Kumvetsetsa mapulani a Medicare Part D

Kampani

Mankhwalawa akhoza kukhala okwera mtengo, ndipo izi ndizopanikiza ngati mukuvutika kuzichita. Ndondomeko ya inshuwaransi yazaumoyo yomwe imakhudzanso zina mwazomwe mumalipira ndi mankhwala ingathandize kuti kukhala wathanzi kuzikhala kosavuta. Medicare Part D itha kuthandizira.

Kodi Medicare Part D imagwira ntchito bwanji?

Medicare Part D ndi gawo losankha la Medicare lomwe limafotokoza mankhwala ambiri omwe mumalandira. Gawo D limaperekedwa kudzera m'makampani a inshuwaransi apadera omwe anthu ambiri pa Medicare amasankha kuthandizira kuchepetsa ndalama zomwe amagwiritsa ntchito.

Medicare ili ndi magawo anayi: A, B, C, ndi D. Medicare Gawo A limafotokoza za kuchipatala kwa odwala, chisamaliro cha akatswiri oyamwitsa, chisamaliro chanyumba atatuluka kuchipatala, komanso chisamaliro cha odwala.

Anthu ambiri omwe akuyenera kulandira Medicare amalandira Gawo A mosavuta.

Medicare Part B imakhudza maulendo opita kuchipatala kwa odwala, ma X-ray, mayeso a labu, chithandizo chamankhwala kunyumba, ntchito zodzitetezera, zida zolimbitsa thupi zamankhwala, ntchito zamaganizidwe, ma ambulansi, ndi chithandizo chamankhwala, pakati pa ntchito zina. Anthu ambiri omwe ali ndi Medicare amasankha kulandira gawo lawo la A ndi Gawo B pamalipiro azachipatala a Medicare, kapena Original Medicare.

Medicare Part C ndi gawo la Medicare lomwe mapulani a inshuwaransi yazaokha - m'malo mwa Original Medicare - amapereka ma Part A ndi B maubwino ndipo nthawi zambiri amaperekanso mankhwala akuchipatala. Mapulani a Part C amatchedwa Medicare Advantage Plans.

Kuti apeze mankhwala okhudzana ndi mankhwala, omwe amapindula ndi Medicare amatha kulembetsa pa Medicare Part D Prescription Drug Plan (PDP) kapena mu Medicare Advantage Prescription Drug plan (MAPD). Othandizira atha kulipira ngongole yamwezi uliwonse kwa omwe amawagwirira inshuwaransi, kenako mankhwala omwe kampani ya inshuwaransi imaphimba amatha kugula. Deductible ndi copay kapena ndalama zandalama zitha kulipidwa ndi omwe amapindulapo, ndipo kampani ya inshuwaransi imalipira mtengo wotsalira.

Pali magawo anayi a Kuphunzira kwa Medicare Part D chaka chonse momwe mitengo ya mankhwala ingasinthe:

1. Zodula: Kuchuluka kwa ndalama m'thumba komwe ogula a Medicare amayenera kulipira chiphaso cha Medicare chisanachitike.
2. Kuphunzira koyamba: Madongosolo a Medicare ndi ogula amagawana nawo mtengo wamankhwala akuchipatala. Copay iyi kapena chitsimikizo chachuma chimayikidwa ndi dongosolo kutengera gawo la mankhwala aliwonse, ndi zina.
3. Kuphunzira kusiyana: Wogula ntchitoyo atalipira ndalama zingapo kuphatikiza mankhwala, wogula amapita kuphompho, lomwe limatchedwanso dzenje la Medicare donut. Mu 2019, mumalipira mwina 25% kapena 37% yamaina odziwika ndi mankhwala achibadwa. Komabe, mu 2020, ikhala 25% kudera lonse, atero a Danielle K. Roberts, katswiri wazachipatala komanso woyambitsa nawo Phindu la Boomer .
4. Kuwunikira koopsa: Gawo lomaliza la kufalitsa kwa Medicare Part D komwe kasitomala amalipira pafupifupi 5% ya mankhwala osokoneza bongo kumapeto kwa chaka. Mu 2019, kufalitsa koopsa kumachitika pambuyo poti wogula yekha amalipira $ 5,100 pamtengo wokwera mthumba.

Ndi mankhwala ati omwe amapezeka ndi Medicare Part D?

Mankhwala omwe amalembedwa ndi Medicare Part D mapulani amasiyana malinga ndi zomwe munthu aliyense wothandizira inshuwaransi amaphimba.

Dongosolo la Medicare Part D limakhudza pafupifupi mankhwala osachepera awiri pagulu lililonse la mankhwala. Mapulani amafunikiranso kuphimba pafupifupi mankhwala aliwonse m'makalasi otsatirawa:

• Antipsychotic: Mankhwalawa amaperekedwa kuti athandize kuthana ndi psychosis. Zitsanzo za antipsychotic yodziwika bwino ndi monga Haldol (haloperidol) ndi Risperdal (risperidone).
• Kupsinjika maganizo: Mankhwalawa amathandiza kuthana ndi mavuto a kukhumudwa komanso kuda nkhawa kwa anthu ambiri. Effexor XR (venlafaxine) ndi Prozac (fluoxetine) ndi mitundu iwiri yodziwika bwino yothanirana ndi nkhawa.
• Ma anticonvulsants: Gulu la mankhwala opangidwa ndi othandizira azamankhwala amathandiza iwo omwe amamva khunyu. Zitsanzo za ma anticonvulsants omwe atha kukhala ndi dongosolo la Medicare Part D ndi Keppra (levetiracetam) ndi Lamictal (lamotrigine).
• Ma Immunosuppressants: Mankhwalawa amachepetsa mphamvu ya chitetezo cha mthupi, chomwe nthawi zina chimafunikira pakuika ziwalo kapena kuchiza matenda amthupi. Mankhwala a Prednisone, monga Deltasone ndi Orasone, ndi zitsanzo za omwe amadziwika kuti ndi ma immunosuppressants.
• Mankhwala a khansa: Madongosolo a Medicare Part D adzafotokoza mankhwala ena a khansa. Ndikofunika kuti mulankhule ndi omwe amakuthandizani ndi omwe amakuthandizani za inshuwaransi kuti muwonetsetse kuti mankhwala omwe mumafuna ataphimbidwa musanalembetse nawo mankhwala. Zitsanzo za mankhwala omwe amapezeka ndi khansa ndi Avastin (bevacizumab) ndi Revlimid (lenalidomide).
• Mankhwala a HIV / AIDS: Dongosolo la Medicare Part D likhala ndi mankhwala amtundu wa HIV / AIDS. Zitsanzo zina zamtundu wa mankhwalawa ndi monga Truvada (emtricitabine-tenofovir), Norvir (ritonavir), ndi Isentress (raltegravir).

Mankhwalawa ndi omwe ali ndi dzina la Medicare Part D, koma mankhwala omwe ali ndi dzina akhoza kuwononga ndalama zambiri kwa omwe adzapindule nawo. Mankhwala osokoneza bongo amaikidwa m'magawo atatu ndi mapulani a Medicare Part D, ndipo mankhwala m'magulu osiyanasiyana adzakhala ndi ndalama zosiyana. Mankhwala osokoneza bongo amatha kuyikidwa m'magulu apamwamba omwe amakhala ndi ndalama zambiri zamapopay kapena zolipirira ndalama.

Chinthu chimodzi chodziwitsa za Medicare Part D ndikuti sichikuphimba mankhwala owonjezera, mavitamini akuchipatala, ndi mankhwala ena. Kuyankhula ndi wothandizira zaumoyo kapena dokotala, ndikuwunikiranso zomwe mungasankhe pachaka ndi njira yabwino kwambiri yodziwira ngati dongosolo lanu la Medicare Part D ndiloyenera kwa inu kutengera zosowa zanu zachipatala. Muli ndi mwayi wosintha mapulani anu kuti akwaniritse zosowa zanu pakulembetsa kwa Open Open. Anthu omwe ali ndi mapulani a Medicare Advantage atha kusintha mapulani pa Nthawi Yolembetsa ya Medicare Advantage.

Kodi mtengo wa Medicare Part D ndi wotani?

Dongosolo lirilonse la Gawo D limakhazikitsa ndalama zake zomwe zimadulidwa, ndalama zoyambira, magawo ake, ndi machitidwe. Mwezi uliwonse kwa omwe ali ndi Medicare Part D amasiyana kutengera dongosolo. Chiwerengero cha mwezi uliwonse cha 2019 ndi $ 33.19, ngakhale pali zotheka kuti izi zisinthe mu 2020.

Ngati kampani ya inshuwaransi ikufuna kuchotsera, izi zimalipidwa kaye, ndikutsatira copay kapena chitsimikizo cha ndalama zamankhwala zilizonse. Pali malire pamomwe ndalama zimachotsedwera; malire a 2019 sangakhale oposa $ 415.

Deductible ikamalipidwa, malingaliro a Medicare Part D adzafuna kuti omwe adzapindule nawo azilipira copay kapena ndalama za inshuwaransi ya mankhwala. Ngati chitsimikizo chikufunika, wopindulitsayo amalipira kuchuluka kwa mankhwala omwe agulidwa.

Limodzi mwa mavuto omwe amakhudza anthu omwe ali ndi Medicare ndichinthu chomwe chimatchedwa kusiyana kwa kufalitsa, kapena dzenje loperekera . Kusiyana komwe kumafikiridwa kumafikiridwa ngati ndalama zonse zomwe wogula amalipira zimakonzedwa. Malire akafika, munthu amatha kulipira ndalama zochulukirapo mthumba chifukwa cha mankhwala ake.

ZOKHUDZA: Kodi ndingagwiritse ntchito SingleCare ndili pa Medicare?

Anthu omwe ali ndi ndalama zambiri atha kulipira ndalama zambiri pakulipira kwa Gawo D. Komanso, anthu omwe ali pa Medicaid kapena omwe ali ndi mwayi wowonjezera thandizo akhoza kulipira ndalama zochepa kwambiri pansi pa Gawo D.

Woyambitsa wa Mankhwala , Kathe Kline, akulangiza kuti timvetsetse momwe Medicare Part D imagwirira ntchito kuti athe kuwerengera zomwe zingachitike.

Dongosolo lirilonse limakhala ndi zolipirira zake zokha, zochotseredwa, ndalama zamapopayi, ndalama zandalama, ndi ma formularies, Kline akuti. The formulary imakuwuzani mankhwala omwe mapulaniwo amakhudzira, ndi zomwe mudzapereke. Anthu ambiri molakwika amangoyang'ana pa premium komanso deductible. Uku ndikulakwitsa. Ndikupangira kuti anthu omwe ali pa Medicare aziyang'ana mtengo wawo pachaka pogwiritsa ntchito chida chotchedwa MyMedicare.gov. Mwanjira imeneyi mudzakhala mukuyang'ana ndalama zonse, kuphatikiza mankhwala anu, omwe atha kukhala ochulukirapo.

Kodi ndingapeze bwanji gawo la Medicare Part D?

Ndikosavuta kuyang'ana ndikufanizira zomwe mungasankhe Mankhwala ngati mukufuna kulembetsa dongosolo la mankhwala a Medicare ngati Medicare Part D. Kuimbira 1-800-Medicare ndikuyankhula ndi mlangizi ndichinthu chabwino ngati mungafune thandizo.

Onetsetsani kuti mukuganizira za premium, kulipitsa ndalama, kuchotsera ndalama, ndi kuchotsera ndalama, ndipo onani mankhwala omwe akuphimbidwa ndi zoletsa zomwe zingagwiritsidwe ntchito kuti muwonetsetse kuti mwasankha dongosolo labwino kwambiri la Medicare Part D.

Nthawi yoyamba kulembetsa kwa atsopano ku Medicare ndipo omwe ali ndi zaka 65 akuphatikizapo miyezi itatu isanafike, mwezi wa, ndi miyezi itatu kutsatira tsiku lawo lobadwa. Chaka chilichonse Nthawi Yolembetsa Yotseguka ikuyamba kuyambira pa Okutobala 15 mpaka Disembala 7. Ngati simulembetsa mkati mwa nthawi izi, mutha kulipira ngongole yolembetsa mochedwa. Ndibwino kuti muwone Medicare.gov kuti muwonetsetse kuti mukudziwa masiku omaliza ndikuwona ngati mukuyenereradi Nthawi Yolembetsa.