Drill Down: Ingabe i-Medicare Ikhava Amazinyo?

-Delile

• Ukunakekelwa kwamazinyo kuhlanganiswa nini yi-Medicare yasekuqaleni?
• I-Medicare Advantage (Ingxenye C) nokutholakala kwamazinyo
• Ngabe ukumbozwa kweMedigap kuzosiza ukukhokhela izinsizakalo zamazinyo?
• Kubiza malini ukuhlolwa kwamazinyo okujwayelekile?
• Yiziphi izinhlelo zeMedicare ezingaba ngcono kuwe uma wazi ukuthi udinga izinsizakalo zamazinyo?
• Ukuqhathanisa izinhlelo zeMedicare zokutholakala kwamazinyo
• Ezinye izinketho zokumboza amazinyo
• Kungani kubalulekile ukuthola ukumbozwa okuhle kwamazinyo njengoba ukhula
• Okubalulekile

Izingxenye zoqobo ze-Medicare A (ukunakekelwa kwesibhedlela) kanye no-B (ukunakekelwa kwezokwelapha) akufaki ukufakwa kwamazinyo. Lokho kusho ukuthi i-Medicare yasekuqaleni (noma "yakudala") ayikhokheli izinsizakalo ezijwayelekile njengezivivinyo zamazinyo, ukuhlanzwa, ukukhishwa kwamazinyo, imisele yezimpande, okufakelwa, imiqhele namabhuloho.

Izingxenye ze-Medicare A no-B nazo azihlanganisi izinto zamazinyo njengamapuleti, amazinyo okufakelwa, imishini ye-orthodontic, noma okugcina.

Kodwa-ke, ezinye izinhlelo zeMedicare Advantage, ezaziwa nangokuthi izinhlelo zeMedicare Part C, zibandakanya ukumbozwa kwe-. Uhlelo ngalunye lunezindleko nemininingwane ehlukile yokuthi inzuzo ingasetshenziswa kanjani.

Funda ukuze uthole kabanzi mayelana nezinketho zakho zokumbozwa kwamazinyo nge-Medicare.

Ukunakekelwa kwamazinyo kuhlanganiswa nini yi-Medicare yasekuqaleni?

Ngenkathi iMedicare yasekuqaleni ingakufihli ukunakekelwa kwamazinyo, kukhona okuhlukile okuphawulekayo. Uma udinga ukunakekelwa kwamazinyo ngenxa yokugula noma ukulimala okudinga ukuhlala esibhedlela, ukwelashwa kwakho kwamazinyo kungambozwa.

Isibonelo, uma uwa futhi uphuka umhlathi, iMedicare yokwakha kabusha amathambo emhlathini wakho.

Ezinye izinqubo eziyinkimbinkimbi zamazinyo nazo ziyambozwa uma zenziwa esibhedlela, kodwa noma ngabe zimbozwe yiNgxenye A noma Ingxenye B kuzonqunywa ukuthi ngubani ohlinzeka ngosizo.

I-Medicare ingakhokhela nokunakekelwa kwakho uma udinga izinsizakalo zamazinyo ngenxa yomdlavuza womlomo noma okunye ukugula okumboziwe.

Ngaphezu kwalokho, i-Medicare ingakhokhela ukukhishwa kwamazinyo uma odokotela bakho becabanga ukuthi kuyadingeka ukukhipha izinyo ngaphambi kokuhlinzwa kwenhliziyo, ukwelashwa ngemisebe, noma enye inqubo ehlanganisiwe.

I-Medicare Advantage (Ingxenye C) nokutholakala kwamazinyo

Izinhlelo zeMedicare Advantage zinikezwa izinkampani zomshuwalense ezizimele ezivunyelwe yiMedicare. Lezi zinhlelo zingenye i-Medicare yasekuqaleni. Bavame ukukhokhela izinsizakalo ezingamboziwe izingxenye zangempela ze-Medicare A no-B.

Ngalolu hlobo lwepulani, kungadingeka ukuthi ukhokhe imali ekhokhwa njalo ngenyanga noma inkokhelo yesibambiso. Udinga futhi ukuhlola ukuthi ngabe udokotela wamazinyo wakho uku kwinethiwekhi yohlelo ukuze insizakalo imbozwe.

Kunezindlela eziningana zokuthola ukuthi ngabe uhlelo oluthile lweMedicare Advantage lumboza ukunakekelwa kwamazinyo. I-Medicare inethuluzi lokuThola i-Medicare Plan elikukhombisa zonke izinhlelo ezitholakala endaweni yakho nokuthi zithinta ini, kufaka phakathi uma zimboza amazinyo. Izinhlelo eziningi ze-Advantage zifaka phakathi izinzuzo zamazinyo.

Ukunquma ukuthi uhlelo lwakho lwamanje lwe-Medicare Part C lubandakanya ukumbozwa kwamazinyo, ungakhuluma nommeleli ovela kumshwalense noma ufunde imininingwane equkethwe kumbhalo we-Evidence of Coverage (EOC) owawuthola ngenkathi ubhalisa kuhlelo.

Ngabe ukumbozwa kweMedigap kuzosiza ukukhokhela izinsizakalo zamazinyo?

Ngokuvamile, ukumbozwa kweMedigap kukusiza ukuthi ukhokhele ama-copay nama-deductibles ahlobene nezinsizakalo ezimbozwe yi-Medicare yasekuqaleni. Isikhathi esiningi, iMedigap ayinikeli ngezinsizakalo ezengeziwe njengokunakekelwa kwamazinyo.

Kubiza malini ukuhlolwa kwamazinyo okujwayelekile?

Ngokuya ngokuthi uhlala kuphi, ukuhlanzwa kwamazinyo nokuhlolwa kwaminyaka yonke kungabiza phakathi kuka- $ 75 kuye ku- $ 200. Lezo zindleko zingaphakama uma udinga ukuhlanzwa okujulile noma ama-X-ray.

Yiziphi izinhlelo zeMedicare ezingaba ngcono kuwe uma wazi ukuthi udinga izinsizakalo zamazinyo?

Njengoba izinsizakalo eziningi zamazinyo nezinsizakusebenza zingamboziwe yiMedicare Part A neNgxenye B, Uma wazi ukuthi ungadinga ukunakekelwa kwamazinyo ngonyaka olandelayo, uhlelo lweMedicare Advantage (Ingxenye C) lungaba yindlela enhle.

Lapho wenza lesi sinqumo, qiniseka ukuthi ubheka izidingo zakho zesikhathi esizayo kanye nomlando wamazinyo womndeni wakho. Uma ucabanga ukuthi kungenzeka ukuthi ungadinga ukufakelwa noma amazinyo okufakelwa ngokuzayo, lokho kufake nasekuthathweni kwakho kwezinqumo.

Ukuqhathanisa izinhlelo zeMedicare zokutholakala kwamazinyo

Ezinye izinketho zokumboza amazinyo

Ungase futhi uthande ukubheka ukumbozwa kwamazinyo ngaphandle kweMedicare. Ungaba nezinketho, njenge:

• Umshuwalense ozimele wedwa. Lezi zinhlelo zidinga ukuthi ukhokhe i-premium ehlukile yokumbozwa.
• Umlingani noma umlingani wohlelo lomshuwalense oluxhaswe ngabasebenzi. Uma kungenzeka ubhalisele ukumbozwa ngaphansi kohlelo lwamazinyo womlingani, lokho kungaba inketho engabizi kakhulu.
• Amaqembu esaphulelo samazinyo. Lokhu akuhlinzeki ngokutholakala komshuwalense, kepha kuvumela amalungu ukuthi athole izinsizakalo zamazinyo ngezindleko eziphansi.
• I-Medicaid. Ngokuya ngesimo ohlala kuso nesimo sakho sezezimali, ungahle ufaneleke ukunakekelwa kwamazinyo ngeMedicaid.
• I-PACE. Lolu wuhlelo olungakusiza ukuthi uthole ukunakekelwa okuhlelekile ngaphakathi komphakathi wangakini, kufaka phakathi izinsizakalo zamazinyo.

Kungani kubalulekile ukuthola ukumbozwa okuhle kwamazinyo njengoba ukhula

Ukunakekelwa kahle kwamazinyo kubalulekile ekugcineni impilo yakho yonke nokuphila kahle. Ukuhlanzeka kwamazinyo kubi kuye kwaxhunyaniswa nokuvuvukala okungapheli, isifo sikashukela, izimo zenhliziyo, nobunye ubunzima bezempilo.

Futhi ucwaningo luye lwabonisa nokuthi abantu kwesinye isikhathi bayakushaya indiva ukunakekelwa kwabo kwamazinyo njengoba bekhula, imvamisa ngoba ukunakekelwa kwamazinyo kungabiza.

I-National Institute of Dental and Craniofacial Research ilinganisela ukuthi amaphesenti ama-23 wabantu abadala awazange ahlolwe amazinyo eminyakeni emihlanu edlule. Lelo nani liphezulu kakhulu kubantu base-Afrika baseMelika nabaseSpain naphakathi kwalabo abahola kancane.

I-poll eyodwa emele izwe eyenziwe ngo-2017 iveze ukuthi izindleko kwakuyisizathu esivame kakhulu ukuthi abantu bangafuni usizo lobuchwepheshe ekunakekeleni amazinyo abo. Kodwa ukunakekelwa okuhle kokuvikela kungakusiza ukuthi ugweme izinkinga zamazinyo ezimbi kakhulu ngokuzayo.

Ngaleso sizathu, kuwumqondo omuhle ukubheka uhlelo olungabizi kakhulu oluzobheka izinsizakalo zamazinyo ozidingayo njengoba ukhula.

• Isinyathelo 1: Nquma ukufaneleka. Uma unomuntu omthandayo ophakathi kwezinyanga ezintathu ezineminyaka engama-65, noma onesifo sokukhubazeka noma sesifo sokugcina sezinso, kungenzeka ukuthi uyakufanelekela ukutholakala kwe-Medicare.
• Isinyathelo 2: Khuluma ngezidingo zabo. Nazi ezinye izinto okufanele uzicabangele lapho unquma ukuthi uyafuna yini ukukhetha uhlelo lokuqala lweMedicare noma uhlelo lweMedicare Advantage:
  • Kubaluleke kangakanani ukugcina odokotela babo bamanje?
  • Imiphi imishanguzo kadokotela abayisebenzisayo?
  • Kungakanani ukunakekelwa kwamazinyo nokubona okungenzeka bakudinge?
  • Bangakanani abakwazi ukukukhokhela kuma-premium akhokhwa nyangazonke nezinye izindleko?

• Isinyathelo 3: Qonda izindleko ezihambisana nokubambezeleka kokubhalisa. Uma uthatha isinqumo sokungabhaliseli othandekayo wakho engxenyeni B noma engxenyeni D, kungadingeka ukhokhe izinhlawulo noma izindleko eziphakeme ngokuhamba kwesikhathi.
• Isinyathelo 4: Vakashela ssa.gov ukubhalisa. Imvamisa awudingi mibhalo, futhi yonke inqubo ithatha cishe imizuzu eyi-10.

Okubalulekile

Ukugcina amazinyo nezinsini zakho ziphilile njengoba ukhula kubalulekile ekugcineni impilo yakho yonke.

Izingxenye zoqobo ze-Medicare A no-B azikhokhi izinsizakalo zamazinyo, kufaka phakathi ukuhlolwa okujwayelekile, ukukhishwa kwamazinyo, imisele yezimpande, nezinye izinsizakalo zamazinyo eziyisisekelo. Futhi azimbozi izimpahla zamazinyo njengamazinyo okufakelwa nezinsimbi.

Kukhona okunye okuhlukile, noma kunjalo: Uma udinga ukuhlinzwa kwamazinyo okuyinkimbinkimbi, noma uma udinga izinsizakalo zamazinyo ngenxa yokugula noma ukulimala okuhlanganisiwe, iMedare ingakhokhela ukwelashwa kwakho.

Izinhlelo eziningi zeMedicare Advantage (Ingxenye C) zinikela ngokutholakala kwamazinyo, kepha kungadingeka ukuthi ukhokhe imali ekhokhwa njalo ngenyanga noma usebenzise odokotela bamazinyo be-in-network ukusizakala ngokumbozwa.

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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