Nā Hoʻolālā Medicare Kaleponi ma 2021

Anter

• He aha ka Medicare?
• Māhele A (ka mea maʻi maʻi a me ka hale maʻi)
• Mahele B (outpatient a me ka maʻi lapaʻau)
• Māhele D (ka lāʻau lāʻau i kuhikuhi ʻia)
• Ka Lapaʻau Medicare
• ʻO wai nā hoʻolālā Medicare Advantage i loaʻa ma Kaleponi?
• HMO
• PPO
• SNP
• Nā mea hoʻolako ma Kaleponi
• ʻO wai ka mea kūpono i Medicare ma Kaleponi?
• Āhea wau e kākau inoa ai ma Medicare ma Kaleponi?
• ʻO ka wā kākau inoa mua
• Manawa koho balota
• Hoʻokomo inoa Medicare Advantage
• Wā kākau inoa nui
• Nā wā kau inoa kūikawā
• Nā ʻōlelo aʻoaʻo no ke kākau inoa ʻana ma Medicare i Kaleponi
• Nā kumuwaiwai ʻo Medicare Kaleponi
• Polokalamu ʻ Insurancelelo Aʻoaʻo ʻInikua olakino olakino olakino (HICAP)
• Medicare
• Uhi kākoʻo a ka luna hana
• He aha kaʻu e hana ai ma hope?

He aha ka Medicare?

ʻO Medicare kahi ʻinikua olakino olakino no nā makahiki 65 a ʻoi. Hiki paha iā ʻoe ke kūpono no Medicare inā ʻoe ma lalo o 65 mau makahiki a ke noho nei ʻoe me kekahi mau kīnā a i ʻole nā ​​kūlana olakino.

Aia nā hoʻolālā Medicare ma Kaleponi:

• kumu Medicare: kahi papahana ʻinikua olakino pekelala e lawelawe ʻia e nā Centers for Medicare & Medicaid Services (CMS)
• Ka Lapaʻau Medicare: hāʻawi ʻia nā hoʻolālā ma o nā ʻoihana ʻinikua pilikino e ʻaelike me CMS
• Hoʻolālā lāʻau lapaʻau lāʻau lapaʻau Medicare: nā hoʻolālā 'inikua e uhi ana i nā kumukūʻai lāʻau lāʻau

Māhele A (ka mea maʻi maʻi a me ka hale maʻi)

Uhi ka ʻāpana A i ka mālama āu e loaʻa ai i ka wā e noho ana i nā haukapila, nā halemai komo koʻikoʻi, a me kahi manawa palena i nā keʻena hanai hānai akamai. ʻAʻole uku ka hapa nui o ka poʻe i ka uku no kēlā me kēia mahina no nā hoʻolālā ʻĀpana A, akā hiki ke unuhi ʻia inā hoʻokomo ʻia ʻoe i kahi haukapila.

Mahele B (outpatient a me ka maʻi lapaʻau)

Māhele ka ʻāpana B i ka mālama ma waho o kahi haukapila no nā mea e like me:

• nā kipa 'ana
• kānana diagnostic
• hoʻokolohua hoʻokolohua
• lako pono ola kino

E uku ʻoe i kahi uku hou aʻe no nā hoʻolālā Part B. Hoʻonohonoho ʻia nā Premiums e CMS a hoʻololi i kēlā me kēia makahiki e pili ana i nā kumukūʻai mālama ola holoʻokoʻa.

Māhele D (ka lāʻau lāʻau i kuhikuhi ʻia)

Kūpono kēlā me kēia mea ma Medicare (Part D), akā pono ʻoe e loaʻa ia mea ma o ka ʻinikua pilikino. He mea nui e hoʻohālikelike i kēia mau hoʻolālā no ka mea ʻokoʻa nā kumukūʻai a me ka uhi ʻana.

Ka Lapaʻau Medicare

Hāʻawi ʻia nā hoʻolālā Medicare Advantage (ʻĀpana C) ma o nā ʻinikua pilikino nāna e ʻākoʻakoʻa i kāu uhi āpau no nā ʻāpana A a me B, a i kekahi manawa i nā lāʻau lapaʻau kuhikuhi, i loko o kahi hoʻolālā hoʻokahi. Me nā hoʻolālā Medicare Advantage, uku mau ʻoe i ka uku Medicare Part B.

Pono nā hoʻolālā Medicare Advantage e uhi i nā mea like me nā ʻāpana Medicare A a me B, akā loaʻa kekahi uhi keu (a me kahi uku uku hou aʻe) no nā mea e like me:

• nā lawelawe kahua niho a hihi paha
• nā huila noho huila hale
• ka lawe ʻai ʻana
• ka lawe ʻana i a mai nā wā lapaʻau

ʻO wai nā hoʻolālā Medicare Advantage i loaʻa ma Kaleponi?

Ma Kaleponi, hāʻule nā ​​hoʻolālā Medicare Advantage i ʻekolu mau ʻāpana: nā hui mālama ola (HMO), nā ʻoihana hāʻawi ʻoihana i makemake ʻia (PPO), a me nā hoʻolālā pono e pono ai (SNP).

HMO

Me kahi HMO, koho ʻoe i kahi kauka mālama mua nāna e hoʻonohonoho i kāu mālama a kuhikuhi iā ʻoe i nā loea e pono ai. ʻO ka hapa nui o nā hoʻolālā e koi iā ʻoe e mālama mai nā mea hoʻolako i ka pūnaewele HMO.

ʻAʻole uhi ʻia ka mālama ma waho o ka pūnaewele HMO ke ʻole ka mālama kūpilikiʻi, ka mālama kūwaho a me ka dialysis waho o ka ʻāina.

Pono kekahi mau hoʻolālā HMO iā ʻoe e kūʻai i ka ʻāpana lāʻau lāʻau lapaʻau ʻokoʻa (Māhele D).

ʻO ka loaʻa o nā hoʻolālā HMO ma Kaleponi e loli ʻia e ka kalana, a ʻaʻole loaʻa lākou ma nā wahi āpau.

PPO

Me kahi PPO, hiki iā ʻoe ke mālama mai nā pūnaewele o nā kauka a me nā pono e hoʻolako i nā lawelawe i uhi ʻia ma lalo o kāu hoʻolālā.

Hiki iā ʻoe ke mālama mai kahi kauka i waho o kāu pūnaewele, akā ʻoi aku ka nui o kāu uku ma waho o ka ʻeke.

ʻAʻole koi ka hapa nui o nā PPO i kahi mea i hoʻouna ʻia e ʻike ai i ka loea.

ʻAʻohe o Kaleponi i kēlā me kēia mokuʻāina ʻo Medicare Advantage PPO hoʻolālā, akā he 21 mau kalana i loaʻa nā hoʻolālā PPO kūloko.

SNP

Loaʻa nā SNP i nā poʻe e pono ana i kahi kiʻekiʻe o ka mālama mālama a me ka mālama mālama. Hiki paha iā ʻoe ke loaʻa kahi SNP inā ʻoe:

• Loaʻa i kahi olakino olakino a disabling olakino paha, e like me ka maʻi kō a i ʻole ka maʻi puʻuwai mau
• "pālua kūpono" no nā Medicare a me Medicaid
• noho i ka hale kahu hānai a i ʻole ke ʻano like a i ʻole ka noho ʻana ma ka home akā e loaʻa i ka pae o ka mālama e like me kekahi ma ka home kahu

Nā mea hoʻolako ma Kaleponi

Hāʻawi kēia mau ʻoihana i nā hoʻolālā Medicare Advantage ma Kaleponi:

• ʻO Aetna Medicare
• Hoʻolālā Ola Pono
• ʻO Anthem Blue Cross
• Keʻa Kolea o Kaleponi
• Lawalu 'la
• Papa Hoʻolālā Medicare Central
• ʻO ka hoʻolālā olakino mālama akamai
• Mokuʻāina Gula
• ʻO Health Net Community Solutions, Inc.
• Upena Ola o Kaleponi
• Humana
• Ka Papa Ola Ola Imperial o Kaleponi, Inc.
• Kaiser Permanente
• Mālama Ola Kālā
• ʻO UnitedHealthcare
• ʻO WellCare

ʻAʻole hāʻawi kēlā me kēia mea lawe i nā hoʻolālā ma loko o ka mokuʻāina, no laila ʻokoʻa nā koho āu i loaʻa ai ma muli o kou kalana noho.

ʻO wai ka mea kūpono i Medicare ma Kaleponi?

Ua kūpono nā kamaʻāina Kaleponi no nā hoʻolālā Medicare a me Medicare Advantage inā:

• he kamaʻāina ʻoe no ʻAmelika Hui Pū ʻIa a i ʻole he kamaʻāina kū kānāwai no nā makahiki he 5 a ʻoi i hala
• he 65 a keu kou mau makahiki, a ʻo ʻoe a ʻo kāu wahine e kū i nā koina no ka hana ma kahi hana i kākoʻo ʻia e Medicare

Hiki ke koho ʻia nā poʻe ma lalo o ka makahiki 65 inā:

• He kīnā kou a loaʻa iā ʻoe ka ʻinikua Pilikino Pilikino Pilikino (SSDI) a i ʻole nā ​​uku kīnā o ka Papa Hoʻoholo Railroad
• Loaʻa iā ʻoe ka amyotrophic lateral sclerosis (ALS) a i ʻole ka hopena hopena maʻi maʻi maʻi (ESRD)

Inā he mau nīnau kāu e pili ana inā he kūpono ʻoe, hiki iā ʻoe ke hoʻohana i ka pono pono pūnaewele ʻo Medicare.

Āhea wau e kākau inoa ai ma Medicare ma Kaleponi?

ʻO ka wā kākau inoa mua

ʻO ka wā kākau inoa mua (EIP) he manawa 7 mau mahina e hoʻomaka ana ʻekolu mau mahina ma mua o kou lā hānau 65th a hoʻopau i 3 mau mahina ma hope o kou piha ʻana i 65 mau makahiki. Inā ʻoe e kākau inoa, e hoʻomaka ana kāu uhi ʻana i ka mua o ka malama i piha iā ʻoe i 65 mau makahiki.

Inā hoʻolohi ʻoe i ke kākau inoa ʻana a hiki i ka mahina o a i ʻole ma hope o kou lā hānau, loaʻa paha iā ʻoe kahi hakahaka i kāu ʻinikua olakino.

Manawa koho balota

Hiki iā ʻoe ke kākau inoa i nā hoʻolālā Medicare Advantage ma waena ʻOkakopa 15 a me Kekemapa 7 i kēlā me kēia makahiki. Hoʻomaka ka uhi ʻana ma Ianuali 1.

Hoʻokomo inoa Medicare Advantage

Inā ʻoe ma kahi hoʻolālā Medicare Advantage a makemake ʻoe e hoʻololi i kahi hoʻolālā Medicare Advantage ʻē aʻe a i ʻole hele i ka Medicare kumu, hiki iā ʻoe ke hana i waena o Ianuali 1 a me Malaki 31 i kēlā me kēia makahiki.

Wā kākau inoa nui

Aia ka papa inoa lehulehu ma waena Ianuali 1 a me Malaki 31 i kēlā me kēia makahiki. Inā he Medicare ʻĀpana A a makemake ʻoe e kākau inoa i ka ʻāpana B, kahi hoʻolālā Medicare Advantage, a i ʻole ʻāpana D kapili hiki iā ʻoe ke hana i kēia manawa. Maikaʻi ka uhi ʻana Iulai 1.

Nā wā kau inoa kūikawā

ʻO nā manawa kau inoa kūikawā e ʻae iā ʻoe e kākau inoa ma waho o nā wā kākau inoa maʻamau ma lalo o nā kūlana kūikawā. ʻO kahi laʻana, ʻae ka manawa inoa inoa kūikawā iā ʻoe e kākau inoa i kahi hoʻolālā hou me ka uku ʻole inā e nalo iā ʻoe kahi hoʻolālā ʻinikua i kākoʻo ʻia e ka luna a pono ʻoe e kākau inoa i ka ʻāpana B, a i ʻole e neʻe mai kahi o ka lawelawe o kāu hoʻolālā o kēia manawa.

Nā ʻōlelo aʻoaʻo no ke kākau inoa ʻana ma Medicare i Kaleponi

Hiki ke huikau nā hoʻolālā Medicare a me Medicare Advantage ma Kaleponi, no laila ma mua o kou kau inoa ʻana he mea nui e loiloi i kāu mau koho a hoʻohālikelike i nā mea like:

• nā koina
• kaupalena
• nā mea hoʻolako a me nā pono hana i ka pūnaewele o ka hoʻolālā
• Nā helu helu CMS hōkū no nā ʻāpana C a me ʻĀpana D

Inā makemake ʻoe i kōkua e hoʻoholo i nā hoʻolālā ʻoi aku ka maikaʻi no kāu mau pono a i ʻole he nīnau kāu e pili ana i nā koho i loaʻa, nui nā kumuwaiwai e kōkua iā ʻoe.

Nā kumuwaiwai ʻo Medicare Kaleponi

Polokalamu ʻ Insurancelelo Aʻoaʻo ʻInikua olakino olakino olakino (HICAP)

Hāʻawi ke Keʻena ʻOihana Hoʻokele Kaleponi i nā ʻōlelo aʻoaʻo Medicare ma o HICAP. Hāʻawi lākou:

• ʻike ma ke kākau inoa ʻana Medicare
• nā wehewehe o nā ʻāpana A, B, a me C, a pehea e hoʻoholo ai i ka uhi e pono ai
• nā pane i nā nīnau e pili ana i ka ʻāpana D kuhikuhi lāʻau lāʻau, nā koina, a me nā pono

He hūnā a manuahi ka HICAP no kekahi i kūpono i Medicare a i ʻole e lilo i koho. Hiki iā ʻoe ke ʻimi no nā lawelawe HICAP kūloko ma ke kalana a i ʻole kāhea iā 800-434-0222.

Medicare

E kāhea pololei iā Medicare no ke kōkua me ke kākau inoa a hoʻolālā paha i nā nīnau ma ke kāhea ʻana iā 800-MEDICARE (800-633-4227) a i ʻole kipa iā medicare.gov. Hiki iā ʻoe ke kāhea i ke keʻena CMS āpana ma Kapalakiko ma 415-744-3501.

Uhi kākoʻo a ka luna hana

Inā he hopohopo paha kāu e pono ai i kahi kōkua me Medicare Kaleponi i kūʻai ʻia ma o ka luna hana, e kāhea aku iā Kaleponi ʻo Managed Health Care ma 888-466-2219 a i ʻole e leka uila iā [email protected].

He aha kaʻu e hana ai ma hope?

Ke mākaukau ʻoe e kau inoa no Medicare i Kaleponi:

• e hoʻoholo i kāu uhi e pono ai a me nā noiʻi e loaʻa ana nā hoʻolālā, nā koho uhi, a me nā kumukūʻai
• e kāhea iā HICAP a i ʻole Medicare inā he nīnau kāu e pili ana i ke koho a i ʻole ka uhi ʻana
• e ʻike i ka wā e hoʻomaka ai ke kau inoa aʻe

Ua hōʻano hou ʻia kēia ʻatikala ma ʻOkakopa 5, 2020 e hōʻike i ka ʻike 2021 Medicare.

Hiki i ka ʻikepili ma kēia pūnaewele ke kōkua iā ʻoe i ka hoʻoholo ʻana pilikino e pili ana i ka ʻinikua, akā ʻaʻole ia i manaʻo ʻia e hāʻawi i nā ʻōlelo aʻoaʻo e pili ana i ke kūʻai a hoʻohana ʻana i nā huahana ʻinikua a me nā ʻinikua paha. ʻAʻole lawelawe ʻo Healthline Media i ka ʻoihana ʻinikua i kekahi ʻano a ʻaʻohe laikini ma ke ʻano he ʻinikua a i ʻole mea hana i kēlā me kēia mana o U.S. ʻAʻole koi a kākoʻo ʻo Healthline Media i nā ʻaoʻao ʻekolu i hiki ke hana i ka ʻoihana ʻinikua.