El Medicare es un programa federal de Seguro de Salud para ciudadanos estadounidenses y residentes legales que hayan vivido en los Estados Unidos durante al menos 5 años consecutivos, incluidos los 5 años anteriores a solicitar Medicare. Para tenerlo se requiere ser mayor de 65 años o menor con discapacidad que califique. También de cualquier edad si se le ha diagnosticado enfermedad renal en etapa terminal o esclerosis lateral amiotrófica,
¿Què cubre Medicare?
El Medicare original tiene dos partes: La parte A ayuda a pagar las estadías en el hospital y cuidado de los pacientes hospitalizados y la Parte B que ayuda a pagar las visitas al médico y el cuidado como paciente ambulatorio.
En 2021, el deducible es de $ 1,484 para la Parte A y de $ 203 para la Parte B. La prima mensual típica de la parte B (que cubre el 80 % de los costos) es de $ 148.50.
VegaMedicare.com
¿Cómo obtener cobertura adicional?
Opción 1
Obtener el Plan de Seguro Complementario de Medicare (Medigap) que ayuda a pagar algunos de los gastos de su bolsillo que no son cubiertos por Medicare Original. El plan de la parte D de Medicare ayuda a pagar los medicamentos con receta. Estos planes son ofrecidos por compañías privadas.
Opción 2
PARTE C: Plan Medicare Advantage. Combina la parte A y la parte B en un solo plan.
Parte D: Generalmente este plan incluye la cobertura de medicamentos con receta y puede ofrecer beneficios adicionales al Medicare Original. Planes también ofrecidos por compañías privadas.
¿Cuándo puedo inscribirme en un plan de Medicare Advantage?
El Período de inscripción inicial dura 7 meses e incluye el mes en que cumple 65 años, más los 3 meses anteriores y los 3 meses posteriores. Usted puede inscribirse en la Parte A, en la Parte B o en ambas.
También puede inscribirse en un plan Medicare Advantage (Parte C) o en plan de medicamentos con receta (Parte D). No está obligado a inscribirse en la parte D, pero hay una multa de 1% de la prima mensual promedio por cada mes de demora en inscribirse.
El Período de Inscripción Anual va del 15 de Octubre al 7 de diciembre.
Durante la inscripción anual, usted puede agregar, cancelar o cambiar su cobertura de Medicare.
Periodo de Inscripción Abierta de Medicare Advantage, del 1ro de Enero al 31 de Marzo
Si usted ya es miembro de un plan de Medicare Advantage, puede cancelar la inscripción en su plan actual y cambiar a un plan Medicare Advantage diferente una sola vez, o bien volver al Medicare Original, durante ese período.
Período de Inscripción Especial
Cuando se jubila y pierde la cobertura del empleador. Cuando se muda fuera del área de servicio del plan y cuando califica para el programa de Ayuda Adicional.
También es posible cuando se le han diagnosticado ciertas condiciones de salud crónicas que califican.
Las Ventajas de Medicare Advantage
Coberturas adicionales de estadías en el hospital. Cobertura adicional de gastos médicos. Medicamentos con receta. Cobertura de visión y audición incluyendo lentes y aparatos auditivos. Límites en los gastos de su bolsillo anuales.
Como elegir un plan de Medicare (Factores a considerar)
Su estado de salud (Condiciones preexistentes). Su lugar de residencia y tus planes anuales de viaje. Su Médico Primario y Especialistas. Medicamentos de Receta. Su presupuesto.
Obtenga información adicional en:
Medicare.gov
Administración del Seguro Social
Vegamedicare.com
Francisco Vega, Agente de Ventas con Licencia.
(305) 498-8383
favega55@gmail.com
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