Muaj feem tau txais ob qho kev pab yog txhais hais tias ib tus neeg muaj feem tau txais Medicaid thiab Medicare ob qho tib si. Qhov muaj feem tau txais ob qho kev pab puv ntoob, nws txhais hais tias koj muaj cai tau txais lub xeev qhov Medicaid cov kev pab puv ntoob thiab tseem tau txais Medicare tib si. Ib tus neeg uas muaj cai tau txais ob qho kev pab puv ntoob tej zaum kuj yuav muaj cai tau txais daim phiaj Dual Special Needs plan (D-SNP).* Qhov no yog ib hom ntawm daim phiaj Medicare Advantage uas muab cov kev pab ntxiv dhau ntawm cov uas Medicare thiab Medicaid ib txwm muab.

Medicare pab them nqi rau cov kev kho mob feem ntau, tab sis Medicaid them rau ib cov nqi uas yus rho nyiaj hauv hnab tshos them rau feem yus nrog them (copays), feem sib koom them tuav pov hwm (coinsurance), feem yus them ua ntej (deductibles) thiab cov nyiaj yus them txhua hli (premiums). Medicaid kuj tseem them rau cov nqi uas daim phiaj Dual Special Needs Plan tsis them, xws li qhov kev pab kho mob mus sij hawm ntev.

Kev muaj feem tau txais ob qho kev pab ib feem xwb txhais hais tias ib tus neeg muaj cai tau txais qhov Medicare Savings Program (MSP). Cov MSPs yog tswj hwm los ntawm qhov khoos kas Medicaid nyob hauv txhua lub xeev. Txawm tias cov MSPs them rau qee cov nqi ntawm Medicare, xws li Medicare Part A thiab Part B cov nqi them txhua hli, cov neeg uas muaj feem tau txais kev pab ob qho ib feem xwb yuav tsis tau txais Medicaid cov kev pab them nqi kho mob puv ntoob.

Ib tus neeg uas muaj cai tau txais kev pab ob qho ib feem xwb tej zaum kuj tseem muaj cai tau txais daim phiaj Dual Special Needs plan (D-SNP).* Txawm tias Medicare them rau cov kev kho mob thiab cov kev pab feem ntau, cov uas muaj feem tau txais kev pab ob qho ib feem xwb yuav tau them cov nqi uas yus rho nyiaj hauv hnab tshos them.

Thaum Medicare cov tswv cuab mus kho mob, Medicare tsis them rau cov nqi kho mob puv ntoob. Qhov nyiaj uas seem tsis them ntawd, uas hu ua tus nqi sib pab them (cost share), yog qhov uas Medicare tus tswv cuab yuav tau them. Qhov nyiaj no raws li paub yog qhov nyiaj yus them txhua hli (premium), feem yus nrog them (copay), feem koom them tuav pov hwm (coinsurance), los yog feem yus them ua ntej (deductible). Thaum muaj cov MSPs, lub xeev qhov khoos kas Medicaid (state Medicaid program) yuav pab cov uas muaj feem tau txais kev pab ob qho ib feem xwb them rau ib cov nqi no. Qhov nyiaj pab them (los yog cost sharing) rau tus neeg ntawd uas Medicaid muab yuav nce rau ntawm tej 2 yam no:

1. Tus neeg cov nyiaj khwv tau (nyiaj tau los) yog npaum cas
2. Nws tej khoom ntiag tug (khoom muaj nqi) yog npaum cas — xws li nws lub tsev

Cov kis ntawm qhov 4 kev muaj feem tau txais kev pab ob qho ib feem xwb yog:

1. Tus Neeg Muaj Cai Tsim Nyog Rau Medicare (Qualified Medicare Beneficiary, QMB) 
   Qhov khoos kas QMB pab them cov nqi yus them txhua hli (premiums) rau Medicare Part A (tuav pov hwm pw tsev kho mob) thiab Medicare Part B  (tuav pov hwm kev kho mob). Cov tswv cuab uas muaj feem tau txais qhov QMB tej zaum kuj tau qhov kev pab them nqi rau cov nqi sib pab them xws li feem yus nrog them (copays), feem koom them tuav pov hwm (coinsurance) thiab feem yus them ua ntej (deductibles).
2. Medicare Tus Txais Txiaj Ntsig Khwv Tau-Nyiaj Tsawg Tshwj Xeeb (Specified Low-Income Medicare Beneficiary, SLMB)
   Qhov kev pab cuam SLMB pab them rau cov nqi them txhua hli (premiums) rau Medicare Part B (tuav pov hwm kev kho mob) nkaus xwb.
3. Tus Neeg Muaj Cai Tsim Nyog Rau (Qualified Individual, QI)
   Qhov kev pab cuam QI pab them rau cov nqi them txhua hli (premiums) rau Medicaid Part B (tuav pov hwm kev kho mob), tab sis cov tswv cuab no muaj tau cov nyiaj khwv tau los siab dua qhov SLMB.
4. Tus Xiam Oob Qhab Muaj Cai Tsim Nyog Rau thiab Cov Neeg Tseem Ua Hauj Lwm (Qualified Disabled and Working Individuals, QDWI)
   Qhov khoos kas QDWI pab them rau Medicare Part A (tuav pov hwm pw tsev kho mob) cov nqi them txhua hli (premiums). Qhov no yog rau cov neeg muaj mob xiam oob khab tab sis tau rov qab mus ua hauj lwm. Tab sis vim qhov lawv rov mus ua hauj lwm, thiaj ua rau lawv poob lawv qhov kev pab them nqi Medicare Part A uas tsis tau them tus nqi txhua hli (premium-free).

Koj puas xav tias koj, ib tus tswv cuab hauv koj tsev neeg los yog ib tus uas koj pab tu nws yuav muaj cai tau txais kev pab ob qho puv ntoob los yog ib feem xwb? Koj yuav siv tau qhov cuab yeej tshawb nrhiav hauv qab no los saib seb daim phiaj kho mob twg uas muaj nyob hauv koj cheeb tsam. Yog hais tias koj tsis paub tseeb, hu tuaj rau peb thiab tham nrog peb ib tus neeg sawv cev uas muaj ntawv tso cai. Nws yuav piav qhia txhua cov kev xaiv ua tau thiab pab koj nrhiav kom tau ib daim phiaj kho mob uas muaj feem tau txais ob qho kev pab rau koj.

Hu rau 1-844-812-5967, TTY: 711
8 AM - 8 PM sij hawm hauv cheeb tsam, 7 hnub toj ib lim tiam. Se habla español.

*Pab them nqi rau cov neeg uas muaj cai tau txais kev pab ob qho ib feem xwb uas tsuas muaj nyob rau hauv qee cheeb tsam xwb.