I-Medicare vs Medicaid: Uyintoni umahluko?

Inkampani

Ukuhamba ngeendlela zokhathalelo lwempilo kunokuba yinkohliso kunye nokudideka. Ayisiyiyo kuphela ukuba kukho isicwangciso seinshurensi yezempilo engapheliyo, kodwa kukwakho neenkqubo ezilawulwa ngurhulumente Unyango kwaye Unyango .

Zombini ezi nkqubo zinzima kakhulu kwaye kunokuba nzima ukuhamba wedwa. Ukuba ufuna ukubhalisa kuyo nayiphi na into, kubalulekile ukuba ufumane umthombo othembekileyo onokukukhokela kwinkqubo. Kwi-Medicare, nxibelelana neNkqubo yoNcedo lwe-Inshurensi yezeMpilo kaRhulumente, okanye i-SHIP, kwilizwe lakho Apha okanye fowunela iZiko lamaLungelo eMedare kwi-1-800-333-4114. Unokutyelela kwakhona cms.gov ngoncedo kubhaliso lweMedicare okanye iMedicaid kunye nokufaneleka.

Ngelixa kungaphelelanga, apha sijonga ukuba yintoni eyahlula iMedicare vs Medicaid.

Yintoni umahluko ophambili phakathi kweMedare kunye neMedicaid?

Ngelixa i-Medicare kunye neMedicaid zombiniilawulwa ngurhulumenteiinkqubo zeinshurensi yezempilo ukunceda ngeendleko zokhathalelo lwempilo, zisebenza ngeenjongo ezahlukeneyo kunye nabantu.

Unyango

Unyango igubungela abantu abadala abaneminyaka engama-65 nangaphezulu kunye nabantu abangaphantsi kwama-65 abakhubazekileyo. Inani leerhafu zeMedare ozihlawule kurhulumente waseburhulumenteni ngelixa uqeshwe ziya kugqiba ukuba uza kuhlawuliswa malini kwiCandelo A (jonga ngezantsi). Nangona kunjalo, usenokufanelekela i-Medicare ukuba awuyikuhlawula irhafu ye-Medicare. Kukho iindawo ezine ezahlukeneyo zeMedare.

• Icandelo A igubungela ukhathalelo lwezibhedlele ezingalaliswayo, ukhathalelo lwezakhono lwabanyamekela abantu, ukhathalelo lwempilo yasekhaya, kunye nokunyamekela abaguli
• Icandelo B igubungela utyelelo logqirha kunye neenkonzo ezininzi zonyango. Icandelo B likwagubungela izixhobo zonyango ezizinzileyo, iinkonzo zeenqwelo zezigulana, iinkonzo zempilo yengqondo, kunye nezinye iinkonzo zonyango. Qaphela: Imveli, intlawulo yenkonzo ye-Medicare Parts A kunye ne-B zihlala zibizwa ngokuba yi-Original Medicare.
• Icandelo C , ekwabizwa ngokuba ziiplani zeMedicare Advantage (okanye i-MA), kukuzikhethela okunikezelwa yinkampani yabucala yeinshurensi endaweni ngqo kurhulumente womanyano. Le yenye indlela yokufumana i-Medicare. Ngamanye amaxesha igubungela izinto ezingafakwanga yiMedicare yoqobo, njengokukhathalela amazinyo kunye nokubona. Inokugubungela amayeza amiselweyo kunye nokongezwa njengokuhanjiswa kwesidlo okanye ukuhanjiswa kutyelelo logqirha.
• Icandelo D yinxalenye yokuzikhethela yeMedare ebonelela ngogonyo lweziyobisi, kwaye iyafumaneka kuphela ngeinshurensi zabucala ezivunyiweyo yiMedicare. (Ngolwazi oluthe kratya malunga neendleko zokuyalelwa ezinxulumene neCandelo D, funda ngakumbi malunga Umngxuma weMedare .

Unyango

I-Medicaid yinkqubo kawonkewonke ebonelela nge-inshurensi yezempilo kubantu abathile abanengeniso ephantsi kwaye ixhaswa ngurhulumente welizwe ukongeza kurhulumente womanyano. I-Medicaid igubungela abantu abadala, abantu abakhubazekileyo, abantwana, abasetyhini abakhulelweyo, abazali kunye nabagcini babantwana.

Abantu banokuba neMedicare kunye neMedicaid ngaxeshanye.

Ngubani ofanelekileyo kwiMedicare vs Medicaid?

Akunabo bonke abantu abanelungelo lokufumana i-Medicare kunye / okanye i-Medicaid. Nazi iziqinisekiso zenkqubo nganye karhulumente.

Unyango

Izidingo zokufaneleka kwezi 65+ zibandakanya:

• Wena (okanye iqabane lakho) nifumana okanye nifanele ukufumana umhlala-phantsi woKhuseleko lwezeNtlalontle okanye iBhodi yoMhlala-phantsi yoLoliwe (RRB). OKANYE
• Ungaba:
  • ngummi waseU.S. OKANYE
  • Umhlali osisigxina ohlala e-US ngokuqhubekayo iminyaka emihlanu ngaphambi kokufaka isicelo.

Kuyenzeka ukuba ufaneleke kwirekhodi yomsebenzi womntu oswelekileyo okanye oqhawule umtshato. Ukulungela izibonelelo ezipheleleyo zeMedicare phantsi kweminyaka engama-65:

• Ufumene iintlawulo ze-Inshurensi yokuKhubazeka kweNtlalo (SSDI) okungenani iinyanga ezingama-24. OKANYE
• Unesifo esifanelekileyo
  • Amyotrophic lateral sclerosis (ALS) ikwabizwa ngokuba sisifo sikaLou Gehrig kwaye ufumane i-SSDI (awunyanzelekanga ukuba ulinde iinyanga ezingama-24)
  • Isifo se-renal sokugqibela efuna ukuphindaphindeka kwidayalisisi okanye ukuba ukhe wafakelwa izintso KUNYE
    • uvumelekile ukuba ufumane i-SSDI okanye iZibonelelo zoMhlala-phantsi koLoliwe
    • Uhlawule irhafu yeMedare ngexesha elithile njengoko kuchaziwe kuLawulo loKhuseleko loLuntu

Ukuba udibana neziqinisekiso zingasentla, kwaye ungummi okanye ube ungumhlali ngokusemthethweni ubuncinci iminyaka emihlanu, kodwa ungenayo imbali yomsebenzi ukuze ufaneleke ukubhaliswa simahla kwiCandelo A le-Medicare, kusenokwenzeka ukuba ulungele izibonelelo zeMedare ukuba umvuzo ophantsi. Kuya kufuneka unxibelelane neMedicare, uLawulo loKhuseleko loLuntu, okanye iqela elikhuthazayo lendawo ukuze ufumane uncedo olungaphezulu.

Ngokumalunga nokubhaliswa, abanye abantu babhaliswa ngokuzenzekelayo kwiCandelo leMedicare A, kwi-inshurensi yesibhedlele, xa befika kuma-65. Abo bafumana izibonelelo zomhlala-phantsi kuKhuseleko lweNtlalo okanye kwiRRB babhaliswa ngokuzenzekelayo kwiCandelo leMedicare A kunye no-B.

Ukuba awukaqiniseki ukuba uyafaneleka okanye awuzange ubhalise ngokuzenzekelayo, tsalela ukhuseleko lwezeNtlalontle ku-800-772-1213. I-Medicare ikwanayo ikhalityhuleyitha ukukunceda ubone ukufaneleka kwakho okanye ubale ipremiyamu yakho.

Ezinxulumene: Isikhokelo sakho kwixesha lokubhalisa elivulekileyo le-Medicare

Unyango

Ukufaneleka kweMedicaid kuyahluka ukusuka kurhulumente ukuya kurhulumente, nangona urhulumente wobumbano ebeka imigangatho emincinci yokufaneleka ekufuneka ilandelwe lilizwe ngalinye. I-Medicaid isekelwe kwinqanaba lokufumana umvuzo, ubungakanani bendlu, ukukhubazeka kunye nezinye izinto ezifana nokukhulelwa, kodwa ezi zinto ziyahlukahluka phakathi kwamazwe. Umthetho woKhathalelo ongenakufikeleleka wazisa ukufaneleka okwandisiweyo kweMedicaid, kwezinye iindawo, ezisebenzisa kuphela imeko yengeniso. Ukuba umvuzo wekhaya ungaphantsi kwe-133% yenqanaba lentlupheko lomanyano (kodwa ngokwenene i-138% ngenxa yendlela ebalwa ngayo) umntu unokulungela le nkxaso ye-Medicaid eyandisiweyo. Amazwe aliqela asebenzisa umda wengeniso owahlukileyo.

Ukujonga ukuba ilizwe lakho landisile iMedicaid kwaye ubone ukuba uyafaneleka na, ndwendwela apha . Ukuqinisekisa umvuzo wakho xa ufaka isicelo seMedicaid, kuya kufuneka unikezele ubungqina. Oku kunokuba kunye ne-stub yokuhlawula, itsheki yokhuseleko lwentlalo, okanye ileta evela kumqeshi wakho, umzekelo. Kukho inani lezinye izinto, iikhrayitheriya zokufaneleka, kunye nezicelo zolwazi olongezelelweyo olunokufuneka xa ufaka isicelo seMedicaid.

Ukuba ilizwe lakho alandiswanga iMedicaid, ndwendwela ilizwe lakho Iwebhusayithi yeMedicaid ukubona ukuba uyafaneleka na. Umanyano indawo yentengiso yezempilo inokukuxelela ukuba zeziphi izicwangciso ezilungileyo kuwe ngokusekwe kwizinto zakho zobuqu.

Kuyenzeka ukuba ufumane izibonelelo zoKhuseleko lweNtlalo ngelixa uneMedicaid.

Ngaba iMedicaid isimahla? Kuthekani ngeMedicare?

Unyango isimahla okanye iindleko eziphantsi zixhomekeke kurhulumente.

I-Medicare ilukhuni ngakumbi. Ngaphandle kokuba unomvuzo ophantsi, kukho isiqinisekiso semali, iicopayments, iipremiyamu, kunye nezidaliweyo ekufuneka zidibene.

• Icandelo lezaMayeza A Isimahla kwabo bafaneleke ngenxa yembali yomsebenzi. Nangona kunjalo, abo bathengayo banokuhlawula ukuya kuthi ga kwiidola ezingama-458 / ngenyanga ngo-2020. Kukwakhona nokuncitshiswa kwe- $ 1,408 kwithuba ngalinye lesibonelelo (eqala mhla ungeniswa esibhedlele njengesigulana esingalaliswayo, okanye kwiziko labongikazi abanezakhono, kwaye iphela kuphela xa sele uphumile esibhedlele okanye kwiziko labongikazi iintsuku ezingama-60 zilandelelana), kunye nesibhedlele kunye nendawo yabongikazi abanezakhono imihla ngemihla, ezinokuba ngamakhulu eedola ngosuku ngaphandle kweinshurensi eyongezelelweyo. Imizekelo ye-inshurensi yokuxhasa, okanye yesibini, ibandakanya (kodwa ayikhawulelwanga) kwimali yomanyano, okanye imigaqo-nkqubo yeMedigap ethengwe ngasese. Ungaqhagamshelana neSebe le-inshurensi yakho ukuze ufunde ngakumbi ukuba zeziphi izicwangciso zeMedigap ezifumanekayo kuwe, ukuba ziya kubiza malini, kwaye zeziphi iinkonzo kunye neendleko zeMedicare abaza kuzihlawula. Abanye abantu abane-Medicare nabo banelungelo lokufumana iMedicaid, eya kuthi ihlawule uninzi lweMedare yecandelo leendleko zokwabelana.
• Icandelo leMedare B Iipremiyamu zii- $ 144.60 ngenyanga, kodwa zinokwahluka ngokwengeniso, kwaye kukho iipesenti ezingama-20 zokuqinisekisa iinkonzo zonyango, iinkonzo zonyango, kunye nezixhobo zonyango ezizinzileyo (ukuba ngaba zivunyiwe yiMedicare). Njengokuba kunjalo kwi-Medicare Part A, i-inshurensi yesibini, iMedigaps, kunye neMedicaid inokunceda ekugubungeleni uninzi lweMedicare Part B ekwabelaneni ngeendleko. Iinkqubo ezilawulwa ngurhulumente zokuLondolozwa kweMithi, okanye ii-MSPs, ezibandakanya i-QMB, i-SLMB, kunye ne-QI-1, ziya kuhlawula iipremiyamu ze-Medicare Part B kwabo bafaneleke ngokwasemalini. Nxibelelana nelizwe lakho okanye iSebe lasekuhlaleni leeNkonzo zeNtlalontle ukuze ufunde okungakumbi malunga nee-MSP.
• Icandelo lonyango leM C , okanye i-Medicare Advantage, ilawulwa nge-inshurensi yabucala ukuze ubume beendleko buhluke phakathi kwezicwangciso.
• Icandelo leMedare D , njengecandelo C, lilawulwa ngeinshurensi yabucala kwaye iindleko ziya kwahluka. Abo bafaneleke ngokwasezimalini kwinkqubo yoNcedo olongezelelekileyo banokufumana iindleko zabo zeMedare yecandelo D (iipremiyamu, iimali ezikhutshiweyo, iikopi kunye nokuqinisekiswa kwemali) kuncitshiswe kakhulu. Yiya e ssa.gov ukufunda ngakumbi ngoNcedo olongezelelweyo, kunye nokufaka isicelo sokuxhamla. Izikhokelo zokufumana umvuzo kuzo zombini iCandelo D Uncedo olongezelelweyo kunye nee-MSPs zinobubele ngakumbi kunalezo zeMedicaid.
  • Ukufumana ukuba leliphi iCandelo C okanye iCandelo D isicwangciso seMedicare esisebenza kakuhle kuwe, Ndwendwela amayeza.gov kunye nokusebenzisa isixhobo sokuFumana isiCwangciso.

Ezinxulumene: Iindleko ezinxulumene nezicwangciso zeMedicare zeCandelo D

Zeziphi izibonelelo eziphambili ezenziwa nguMedicaid ezingafakwanga yiMedicare?

Uninzi lweenkonzo ezigutyungelwe yiMedicaid kunye neMedicare ziyadibana. Nangona kunjalo, kukho ezinye iinkonzo ezibonelelwa yiMedicaid ezingafakwanga phantsi kweMedicare. Ezi nkonzo zibandakanya:

• Iinkonzo zamehlo
• Ukunyamekelwa rhoqo kwamazinyo
• Inkathalelo (inkathalelo yemihla ngemihla okt, uncedo ngemisebenzi yokuPhila kweMihla ngemihla [ADLs] njengokutya, ukuhlamba)
• Ukunyamekela ekhaya

Iinkonzo zeMedicaid ziyahluka phakathi kwamazwe. Ngokubanzi izibonelelo zeMedicaid zibandakanya:

• Iinkonzo zesibhedlele kunye nezigulana ezingalaliswayo, utyelelo logqirha, uvavanyo lwegazi, iX-reyi, kunye nokhathalelo lwempilo ekhaya

Izibonelelo zeMedare ziyahluka phakathi kweCandelo A kunye neCandelo B.

• Icandelo A igubungela ukhathalelo lwezibhedlele ezingalaliswanga, ukuhlala ixeshana elifutshane kwizibonelelo zabongikazi, i-hospice, kunye nezinye iinkonzo zonyango ekhaya.

Icandelo B igubungela ukhathalelo olungezizo ezasesibhedlele kubandakanya ukutyelelwa yi-ofisi kagqirha, ukuhlolwa, ukuvavanywa kwegazi, ii-X-reyi, izixhobo, kunye nololongo lwangaphandle.