lāʻau lapaʻau.

ʻAʻole hāʻawi nā mokuʻāina āpau iā Medicare SNPs. E like me ka 2016, 38 mau mokuʻāina me Wakinekona, D.C., a me Puerto Rico i hāʻawi aku iā D-SNPs.

Uhaʻi ʻia nā SNP i ʻekolu mau mahele e pili ana i ke ʻano o ka poʻe kūpono iā lākou.

• Pono nā papa hana kūpono ʻelua pono i nā hoʻolālā (D-SNPs). ʻO kēia mau hoʻolālā no ka poʻe i kūpono i ka Medicare a me ka papahana Medicaid o ko lākou mokuʻāina.
• Nā Kūlana Manaʻo Kūpono Kūlana Kūpono (C-SNPs). Ua hoʻokumu ʻia kēia mau hoʻolālā maikaʻi no nā poʻe me nā kūlana olakino olakino e like me ka puʻuwai puʻuwai, maʻi ʻaʻai, hopena maʻi hōʻeha hope loa, lāʻau a me ka hilinaʻi ʻana i ka wai ʻona, HIV, a me nā mea hou aʻe.
• Nā Hoʻolālā Pono Pono Pono o nā Kula (I-SNPs). Ua hoʻolālā ʻia kēia mau hoʻolālā Advantage no nā poʻe e pono e noho i kahi ʻoihana a i ʻole kahi mālama mālama wā lōʻihi no nā lā he 90.

ʻO wai ka mea i kūpono no Medicare Dual Eligible SNPs?

E noʻonoʻo ʻia no kekahi o nā SNP, pono ʻoe e kākau inoa mua ʻia i nā ʻāpana Medicare A a me B (ʻo Medicare kumu), e uhi ana i ka haukapila a me nā lawelawe lapaʻau ʻē aʻe.

Loaʻa nā ʻano like ʻole D-SNPs. ʻO kekahi he Polokalamu Malama Pono Ola (HMO), a ʻo kekahi paha he papahana ʻoihana Hoʻolaha Manaʻo (PPO). Kūlike nā hoʻolālā ma muli o ka ʻoihana inikua āu e koho ai a me kahi āu e noho ai. He mau koina ko kēlā me kēia papahana.

Hiki iā ʻoe ke kāhea iā 800-MEDICARE no ka ʻike hou aku a i ʻole e nīnau i nā nīnau e pili ana i nā D-SNP a me nā pono Medicare ʻē aʻe.

Ke kūpono no Medicare

Ua kūpono ʻoe no Medicare i ka makahiki 65 a ʻoi. Loaʻa iā ʻoe he 3 mau mahina ma mua a ma hope o ka mahina e huli ai ʻoe i 65 e kākau inoa no ka uhi mua Medicare.

Ua kūpono ʻoe no Medicare, me ka nānā ʻole i nā makahiki, inā loaʻa iā ʻoe kahi kūlana kūpono a kīnā ʻole paha, e like me ka hopena o ka maʻi kōkō a i ʻole ka amyotrophic lateral sclerosis, a i ʻole inā ʻoe ma ka ʻInikua Pilikino Pilikino no 24 mau mahina a ʻoi paha.

Inā kūpono ʻoe, hiki iā ʻoe ke kākau inoa i kahi D-SNP i ka manawa o ke kau inoa Medicare kūpono, inā hāʻawi ʻia nā D-SNP i kāu wahi.

• Kakau inoa mua. Hoʻomaka kēia manawa i 3 mau mahina ma mua o kou 65th lā hānau a hoʻolōʻihi a 3 mau mahina ma hope o kou 65 hānau.
• Hoʻokomo inoa Medicare Advantage. Mai Ianuali 1 a Malaki 31 i kēia manawa, hiki iā ʻoe ke kākau inoa a hoʻololi paha i kāu hoʻolālā Medicare Advantage. Hiki paha iā ʻoe ʻaʻole e kuapo mai Medicare kumu i kahi papahana Advantage i kēia manawa; hiki iā ʻoe ke hana i kēia ma ke kau inoa inoa wehe wale ʻia.
• Ke kākau inoa ʻana o General Medicare. ʻO kēia wā mai Ianuali 1 a hiki i Malaki 31. Inā ʻaʻole ʻoe i kau inoa no ka Medicare mua i kou wā kau inoa mua, hiki iā ʻoe ke kākau inoa i kēia manawa.
• Hoʻokomo inoa. ʻO kēia mai ʻOkakopa 15 a Kekemapa 7. ʻO kēlā me kēia mea i kūpono i Medicare hiki ke kau inoa i kēia manawa inā ʻaʻole lākou. Hiki iā ʻoe ke hoʻololi aʻe mai Medicare kumu i kahi hoʻolālā Advantage, a hiki paha iā ʻoe ke loli a haʻalele paha i kāu Advantage o kēia manawa, Māhele D, a i ʻole Medigap hoʻolālā i kēia wā.
• Nā wā kau inoa kūikawā. Loaʻa kēia mau mea i loko o ka makahiki a hoʻokumu ʻia i ka loli i kāu kūlana, e like me ke koho hou no Medicare a i ʻole Medicaid, kahi neʻe, kahi hoʻololi i kāu kūlana olakino, a i ʻole ka hoʻopau ʻana o kāu hoʻolālā o kēia manawa.

Ke kūpono no Medicaid

Hoʻokumu ʻia ka pono Medicaid ma luna o nā kumu he nui, e like me kāu loaʻa kālā, nā kūlana olakino, a inā paha ʻoe e kūpono i ka loaʻa kālā palekana kākoʻo. E ʻike ai inā kuleana ʻoe i ka uhi Medicaid i kou mokuʻāina a loaʻa ka hōʻoia o kou kuleana, e kāhea i ke keʻena Medicaid o kāu mokuʻāina.

Pehea ʻoe e kākau inoa ai i kahi Dual Eligible SNP?

Hiki iā ʻoe, ma lalo o kekahi mau kumu, ke kau inoa inoa inoa ʻia no nā ʻāpana Medicare A a me B ke huli ʻoe i 65. Akā ʻaʻole ʻoe e kau inoa inoa ʻia i kahi D-SNP no ka mea he ʻano ia o ka Medicare Advantage (ʻĀpana C) hoʻolālā.

Hiki iā ʻoe ke kūʻai i nā hoʻolālā Medicare Advantage, me D-SNPs, i loko o nā wā kākau ʻae ʻia e Medicare: ʻo ka wā kākau inoa Medicare Advantage mai Ianuali 1 a Malaki 31, wehe inoa inoa mai ʻOkakopa 15 a Kekemapa 7, a i loko o kahi manawa kākau inoa kūikawā inā loaʻa iā ʻoe e hoʻololi i kāu kūlana pākahi.

No ke kākau inoa ʻana i kekahi hoʻolālā Medicare Advantage, me D-SNPs, e hāhai i kēia mau kaʻina hana:

• Koho i kahi hoʻolālā ma kāu wahi (e ʻike i ka mea hana ʻimi hoʻolālā a Medicare no nā hoʻolālā i kāu code ZIP).
• No ke kākau inoa ʻana ma ka pūnaewele a noi paha i kahi pepa e kākau inoa ai ma ka leka uila, e kipa aku i ka pūnaewele o ka ʻoihana inikua no ka hoʻolālā āu i koho ai.
• Kāhea iā 800-MEDICARE (800-633-4227) inā makemake ʻoe i kōkua.

• kāu kāleka Medicare
• ka lā kikoʻī āu i hoʻomaka ai i nā ʻāpana Medicare A a me / a i ʻole B ka uhi ʻana
• hōʻoia o ka uhi ʻana o Medicaid (kāu kāleka Medicaid a i ʻole kahi leka luna)

He aha ka uhi a Dual Eligible SNP?

ʻO nā D-SNP nā hoʻolālā Medicare Advantage, no laila uhi lākou i nā lawelawe like ʻole e like me nā hoʻolālā Medicare Advantage ʻē aʻe. Pākuʻi ʻia kēia mau mea:

• $ 0 uku mua o kēlā me kēia mahina
• lawelawe lawelawe hoʻonohonoho
• Mahele Medicare D
• kekahi o nā lako a me nā lāʻau i kūʻai ʻia ma kahi kūʻai aku
• halihali i nā lawelawe olakino
• telehealth
• nā pono o ka ʻike a me ka hoʻolohe ʻana
• nā lālā hoʻoikaika kino a me nā hale hoʻoikaika kino

Me ka hapa nui o nā hoʻolālā Medicare Advantage, uku ʻoe i kahi ʻāpana o kāu hoʻolālā i uku ʻia mai loko mai o ka ʻeke. Me kahi D-SNP, uku ʻo Medicare a me Medicaid i ka hapa nui a i ʻole nā ​​koina āpau.

Uku ʻo Medicare i kahi mahele o kāu kumukūʻai olakino ma mua, a laila uku ʻo Medicaid i nā koina i koe paha. ʻIke ʻia ʻo Medicaid ʻo ia ka mea uku "hope hope" no nā koina i uhi ʻole ʻia a uhi hapa ʻia e Medicare.

ʻOiai ke kau nei ke kānāwai pekelala i nā kūlana loaʻa kālā Medicaid, loaʻa i kēlā me kēia mokuʻāina kona pono Medicaid a me nā palena palena. Hoʻololi ka ʻaoʻao kuhi i ka mokuʻāina, akā aia kekahi mau hoʻolālā e hoʻopili ana i nā pono Medicare a me Medicaid.

He aha ke kumu kūʻai o kahi Dual Eligible SNP?

ʻO ka maʻamau, me kahi Palena Pono Pono (SNP), uku ʻoe i kahi mahele like me ka mea āu e uku ai ma lalo o nā hoʻolālā Medicare Advantage. Hiki ke loli paha nā Premiums, copayments, coinsurances, a me nā deductibles ma muli o ka hoʻolālā āu e koho ai. Me kahi D-SNP, haʻahaʻa kāu mau kumukūʻai no ka mea ʻo kou olakino, kīnā ʻole, a i ʻole ke kūlana kālā i kūpono iā ʻoe no ke kākoʻo hou mai nā aupuni pekelala a me nā mokuʻāina.

Nā kumukūʻai maʻamau no nā D-SNPs ma 2020

ʻO ka lawe lawe ʻana

• Inā loaʻa iā ʻoe kahi pono olakino nui a kīnā ʻole paha a kaupalena ʻia kāu loaʻa kālā, hiki iā ʻoe ke kūpono no ke kākoʻo pekelala a me ka mokuʻāina.
• ʻO nā hoʻolālā pono kūikawā kūpono ʻelua (D-SNPs) kahi ʻano o ka hoʻolālā Medicare Advantage e uhi ana i kāu haukapila, mālama olakino, a me nā kuhikuhi; uhi ʻia nā kumukūʻai o ka hoʻolālā e nā pekelala a me nā kālā mokuʻāina.
• Inā kūpono ʻoe i ka Medicare a me ka papahana Medicaid o kou mokuʻāina, hiki iā ʻoe ke kuleana i kahi lawelawe olakino haʻahaʻa a uku ʻole paha ma lalo o kahi D-SNP.