I-Medicare Part D Idonswa ngo-2021: Izindleko shazi

-Delile

• Ziyini izindleko ze-Medicare Part D?
• Okudonswayo
• Amaphrimiyamu
• Ama-Copays kanye ne-coinsurance
• Lithini igebe lokumboza le-Medicare Part D (“hole donut”)?
• Izidakamizwa ezibizwa ngegama lomkhiqizo
• Izidakamizwa ezijwayelekile
• Ukufakwa kwenhlekelele
• Ngabe kufanele ngithole i-Medicare Part D noma uhlelo lwe-Medicare Advantage?
• Izinzuzo nezingozi zeMedicare Advantage
• Inhlawulo yokubhaliswa emuva kwesikhathi
• Ngibhalisa kanjani kwiMedicare Part D?
• Ngingaluthola kanjani usizo ngezindleko zami zemithi kadokotela?
• Amanye amathiphu wokonga izindleko
• Ukuthatha

I-Medicare Part D, eyaziwa nangokuthi ukutholakala kwezidakamizwa kadokotela, yingxenye yeMedicare ekusiza ukukhokhela imishanguzo kadokotela. Uma ubhalisa ohlelweni lwengxenye D, unesibopho sokukhokha amanani akho akhokhelwayo, ama-premium, ama-copayment, nama-coinsurance. Isilinganiso esiphakeme seMedicare Part D esikhishwe ngo-2021 singama- $ 445.

Ake sibhekisise ukuthi i-Medicare Part D imayelana nani nokuthi ukubhalisela uhlelo lwe-Medicare Part D kungakubiza ini ngo-2021.

Ziyini izindleko ze-Medicare Part D?

Uma usubhalise kwi-Medicare Part A ne-Part B, i-Medicare yasekuqaleni, ungabhalisa ku-Medicare Part D. Izinhlelo zamakhambi ezisetshenziswa ngemithi ka-Medicare zisiza ukumboza noma imiphi imishanguzo kadokotela engamboziwe ngaphansi kohlelo lwakho lokuqala lwe-Medicare.

Okudonswayo

I-Medicare Part D edonswayo yinani ozolikhokha unyaka ngamunye ngaphambi kokuthi uhlelo lwakho lwe-Medicare lukhokhe ingxenye yalo. Ezinye izinhlelo zezidakamizwa zibiza u- $ 0 ngonyaka odonswayo, kepha leli nani lingahluka ngokuya ngomhlinzeki, indawo okuyo, nokuningi. Inani eliphakeme kakhulu elingadonswa noma yiluphi uhlelo lweNgxenye D olungakhokhisa ngo-2021 ngama- $ 445.

Amaphrimiyamu

I-Medicare Part D premium iyinani ozolikhokha nyangazonke ukuze ubhalise ohlelweni lwakho lwezidakamizwa. Njengokudonswa kwemali engu- $ 0, ezinye izinhlelo zezidakamizwa zibiza u- $ 0 ngenyanga.

Iphrimiyamu yanyanga zonke yanoma yiluphi uhlelo ingahluka ngokuya ngezici ezahlukahlukene, kufaka phakathi iholo lakho. Uma imali yakho engenayo ingaphezu kombundu othile, kungadingeka ukhokhe inani lokulungiswa elihlobene nenyanga (IRMAA). Leli nani elilungisiwe le-2021 lisuselwa ekubuyiseni kwakho kwentela ka-2019.

Nawa ama-IRMAA we-2021 Ingxenye D asuselwa ezingeni lemali engenayo njengomuntu ofaka ifomu lakho lentela:

• $ 88,000 noma ngaphansi: ayikho imali eyengeziwe ekhokhwayo
• > $ 88,000 kuya ku- $ 111,000: + $ 12.30 ngenyanga
• > $ 111,000 kuya ku- $ 138,000: + $ 31.80 ngenyanga
• > $ 138,000 kuya ku- $ 165,000: + $ 51.20 ngenyanga
• > $ 165,000 kuya ku- $ 499,999: + $ 70.70 ngenyanga
• $ 500,000 nangaphezulu: + $ 77.10 ngenyanga

Imibundu yehlukile kubantu abafaka ngokuhlanganyela nalabo abashadile futhi bafaka amafayela ngokwahlukana. Kodwa-ke, ukwanda kwanyanga zonke kuzohlala kusuka ku- $ 12.40 kuye ku- $ 77.10 okungeziwe ngenyanga, kuya ngeholo lakho kanye nesimo sokufaka.

Ama-Copays kanye ne-coinsurance

Imali ekhokhwayo ye-Medicare Part D kanye namanani we-coinsurance yizindleko ozikhokhayo ngemuva kokuthi i-Part D yakho idonswe. Ngokuya ngohlelo olukhethayo, uzokweleta imali ekhokhwayo noma imali yokuqinisekisa.

I-copayment yinani elibekiwe olikhokhela umuthi ngamunye, kanti i-coinsurance iyiphesenti lezindleko zomuthi onomthwalo wokuzikhokha.

Inani le-Part D lokukhokha kanye ne-coinsurance lingahluka ngokuya "ngezigaba" umuthi ngamunye okuzo. Intengo yesidakamizwa ngasinye ngaphakathi kwe-formulary yohlelo lwezidakamizwa iyakhuphuka njengoba ama-tiers anda.

Isibonelo, uhlelo lwakho lomuthi kadokotela lungaba nohlelo olulandelayo:

Lithini igebe lokumboza le-Medicare Part D (“hole donut”)?

Izinhlelo eziningi ze-Medicare Part D zinegebe lokumboza, elibizwa nangokuthi "umgodi wedonathi." Lesi sikhala sokumbozwa senzeka lapho usufinyelele umkhawulo wokuthi uhlelo lwakho lwengxenye D luzokukhokhela ini ngemithi yakho kadokotela. Lo mkhawulo ungaphansi kwenani lemali yakho eliyinhlekelele, noma kunjalo, okusho ukuthi uzoba negebe ekuhlanganisweni kwakho.

Nakhu ukuthi igebe lokumboza le-Medicare Part D lisebenza kanjani ngo-2021:

• Ukudonswa konyaka. U- $ 445 yi-deductible ephezulu izinhlelo zeMedicare Part D ezingayikhokhisa ngo-2021.
• Ukufakwa kokuqala. Umkhawulo wokuqala wokumboza wezinhlelo zeMedicare Part D ngo-2021 ngu- $ 4,130.
• Ukufakwa kwenhlekelele. Inani eliyinhlekelele lokukhahlela likhahlela kanye lapho ususebenzise u- $ 6,550 ephaketheni ngo-2021.

Ngakho-ke, kwenzekani lapho ukugebe lokusabalala lohlelo lwakho lwengxenye D? Lokho kuncike kokulandelayo:

Izidakamizwa ezibizwa ngegama lomkhiqizo

Uma usufinyelele igebe lokumboza, ngeke ukhokhe ngaphezu kwamaphesenti angama-25 wezindleko zemithi kadokotela enegama lomkhiqizo ehlanganiswe ngohlelo lwakho. Ukhokha amaphesenti angama-25, umenzi akhokhe amaphesenti angama-70, bese kuthi uhlelo lwakho lukhokhe amaphesenti amahlanu asele.

Isibonelo: Uma umuthi wakho wegama lomuthi libiza u- $ 500, uzokhokha u- $ 125 (kanye nemali ekhishwa) Umenzi wezidakamizwa nohlelo lwakho lweNgxenye D bazokhokha u- $ 375 osele.

Izidakamizwa ezijwayelekile

Uma usufinyelele igebe lokumboza, uzokweleta amaphesenti angama-25 wezindleko zemithi ejwayelekile ehlanganiswe ngohlelo lwakho. Ukhokha amaphesenti angama-25 bese uhlelo lwakho lukhokha amaphesenti angama-75 asele.

Isibonelo: Uma umuthi wakho ojwayelekile kadokotela ubiza u- $ 100, uzokhokha u- $ 25 (kanye nemali ekhishwayo). Uhlelo lwakho lweNgxenye D luzokhokha ama- $ 75 asele.

Ukufakwa kwenhlekelele

Ukuze ukwenze kuphume esikhaleni sokumboza, kufanele ukhokhe isamba esingu- $ 6,550 ezindlekweni ezingaphandle kwephaketheni. Lezi zindleko zingafaka:

• Isidakamizwa sakho sidonswa
• ukukhokhelwa kwezidakamizwa / ukubonelelwa kwemali yakho
• izindleko zomuthi wakho esikhaleni
• inani elikhokhwa ngumenzi wezidakamizwa ngesikhathi somgodi wamadonathi

Uma usuyikhokhile le mali ephume ephaketheni, ukumbozwa kwakho okuyinhlekelele kuyangena. Ngemuva kwalokho, uzoba nesibopho sokukhokha imali encane noma isiqiniseko semali. Ngo-2021, inani le-coinsurance liyi-5% kanti inani le-copayment lingu- $ 3.70 lemithi ejwayelekile kanye ne- $ 9.20 yezidakamizwa ezinegama lomkhiqizo.

Ngabe kufanele ngithole i-Medicare Part D noma uhlelo lwe-Medicare Advantage?

Uma ubhalisa kwi-Medicare, unenketho yokukhetha i-Medicare Part D noma i-Medicare Advantage (Ingxenye C) ukuhlangabezana nezidingo zakho zokutholakala kwezidakamizwa.

Izinzuzo nezingozi zeMedicare Advantage

Iningi lezinhlelo ze-Medicare Advantage zifaka ukumbozwa kwezidakamizwa kadokotela ngokungeziwe kwezinye izinketho zokufaka ezifana namazinyo, umbono, ukuzwa, nokuningi. Lokhu kufakwa okungeziwe kungaholela ekwandeni kwezindleko zonke, futhi ungaqeda ukukhokha ngaphezulu uhlelo lweMedicare Advantage kunokufaka nje Ingxenye D kuhlelo lwakho lwasekuqaleni.

Ngaphezu kwalokho, ezinye izinhlelo ze-Medicare Advantage HMO zinganciphisa ukumbozwa kwakho kodokotela abangaphakathi kwenethiwekhi kanye namakhemisi. Lokhu kusho ukuthi udokotela wakho wamanje noma ikhemisi kungenzeka lingahlanganiswa nohlelo lweMedicare Advantage ofuna ukubhalisa kulo.

Inhlawulo yokubhaliswa emuva kwesikhathi

Akunandaba ukuthi ukhetha i-Medicare Part D noma uhlelo lwe-Medicare Advantage, i-Medicare idinga ukuthi ube nohlobo oluthile lokutholakala kwemithi kadokotela. Uma uhamba ngaphandle kokutholakala kwezidakamizwa kadokotela isikhathi esiyizinsuku ezingama-63 ezilandelanayo noma ngaphezulu ngemuva kokuqala ukubhalisa kwi-Medicare, uzokhokhiswa inhlawulo yokubhaliswa unomphela ye-Medicare Part D. Le mali yenhlawulo yengezwa ku-premium yakho yohlelo lwezidakamizwa inyanga ngayinye ongabhaliswanga ngayo.

Isijeziso sokubhaliswa sekwedlule isikhathi seMedicare Part D sibalwa ngokuphindaphinda “imali ekhokhwayo yabazuzi besisekelo sikazwelonke” ngamaphesenti ayi-1 bese siphindaphindwa lelo nani ngenani lezinyanga ozihambile ngaphandle kokutholakala. Iphrimiyamu kazwelonke yabahlomuli ngu- $ 33.06 ngo-2021, ngakho-ke ake sibheke ukuthi lesi sijeziso singabukeka kanjani kumuntu obhalisa ngasekupheleni kuka-2021:

• Isikhathi sokuqala sokubhaliswa kukaMnu Doe siphela ngoJanuwari 31, 2021.
• UMnu Doe akabhalisi embozweni wemithi kadokotela obolekayo kuze kube uMeyi 1, 2021 (izinyanga ezintathu kamuva).
• UMnu Doe uzokweleta isijeziso sika- $ 0.33 ($ 33.06 x 1%) ngenyanga ahamba ngaphandle kokumbozwa (izinyanga ezi-3).
• UMnu Doe uzokhokha inhlawulo ye-premium yenyanga engu- $ 1.00 ($ .33 x 3 = $ .99, eqoqelwe ku- $ 0.10 eseduzane) ukuya phambili.

Isijeziso sokubhaliswa sekwedlule isikhathi singashintsha uma imali ekhokhwayo kazwelonke yabahlomuli ishintsha unyaka nonyaka.

Ngibhalisa kanjani kwiMedicare Part D?

Uvumelekile ukubhalisa ohlelweni lwe-Medicare Part D ngesikhathi sakho sokuqala sokubhaliswa kwe-Medicare. Lesi sikhathi sisebenza ezinyangeni ezintathu ngaphambi, inyanga ka, nezinyanga ezi-3 ngemuva kosuku lwakho lokuzalwa lwama-65. Kukhona nezikhathi zokubhalisa ezengeziwe ze-Medicare Part D, njenge:

• Okthoba 15 kuya kuDisemba 7. Ungabhalisa uma usuvele ubhalise ezingxenyeni A no-B kodwa ungakabhalisi ku-Part D, noma uma ufuna ukushintshela kwelinye icebo le-Part D.
• Ephreli 1 kuya kuJuni 30. Ungabhalisa uma ubhalise kwi-Medicare Part B ngesikhathi sokubhaliswa kweNgxenye B ejwayelekile (ngoJanuwari 1 kuya kuMashi 31).

Uhlelo ngalunye lwe-Medicare Part D lunohlu lwemithi kadokotela eluhlanganisayo, ebizwa ngokuthi i-formulary. Amafomula wohlelo lwezidakamizwa ahlinzekwa amboza amagama egama lomuthi kanye nemithi ejwayelekile evela ezigabeni zemithi ezijwayele ukwenziwa. Ngaphambi kokuthi ubhalise ohlelweni lwengxenye D, hlola ukuthi imithi yakho imboziwe ngaphansi kwefomula yecebo.

Uma ubhalisa engxenyeni D, kunezimali zohlelo ngaphezu kwezindleko zakho zangempela ze-Medicare. Lezi zimali zibandakanya ukukhishwa kwezidakamizwa minyaka yonke, i-premium yohlelo lwezidakamizwa nyangazonke, ukukhokhelwa kwezidakamizwa, kanye nokuqinisekiswa kwemali.

Ngingaluthola kanjani usizo ngezindleko zami zemithi kadokotela?

Abazuzi beMedicare abanenkinga yokuhlangabezana nezindleko zemithi kadokotela bangahlomula kuhlelo lwe-Extra Help. Usizo Olungeziwe uhlelo lweMedicare Part D olusiza ekukhokheni amaprimiyamu, ukudonswa kwemali, nezindleko zokuqinisekisa imali ezihambisana nohlelo lwakho lwezidakamizwa.

Ukuze ufanelekele usizo lwe-Medicare Extra, izinsiza zakho akumele zeqe inani eliphelele elibekiwe. Izinsizakusebenza zakho zifaka ukheshi esandleni noma ebhange, ukonga, kanye nokutshalwa kwemali. Uma ufanelekela ukuthola usizo olungeziwe, ungafaka isicelo ngohlelo lwakho lwezidakamizwa olunikezwa ngemibhalo esekelayo, njengesaziso esisemthethweni seMedicare.

Noma ungalufanelekeli Usizo Olungeziwe, ungahle ufanelekele iMedicaid. I-Medicaid inikeza ukunakekelwa kwezempilo kubantu abahola kancane abaneminyaka engaphansi kwengama-65. Kodwa-ke, abanye abahlomuli beMedicare nabo bayakufanelekela ukutholakala kweMedicaid, kuya ngezinga lemali engenayo. Ukubona ukuthi uyayifanelekela yini iMedicaid, vakashela ihhovisi lezinsizakalo zenhlalo yangakini.

Amanye amathiphu wokonga izindleko

Ngaphandle kokuthola usizo lwezezimali, kunezinye izinto ongazenza ukusiza ukwehlisa izindleko zakho zemithi kadokotela:

• Thenga amakhemisi ahlukene. Amakhemisi angathengisa izidakamizwa ngamanani ahlukile, ngakho-ke ungashayela ucingo ubuze ukuthi umuthi othile ungakubiza malini.
• Sebenzisa amakhuphoni womkhiqizi. Amawebhusayithi womkhiqizi, amawebhusayithi wokonga izidakamizwa, kanye namakhemisi angahlinzeka ngamakhuphoni okusiza ukwehlisa izindleko zakho zezidakamizwa ezingaphandle.
• Buza udokotela wakho ngezinhlobo ezijwayelekile. Imithi ejwayelekile ivame ukubiza ngaphansi kwezinguqulo zamagama, noma ngabe ifomula icishe ifane ngokuphelele.

Ukuthatha

Ukutholakala kwe-Medicare Part D kuphoqelekile njengomzuzi weMedicare, ngakho-ke kubalulekile ukukhetha uhlelo olusebenzela wena. Lapho uthenga ezungeza ukutholakala kwemithi kadokotela, cabanga ukuthi imiphi imishanguzo yakho ehlanganisiwe nokuthi izobiza malini.

Ngokuhamba kwesikhathi, izindleko zohlelo lwemithi kadokotela zingangeza, ngakho-ke uma unenkinga yokukhokha izindleko zakho, kunezinhlelo ezingasiza.

Ukuqhathanisa i-Medicare Part D noma i-Medicare Advantage (Ingxenye C) yezinhlelo zemithi kadokotela eduze kwakho, vakashela i-Medicare's thola ithuluzi lohlelo lokufunda kabanzi.

Lo mbhalo uvuselelwe ngoNovemba 19, 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.