Icandelo le-Medicare D lincitshisiwe ngo-2021: Iindleko xa uthi krwaqu

Umxholo

• Zithini iindleko zecandelo D leMedare?
• Ukutsalwa
• Iintlawulo zanyanga le
• Iikopi kunye noqinisekiso lwemali
• Yintoni i-Medicare Part D gap gap ("donut hole")?
• Amachiza anegama lophawu
• Iziyobisi eziqhelekileyo
• Ukugubungela intlekele
• Ngaba kufuneka ndifumane i-Medicare Part D okanye isicwangciso se-Medicare Advantage?
• Uncedo kunye neengozi kwi-Medicare
• Isohlwayo sokubhalisa emva kwexesha
• Ndibhalisa njani kwiCandelo D leMedare?
• Ndingalufumana njani uncedo ngeendleko zam zamayeza amiselweyo?
• Ezinye iingcebiso zokonga iindleko
• Ukuthatha

Icandelo leMedicare D, ekwabizwa ngokuba kukugubungela amayeza kagqirha, yinxalenye yeMedare ekunceda ukuhlawulela amayeza amiselweyo. Xa ubhalisa kwisicwangciso seCandelo D, unoxanduva lokuhlawula i-deductible, i-premium, i-copayment kunye ne-coinsurance yakho. Elona candelo liphezulu le-Medicare D litsalwe ngo-2021 ngama- $ 445.

Makhe siqwalasele ngokuthe gca malunga nokuba yimalini ye-Medicare Part D kwaye malunga nokubhalisa kwisicwangciso se-Medicare Part D kungakubiza ngo-2021.

Zithini iindleko zecandelo D leMedare?

Nje ukuba ubhalise kwiCandelo le-Medicare A kunye neCandelo B, i-Medicare yoqobo, ungabhalisa kwi-Medicare Part D. Izicwangciso zonyango zamayeza amayeza ziyanceda ekugubungeleni naziphi na iziyobisi ezingafakwanga phantsi kwesicwangciso sakho sokuqala se-Medicare.

Ukutsalwa

Icandelo le-Medicare D elichithwayo lixabiso oya kulihlawula unyaka nonyaka ngaphambi kokuba isicwangciso sakho seMedicare sihlawule isabelo saso. Ezinye izicwangciso zamachiza zibiza i- $ 0 ngonyaka, kodwa le mali ingahluka ngokuxhomekeke kumboneleli, indawo okuyo, nangaphezulu. Elona xabiso liphezulu linokutsalwa elinokuhlawuliswa lilo naliphi na icandelo D kwi-2021 yi- $ 445.

Iintlawulo zanyanga le

I-premium ye-Medicare Part D yimalini oza kuyibhatala inyanga nenyanga ukuze ubhalise kwisicwangciso sakho samachiza amiselweyo. Njengokutsalwa kwe- $ 0, ezinye izicwangciso zamachiza zibiza i-premium yenyanga eyi- $ 0.

Intlawulo yenyanga ngenyanga kuso nasiphi na isicwangciso inokwahluka ngokuxhomekeke kwizinto ezahlukeneyo, kubandakanya umvuzo wakho. Ukuba umvuzo wakho ungaphezulu komda othile, kungafuneka uhlawule isixa senyanga sokuhlengahlengiswa okunxulumene nengeniso (IRMAA). Eli xabiso lihlengahlengisiweyo le-2021 isekwe kwimbuyekezo yakho yerhafu ka-2019.

Nazi ii-IRMAAs ezingama-2021 ezisekwe kwinqanaba lomvuzo njengomntu ogcwalisa ingxelo yakho yerhafu:

• $ 88,000 okanye ngaphantsi: akukho ntlawulo yongezelelweyo
• > $ 88,000 ukuya kwi-111,000 yeedola: + $ 12.30 ngenyanga
• > $ 111,000 ukuya kwi-138,000 yeedola: + $ 31.80 ngenyanga
• > $ 138,000 ukuya kwi-165,000 yeedola: + $ 51.20 ngenyanga
• > $ 165,000 ukuya kwii-499,999 zamaRandi: + $ 70.70 ngenyanga
• $ 500,000 nangaphezulu: + $ 77.10 ngenyanga

Imibundu yahlukile kubantu abafayila ngokudibeneyo kunye nabo batshatileyo kwaye bafaka iifayile ngokwahlukeneyo. Nangona kunjalo, ukonyuka kwenyanga kuyakuhlala kuphela ukusuka kwi- $ 12.40 kuye kwi- $ 77.10 eyongezelelweyo ngenyanga, kuxhomekeke kumvuzo wakho kunye nenqanaba lokufayilisha.

Iikopi kunye noqinisekiso lwemali

Icandelo le-Medicare Part D kunye nokuhlawulwa kweemali zemali ziindleko ozihlawulayo emva kokuba iCandelo D lichithwe. Kuxhomekeke kwisicwangciso osikhethileyo, uya kuba netyala lokuhlawuliswa okanye lokuhlawulwa kwemali.

Intlawulo ekhutshelweyo sisixa esimiselweyo ohlawula ngaso ichiza ngalinye, ngelixa isiqinisekiso semali yipesenti yexabiso leziyobisi onoxanduva lokuhlawula.

Icandelo lokukhutshelwa kwecandelo D kunye neemali ze-coinsurance zingahluka ngokuxhomekeke "kwinqanaba" elikuyo ichiza ngalinye. Ixabiso lechiza ngalinye ngaphakathi kwifomula yesicwangciso samachiza liyenyuka njengoko amanqanaba enyuka.

Umzekelo, isicwangciso sakho sokuyalela unokuba nale nkqubo ilandelayo:

Yintoni i-Medicare Part D gap gap ("donut hole")?

Uninzi lwezicwangciso zeMedicare D zinendawo yokugubungela, ekwabizwa ngokuba yi "hole donut." Lo msantsa wokugubungela wenzeka xa ufikelele kumda wento icebo lakho leCandelo D eliya kuyihlawula amayeza akho amiselweyo. Lo mda ungaphantsi kunemali yakho yokugubungela intlekele, nangona kunjalo, oko kuthetha ukuba uyakuba nesikhewu kugubungelo lwakho.

Nantsi indlela isithuba sokugubungela icandelo leMedicare D lisebenza ngo-2021:

• Ukutsalwa konyaka. Iidola ezingama-445 lelona xabiso liphezulu linokutsalwa kwizicwangciso zeMedicare zeCandelo D ukuhlawulisa ngo-2021.
• Ukufakwa okokuqala. Umda wokuqala wokugubungela izicwangciso ze-Medicare Icandelo D ngo-2021 yi- $ 4,130.
• Ukugubungela intlekele. Isixa sokugubungela intlekele sikhaba kanye xa uchithe i-6,550 yeedola epokothweni ngo-2021.

Ke, kwenzeka ntoni xa ukwisithuba sokugubungela isicwangciso sakho seCandelo D? Oko kuxhomekeke koku kulandelayo:

Amachiza anegama lophawu

Nje ukuba ubethe isithuba sokugubungela, awuyi kuba netyala ngaphezulu kweepesenti ezingama-25 zeendleko zegama lomthi elichazwe kwisicwangciso sakho. Uhlawula iipesenti ezingama-25, umenzi uhlawula iipesenti ezingama-70, kwaye isicwangciso sakho sihlawula ama-5 ekhulwini aseleyo.

Umzekelo: Ukuba igama lakho lonyango elichaza igama lakho lixabisa i-500 yeedola, uya kuhlawula i-125 yeedola (kunye nentlawulo yokuhambisa). Umenzi weziyobisi kunye necebo lakho leCandelo D liya kuhlawula i $ 375 eseleyo.

Iziyobisi eziqhelekileyo

Nje ukuba ubethe umsantsa wokugubungela, uyakutyala iipesenti ezingama-25 zeendleko zamachiza enziwe afana nalawo aveliswe sisicwangcwiso sakho. Uhlawula iipesenti ezingama-25 kwaye isicwangciso sakho sihlawula iipesenti ezingama-75 eziseleyo.

Umzekelo: Ukuba amayeza akho aqhelekileyo axabisa i-100 leedola, uyakuhlawula i-25 yeedola (kunye nemirhumo yokuhambisa). Isicwangciso sakho seCandelo D siya kuhlawula i $ 75 eseleyo.

Ukugubungela intlekele

Ukuze uyenze ngaphandle kwesithuba sokugubungela, kuya kufuneka uhlawule iidola ezingama-6,550 zizonke kwiindleko eziphuma epokothweni. Ezi ndleko zinokubandakanya:

• ichiza lakho linokutsalwa
• Ukuhlawulwa kweziyobisi / ukuqinisekiswa kwemali
• iindleko zakho zamachiza kwisithuba
• isixa esihlawulwa ngumenzi weziyobisi ngexesha lomngxunya wedonut

Nje ukuba uhlawule le mali iphuma epokothweni, ingxelo yakho eyintlekele iyaqala. Emva koko, uya kuba noxanduva lokuhlawula imali encinci okanye ukuhlawulwa kwemali. Ngo-2021, isixa semali ye-coinsurance yipesenti ezi-5 kwaye imali yokuhlawula ikopi yi- $ 3.70 yeziyobisi eziqhelekileyo kunye ne- $ 9.20 yeedrama-brand-drug.

Ngaba kufuneka ndifumane i-Medicare Part D okanye isicwangciso se-Medicare Advantage?

Xa ubhalisa kwi-Medicare, unokhetho lokukhetha i-Medicare Part D okanye i-Medicare Advantage (Icandelo C) ukuhlangabezana neemfuno zokugubungela iziyobisi.

Uncedo kunye neengozi kwi-Medicare

Uninzi lwezicwangciso ze-Medicare Advantage zibandakanya ukugubungela amayeza amayeza ukongeza kwezinye iindlela zokugubungela ezinje ngamazinyo, umbono, ukuva, kunye nokunye. Le ngxelo eyongezelelweyo ingakhokelela ekunyuseni kwiindleko ezipheleleyo, kwaye unokugqiba ukuhlawula ngaphezulu isicwangciso se-Medicare Advantage kunokuba nje ungeze iCandelo D kwisicwangciso sakho sokuqala.

Ukongeza, ezinye izicwangciso ze-HMO ze-Medicare Advantage zinokunciphisa umda wokugubungela oogqirha abakwiinethiwekhi kunye nee-pharmacy. Oku kuthetha ukuba ugqirha wakho wangoku okanye ikhemesti ayinakho ukugqunywa kwisicwangciso seMedicare Advantage ofuna ukubhalisa kuso.

Isohlwayo sokubhalisa emva kwexesha

Kungakhathaliseki ukuba ukhetha i-Medicare Part D okanye isicwangciso se-Medicare Advantage, i-Medicare idinga ukuba unayo uhlobo oluthile lokukhutshwa kweziyobisi. Ukuba uhamba ngaphandle kokumelwa ngugqirha iziyobisi kangangesithuba seentsuku ezingama-63 ezilandelelanayo okanye nangaphezulu emva kokuba ubhalisile okokuqala kwi-Medicare, uya kuhlawuliswa isigwebo se-Medicare Part D esisigxina sokubhaliswa kade. Le ntlawulo yesohlwayo yongezwa kwipremiyamu yesicwangciso sakho samachiza kwinyanga nganye ungabhaliswanga.

Isohlwayo se-Medicare Part D emva kwexesha sobhaliso sibalwa ngokuphindaphinda “ipremiyamu yesiseko somxhamli wesizwe” ngepesenti enye kwaye ukuphindaphinda elo nani ngenani leenyanga ozihambileyo ngaphandle kokugubungela. Iprimiyamu yesibonelelo selizwe lesizwe yi- $ 33.06 ngo-2021, ke makhe sijonge ukuba ingaba esi sohlwayo sinokubonakala njani kumntu obhalisa ngasekupheleni kuka-2021:

• Ixesha lokubhalisa likaMnu Doe liphela ngoJanuwari 31, 2021.
• Umnumzana Doe akabhalisi kugqirha amayeza afanelekileyo ukuya kuthi ga ngoMeyi 1, 2021 (kwiinyanga ezintathu kamva).
• Mr.U-Doe uza kunikwa isohlwayo se-0.33 yeedola (i-33.06 x 1%) ngenyanga awayehamba ngayo ngaphandle kokugubungela (iinyanga ezi-3).
• Umnumzana Doe uzakuhlawula isohlwayo seprimiyamu yenyanga eyi-1.00 ($ .33 x 3 = $ .99, ajikelezwe kwi-0.10 yeedola ekufuphi) ukuya phambili.

Isohlwayo sobhaliso lwasemva kwexesha luxhomekeke kutshintsho njengoko ipremiyamu yesiseko sabazuzi itshintsha minyaka le.

Ndibhalisa njani kwiCandelo D leMedare?

Uvumelekile ukubhalisa kwisicwangciso seMedare ye-Medicare ngexesha lakho lokuqala lokubhalisa kwi-Medicare. Eli xesha liqhuba iinyanga ezi-3 ngaphambili, inyanga, kunye neenyanga ezi-3 emva kosuku lwakho lokuzalwa lwama-65. Kukho amaxesha ongezelelweyo obhaliso kwi-Medicare Part D, anje ngala:

• Oktobha 15 ukuya kuDisemba 7. Ungabhalisa ukuba sele ubhalisile kumacandelo A no-B kodwa awukabhalisi kwiCandelo D, okanye ukuba ufuna ukutshintshela kwesinye isicwangciso seCandelo D.
• Epreli 1 ukuya kuJuni 30. Ungasayina ukuba ubhalise kwi-Medicare Part B ngexesha lokubhaliswa kweCandelo B ngokubanzi (nge-1 kaJanuwari ukuya kwi-Matshi 31).

Isicwangciso ngasinye seCandelo leMedare D sinoluhlu lwamayeza amiselweyo agubungelayo, abizwa ngokuba yi-formulary. Iifomula zesicwangciso samachiza amayeza zigubungela igama lophawu kunye namachiza enziwa afana nalawo aveliswe ngumenzi avela kuluhlu lweziyobisi oluqhelekileyo Ngaphambi kokuba ubhalise kwisicwangciso seCandelo D, jonga ukuba amayeza akho agutyungelwe phantsi kwefomula yesicwangciso.

Xa ubhalisa kwiCandelo D, kukho iifizi zesicwangciso ukongeza kwiindleko zakho zokuqala zeMedicare. Ezi ntlawulo zibandakanya ukuncitshiswa kweziyobisi minyaka le, iziyobisi zepremiyamu yenyanga, ukuhlawulwa kweziyobisi kunye nokuqinisekiswa kwemali.

Ndingalufumana njani uncedo ngeendleko zam zamayeza amiselweyo?

Abaxhamli be-Medicare abanengxaki yokuhlangabezana neendleko zamachiza amiselweyo banokufumana uncedo kwinkqubo eyongezelelweyo yoNcedo. Uncedo olongezelelekileyo yinkqubo ye-Medicare Part D encedisa ekuhlawuleni iipremiyamu, ukuncitshiswa, kunye neendleko zokufumana imali ezihambelana nesicwangciso sakho sokuyalela.

Ukulungela i-Medicare eyongezelelweyo yoNcedo, oovimba bakho akufuneki badlule kwisixa esipheleleyo. Izixhobo zakho zibandakanya ikheshi esandleni okanye ebhankini, ukonga kunye notyalo mali. Ukuba ukulungele ukufumana uNcedo olongezelelweyo, unokufaka isicelo ngocwangciso lwakho lwamayeza amiselweyo kunye namaxwebhu axhasayo, njengesaziso esisemthethweni seMedicare.

Nokuba awulufanelekelanga uNcedo olongezelelweyo, usenokufanelekela iMedicaid. I-Medicaid ibonelela ngogcino lwezempilo kubantu abanomvuzo ophantsi abangaphantsi kweminyaka engama-65. Nangona kunjalo, abanye abaxhamli be-Medicare banelungelo lokugubungela iMedicaid, kuxhomekeke kwinqanaba lokufumana imali. Ukubona ukuba ufanelekile na kwiMedicaid, ndwendwela iofisi yakho yeenkonzo zentlalo.

Ezinye iingcebiso zokonga iindleko

Ngaphandle kokufumana uncedo lwezezimali, zikho ezinye izinto onokuzenza ukunceda ukuthoba iindleko zonyango:

• Thenga iikhemesti ezahlukeneyo. Iikhemesti zingathengisa iziyobisi ngexabiso elahlukileyo, kungoko ungatsalela umnxeba ubuze ukuba lingakubiza malini na ichiza elithile.
• Sebenzisa amatikiti omenzi. Iiwebhusayithi zabavelisi, iiwebhusayithi zokonga iziyobisi, kunye neekhemesti zinokubonelela ngamakhuphoni ukunceda ukunciphisa iindleko zamachiza aphuma epokothweni.
• Buza ugqirha wakho malunga neenguqulelo eziqhelekileyo. Amachiza enziwe afana nalawo aveliswe ngumenzi ahlala exabisa ngaphantsi kweenguqulelo zegama, nokuba ifomula iphantse yafana.

Ukuthatha

Unyango lwe-Medicare Icandelo D kunyanzelekile njengomxhamli weMedicare, ke kubalulekile ukuba ukhethe isicwangciso esikusebenzelayo. Xa uthenga indawo yokugubungela amayeza kagqirha, jonga ukuba leliphi iyeza lakho eligutyungelweyo kwaye liya kubiza malini.

Ixesha elingaphezulu, iindleko zokucwangciswa kwamachiza zinokongeza, ke ukuba unengxaki yokuhlawula iindleko zakho, kukho iinkqubo ezinokunceda.

Ukuthelekisa i-Medicare Part D okanye i-Medicare Advantage (Icandelo C) yezicwangciso zeziyobisi ezikufutshane nawe, ndwendwela i-Medicare ufumane isixhobo sesicwangciso sokufunda ngakumbi.

Eli nqaku lahlaziywa ngo-Novemba 19, 2020, ukubonisa ulwazi ngo-2021 lonyango.

Ulwazi olukule webhusayithi lunokukunceda ekwenzeni izigqibo malunga neinshurensi, kodwa ayenzelwanga ukunika iingcebiso malunga nokuthengwa okanye ukusetyenziswa kwayo nayiphi na i-inshurensi okanye iimveliso zeinshurensi. I-Healthline Media ayihambelani neshishini leinshurensi nangayiphi na indlela kwaye ayinayo ilayisensi njengenkampani yeinshurensi okanye umvelisi kulo naliphi na igunya laseMelika. I-Healthline Media ayikhuthazi okanye ixhase nabani na onokuthi enze ishishini leinshurensi.