Ihlawulwa njani i-Medicare: Ngubani oHlawula iMedicare?

Umxholo

• Uxhaswa njani uMedare?
• Ixabisa malini i-Medicare ngo-2020?
• Icandelo leMedicare A iindleko
• Amayeza eendleko zeCandelo B
• Iindleko zeCandelo leMedare C (Advantage)
• Icandelo leMedare D iindleko
• Iindleko zonyango lweMedare (iMedigap)
• Ukuthatha

• I-Medicare ixhaswe ikakhulu yi-Federal Insurance Contributions Act (FICA).
• Iirhafu ezivela kwi-FICA zinegalelo kwiingxowa-mali ezimbini zokugubungela inkcitho ye-Medicare.
• Ingxowa-mali ye-Inshurensi yeSibhedlele i-Medicare (HI) igubungela iindleko zeMedicare Part A.
• Ingxowa-mali yokuxhasa i-Inshurensi yoNyango (i-SMI) igubungela icandelo le-Medicare Icandelo B kunye neCandelo D kwiindleko.
• Ezinye iindleko zeMedicare zixhaswa ngezimali zeprimiyamu, inzala yengxowa mali, kunye nezinye iimali ezivunyiweyo ngurhulumente.

I-Medicare lukhetho lwe-inshurensi yezempilo exhaswa ngurhulumente enikezela ngesibonelelo kwizigidi zabantu baseMelika abaneminyaka engama-65 nangaphezulu, kunye nabantu abaneemeko ezithile. Nangona ezinye izicwangciso zeMedicare zipapashwa "njengasimahla," inkcitho yeMedare iyonke ikhulu lamakhulu ezigidi zeedola ngonyaka.

Ke ngubani ohlawulela iyeza? I-Medicare ixhaswe ngemali yengxowa mali ethembekileyo exhaswa yirhafu, inzala yengxowa mali, iipremiyamu zabaxhamli, kunye nemali eyongezelelweyo evunywe yiCongress.

Eli nqaku liza kuphonononga iindlela ezahlukeneyo ezixhaswa ngemali licandelo ngalinye leMedicare kunye neendleko ezinxulumene nokubhalisa kwisicwangciso seMedicare.

Uxhaswa njani uMedare?

Ngo-2017, i-Medicare yagubungela abaxhamli abangaphezu kwezigidi ezingama-58, kwaye inkcitho iyonke yokugubungela yadlula kwi-705 yezigidigidi.

Inkcitho yamayeza ihlawulwa ikakhulu ziimali ezimbini zetrust:

• INgxowa-mali ye-Inshurensi yeSibhedlele i-Medicare (HI)
• Ingxowa-mali yokuxhasa i-Inshurensi yoNyango (i-SMI)

Phambi kokuba singene nzulu kwindlela nganye kwezi ezihlawula ngayo i-Medicare, kufuneka siqale siqonde ukuba axhaswa njani.

Ngo-1935, i-Federal Insurance Contributions Act (FICA) yamiselwa. Olu nikezelo lwerhafu luqinisekisa ngenkxaso mali kuzo zombini iinkqubo zeMedare kunye nezoKhuseleko lweNtlalo ngokuhlawula kunye neerhafu zengeniso. Nantsi indlela esebenza ngayo:

• Kumvuzo wakho opheleleyo, iipesenti ezi-6.2 zibanjiwe kuKhuseleko lweNtlalo.
• Ukongeza, iipesenti ezi-1.45 zemivuzo yakho egciniweyo zigcinelwe iMedicare.
• Ukuba uqeshwe yinkampani, umqeshi wakho ulingana neepesenti ezingama-6.2 zoKhuseleko lweNtlalo kunye neepesenti eziyi-1.45 zeMedicare, iyonke iyipesenti eyi-7.65.
• Ukuba uqeshwe ngokwakho, uya kuhlawula iipesenti ezingama-7.65 zerhafu.

Ukubonelelwa kwerhafu ye-2.9 ye-Medicare iya ngqo kwiingxowa-mali ezimbini zokubonelela ezibonelela ngenkcitho ye-Medicare. Bonke abantu abasebenza ngoku e-United States banegalelo kwiirhafu ze-FICA ukuxhasa ngemali inkqubo yangoku ye-Medicare.

Imithombo eyongezelelweyo yenkxaso mali yeMedare ibandakanya:

• iirhafu ezihlawulwe kwingeniso yoKhuseleko lweNtlalo
• Inzala evela kwiingxowa-mali ezimbini zetrust
• iimali ezivunywe yiCongress
• iipremiyamu ezivela kumayeza e-Medicare A, B, kunye no-D

Inkqubo ye- Ingxowa mali ye-Medicare HI ikakhulu ibonelela ngenkxaso mali kwiCandelo leMedicare A. Phantsi kweCandelo A, abaxhamli bayafakwa kwiinkonzo zesibhedlele, kubandakanya:

• Ukunyamekela esibhedlele
• ukhathalelo lokunyanga ngaphakathi
• ukhathalelo lweziko lokonga
• ukhathalelo lwempilo ekhaya
• Unonophelo lwehosisi

Inkqubo ye- Ingxowa mali ye-SMI ikakhulu ibonelela ngenkxaso mali kwiCandelo B kunye neMedicare Icandelo D. Phantsi kweCandelo B, abaxhamli bafumana ukhuseleko kwiinkonzo zonyango, kubandakanya:

• iinkonzo zokuthintela
• iinkonzo zokuxilonga
• iinkonzo zonyango
• iinkonzo zempilo yengqondo
• amayeza athile amiselweyo kunye nokugonya
• izixhobo zonyango ezizinzileyo
• Uvavanyo lwezonyango

Zombini iimali zentembeko zikwanceda ukuhlawula iindleko zolawulo lweMedare, njengokuqokelela iirhafu zeMedare, ukuhlawulela izibonelelo, kunye nokujongana namatyala obuqhetseba beMedare kunye nokuxhatshazwa.

Nangona icandelo leMedicare D lifumana inkxaso-mali kwi-SMI trust fund, inxenye yenkxaso-mali yazo zombini i-Medicare Part D kunye ne-Medicare Advantage (Icandelo C) zivela kwiipremiyamu zabaxhamli.Kwizicwangciso ze-Medicare Advantage ngokukodwa, naziphi na iindleko ezingafakwanga kwinkxaso-mali yeMedare kufuneka zihlawulwe ngezinye iimali.

Ixabisa malini i-Medicare ngo-2020?

Kukho iindleko ezahlukeneyo ezinxulumene nokubhalisa kwiMedicare. Nazi ezinye oza kuthi uziqaphele kwisicwangciso sakho seMedicare:

• Iintlawulo zanyanga le. Ipremiyamu sisixa osibhatalayo ukuze uhlale ubhalisiwe kwiMedicare. Amacandelo A kunye no-B, enza i-Medicare yoqobo, zombini zineeprimiyamu zenyanga. Ezinye izicwangciso ze-Medicare Part C (Advantage) zine-premium eyahlukileyo, ukongeza kwiindleko zokuqala zeMedare. Izicwangciso zeCandelo D kunye nezicwangciso zeMedigap zihlawulisa ipremiyamu yenyanga.
• Ukutsalwa. Ukuxhuzulwa yimali oyihlawulayo ngaphambi kokuba i-Medicare igubungele iinkonzo zakho. Icandelo A linokutsalwa ngexa ngalinye lezibonelelo, ngelixa iCandelo B linokutsalwa ngonyaka. Ezinye izicwangciso zeCandelo D kunye nezicwangciso zeMedare eziluncedo kunye nokugubungela iziyobisi nazo zinokutsalwa iziyobisi.
• Iikopi. Iikopa zentlawulo ziimali ezingaphambili ozihlawula ngalo lonke ixesha undwendwela ugqirha okanye ingcali. Izicwangciso ze-Medicare Advantage, ngakumbi uMbutho woLondolozo lwezeMpilo (HMO) kunye nezicwangciso zoMboneleli oKhethiweyo (PPO), zibiza imali eyahlukeneyo kolu tyelelo. Icandelo le-Medicare Icandelo D lihlawulisa ii-copayments ezahlukeneyo ngokuxhomekeke kumayeza owathathayo.
• UQinisekiso. I-Coinsurance yipesenti yeendleko zeenkonzo ekufuneka uzihlawule epokothweni. KwiCandelo leMedicare A, i-coinsurance yonyusa ixesha elide usebenzisa iinkonzo zesibhedlele. KwiCandelo leMedare B, isiqinisekiso semali yipesenti ebekiweyo. Icandelo le-Medicare Icandelo D lihlawulisa i-coinsurance okanye i-copayment yamayeza akho.
• Ubuninzi bepokotho. Zonke izicwangciso ze-Medicare Advantage zibeka ikepusi ekubeni uza kuchitha malini epokothweni; Oku kubizwa ngokuba ngumthwalo ongaphandle epokothweni. Eli xabiso liyahluka ngokuxhomekeke kwisicwangciso sakho seNzuzo.
• Iindleko zeenkonzo ezingagutyungelwanga sisicwangciso sakho. Ukuba ubhalisile kwisicwangciso seMedicare esingazibandakanyi iinkonzo ozifunayo, uya kuba noxanduva lokuhlawula ezi ndleko epokothweni.

Icandelo ngalinye leMedicare lineendleko ezahlukeneyo, njengoko zidwelisiwe apha ngasentla. Kunye neengxowa-mali ezimbini zokuthemba ezenzelwe icandelo ngalinye le-Medicare, ezinye zeendleko zenyanga zikwanceda ukuhlawulela iinkonzo zeMedare.

Icandelo leMedicare A iindleko

Inxalenye yePremiyamu iyi- $ 0 yabanye abantu, kodwa inokuba phezulu njenge- $ 458 kwabanye, kuxhomekeke ekubeni usebenze ixesha elingakanani.

Icandelo A lincitshisiwe li- $ 1,408 ngexesha lezibonelelo, eliqala umzuzu wokungeniswa kwakho esibhedlele kwaye uphele xa ukhutshiwe iintsuku ezingama-60.

Icandelo lesiQinisekiso semali ngu- $ 0 kwiintsuku zokuqala ezingama-60 zokuhlala kwakho esibhedlele. Emva komhla wama-60, i-coinsurance yakho inokusukela kwi-352 yeedola ngosuku ngeentsuku ezingama-61 ukuya kuma-90 ukuya kuma-704 eedola “kwisithuba sokuphila” kwiintsuku emva komhla wama-90. Inokuya kufikelela kwiipesenti ezili-100 zeendleko, kuxhomekeke kubude hlala.

Amayeza eendleko zeCandelo B

Ipremiyamu yesiqendu B iqala kwi- $ 144.60 kwaye inyuke isekwe kwinqanaba lomvuzo wakho wonyaka.

Isahlulo B sitsalwa siyi-198 yeedola ngo-2020. Ngokungafaniyo neCandelo A elixhuzulweyo, eli xabiso ngonyaka okanye kwixesha lezibonelelo.

Icandelo B lokuqinisekisa iipesenti ezingama-20 zexabiso lemali evunyiweyo ye-Medicare. Le yile mali iMedare evumile ukuhlawula umboneleli wakho ngeenkonzo zonyango. Kwezinye iimeko, unokuhlawulwa kwakhona kwiCandelo B.

Iindleko zeCandelo leMedare C (Advantage)

Ukongeza kwiindleko ze-Medicare yasekuqaleni (iinxalenye ze-A kunye ne-B), ezinye izicwangciso ze-Medicare Advantage nazo zihlawulisa i-premium yenyanga ukuhlala ubhalisile. Ukuba ubhalise kwisicwangciso seCandelo C esigubungela amayeza amiselweyo, kuya kufuneka uphinde uhlawule ichiza elikhutshiweyo, iikopi kunye nokuqinisekiswa kwemali. Kwaye, uya kuba noxanduva lwexabiso lokuhlawula xa undwendwela ugqirha wakho okanye ingcali.

Icandelo leMedare D iindleko

I-premium ye-Part D iyahluka ngokuxhomekeke kwisicwangciso osikhethayo, esinokuchaphazeleka yindawo okuyo kunye nenkampani ethengisa isicwangciso. Ukuba ufike kade ekubhaliseni kwisicwangciso sakho seCandelo D, le premiyamu inokuba ngaphezulu.

ICandelo D latsala ikwahluka ngokuxhomekeke kwisicwangciso osibhalisileyo. Elona xabiso liphezulu linokutsalwa elinokuhlawuliswa lilo naliphi na icandelo D liyi- $ 435 ngo-2020.

Icandelo lokukhutshelwa kunye nokuhlawulwa kweemali zemali kuxhomekeke ngokupheleleyo kwiziyobisi ozithathayo ngaphakathi kwifomula yesicwangciso sakho samachiza. Zonke izicwangciso zine-formulary, eyiqela lawo onke amayeza acwangcisiweyo.

Iindleko zonyango lweMedare (iMedigap)

I-premium yeMedigap iyahluka ngokuxhomekeka kuhlobo lwe-inshorensi obhalise kuyo. Umzekelo, izicwangciso zeMedigap ezinababhalisi abambalwa kunye nokugubungela okungaphezulu kunokubiza ngaphezulu kwezicwangciso zeMedigap ezigubungela kancinci.

Khawukhumbule nje ukuba emva kokuba ubhalise kwisicwangciso seMedigap, ezinye zeendleko zokuqala zeMedare ziya kugutyungelwa sisicwangciso sakho.

Ukuthatha

I-Medicare ixhaswa ikakhulu ngemali ye-trust, iipremiyamu zabaxhamli zenyanga, iimali ezivunyiweyo zeCongress, kunye nenzala yengxowa mali. Amayeza e-Medicare A, B, kunye no-D bonke basebenzisa imali yengxowa mali yokunceda ukuhlawulela iinkonzo. Ukongezwa kwe-Medicare ye-Advantage yokufumana inkxaso-mali ixhaswa ngoncedo lweeprimiyamu zenyanga.

Iindleko ezinxulumene neMedicare zinokongeza, ke kubalulekile ukuba wazi ukuba uza kuhlawula ntoni epokothweni wakube ubhalisile kwisicwangciso seMedicare.

Ukuthenga malunga nezicwangciso zeMedicare kwindawo yakho, ndwendwela i-Medicare.gov ukuthelekisa iindlela ezikufutshane nawe.