Ngabe I-Medicare Imahhala Nini?
-Delile
- Yiziphi izingxenye zeMedicare ezimahhala?
- Ngabe i-Medicare Part A imahhala?
- Ngabe iMedicare Part A imahhala uma ngikhubazekile?
- Ngabe i-Medicare Part B imahhala?
- Ingabe iMedicare Part C (Medicare Advantage) imahhala?
- Ngabe i-Medicare Part D imahhala?
- Ngabe i-Medicare Supplement (Medigap) ihlale ikhululekile?
- Ukuthatha
- I-Medicare ayikhokhelwa kepha ikhokhelwa kusengaphambili impilo yakho yonke ngezintela ozikhokhayo.
- Akudingeki ukuthi ukhokhe imali ekhokhelwa i-Medicare Part A, kepha usengaba nayo i-copay.
- Okukhokhela i-Medicare kuya ngokuthi usebenze isikhathi esingakanani, wenza malini manje, nokuthi yiziphi izinhlelo ozikhethayo.
- Ukuqhathanisa izinhlelo zeMedicare kungakusiza ukhethe izinketho ezinhle kakhulu zesimo sakho.
I-Medicare ayikhululekile; kodwa-ke, akuwona wonke umuntu ozokhokha imali eyisisekelo. Kunezinhlelo ezahlukahlukene zeMedicare, kanti ezinye ziyakhethwa. Inani olikhokhayo lincike ezinhlelweni ozikhethayo, nokuthi ingakanani impilo yakho oyichithe usebenza futhi ukhokha ohlelweni lwe-Medicare ngezintela zakho.
Ngenkathi iMedicare ingekho mahhala impela, abantu abaningi ngeke bakhokhele imali ekhokhwa njalo ngenyanga yokunakekelwa okuyisisekelo. I-Medicare wuhlelo lomshuwalense wezempilo olufanelekayo lapho uneminyaka engama-65 noma unezinkinga ezithile zezempilo noma ukukhubazeka. Ukhokha ohlelweni lweMedicare kukho konke ukuphila kwakho okusebenzayo njengengxenye yentela yakho bese uthola izinzuzo zale minikelo kamuva empilweni noma uma kutholakala ukuthi unokukhubazeka.
Qhubeka ufunde ukuze uthole ukuthi yiziphi izici zohlelo ezifakiwe ekuhlanganisweni kwakho "mahhala" nokuthi yiziphi izinketho ezingakubiza kakhulu.
Yiziphi izingxenye zeMedicare ezimahhala?
Kunezinhlelo noma izingxenye ezahlukahlukene zeMedicare, ngayinye inezidingo zezempilo ezahlukahlukene. Ngayinye yalezi zinhlelo inezindleko ezahlukahlukene zanyanga zonke ngendlela yamaphrimiyamu, ama-copayments, kanye nemali ebanjwayo.
Ngenkathi abantu bengazibheka ezinye zalezi zinhlelo nezinsizakalo “njengemahhala,” empeleni zinhlelo ezinelungelo lokukhokhela yonke iminyaka osebenza ngayo. Uma ungenayo imali ekhokhwayo yanyanga zonke yohlelo lweMedicare, kungenxa yokuthi usuvele utshale imali kulolo hlelo. Kodwa-ke, akuwona wonke umuntu othola lezi zinsizakalo mahhala.
Ngabe i-Medicare Part A imahhala?
I-Medicare Part A ibonakala “imahhala,” kodwa ingenye yalezo zinzuzo osuzikhokhele izintela ozikhokhile phakathi neminyaka yakho yokusebenza. Abantu abaningi ngeke bakhokhe imali ekhokhwa nyangazonke ye-Medicare Part A, ehlanganisa ukunakekelwa kwezibhedlela kanye neziguli ezinakekela abagulayo, kanye ne-hospice nezinye izinsizakalo zezempilo zasekhaya. Izindleko eziqondile zeNgxenye A zincike esimeni sakho nokuthi usebenze isikhathi esingakanani.
Ngeke ukhokhe imali ekhokhwa nyangazonke ye-Medicare Part A uma umdala kuneminyaka engama-65 futhi noma yikuphi kwalokhu kuyasebenza:
- Uthola izinzuzo zokuthatha umhlalaphansi ku-Social Security.
- Uthola izinzuzo zokuthatha umhlalaphansi kwiBhodi Yesitimela Yomhlalaphansi.
- Wena noma owakwakho nisebenzele uhulumeni futhi nathola ukutholakala kwe-Medicare.
Ungase futhi ufanelekele ukuthola i-Medicare Part A engenayo i-premium uma ungaphansi kweminyaka engama-65 futhi noma yikuphi kwalokhu kuyasebenza:
- Uthole izinzuzo zokukhubazeka Komphakathi izinyanga ezingama-24.
- Uthole izinzuzo zokukhubazeka kweBhodi Yesitimela Yomhlalaphansi izinyanga ezingama-24.
- Unesifo sezinso sesigaba sokuphela.
Uma ungenalo ikhwalithi ye-Medicare Part A engakhokhelwa nge-premium, uzokhokha imali ekhokhelwa ngokususelwa kwinani lezindawo osebenze kuzo ngesikhathi sokuphila kwakho.
| Inani lesikhathi elisetshenzisiwe (futhi ikhokhwe ku-Medicare) | Iphrimiyamu yanyanga zonke ngo-2021 |
|---|---|
| <30 amakota (amasonto angama-360) | $471 |
| Amakota angama-30–39 (amasonto angama-360-468) | $259 |
Ngenkathi Ingxenye A ihlanganisa ukunakekelwa kwakho kweziguli nezidingo ezithile zempilo yasekhaya, kuzodingeka nokuthi ube nokutholakala kweNgxenye B kokunye ukuvakashelwa kwezokwelapha nokunakekelwa kokuvimbela.
Ngabe iMedicare Part A imahhala uma ngikhubazekile?
Kunokukhubazeka okuningana okufanele ukutholakala mahhala ngaphansi kwe-Medicare Part A. I-Social Security Administration ichaza ukuthi yikuphi ukukhubazeka okukufanelekela ukuthola i-Medicare Part A engakhokhelwa nge-premium, kepha izindaba ezijwayelekile zezokwelapha ezilindeleke ukuthi zihlale isikhathi esingaphezu konyaka noma umphumela wokufa ufanelekile kulezi zinzuzo.
Ngabe i-Medicare Part B imahhala?
I-Medicare Part B wuhlelo lomshuwalense wezempilo oluhlinzeka ngezinsizakalo ezihlinzeka iziguli ezingaphandle njengokuvakashelwa udokotela nokunakekelwa kokuvikela Ayinikezi inketho yamahhala engakhokhwa njenge-Part A. Amaphrimiyamu enyanga ngayinye akhokhiswa ngokususelwa ezingeni leholo lakho, kepha hhayi wonke umuntu othola isikweletu se-premium yakhe.
I-premium yakho ye-Medicare Part B izodonswa ngokuzenzakalela ekuhlolweni kwakho kwezinzuzo zanyanga zonke uma uthola noma ikuphi kokulandelayo:
- Izinzuzo Zokuphepha Komphakathi
- izinkokhelo ezivela kuBhodi Yomhlalaphansi Yesitimela
- izinkokhelo ezivela eHhovisi Lokuphathwa Kwezabasebenzi
Kulabo abakhokha iphrimiyamu yengxenye B, izindleko ziyahluka ngokuya ngeholo lakho. Imali engenayo yonyaka kusuka ku-2019 isetshenziselwa ukubala ukuthi uzokhokha ini ngo-2021.
| Imali engenayo yomuntu ngamunye | Imali engenayo ehlangene yezithandani | Iphrimiyamu yanyanga zonke |
|---|---|---|
| ≤ $88,000 | ≤ $176,000 | $148.50 |
| > $88,000–$111,000 | > $176,000–$222,000 | $207.90 |
| > $111,000–$138,000 | > $222,000–$276,000 | $297 |
| > $138,000–$165,000 | > $276,000–$330,000 | $386.10 |
| > $165,000–< $500,00 | > $330,000–< $750,000 | $475.20 |
| ≥ $500,000 | ≥ $750,000 | $504.90 |
Ezinye izinhlelo zeMedigap zihlanganisa izindleko zeMedicare Part B ekhishwayo. Kodwa-ke, ngo-2015 kwaphasiswa umthetho (i-Medicare Access kanye ne-CHIP Reauthorization Act ka-2015 [MACRA]) okwenza kwaba semthethweni ngezinhlelo ze-Medicare Supplement (Medigap) ukukhokhela ingxenye B ebanjwayo kubabhalisi abasha kusukela ngo-2020.
Ngenkathi abantu ababesele benohlelo olukhokhele le-premium bagcina ukumbozwa kwabo, kusukela ngoJanuwari 1, 2020, ababhalisile abasha beMedicare abakwazanga ukubhalisela izinhlelo zokwengeza ezikhokhela i-Part B premium. Kodwa-ke, uma ngabe ubusuvele ubhalisile kwi-Medicare futhi unohlelo lweMedigap olukhokha ingxenye B edonswayo, ungayigcina.
Ingabe iMedicare Part C (Medicare Advantage) imahhala?
Izinhlelo zeMedicare Part C (Medicare Advantage) yizinhlelo zomshuwalense wangasese ezihlanganisa izici zombili iMedicare Part A neMedicare Part B, kanye nezinye izinsizakalo. Izinkampani ezizimele zithola uxhaso kuMedicare, ngakho-ke ezinye izinhlelo zisenganikela “mahhala” noma zinciphise amaprimiyamu anyanga zonke.
Izindleko zeprimiyamu ethile ye-Part C ihluka ngohlelo. Kunezinketho ezahlukahlukene zensizakalo, izinhlobo zokubika, kanye namanani wezinhlelo zeMedicare Part C. Abanye baze bahlanganise nezinsizakalo ezifana nokuhlolwa kwamehlo, ukunakekelwa kwamazinyo, izinsiza-kuzwa nezinhlelo zokuqina.
Izinhlelo ezinganikeli amaphrimiyamu nyangazonke zisengaba nezinye izindleko, noma kunjalo, njengama-copays, i-coinsurance, kanye nezimali ezidonswayo. Izinhlelo eziningi, noma kunjalo, zifaka ama-maximum aphuma ephaketheni. I-Medicare inikeza ithuluzi eliku-inthanethi ukuqhathanisa izindleko kanye nezinsizakalo ezifakwe ezinhlelweni ze-Medicare Advantage ezinikezwa endaweni yakho.
Ngabe i-Medicare Part D imahhala?
I-Medicare Part D ihlanganisa imishanguzo kadokotela futhi ikhokhwa ngamaphrimiyamu nezinye izimali. Izinhlelo zeMedicare Advantage zingafaka ukumbozwa kadokotela, kepha usazobophezeleka engxenyeni ethile yezindleko zakho zemithi.
Izindleko ze-Premium ziyahlukahluka ngendawo nohlelo, futhi ungasebenza nodokotela wakho ukuze uqiniseke ukuthi imishanguzo oyinikezwayo ifakiwe kuhlu lwezidakamizwa (olubizwa ngokuthi i-formulary) olwamukelwa yi-Medicare. Uma umuthi wakho ungekho ohlwini olugunyaziwe, udokotela wakho angacela okwehlukile noma akhethe umuthi ohlukile.
Ngabe i-Medicare Supplement (Medigap) ihlale ikhululekile?
Izinqubomgomo zeMedigap (Medicare Supplement) ziyatholakala ngezinkampani zomshuwalense ezizimele. Azikho mahhala kodwa zingakusiza ukuthi wonge imali kwezinye izindleko zohlelo lwe-Medicare.
Ezinye izinhlelo zeMedigap, njenge-C ne-F, zisetshenziselwa ukumboza imali ekhishwe eMedicare Part B. Lokhu ngeke kushintshe kubantu asebenazo lezi zinhlelo, kepha abantu abasha ku-Medicare ngemuva kukaJanuwari 1, 2020 ngeke besakwazi ukuthenga lezi zinhlelo.
I-Medicare inikeza ithuluzi eliku-inthanethi ukuthola izinhlelo zeMedigap endaweni yangakini. Ungaqhathanisa izindleko ze-premium nokuthi yikuphi okusebenza ngama-copays nokudonswayo. Izinzuzo zeMedigap zingena ngemuva kwezinhlelo eziyisisekelo zeMedicare ezinjengeNgxenye A nengxenye B ukumbozwa sekuphelile.
Ukuthatha
- Ukutholakala kwe-Medicare kuyinkimbinkimbi, futhi kunezinto eziningi ezibhekwayo ezihlukile kwisimo sakho.
- Azikho ngokuphelele izinhlelo zamahhala "zamahhala". Usebenze isikhathi esingakanani, wenza malini, nokuthi ungakhokhela malini njengokudonswayo ngaphambi kokuba izinzuzo zakho zingene kuzo zonke izici ezibandakanyekayo ekubaleni izindleko zakho ze-Medicare.
- Ngenkathi kunezinhlelo ezithile ezinikela ngamaphrimiyamu aphansi noma “amahhala”, qhathanisa amapulani bese ubheka zonke izindleko ezithintekayo, kufaka phakathi imali ekhishwayo, ama-copayments, kanye nokuqinisekisa imali
Lo mbhalo uvuselelwe ngoNovemba 20, 2020, ukukhombisa imininingwane ye-2021 Medicare.
Imininingwane ekule webhusayithi ingakusiza ekwenzeni izinqumo eziphathelene nomshuwalense, kepha ayihloselwe ukunikeza iseluleko maqondana nokuthengwa noma ukusetshenziswa kwanoma imuphi umshwalense noma imikhiqizo yomshuwalense. I-Healthline Media ayisebenzisi ibhizinisi lomshwalense nganoma iyiphi indlela futhi ayinamalayisensi njengenkampani yomshuwalense noma umkhiqizi kunoma iyiphi indawo yase-U.S. I-Healthline Media ayincomi noma ivumele noma yiziphi izinkampani zangaphandle ezingase zenze ibhizinisi lomshwalense.
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