Ukuqonda izinhlelo ze-Medicare Part D

Inkampani

Ama-prescription angabiza, futhi lokho kuyacindezela uma unenkinga yokuwasebenzisa. Uhlelo lomshuwalense wezempilo oluhlanganisa ezinye izindleko zemithi yakho lungasiza ekwenzeni impilo ibe lula kancane. I-Medicare Part D ingasiza.

Isebenza kanjani iMedicare Part D?

I-Medicare Part D yingxenye yokuzikhethela yeMedicare ehlanganisa imithi eminingi kadokotela. Ingxenye D inikezwa ngezinkampani zomshuwalense ezizimele abantu abaningi abakwaMedicare abakhetha ukusiza ngazo izindleko zezidakamizwa.

I-Medicare inezingxenye ezine: A, B, C, no-D.Medicare Part A ihlanganisa ukunakekelwa kwezibhedlela ezingalaliswayo, ukunakekelwa kwendawo yokunakekela abanamakhono, ukunakekelwa kwempilo ekhaya ngemuva kokuphuma esibhedlela sokugula, nokunakekelwa kwe-hospice.

Iningi labantu abafanele iMedicare bathola i-Part A ngokuzenzakalela.

I-Medicare Part B ihlanganisa ukuvakashelwa kwamahhovisi odokotela abagulayo, ama-X-ray, ukuhlolwa kwelebhu, izinsizakalo zezempilo zasekhaya, izinsizakalo zokuvimbela, imishini yezokwelapha eqinile, izinsizakalo zezempilo yengqondo, izinsizakalo ze-ambulensi, kanye nokwelashwa ngokomzimba, phakathi kwezinye izinsiza. Iningi labantu abane-Medicare bakhetha ukuthola izinzuzo zabo ze-Part A ne-Part B ngaphansi kwemali ekhokhwayo yenkonzo yemithi, noma i-Original Medicare.

I-Medicare Part C iyingxenye ye-Medicare lapho izinhlelo zomshuwalense wezempilo ezizimele-esikhundleni se-Original Medicare-zisebenzisa izinzuzo ze-Part A no-B futhi kaningi zinikela ngenzuzo yomuthi kadokotela. Izinhlelo ze-Part C zivame ukubizwa ngokuthi ama-Medicare Advantage Plans.

Ukuthola ukutholakala kwezidakamizwa kadokotela, abahlomuli beMedicare bangabhalisa kuhlelo oluzimele lweMedicare Part D Prescription Drug (PDP) noma kuhlelo lweMedicare Advantage Prescription Drug (MAPD). Abahlomuli bangakhokha imali ekhokhwa njalo ngenyanga kumphathi wabo womshuwalense, bese kuthengwa nemithi inkampani yomshuwalense eyimbozayo. I-deductible ne-copay noma i-coinsurance ingakhokhwa ngumzuzi, futhi inkampani yomshuwalense ihlanganisa izindleko ezisele.

Kunezigaba ezine ze- Ukusabalala kwe-Medicare Part D unyaka wonke lapho izindleko zemithi zingashintsha:

1. Ukudonswa: Inani lokuphuma ephaketheni libiza umthengi we-Medicare okufanele akhokhe ngaphambi kokutholakala kokutholakala kwe-Medicare.
2. Ukufakwa kokuqala: Izinhlelo zeMedicare kanye nomthengi babelana ngezindleko zemithi kadokotela. Le copay noma i-coinsurance isethwe ngohlelo ngokuya ngohlobo lwesidakamizwa ngasinye, nezinye izinto.
3. Ukuhlanganisa igebe: Ngemuva kokuthi umthengi necebo bakhokhe inani elithile elihlanganisiwe emithini ehlanganisiwe, umthengi uthuthela esikhaleni sokuhlanganisa, esibizwa nangokuthi imbobo yedonut Medicare. Ngo-2019, ukhokha ama-25% noma ama-37% ngamagama ezimpawu zomuthi kanye nemithi ejwayelekile. Kodwa-ke, ngo-2020, kuzoba ngama-25% ebhodini lonke, kusho uDanielle K. Roberts, isazi seMedicare nomsunguli wabambisene Izinzuzo zeBoomer .
4. Ukufakwa kwenhlekelele: Isigaba sokugcina sokutholakala kwe-Medicare Part D lapho umthengi akhokha khona cishe u-5% wezindleko zakhe zemithi ngasekupheleni konyaka. Ngo-2019, ukumbozwa okuyinhlekelele kufinyelelwa ngemuva kokuthi umthengi eyedwa akhokhe ama- $ 5,100 ezindlekweni eziphelele.

Yimiphi imishanguzo embozwe yi-Medicare Part D?

Imithi kadokotela embozwe yizinhlelo ze-Medicare Part D zizohluka ngokuya ngokuthi umuntu ngamunye ophethe umshuwalense uthini.

Uhlelo lweMedicare Part D luzohlanganisa okungenani imishanguzo emibili kuzo zonke izigaba zemithi. Kudingeka nezinhlelo ukumboza cishe yonke imishanguzo kulawa makilasi alandelayo:

• Ama-antipsychotic: Le mithi inikezwe ukusiza ukuphatha i-psychosis. Izibonelo zama-antipsychotic ajwayelekile abandakanya i-Haldol (haloperidol) ne-Risperdal (risperidone).
• Izidakamizwa zokucindezeleka: Le mithi isiza ekwelapheni ukucindezeleka nokukhathazeka kwabantu abaningi. I-Effexor XR (venlafaxine) ne-Prozac (i-fluoxetine) yizinto ezimbili ezibekwa imishanguzo ejwayelekile.
• Ama-anticonvulsants: Leli qembu lezidakamizwa elinama-pharmacological agents lisiza labo abahlangabezana nokuquleka kwesithuthwane. Izibonelo zama-anticonvulsants ezingambozwa uhlelo lweMedicare Part D zifaka iKeppra (levetiracetam) neLamictal (lamotrigine).
• Ama-immunosuppressants: Le mithi yehlisa amandla amasosha omzimba, kwesinye isikhathi adingeka ukufakelwa izitho noma ukwelapha izifo ezizimele. Imithi ye-Prednisone, efana ne-Deltasone ne-Orasone, iyizibonelo zama-immunosuppressants ajwayelekile.
• Izidakamizwa zomdlavuza: Izinhlelo zeMedicare Part D zizohlanganisa ezinye izidakamizwa zomdlavuza. Kubalulekile ukukhuluma nomhlinzeki wakho wezokunakekelwa kwempilo kanye nomphathi womshuwalense ukuze uqiniseke ukuthi umuthi owudingayo uyambozwa ngaphambi kokubhalisela inzuzo yemithi kadokotela. Izibonelo zemithi yomdlavuza ejwayele ukubalwa zifaka i-Avastin (bevacizumab) ne-Revlimid (lenalidomide).
• Izidakamizwa ze-HIV / AIDS: Uhlelo lwe-Medicare Part D luzohlanganisa eminye imishanguzo kadokotela ye-HIV / AIDS. Ezinye izibonelo zalezi zinhlobo zemithi zifaka iTruvada (emtricitabine-tenofovir), iNorvir (ritonavir), ne-Isentress (raltegravir).

Kokubili imishanguzo ejwayelekile kanye negama lomkhiqizo imbozwe yiMedicare Part D, kepha imishanguzo enegama lomkhiqizo ingabiza kakhulu kubahlomuli. Izidakamizwa zifakwa emaceleni ngamacebo e-Medicare Part D, futhi izidakamizwa ezigabeni ezahlukene izoba nezindleko ezihlukile. Izidakamizwa ezibizwa ngegama lomkhiqizo zingafakwa kumazinga aphezulu anezindleko eziphakeme ze-copay noma ze-coinsurance.

Into eyodwa okufanele uyazi ngeMedicare Part D ukuthi ayihlanganisi imishanguzo yamakhasimende, amavithamini kadokotela, neminye imithi ethile. Ukukhuluma nomhlinzeki wezokunakekelwa kwempilo noma udokotela, futhi ukubuyekeza izinketho zakho zohlelo minyaka yonke kuyindlela engcono yokuthola ukuthi uhlelo lwakho lweMedicare Part D luwuhlelo olulungele wena ngokuya ngezidingo zakho zokwelashwa. Unethuba lokushintshela izinhlelo ezifanelana kangcono nezidingo zakho ngesikhathi sokubhaliswa kwe-Fall Open. Abantu abanezinhlelo ze-Medicare Advantage bangakwazi ukushintsha izinhlelo ngesikhathi seMedicare Advantage Open Enspiration Period.

Ziyini izindleko ze-Medicare Part D?

Uhlelo ngalunye lwengxenye D luzibeka ngokwalo oludonselwayo, amaphrimiyamu, amazinga okuhlangana, namafomula. Iphrimiyamu yanyanga zonke yalabo abane-Medicare Part D izohluka ngokuya ngohlelo. Isilinganiso sanyanga zonke sikazwelonke sonyaka wezi-2019 singama- $ 33.19, noma kukhona amathuba okuthi lokhu kushintshe ngo-2020.

Uma inkampani yomshuwalense idinga ukukhishwa, lokho kuzokhokhwa kuqala, kulandelwe i-copay noma i-coinsurance yemithi yonke kadokotela. Kunemikhawulo yokuthi kuzodonswa malini; umkhawulo wango-2019 awukwazi ukuba ngaphezu kuka- $ 415.

Ngemuva kokuthi kukhokhwe imali ekhishwayo, izinhlelo zeMedicare Part D zizodinga ukuthi abahlomuli bakhokhe i-copay noma i-coinsurance yemiyalelo. Uma kudingeka i-coinsurance, umzuzi uzokhokha iphesenti lomuthi othengiwe.

Enye yezinkinga ezithinta abantu abane-Medicare yinto ebizwa ngokuthi yi-gap gap, noma imbobo yedonathi . Igebe lokumboza lifinyelelwa lapho izindleko eziphelele zezidakamizwa ezikhokhwe ngumthengi kanye nohlelo zifinyelela kumkhawulo othile. Lapho umkhawulo usufinyelelwe, umuntu kungenzeka akhokhe izindleko eziphakeme kakhulu ezikhwameni zemithi yakhe.

OKUSHIWO: Ngingayisebenzisa i-SingleCare ngenkathi ngikwi-Medicare?

Abantu abanemiholo ephezulu bangakhokha izindleko eziphakeme zokutholakala kwabo kweNgxenye D. Ngakolunye uhlangothi, abantu abakuMedicaid noma abafanelekela ukuthola usizo olungaphezulu bangakhokha izindleko eziphansi kakhulu ngaphansi kweNgxenye D.

Umsunguli we I-MedicareQuick , Kathe Kline, uncoma ukuthola ukuqonda okugcwele kokuthi iMedicare Part D isebenza kanjani ukulinganisa izindleko ezingaba khona.

Uhlelo ngalunye lunezindleko zalo ze-premium, ama-deductibles, amanani we-copay, amanani we-coinsurance nama-formularies, kusho uKline. I-formulary ikutshela ukuthi yiziphi izidakamizwa uhlelo oluzihlanganisayo, nokuthi izindleko zakho zizoba yini. Abantu abaningi ngephutha babheka kuphela i-premium ne-deductible. Yiphutha lelo. Ngincoma ukuthi abantu abakwaMedicare babheke izindleko zabo minyaka yonke besebenzisa ithuluzi elibizwa nge-MyMedicare.gov. Ngaleyo ndlela uzobe ubheka zonke izindleko, kufaka phakathi imishanguzo yakho, okungaba yiningi lezindleko.

Ngiyithola kanjani iMedicare Part D?

Kulula ukubuka futhi uqhathanise izinketho zohlelo I-Medicare.gov uma unentshisekelo yokubhalisela uhlelo lwemithi kadokotela olufana ne-Medicare Part D. Ukushayela u-1-800-Medicare nokukhuluma nomeluleki nakho kuyindlela enhle uma udinga usizo.

Qiniseka ukuthi ubheka i-premium, i-copayment, i-coinsurance, nama-deductibles, bese ubheka imishanguzo emboziwe kanye nemikhawulo yezidakamizwa ongaba nayo ukuze uqiniseke ukuthi ukhetha uhlelo oluhle kakhulu lwe-Medicare Part D.

Izikhathi zokuqala zokubhalisa zalabo abasha kwi-Medicare nabaneminyaka engama-65 ubudala zifaka izinyanga ezintathu ezedlule, inyanga nezinyanga ezintathu ezilandela usuku lwabo lokuzalwa. Okonyaka Isikhathi sokubhalisa esivulekile iqala ngo-Okthoba 15 kuye kuDisemba. Uma ungabhalisi phakathi kwalezi zikhathi, ungakhokha inhlawulo yokubhaliswa sekwedlule isikhathi. Kungumqondo omuhle ukubheka i-Medicare.gov ukuqinisekisa ukuthi uyazi izikhathi zokugcina futhi ubone ukuthi ufanelekile yini Isikhathi Esikhethekile Sokubhalisa.