Ingabe i-Medicare Cover Cataract Surgery?

-Delile

• Kubiza malini ukuhlinzwa ngamehlo?
• Ziyini izindleko nge-Medicare?
• Yiziphi izingxenye zeMedicare ezimboza ukuhlinzwa kwe-cataract?
• Ingxenye yeMedicare A
• Ingxenye yeMedare B
• Ingxenye yeMedicare C
• Ingxenye yeMedare D
• Izinhlelo zokwengeza ze-Medicare (Medigap)
• Ungazi kanjani ukuthi izindleko zakho zizoba yini ngaphambi kokuhlinzwa kwe-cataract?
• Yiziphi ezinye izinto ezingathinta ukuthi ukhokha malini?
• I-cataract nokuhlinzwa kwamehlo
• Okubalulekile

Ukuhlinzwa kwe-cataract kuyindlela ejwayelekile yamehlo. Ngokuvamile ukuhlinzwa okuphephile futhi kumbozwe ngabakwaMedicare. Abantu abangaphezu kwamaphesenti angama-50 baseMelika abaneminyaka engama-80 noma ngaphezulu banolwelwesi lwamehlo noma bahlinzwe ngamehlo.

I-Medicare uhlelo lokunakekelwa kwezempilo lukahulumeni wase-U.S. Oluhlanganisa izidingo zezempilo zabantu abaneminyaka engama-65 nangaphezulu. Ngenkathi iMedicare ingakufihli ukuhlolwa kombono okujwayelekile, ifaka ukuhlinzwa kwe-cataract kubantu abangaphezu kweminyaka yobudala engama-65.

Kungase kudingeke ukuthi ukhokhe izindleko ezingezekile njengezimali zesibhedlela noma zomtholampilo, okudonswayo, kanye nokukhokha ngokubambisana.

Ezinye izinhlobo zomshuwalense wezempilo we-Medicare zingamboza ngaphezu kwezinye. Izinhlobo ezahlukahlukene zokuhlinzwa kwe-cataract nazo zinezindleko ezahlukahlukene.

Kubiza malini ukuhlinzwa ngamehlo?

Kunezinhlobo ezimbili eziyinhloko zokuhlinzwa kwe-cataract. I-Medicare ihlanganisa ukuhlinza kokubili ngezinga elifanayo. Lezi zinhlobo zifaka:

• Phacoemulsification. Lolu hlobo lusebenzisa i-ultrasound ukwephula ilensi enamafu ngaphambi kokuba isuswe futhi kufakwe i-lens ye-intraocular (IOL) ukufaka i-lens enamafu.
• I-extracapsular. Lolu hlobo lususa ilensi enamafu engxenyeni eyodwa, bese kufakwa i-IOL ezongena esikhundleni selensi enamafu.

Udokotela wamehlo wakho uzonquma ukuthi yiluphi uhlobo lokuhlinzwa olulungele wena.

Ngokusho kwe-American Academy of Ophthalmology (AAO) ngo-2014, izindleko ezijwayelekile zokuhlinzwa kwelanga esweni elilodwa ngaphandle komshwalense zazingama- $ 2,500 ngemali ekhokhwayo yodokotela abahlinzayo, imali yesikhungo sokuhlinza abagulayo, imali ekhokhwa ngudokotela wokubulala izinzwa, ilensi yokufakelwa nezinyanga ezintathu yokunakekelwa kwangemva kokuhlinzwa.

Kodwa-ke, lawa mazinga azohluka ngesimo kanye nemininingwane yesimo nezidingo zomuntu ngamunye.

Ziyini izindleko nge-Medicare?

Izindleko eziqondile zokuhlinzwa kwakho kwe-cataract kuzoya ngokuthi:

• uhlelo lwakho lwe-Medicare
• uhlobo lokuhlinzwa oludingayo
• ukuhlinzwa kwakho kuthatha isikhathi esingakanani
• lapho uhlinzwa khona (emtholampilo noma esibhedlela)
• ezinye izimo zezokwelapha onazo
• izinkinga ezingaba khona

Izindleko ezilinganiselwayo zokuhlinzwa kwe-cataract zingaba *:

• Esikhungweni sokuhlinza noma emtholampilo, izindleko eziphakathi nendawo zingama- $ 977. I-Medicare ikhokha u- $ 781, kanti izindleko zakho zingu- $ 195.
• Esibhedlela (umnyango wezokwelapha), izindleko eziphakathi nendawo zingama- $ 1,917. I-Medicare ikhokha u- $ 1,533 kanti izindleko zakho zingu- $ 383.

* Ngokusho kweMedicare.gov, lezi zimali azibandakanyi imali yodokotela noma ezinye izinqubo ezingadingeka. Yizilinganiso zomhlaba wonke futhi zingahluka ngokuya ngendawo.

Yiziphi izingxenye zeMedicare ezimboza ukuhlinzwa kwe-cataract?

I-Medicare ihlanganisa ukuhlinzwa okuyisisekelo kwe-cataract kufaka phakathi:

• ukususwa kwe-cataract
• ukufakwa kwelensi
• ngazimbili izibuko zamehlo kadokotela noma iqoqo lamalensi oxhumana nawo ngemuva kwenqubo

I-Original Medicare ihlukaniswe izingxenye ezine eziyinhloko: A, B, C, noD. Ungase futhi uthenge uhlelo lweMedigap, noma lwe-supplement. Ingxenye ngayinye ihlanganisa uhlobo oluhlukile lwezindleko zokunakekelwa kwempilo. Ukuhlinzwa kwakho kwe-cataract kungambozwa izingxenye eziningana zohlelo lwakho lwe-Medicare.

Ingxenye yeMedicare A

I-Medicare Part A ihlanganisa izindleko zabangalaliswayo nezibhedlela. Ngenkathi ezimweni eziningi kungekho sibhedlela esidingekayo sokuhlinzwa kwe-cataract, uma udinga ukungeniswa esibhedlela, lokhu kuzoba ngaphansi kwengxenye ye-Part A.

Ingxenye yeMedare B

I-Medicare Part B ihlanganisa izindleko zokugula kanye nezinye izindleko zokwelashwa. Uma une-Original Medicare, ukuhlinzwa kwakho kwe-cataract kuzombozwa ngaphansi kweNgxenye B. Ingxenye B iphinde ifake nokuqokwa kukadokotela njengokubonana nodokotela wamehlo ngaphambi nangemva kokuhlinzwa kwe-cataract.

Ingxenye yeMedicare C

I-Medicare Part C (Advantage Plans) ihlanganisa izinsizakalo ezifanayo nezingxenye zoqobo ze-Medicare A no-B. Kuya nge-Advantage Plan oyikhethayo, konke noma ingxenye yokuhlinzwa kwakho kwe-cataract kuzombozwa.

Ingxenye yeMedare D

Ingxenye D ihlanganisa imishanguzo ethile kadokotela. Uma udinga imishanguzo kadokotela ngemuva kokuhlinzwa kwekati lakho, ingahlanganiswa ne-Medicare Part D. Uma umuthi wakho ungekho ohlwini olugunyaziwe, kungadingeka ukhokhe uphume ephaketheni.

Eminye imishanguzo ehlobene nokuhlinzwa kwakho ingambozwa nengxenye B uma ithathwa njengezindleko zokwelashwa. Isibonelo, uma udinga ukusebenzisa amaconsi athile wamehlo kuphela ngaphambi kokuhlinzwa kwakho, angambozwa yiNgxenye B.

Izinhlelo zokwengeza ze-Medicare (Medigap)

Izinhlelo zokwengeza zeMedicare (iMedigap) zihlanganisa ezinye izindleko i-Original Medicare engazenzi. Uma unohlelo lweMedigap, shayela umhlinzeki wakho wezokunakekelwa kwempilo ukuthola ukuthi iziphi izindleko ezimbozayo. Ezinye izinhlelo zeMedigap zimboza imali ekhishwayo bese ikhokhela ama-Medicare izingxenye A no-B.

Ungazi kanjani ukuthi izindleko zakho zizoba yini ngaphambi kokuhlinzwa kwe-cataract?

Ukunquma ukuthi yini ongayidinga ukuyikhokha ephaketheni ngokuhlinzwa kwe-cataract, uzodinga imininingwane kudokotela wakho wamehlo nakumhlinzeki wakho weMedicare.

Ungabuza udokotela wakho noma umhlinzeki womshuwalense le mibuzo elandelayo ukusiza ukuthola izindleko zakho zokuphuma ephaketheni zokuhlinzwa kwe-cataract:

• Uyayemukela iMedicare?
• Ingabe inqubo izokwenziwa esikhungweni sokuhlinza noma esibhedlela?
• Ngabe ngizoba yisiguli noma isiguli esingalaliswa kulokhu kuhlinzwa?
• Imiphi imishanguzo kadokotela engizoyidinga ngaphambi nangemva kokuhlinzwa ngamehlo?
• Iyini ikhodi ye-Medicare noma igama elithile lenqubo ohlela ukuyenza? (Ungasebenzisa le khodi noma igama ukubheka izindleko kuthuluzi lokubheka inani lentengo ye-Medicare.)

Udokotela wakho angakwazi ukukutshela ukuthi yimaphi amaphesenti wokuhlinzwa kwakho okuhlanganisiwe nokuthi yini ozokweleta ngaphandle kwe-pocket.

Uma uthenge i-Medicare Advantage noma elinye icebo ngomhlinzeki womshuwalense wangasese, umhlinzeki wakho angakutshela izindleko zakho ezilindelwe zokuphuma ephaketheni.

Yiziphi ezinye izinto ezingathinta ukuthi ukhokha malini?

Inani eliqondile ozolikhokha ephaketheni lizonqunywa ukumbozwa kwakho kwe-Medicare nezinhlelo ozikhethayo. Ezinye izinto zokumboza ezizonquma izindleko zakho zokuphuma ephaketheni zifaka:

• izinhlelo zakho zeMedicare
• ukudonswa kwemali yakho
• imikhawulo yakho ephume ephaketheni
• uma unenye imishwalense yezempilo
• uma une-Medicaid
• uma i-Medicare Part D ihlanganisa imithi oyodinga
• uma unezinye izimo zezokwelapha ezenza inqubo ibe yinkimbinkimbi ngokwengeziwe

Uma ungumakadebona, izinzuzo zakho ze-VA zingabiza kakhulu ukuhlinzwa nge-cataract.

I-cataract nokuhlinzwa kwamehlo

I-cataract yakha lapho ilensi ecacile yeso lakho iba lukhuni noma liguqubele. Izimpawu ze-cataract zifaka:

• umbono onamafu
• ukufiphala noma ukubona okuncane
• imibala efiphele noma ephuzi
• ukubona kabili
• kunzima ukubona ebusuku
• ukubona ama-halos azungeze amalambu
• ukuzwela ekukhanyeni okukhanyayo nokukhanya okukhulu
• izinguquko embonweni

Ukuhlinzwa kwe-cataract kususa i-lens enamafu futhi kufakwa i-lens entsha ngokuhlinzwa. Lokhu kuhlinzwa kwenziwa ngudokotela ohlinzayo wamehlo, noma udokotela wamehlo. Ukuhlinzwa kwe-cataract kuyindlela yenqubo yokugula. Lokhu kusho ukuthi awudingi ukuhlala esibhedlela ubusuku bonke.

Okubalulekile

Ukuhlinzwa kwe-cataract kuyindlela ejwayelekile embozwe yi-Medicare. Kodwa-ke, iMedicare ayikhokhi konke futhi iMedigap kungenzeka ingakwenzi kube nezindleko ngokuphelele.

Kungadingeka ukhokhe imali edonswayo, ukukhokha ngokuhlanganyela, umshuwalense, kanye nemali ekhokhwayo ye-premium. Ungase futhi ubhekane nezinye izindleko uma udinga ukuhlinzwa okuthuthukile kakhulu kwe-cataract noma unezinkinga zempilo.

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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