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Medicare & Medi-Cal 联邦红蓝卡 & 白卡

Medicare & Medi-Cal 联邦红蓝卡 & 白卡. * Education purpose only *本講座純屬教育性質. About me / 關於我. 美國金宏保險 销售副經理 California Licensed Insurance Specialist. 畢業於加州大學洛杉磯分校 (UCLA) Graduated from UCLA. 全球注册财务规划师 CFP UCI 学院学员 Certified Financial Planner Candidate. 环球东方卫视 健康保险 嘉宾讲师

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Medicare & Medi-Cal 联邦红蓝卡 & 白卡

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  1. Medicare & Medi-Cal 联邦红蓝卡 & 白卡 *Education purpose only *本講座純屬教育性質

  2. About me / 關於我 • 美國金宏保險 销售副經理 • California Licensed Insurance Specialist • 畢業於加州大學洛杉磯分校(UCLA) • Graduated from UCLA • 全球注册财务规划师 CFP UCI学院学员 • Certified Financial Planner Candidate • 环球东方卫视 健康保险 嘉宾讲师 • EDI Media’s Healthcare Guest Speaker • 3个非洲儿童终身赞助母亲 • Save the Children – adoption mother Coco K. Wang 王 珂 CA Lic. #0I03013 Tel: (909)598-6667 coco@ghinsurances.com • 鑽石吧獅子會光明委員會主席 • Bright Eye Committee Chair @ LA Diamond Lions Club

  3. 獅子會眼库:复原、评量与分配人体眼部组织,以供视力重建、研究与教育等目的使用。獅子會眼库:复原、评量与分配人体眼部组织,以供视力重建、研究与教育等目的使用。 國際獅子會(Lions Clubs International)於1917年由Melvin Jones成立,是世界最大的服務 (volunteer) 組織,總部設於美國。

  4. SaveTheChildren 終身贊助母親 请加入我公益的脚步

  5. Agenda of the day: 1、Medicare 联邦医疗红蓝卡 目 2、MAPD 红蓝卡优惠计划 录 3、Supplement 红蓝卡辅助计划 + Drug plan 加處方藥物計劃 4、Medi-Cal 白卡

  6. 第一部分 Part 1 Medicare 联邦医疗红蓝卡

  7. What Is Medicare? Health insurance for people… 1. • 65 and older 2. • Under 65 with certain disabilities • ALS (Amyotrophic Lateral Sclerosis, • also called Lou Gehrig’s disease) • without waiting period 3. • Any age with End-Stage Renal Disease

  8. 什么是联邦医疗紅藍卡? 联邦政府提供的医疗保险,给到符合条件的人: 1. • 年滿65歲以上的美國公民 • 綠卡持有5年以上者 。 2. • 不限年齡的腎臟病末期(ESRD)患者 • (需要透析治療或腎移植的永久性腎功能衰竭)。 3. 65歲以下永久性殘障者, 擁有美國綠卡或公民, 並在美國領取傷殘福利超過24個月。

  9. What arethe4partsof Medicare? Medicare Advantage Part C 部分 聯邦紅藍卡优惠计划 Original Medicare 聯邦紅藍卡 Medicare Prescription Drug Coverage 处方药物计划 Part D 部分 Part A 部分 prescription drug coverage 处方药物计划 Part B 部分 Part A 部分 Part B 部分 Medical Insurance 門診保險 Hospital Insurance 醫院保險 Part D 部分 (Usually 通常包含)

  10. Original Medicare: What is the Coverage and Cost of Part A? Part A–Hospital Insurance helps cover medically necessary • Inpatient hospital care • Inpatient skilled nursing facility (SNF) care • Blood (inpatient) • Certain inpatient non-religious, nonmedical health care in approved religious nonmedical institutions (RNHCIs) • Home health care • Hospice care Part A Hospital Insurance

  11. Original Medicare: What is the Coverage and Cost of Part A? (continue) What's not covered? • Private-duty nursing • Private room (unless medically necessary) • Television and phone in your room (if there's a separate charge for these items) • Personal care items, like razors or slipper socks Part A Hospital Insurance

  12. Original Medicare: Part A 部分 醫院保險 的 保費和保障? Medicare A 部分(醫院保險)服務範圍: • • 住院病人的醫院護理 • • 專業護理機構看護 • • 臨終安寧護理 • • 家庭醫療護理 • 但是不承保! • 私人护理 • 私人房间(除非有医疗必要) • 您房间内的电视和电话(如果这些项目单独收费) • 个人护理用品,如剃须刀或拖鞋袜 Part A部分 Hospital Insurance 醫院保險

  13. Original Medicare: What is the Coverage and Cost of Part A? (continue) Part A–Hospital Insurance Premium 保費: • Most people don't pay a monthly premium for Part A ( If you paid Medicare taxes for at least 40 quarters) 報稅滿40點,則免費(無月費) • If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $437. • If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $240.Hospice care 如果購買, 報稅點數30點以下:每月保費$437 報稅點數30至39點:每月保費$240 Part A Hospital Insurance

  14. Original Medicare: What is the Coverage and Cost of Part B? • Part B—Medical Insurance helps cover medically necessary • Doctors’ services • Outpatient medical and surgical services and supplies • Clinical lab tests • Durable medical equipment (may need to use certain suppliers) • Diabetic testing supplies • Preventive services (like flu shots and a yearly wellness visit) • Home health care • Typical premium for part B is $135.50 per month for 2019. Part B Medical Insurance

  15. Original Medicare: Part B部分 醫院保險 的 保費和保障? • Medicare B 部分(醫療保險)服務範圍: • • 醫生和其他醫療服務提供者所提供的服務 • • 門診護理 • • 家庭醫療護理 • • 耐用的醫療設備(DME) • • 多項預防性服務 • 大多數人每月支付標準的聯邦醫療保險 B 部分保費 • 2019年寄出保費為$135.50一個月 Part B Medical Insurance 醫療保險

  16. 20% out of my own pocket Part A 部分 Part B 部分 100% of Prescription Drug expense Cover roughly 80%of covered services Has NO prescription drug coverage?

  17. Hopeless 絕望 Innocent 無辜 Shocked 吃驚

  18. Medicare Prescription Drug Plan + Supplement Plan (Medi-Gap) D 部分(聯邦醫療保險處方藥物涵蓋範圍) 加 紅藍卡輔助計劃 2 Solutions 解決方法 方法1 方法2 Solution 1 Solution 2 Medicare Advantage Plan (Part C) C 部分 (聯邦醫療保險優良計劃)

  19. I am so excited!!!我好興奮!!!

  20. Medicare Part C C 部分

  21. Medicare Advantage Plan (Part C) C 部分 (聯邦醫療保險優良計劃) Eligibility條件: Active Part A & B 生效的A&B部分 01 Eligibility條件: Living in service area 住在該計劃服務區 02 Eligibility條件: No end-stage renal disease 沒有末期性腎衰竭 03

  22. Medicare Advantage Plan (Part C) C 部分 (聯邦醫療保險優良計劃) Combo 套餐組合 Extra Benefit 額外計劃福利 Part A 部分 Part B 部分 Part D 部分

  23. Medicare Advantage Plan (Part C) C 部分 (聯邦醫療保險優良計劃) Dental Services 免費牙科 保險 Eyeglass Allowance 配眼鏡福利 OTC Benefit 櫃檯成藥福利 Transportation 免費交通 車接送 Worldwide ER Coverage 全球緊急醫療 Acupuncture 針灸福利 Extra Benefit 額外計劃福利

  24. 而且多數的C計劃,都是$0保費哦~Majority of the Part C Plan are $0 premium plans

  25. Chose a Medical Group Chose a family doctor within the group Labs, hospitals, etc. are all in the medical group Family docor will refer you to any specialist Majority of the Medicare part C Plans areHMOplans

  26. 選擇一個 醫療網 需要家庭醫生轉診 才可以看醫療網內的醫院、檢查站,等等 在醫療網裡面 選擇家庭醫生 需要家庭醫生轉診 才可以看醫療網內的專科庭醫生 C 計劃大多數是 HMO計劃

  27. Dislike HMO? 不喜歡HMO怎麼辦? • I have various doctors that I must see • but located in different medical groups. • 我有很多需要看醫生,在不同醫療網,怎麼辦? • What if I travel around too much, need to be • able to see doctor in various states. • 我常常去到不同的州居住,需要在這些地方都 • 能看醫生,怎麼辦? • What if I want the freedom to see any specialist • Without having to get referral by my family doctor. • 我希望不要經過家庭醫生的轉診,就可以自由地看 • 專科醫生,怎麼辦?

  28. Supplement + Drug plan 红蓝卡辅助计划 加處方藥物計劃

  29. 80% of A – Hospital 住院 80% of B – Medical 醫療 20% of A – Hospital 住院 20% of B – Medical 醫療 Recall 記得嗎? 自己需要解決的部分 Self-responsible 紅藍卡 Medicare Prescription Drug Plan 處方藥計劃

  30. Supplement (Medi-Gap) Plans红蓝卡辅助计划 A Medicare Supplement Insurance (Medigap) policy helps pay some of the health care costs that Original Medicare doesn‘t cover, like: Copayments,Coinsurance,and Deductibles.Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then, your Medigap policy pays its share. 原有「聯邦醫療保險」支付許多,但並非所有的醫 療保健服務和供應品。聯邦醫療補充保險保險單, 由私人公司出售,可幫助支付原有「聯邦醫療保 險」沒有承保您應分擔的一些醫療保健費用,如共付額,共同保險,和自付額。

  31. Example: Supplement Plan F例如:红蓝卡辅助F计划 Doctor Visits 看醫生 Hospital Stays 住醫院 Reminder 提醒 Must pay the monthly premium for the plan. 但是要繼續支付每個月計劃的保費~ Medicare Beneficiary 紅藍卡持卡人 Pays 0% 支付 0% 红蓝卡辅助F计划 Medigap Plan F Pays 20% 支付 20% 紅藍卡 Medicare Pays 80% 支付 80%

  32. 問題解決完全了嗎 ? Part B-Hospitals Part A-Hospitals 住院部分 看病部分 What about Prescription Drug plan? 處方藥物計劃呢?

  33. Buy separately 需要單獨購買 Prescription Drug plan 處方藥物計劃 Pay premium 支付保費 Copayment 拿藥有 分攤額度

  34. Both additional premium 都有額外額外月費 Freedom to see any doctor that takes medicare可以看任何接受紅藍卡的醫生 Provided by the federal government 由聯邦政府提供 $0 Premium 月費 Usually includes part D 一般有提供藥物計劃 Added benefits 額度外福利 Medigap + Part D Plan 紅藍卡輔助計劃 加 處方藥計劃 Medicare 紅藍卡 Part C 紅藍卡 優惠計劃

  35. Medi-Cal 加州白卡

  36. Medi-Cal加州白卡 Old Medi-Cal Card New Design 加州白卡的傳統設計加州白卡的更新設計

  37. Income limitation For applicant between ages 19 to 64 Family income less than 138% of Federal Poverty Line 1 Asset limitation For applicant over age 65 Can own1 real estate property and 1 car, cash equivalents less than $2,000 2 Other Programs Working Disabled Program, Supplemental Security Income (SSI), Aged, Blind & Disabled - Medically Needy Medi-Cal 3

  38. 收入限制 针对19-64岁的申请人 家庭总收入在联邦贫穷线的138%以下 一 资产限制 针对65岁以上的老人 可以有一套房产和一部车 资产(含名下的存款和股票等)不超过$2000 二 Medi-Cal 加州白卡 其他 SSI(社安补助金)受益人、怀孕妇女、残疾人士、安养院住户、乳癌或子宫颈癌罹癌确诊等 三

  39. Online, mail-in, or Go to county office 上网,邮寄,或是 预约 County 社福机构 Apply Anytime 随时都 可以申请 Qualified for Medi-Cal? How to apply? 如何申請? 認為符合申請資格嗎?

  40. Thank You 感谢您

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