Medicare vs. Medicaid: Ndeupi mutsauko?

Kambani

Kufamba-famba kuburikidza nesarudzo dzehutano kunogona kuve nzira inonyengera uye inovhiringidza. Kwete chete kune asingaperi einishuwarenzi yehutano hurongwa sarudzo, asi kune zvekare zvirongwa-zvinofambiswa nehurumende Medicaid uye Medicare .

Ose mapurogiramu aya akaomarara zvinoshamisa uye zvinogona kunetsa kufamba wega. Kana iwe uri kutsvaga kunyoresa mune chero, zvakakosha kuti uwane inovimbwa sosi iyo inogona kukutungamira iwe kuburikidza neichi chiitiko. Kune Medicare, bvunza iyo State Health Insurance Assistance Chirongwa, kana SHIP, mudunhu rako pano kana kufonera iyo Medicare Kodzero Center pa1-800-333-4114. Iwe unogona zvakare kushanya cms.gov nerubatsiro neMedicare kana kunyoresa kweMedicaid uye kukodzera.

Kunyangwe isina kukwana, pano isu titarise izvo zvinosiyanisa Medicare vs. Medicaid.

Ndeapi misiyano yakakosha pakati peMedare neMedicaid?

Ipo Medicare neMedicaid zviri zviviriinotarisirwa nehurumendemapurogiramu einishuwarenzi ehutano kubatsira nemari yehutano, ivo vanoshanda zvakasiyana zvinangwa uye vanhu.

Medicare

Medicare inovhara vakuru vane makore makumi matanhatu nemashanu zvichikwira pamwe nevanhu vari pasi pemakumi matanhatu nemashanu vane zvimwe hurema. Huwandu hwemitero yeMedare iwe yawakabhadhara kuhurumende yemubatanidzwa iwe uchishandira ndiyo ichaona kuti uchabhadhariswa marii paChikamu A (ona pazasi). Zvisinei, iwe unogona kunge uchikwanisa kuwana Medicare kana iwe usina kubhadhara Medicare mitero. Kune zvikamu zvina zvakasiyana zveMedare.

• Chikamu A inovhara inpatient chipatara kuchengetwa, hunyanzvi huremu hwekuchengetedza, kuchengetwa kwehutano hwepamba, uye kutarisira varwere.
• Chikamu B inovhara kushanya kwechiremba uye mazhinji ekurapa varwere. Chikamu B zvakare chinofukidza yakasimba mishonga yezvokurapa, ambulensi services, hutano hwepfungwa mabasa, uye akati wandei ekurapa ekurapa. Cherekedza: Chinyakare, mubhadharo-we-webasa Medicare Zvikamu A uye B zvinowanzo kunzi sePakutanga Medicare.
• Chikamu C , inonziwo zvirongwa zveMedicare Advantage (kana MA), inosarudzika inopihwa nekambani yeinishuwarenzi yakazvimiririra panzvimbo pekunanga kubva kuhurumende yemubatanidzwa. Iyi ndiyo imwe nzira yekugamuchira Medicare. Iyo dzimwe nguva inovhara zvinhu izvo Original Medicare isingaite, seyakajairwa mazino uye kuona kutarisirwa. Inogona zvakare kuvhara mishonga yemishonga uye zvekuwedzera sekutakura kwekudya kana kutakura kuenda kunana chiremba.
• Chikamu D inosarudzika chikamu cheMedare chinopa mishonga yekunyorera mishonga, uye inowanikwa chete kuburikidza neinishuwarenzi vega ayo akatenderwa neMedicare. (Kuti uwane rumwe ruzivo nezve mari yemutero inosanganisirwa neChikamu D, verenga zvakawanda nezve iyo Medicare gomba gomba .

Medicaid

Medicaid chirongwa cheveruzhinji chinopa inishuwarenzi yehutano kune vamwe vanhu vane mari shoma uye inobhadharwa nehurumende yenyika kuwedzera kune hurumende yemubatanidzwa. Medicaid inovhara vanhu vakuru, vanhu vakaremara, vana, vakadzi vane nhumbu, vabereki, uye vanochengeta vana.

Vanhu vanogona kuva neMedicare neMedicaid panguva imwe chete.

Ndiani anokodzera Medicare vs. Medicaid?

Haasi munhu wese anokodzera kufukidzwa kweMedare uye / kana kufukidzwa kweMedicaid. Heano akakodzera epurogiramu yega yega yehurumende.

Medicare

Izvo zvinodiwa zvekukodzera zveaya makumi matanhatu nenomwe zvinosanganisira:

• Iwe (kana murume / mukadzi) unogashira kana kukodzera kuwana Social Security pamudyandigere kana Railroad Retirement Board (RRB) mabhenefiti. KANA
• Ungave:
  • mugari weU.S. KANA
  • anogara zvachose zviri pamutemo anogara achienderera muU.SA kweanosvika makore mashanu asati anyorera.

Izvo zvinoita zvakare kukodzera pane rekodhi rekodhi yemufi kana akarambana mukadzi. Kuti uve unokodzera kuzere Medicare mabhenefiti pasi pemakore makumi matanhatu nemashanu:

• Wakatambira Social Security Disability Insurance (SSDI) kubhadhara kwemwedzi ingangosvika makumi maviri nemana. KANA
• Iwe une chirwere chinokodzera
  • Amyotrophic lateral sclerosis (ALS) inonziwo chirwere chaLou Gehrig uye inogamuchira SSDI (haufanire kumirira mwedzi makumi maviri nemana)
  • End-nhanho renal chirwere zvinoda kudzokororazve dialysis kana kana iwe wakambove neitsvo kuisirwa uye
    • unokodzera kugamuchira SSDI kana Railroad Retirement Bhenefiti KANA
    • Iwe wabhadhara Medicare mutero kweimwe yakatarwa nguva seinotsanangurwa neSocial Security Administration

Kana iwe ukasangana nezvakakodzera pamusoro, uye uri mugari kana wanga uri mugari wepamutemo makore asingasviki mashanu, asi usina nhoroondo yebasa yekukwanisa kunyoreswa mahara muMedicare Chikamu A, zvichiri kungokwanisika kuwana mukana weMedare kana iwe uine mari shoma. Iwe unofanirwa kubata Medicare, iyo Social Security Administration, kana boka renharaunda rekutsigira nerumwe rubatsiro.

Kana zviri zvekunyoresa, vamwe vanhu vanozvinyora voga muMedicare Chikamu A, inishuwarenzi yechipatara, pavanosvika makore makumi matanhatu nemashanu. Avo vanogamuchira mabhenefiti kubva kuSocial Security kana iyo RRB vanonyoreswa muMedicare Chikamu A naB.

Kana iwe uchiri kusava nechokwadi kana uchikodzera kana kuti hauna kungozvinyoresa, fonera Social Security pa800-772-1213. Medicare zvakare ine karukureta kuti ikubatsire kuona kukodzera kwako kana kuverenga yako yekutanga.

RELATED: Wako mutungamiri kune iyo Medicare yakavhurika kunyoresa nguva

Medicaid

Kukodzera kweMedicaid kunosiyana kubva kumatunhu kuenda kunharaunda, asi hurumende yemubatanidzwa inoisa zviyero zvishoma zvekukodzera izvo nyika imwe neimwe inofanirwa kutevedzera. Medicaid inowanzoenderana nehuremu hwemari, saizi yemhuri, hurema, uye zvimwe zvinhu zvakaita sekuzvitakura, asi izvi zvinhu zvinogona kusiyana pakati penyika. Iyo isingadhuri Care Act zvakare yakaunza munzvimbo kuwedzerwa kukodzera kweMedicaid, mune dzimwe nzvimbo, iyo inongoshandisa chete chinzvimbo chemari. Kana mari yemhuri iri pazasi pe133% yeiyo federal hurombo huwandu (asi chaizvo 138% nekuda kwenzira yazvinoverengerwa) munhu anogona kukodzera kuwana uku kuwanda kweMedicaid kufukidzwa. Nyika dzinoverengeka dzinoshandisa muganho wakasiyana wemari.

Kuti uone kana nyika yako yawedzera Medicaid uye kuti uone kana uchikodzera, shanyira pano . Kuti uone mari yako kana uchinyorera Medicaid, unofanirwa kupa humbowo. Izvi zvinogona kunge uine mubhadharo, mubhadharo wemagariro, kana tsamba kubva kune waunoshandira, semuenzaniso. Kune zvimwe zvinoverengeka zvezvimwe zvinhu, nzira yekukodzera, uye zvikumbiro zverimwe ruzivo rwunogona kudikanwa kana uchinyorera Medicaid.

Kana nyika yako isina kuwedzera Medicaid, shanyira nyika yako Webhusaiti yeMedicaid kuti uone kana uchikodzera. Mubatanidzwa musika wezvehutano inogona zvakare kukuudza iwe kuti ndeapi marongero akakunakira iwe zvichibva pane zvako pachako zvinhu.

Izvo zvinokwanisika kugashira Social Security mabhenefiti iwe uine Medicaid.

Medicaid yakasununguka here? Ko zvakadii Medicare?

Medicaid yemahara kana yakaderera mutengo zvichienderana nehurumende.

Medicare iri zvishoma inonyengera. Kunze kwekunge iwe uine yakaderera-mari, kune mari yemubhadharo, makopi, maprimiyamu, uye zvakaderedzwa izvo zvinofanirwa kusangana.

• Medicare Chikamu A yakasununguka kune avo vanokodzera nekuda kwenhoroondo yebasa. Nekudaro, avo vanotenga mukati vanogona kubhadhara kusvika kumadhora makumi mashanu nemashanu / mwedzi muna 2020. Kune zvakare $ 1,408 inobviswa pane imwe nguva yekubatsirwa (iyo inotanga zuva raunobvumirwa kuchipatara seanorwara, kana kunzvimbo yevanamukoti vane hunyanzvi, uye rinopera chete kana wabuda muchipatara kana nzvimbo yekuyamwisa kwemazuva makumi matanhatu akateedzana), pamwe nechipatara uye nehunyanzvi hunyanzvi nzvimbo yekuchengetedza zuva rega rega, iyo inogona kuve mazana emadhora pazuva isina inishuwarenzi yekuwedzera. Mienzaniso yeinowedzerana, kana yechipiri inishuwarenzi, inosanganisira (asi haigumiri kune) kubhadhara pamudyandigere kubva kumubatanidzwa, kana zvakavanzika-zvakatengwa Medigap marongero. Unogona kutaurirana nedhipatimendi rako reinishuwarenzi kuitira kuti udzidze zvakawanda izvo zvirongwa zveMedigap zvinowanikwa kwauri, kuti zvichadhura zvakadii, uye ndeapi masevhisi eMedare uye mutengo wavanobhadhara. Vamwe vanhu vane Medicare vanokodzerawo Medicaid, iyo inobhadharira mazhinji Medicare Chikamu A mutengo wekugovana.
• Medicare Chikamu B maprimiyamu anowanzoita $ 144.60 pamwedzi, asi anogona kusiyana zvichibva pamari, uye kune makumi maviri muzana emari yekusimbiswa kwemabasa echiremba, ekurapa varwere, nemidziyo yekurapa yakasimba (kana iri Medicare-inogamuchirwa). Sezvo neMedicare Chikamu A, inishuwarenzi yechipiri, Medigaps, uye Medicaid dzinogona kubatsira kufukidza akawanda Medicare Chikamu B mutengo wekugovana. Zvirongwa zvinopihwa nehurumende Medicare Savings Programs, kana MSPs, izvo zvinosanganisira QMB, SLMB, uye QI-1, ichabhadharawo iwo maprimiyamu eMedare Chikamu B kune avo vanokodzera mari. Bata nyika yako kana veDhipatimendi renharaunda reSosaiti kuitira kuti udzidze zvakawanda nezveMSPs.
• Medicare Chikamu C , kana Medicare Advantage, inoitiswa kuburikidza neinishuwarenzi yakazvimirira yega saka chimiro chemutengo chinosiyana pakati pezvirongwa.
• Medicare Chikamu D , sechikamu C, inoitiswa kuburikidza neinishuwarenzi vega uye mutengo unosiyana. Ivo vane mari vanokodzera yeFederal Extra Rubatsiro chirongwa vanogona kuve nemari yavo yeMedare Chikamu D mari (maprimiyamu, anodonhedzwa, macopay kana koresheni) zvakaderedzwa zvakanyanya. Enda ku ssa.gov kudzidza zvakawanda nezveZvekuwedzera Rubatsiro, uye kunyorera rubatsiro. Iwo maringe nemitero yekukodzera kuwana mari kune ese Chikamu D Rakawedzerwa Rubatsiro uye maMSPs ane rupo zvakanyanya kupfuura iwo eMedicaid.
  • Kuti uwane chikamu Chikamu C kana Chikamu D Medicare chirongwa chinoshanda zvakanyanya kwauri, shanyira medicare.gov uye shandisa iyo Chirongwa Chekutsvaga.

RELATED: Mari inosanganisirwa nehurongwa hweMedicare Chikamu D

Ndeapi mabhenefiti akakosha anoita Medicaid kuvhara iyo Medicare isingaiti?

Mazhinji emasevhisi akafukidzwa neMedicaid uye Medicare inopindirana. Zvisinei, kune mamwe masevhisi ayo Medicaid inopa ayo asina kuvharwa pasi peMedare. Aya masevhisi anosanganisira:

• Optometry masevhisi
• Kugara uchitarisira mazino
• Kuchengetwa (kuchengetwa kwezuva nezuva kureva, kubatsirwa neZvinhu zveDaily Living [ADLs] sekudya, kugeza)
• Kuchengetwa kwemusha unochengetwa

Medicaid services inogona kusiyanisa pakati penyika. Muzvizhinji zveMedicaid mabhenefiti anosanganisira:

• Inpatient uye outpatient zvipatara zvipatara, kushanya kwachiremba, kuongororwa kweropa, X-ray, uye kuchengetwa kwehutano hwepamba

Medicare mabhenefiti anosiyana pakati peChikamu A uye Chikamu B.

• Chikamu A inovhara inpatient chipatara kuchengetwa, kwenguva pfupi-kugara munzvimbo dzine hunyanzvi nzvimbo dzekuchengetedza, hospice, uye mamwe mabasa epamba ekurapa.

Chikamu B inovhara kuchengetwa kusiri kwechipatara kunosanganisira kushanya kwehofisi kwachiremba, kuongororwa, kuongororwa ropa, maX-ray, zvishandiso, uye vazhinji vanorapa varwere.