Ngabe i-Medicare Ikhava Ukuhlolwa Kwegazi?

-Delile

• Yiziphi izingxenye zeMedicare ezihlanganisa ukuhlolwa kwegazi?
• Kubiza malini ukuhlolwa kwegazi?
• Izindleko zeMedicare Part A
• Izindleko zeMedicare Part B
• Izindleko ze-Medicare Advantage
• Izindleko zeMedigap
• Ngingaya kuphi ukuyohlolwa?
• Yiziphi izinhlobo zokuhlolwa kwegazi okuvamile ezihlanganiswayo?
• Yiziphi ezinye izinhlobo zokuhlolwa kwelebhu ezijwayelekile ezihlanganiswayo?
• Ukuthatha

• I-Medicare ihlanganisa ukuhlolwa kwegazi okudingekayo ngokwezempilo oku-odolwe ngudokotela ngokuya ngemikhombandlela ye-Medicare.
• Izinhlelo zeMedicare Advantage (Ingxenye C) zingahlanganisa izivivinyo eziningi, kuya ngohlelo.
• Ayikho imali ehlukile yokuhlolwa kwegazi ngaphansi kwe-Medicare yasekuqaleni.
• Uhlelo lokungezelela (iMedigap) lungasiza ngezindleko ezingaphandle kwephakethe njengokudonswayo.

Ukuhlolwa kwegazi kuyithuluzi elibalulekile lokuxilonga odokotela abalisebenzisayo ukuhlola izinto ezinobungozi nokuqapha izimo zezempilo. Ngokuvamile inqubo elula yokulinganisa ukuthi umzimba wakho usebenza kanjani futhi uthole noma yiziphi izimpawu zesexwayiso zakuqala.

I-Medicare ihlanganisa izinhlobo eziningi zokuvumela umhlinzeki wakho wezokunakekelwa kwempilo ukuthi alandelele impilo yakho kanye nesikrini sokuvikela izifo. Ukutholakala kungancika ekuhlangabezaneni nenqubo esungulwe yokuhlolwa kwe-Medicare.

Ake sibheke ukuthi iziphi izingxenye zeMedicare ezihlanganisa ukuhlolwa kwegazi nokunye ukuhlola.

Yiziphi izingxenye zeMedicare ezihlanganisa ukuhlolwa kwegazi?

I-Medicare Part A inikeza ukumbozwa kokuhlolwa kwegazi okudingekayo ngokwezokwelapha.Ukuhlolwa kungalawulwa ngudokotela wesibhedlela esingalaliswayo, ubuhlengikazi abanamakhono, i-hospice, impilo yasekhaya, kanye nezinye izinsizakalo ezihlanganisiwe ezihlanganisiwe.

I-Medicare Part B ihlanganisa izivivinyo zegazi ezingalaliswayo eziyalelwe ngudokotela ngokuxilongwa okudingekayo ngokwezempilo ngokuya ngemikhombandlela yokutholakala kwe-Medicare. Izibonelo kungaba ukuhlola ukuhlolwa kwegazi ukuthola noma ukuphatha isimo.

I-Medicare Advantage, noma i-Part C, nayo ihlela ukuhlolwa kwegazi. Lezi zinhlelo zingabandakanya nokuhlolwa okwengeziwe okungamboziwe yi-Medicare yasekuqaleni (izingxenye A no-B). Uhlelo ngalunye lweMedicare Advantage lunikeza izinzuzo ezahlukahlukene, ngakho-ke hlola uhlelo lwakho mayelana nokuhlolwa kwegazi okuthile. Futhi cabanga ngokuya kodokotela be-in-network namalabhu ukuthola izinzuzo eziphezulu.

I-Medicare Part D ihlinzeka ngemithi kadokotela futhi ayihlanganisi ukuhlolwa kwegazi.

Kubiza malini ukuhlolwa kwegazi?

Izindleko zokuhlolwa kwegazi nokunye ukuhlolwa kwelebhu noma ukuhlolwa kokuxilongwa kungahluka. Izindleko zisuselwa kuhlolo oluthile, indawo okuyo, kanye nelebhu esetshenzisiwe. Ukuhlolwa kungasebenza kusuka kumadola ambalwa kuya ezinkulungwaneni zamaRandi. Kungakho kubalulekile ukuthi uhlole ukuthi ukuhlolwa kwakho kuyambozwa ngaphambi kokuthi ukwenze.

Nazi ezinye izindleko zokuhlolwa kwegazi ongazilindela ngezingxenye ezahlukahlukene zeMedicare.

Izindleko zeMedicare Part A

Umsebenzi wegazi wasesibhedlela odonswe ngudokotela wakho uvame ukumbozwa ngokuphelele ngaphansi kwe-Medicare Part A. Kodwa-ke, kusadingeka ukuthi uhlangane nemali yakho engadonswa.

Ngo-2020, iNgxenye A edonswayo ingama- $ 1,408 kubahlomuli abaningi ngesikhathi somhlomulo. Isikhathi somhlomulo sithatha kusukela ngosuku ongena ngalo esibhedlela ezinsukwini ezingama-60 ezizayo. Kungenzeka ube nezikhathi eziningi zenzuzo ngonyaka.

Izindleko zeMedicare Part B

IMedicare Part B ibuye ihlanganise ukuhlolwa kwegazi kweziguli ezidinga ukwelashwa. Kufanele uhlangane nemali yakho ekhishwayo yaminyaka yonke yalokhu kufakwa futhi. Ngo-2020, imali ekhishwayo ingu- $ 198 kubantu abaningi. Khumbula, futhi kufanele ukhokhe imali yakho ekhokhwa njalo ngenyanga ye-Part B, eyi- $ 144.60 ngo-2020 yabazuzi abaningi.

Izindleko ze-Medicare Advantage

Izindleko ngecebo le-Medicare Advantage zixhomeke ekuhlanganisweni kwepulani ngalinye. Hlola ngohlelo oluthile endaweni yangakini mayelana nama-copay, ama-deductibles, nezinye izindleko ezingaphandle kwephaketheni.

Ezinye izinhlelo ze-Medicare Advantage nazo zinganikeza ukumbozwa okukhulu, ngakho-ke akudingeki ukhokhe noma yini ephaketheni.

Izindleko zeMedigap

Izinhlelo zeMedigap (Medicare supplemental Insurance) zingasiza ukukhokhela ezinye izindleko zokuphuma ephaketheni ezinjenge-coinsurance, imali ekhishwayo, noma ama-copayment wokuhlolwa okuhlanganisiwe nokunye ukuhlolwa kokuxilongwa.

Uhlelo ngalunye kwezingu-11 ezitholakalayo zeMedigap lunenzuzo nezindleko ezahlukahlukene, ngakho-ke cwaninga ngokucophelela ukuthola inani elingcono kakhulu lezidingo zakho.

Kunezimo ezithile lapho izindleko zokuhlolwa kwegazi zingaphakama kunokujwayelekile, kufaka phakathi ukuthi:

• uvakashela abahlinzeki noma amalebhu angamukeli ukwabiwa
• unohlelo lweMedicare Advantage bese ukhetha udokotela ongaphandle kwenethiwekhi noma indawo yelebhu
• udokotela wakho uyalela ukuhlolwa kwegazi kaningi kunalokho okuhlanganisiwe noma uma ukuhlolwa kungamboziwe yi-Medicare (ezinye izivivinyo zokuhlola azimboziwe uma kungekho zimpawu noma izimpawu zesifo noma kungekho mlando)

Iwebhusayithi ye-Medicare inethuluzi lokusesha ongalisebenzisa ukuthola odokotela namalabhu abambe iqhaza.

Ngingaya kuphi ukuyohlolwa?

Ungaba nokuhlolwa kwegazi okwenziwe ezinhlotsheni eziningana zamalebhu. Udokotela wakho uzokwazisa ukuthi ungakwenza kuphi ukuhlolwa. Vele uqiniseke ukuthi isikhungo noma umhlinzeki wamukela ukwabiwa.

Izinhlobo zamalebhu ahlanganiswe yiMedicare zifaka:

• amahhovisi odokotela
• amalebhu esibhedlela
• amalebhu azimele
• amalebhu ezindawo zabahlengikazi
• amanye amalebhu esikhungo

Uma uthola noma ucelwa ukuthi usayine i-Advance Beneficiary Notice (ABN) evela ebhodini noma kumhlinzeki wesevisi, ungahle ubhekane nezindleko zensizakalo ngoba ayihlanganisiwe. Buza imibuzo mayelana nesibopho sakho sezindleko ngaphambi kokusayina.

Yiziphi izinhlobo zokuhlolwa kwegazi okuvamile ezihlanganiswayo?

Izinhlelo zangempela zeMedicare neMedicare Advantage zimboza izinhlobo eziningi zokuhlolwa nokuhlolwa kwegazi. Kungahle kube nemikhawulo yokuthi i-Medicare izokwemboza kangaki izivivinyo ezithile.

Ungafaka isikhalazo ngesinqumo sokumbozwa uma wena noma udokotela wakho ezwa ukuthi isivivinyo kufanele simbozwe. Ukuhlolwa kwegazi kokuhlola, njengaleso sesifo senhliziyo, kumbozwe ngokuphelele ngaphandle kokuqinisekiswa kwemali noma okutholakalayo.

Nazi ezinye zezimo ezivame ukuhlolwa ngokuhlolwa kwegazi nokuthi ungazenza kangaki ngokutholakala kwe-Medicare:

• Isifo sikashukela: kanye ngonyaka, noma kuze kube kabili ngonyaka uma usengozini enkulu
• Isifo senhliziyo: cholesterol, lipids, triglycerides ukuhlolwa kanye njalo eminyakeni emihlanu
• I-HIV: kanye ngonyaka kususelwa engcupheni
• I-Hepatitis (B no-C): kanye ngonyaka kuye ngobungozi
• Umdlavuza ocacile: kanye ngonyaka
• Umdlavuza wendlala yesinye (PSA [prostate specific antigen] test): kanye ngonyaka
• Izifo ezithathelwana ngocansi: kanye ngonyaka

Uma udokotela wakho ecabanga ukuthi udinga ukuhlolwa kaningi kakhulu kokuhlolwa okuthile kokuxilongwa ngenxa yezici zakho ezithile zobungozi, kungadingeka ukhokhele ukuhlolwa kaningi. Buza udokotela wakho kanye nelebhu ukuthola eminye imininingwane ngokuhlolwa kwakho okuthile.

Kungaba wusizo ukuba nohlelo olwengeziwe lokuhlolwa kaningi. Ungaya kuwebhusayithi yenqubomgomo ye-Medicare Medigap ukuthola imininingwane ngazo zonke izinhlelo zango-2020 nokuthi yini okuhlanganisiwe. Ungashayela nohlelo ngqo ukuthola eminye imininingwane.

Yiziphi ezinye izinhlobo zokuhlolwa kwelebhu ezijwayelekile ezihlanganiswayo?

I-Medicare Part B ihlanganisa izinhlobo eziningi zezifo ezi-odolwe iziguli ezifana nokuchama, ukuhlolwa kwezicubu zesicubu, kanye nokuhlolwa kokuhlolwa. Awekho ama-copay alezi zivivinyo, kepha ama-deductibles akho asasebenza.

Izibonelo zezivivinyo ezihlanganisiwe zifaka:

I-Medicare ifaka ama-mammograms wokuxilonga kaningi uma udokotela wakho ewayala. Unesibopho sezindleko ezingama-20 zemali.

Okunye ukuhlolwa kokuhlonza okungabhalisi okwenziwa ngabakwaMedicare kufaka phakathi ama-X-ray, ukuskena kwe-PET, i-MRI, i-EKG, ne-CT scan. Kufanele ukhokhe i-coinsurance yakho engamaphesenti angama-20 kanye nemali yakho ekhishwayo kanye nanoma yimaphi ama-copay. Khumbula ukuya kubahlinzeki abamukela isabelo ukuze bagweme ukukhokhiswa iMedicare ngeke ikukhokhele.

• I-Medicare inikeza ithuluzi ongalisebenzisa ukuhlola ukuthi iziphi izivivinyo ezihlanganiswayo.
• Ungaya futhi lapha ukubuka uhlu lokuhlolwa okuhlanganisiwe okuvela kwaMedicare.
• Nalu uhlu lwamakhodi nokuhlolwa okwenziwa yiMedicare hhayi ikhava. Ngaphambi kokusayina i-ABN, buza ngezindleko zokuhlolwa bese uthenga ezungeze. Amanani ayahluka ngomhlinzeki nendawo.

Ukuthatha

I-Medicare ihlanganisa izinhlobo eziningi zokuhlolwa kwegazi okujwayelekile okudingekayo ukuxilonga nokuphatha izimo zezempilo uma nje zidingeka ngokwezempilo. Nawa amathiphu ambalwa wokugcina okufanele uwacabangele:

• Buza udokotela wakho imininingwane ngohlobo oluthile lokuhlolwa kwegazi nokuthi ungakulungiselela kanjani (uma kufanele noma ungafanele udle ngaphambi kwesikhathi, njll).
• Vakashela abahlinzeki abamukela isabelo sokugwema ukukhokha izindleko ezingaphandle kwezikhwama zamasevisi ahlanganisiwe
• Uma unesimo esidinga ukuhlolwa kaningi, cabanga ngohlelo lokulekelela olufana neMedigap ukusiza ngezindleko ezingaphandle kwephaketheni.
• Uma insizakalo ingamboziwe, hlola ukuze uthole umhlinzeki wezindleko eziphansi kakhulu.

Funda le ndatshana ngeSpanishi