Ingabe i-Dialysis Ihlanganiswa Ngu-Medicare?

-Delile

• Ukufaneleka kwe-Medicare
• Uma ungabhalisi ngokushesha
• Uma uku-dialysis
• Uma uthola ukufakelwa kwezinso
• Lapho ukufakwa kwe-Medicare kuphela
• Izinsizakalo zeDialysis nezinto ezihlinzekwa yiMedicare
• Ukusabalala kwezidakamizwa
• Ngizoyikhokhela ini i-dialysis?
• Ukudla okudlela endlini

I-Medicare ihlanganisa i-dialysis kanye nezindlela zokwelapha eziningi ezibandakanya izifo zesifo sokushiswa kwezinso (ESRD) noma ukwehluleka kwezinso.

Lapho izinso zakho zingasakwazi ukusebenza ngokwemvelo, umzimba wakho ungena ku-ESRD. I-Dialysis iyindlela yokwelapha esiza umzimba wakho usebenze ngokuhlanza igazi lakho lapho izinso zakho ziyeka ukusebenza zodwa.

Kanye nokusiza umzimba wakho ukugcina inani elifanele loketshezi nokulawula umfutho wegazi, i-dialysis isiza ukuqeda imfucuza eyingozi, uketshezi nosawoti owakhekayo emzimbeni wakho. Yize zingakusiza uphile isikhathi eside futhi uzizwe ungcono, ukwelashwa nge-dialysis akuyona ikhambi lokwehluleka kwezinso unomphela.

Qhubeka ufunda ukuze ufunde kabanzi nge-dialysis ye-Medicare nokwelashwa, kufaka phakathi ukufaneleka nezindleko.

Ukufaneleka kwe-Medicare

Izidingo zokufaneleka ze-Medicare zehlukile uma ukufaneleka kwakho kususelwa ku-ESRD.

Uma ungabhalisi ngokushesha

Uma ufanelekile ukuthola i-Medicare ngokususelwa ku-ESRD kodwa ungaphuthelwa isikhathi sakho sokuqala sokubhalisa, ungahle ufanelekele ukumbozwa okubuyiselwayo okungafika ezinyangeni eziyi-12, uma usubhalisile.

Uma uku-dialysis

Uma ubhalisa ku-Medicare ngokususelwa ku-ESRD futhi njengamanje uku-dialysis, ukumbozwa kwakho kwe-Medicare kuvame ukuqala ngosuku lokuqala lwenyanga yakho yokwelashwa nge-dialysis. Ukufunda kungaqala ngenyanga ye-1 uma:

• Phakathi nezinyanga ezintathu zokuqala ze-dialysis, ubamba iqhaza ekuqeqesheni i-dialysis yasekhaya esikhungweni esiqinisekiswe yi-Medicare.
• Udokotela wakho ukhombisa ukuthi kufanele uqede ukuqeqeshwa ukuze uzenzele ezakho izindlela zokwelapha nge-dialysis.

Uma uthola ukufakelwa kwezinso

Uma ungeniswa esibhedlela esiqinisekiswe yi-Medicare sokufakelwa izinso futhi ukufakelwa kwenzeka ngaleyo nyanga noma ezinyangeni ezimbili ezilandelayo, iMedicare ingaqala ngaleyo nyanga.

Ukutholakala kwe-Medicare kungaqala ezinyangeni ezimbili ngaphambi kokufakelwa kwakho uma ukufakelwa kubambezeleka ngaphezu kwezinyanga ezimbili ngemuva kokungeniswa esibhedlela.

Lapho ukufakwa kwe-Medicare kuphela

Uma ufaneleke ukuthola i-Medicare kuphela ngenxa yokuhluleka ukusebenza kwezinso unomphela, ukumbozwa kwakho kuzoma:

• Izinyanga eziyi-12 ngemuva kwenyanga ukwelashwa kwe-dialysis kumisiwe
• Izinyanga ezingama-36 kulandela inyanga uthola ukufakelwa izinso

Ukutholakala kwe-Medicare kuzoqhubeka uma:

• kungakapheli izinyanga eziyi-12 ngemuva kwenyanga, uyeka ukuthola i-dialysis, uqala i-dialysis futhi noma ukufakelwa izinso
• kungakapheli izinyanga ezingama-36 ngemuva kwenyanga uthola ukufakelwa izinso uthola okunye ukufakelwa kwezinso noma uqale i-dialysis

Izinsizakalo zeDialysis nezinto ezihlinzekwa yiMedicare

I-Original Medicare (Ingxenye yomshuwalense wesibhedlela kanye nomshuwalense wezokwelapha wengxenye B) ihlanganisa izinto eziningi nezinsizakalo ezidingekayo ku-dialysis, kufaka phakathi:

• izindlela zokwelashwa kwe-dialpatient: ezihlanganiswe yi-Medicare Part A
• Ukwelashwa kwe-dialysis yeziguli ezingaphandle: kumbozwe yi-Medicare Part B
• Izinsizakalo zodokotela ezingaphandle: zimbozwe yiMedicare Part B
• ukuqeqeshwa kwe-dialysis yasekhaya: embozwe yi-Medicare Part B
• imishini yokudayela ekhaya kanye nempahla: embozwe yiMedicare Part B
• izinsizakalo ezithile zokusekelwa kwasekhaya: zimbozwe yiMedicare Part B
• Izidakamizwa eziningi ze-dialysis esezindlini nezisendlini: zimbozwe yi-Medicare Part B
• ezinye izinsiza kanye nokunikezwa, okufana nokuhlolwa kwelabhorethri: kumbozwe yiMedicare Part B

I-Medicare kufanele ihlanganise izinsizakalo ze-ambulensi ukuya nokubuya ekhaya lakho ukuya esikhungweni esiseduzane se-dialysis uma udokotela wakho enikeza ama-oda abhaliwe aqinisekisa ukuthi kuyisidingo sezokwelapha.

Izinsizakalo nezinsizakusebenza ezingamboziwe yiMedicare zifaka:

• inkokhelo yabasizi ukusiza nge-dialysis yasekhaya
• inkokhelo elahlekile ngesikhathi sokuqeqeshwa kwe-dialysis yasekhaya
• indawo yokuhlala ngesikhathi sokwelashwa
• igazi noma amaseli abomvu apakishiwe we-dialysis yasekhaya (ngaphandle kokuthi kufakwe nensizakalo kadokotela)

Ukusabalala kwezidakamizwa

I-Medicare Part B ihlanganisa imishanguzo efakwa ngaphakathi komjovo kanye nemithambo yegazi kanye nama-biologicals kanye namafomu abo omlomo ahlinzekwa yisikhungo se-dialysis.

Ingxenye B ayihlanganisi imithi etholakala kuphela ngomlomo.

I-Medicare Part D, ethengwa ngenkampani yomshuwalense yangasese evunyelwe yi-Medicare, inikela ngemithi kadokotela ethi, ngokuya ngenqubomgomo yakho, imboza lolu hlobo lwemithi.

Ngizoyikhokhela ini i-dialysis?

Uma uthola i-dialysis ngemuva kokungeniswa esibhedlela, i-Medicare Part A ihlanganisa izindleko.

Izinsizakalo zodokotela abangalashwa zihlanganiswa yiMedicare Part B.

Unesibopho samaphrimiyamu, ama-deductibles akhishwa minyaka yonke, i-coinsurance, nama-copays:

• Imali ekhishwa minyaka yonke ye-Medicare Part A ingu- $ 1,408 (lapho ingeniswa esibhedlela) ngo-2020. Lokhu kuhlanganisa izinsuku zokuqala ezingama-60 zokunakekelwa kwesibhedlela esikhathini sokuzuza. Ngokusho kwe-U.S. Centers for Medicare & Medicare Services, cishe amaphesenti angama-99 abahlomuli beMedicare abanayo imali ekhokhelwa iNgxenye A.
• Ngo-2020, imali ekhokhwa nyangazonke ye-Medicare Part B ingu- $ 144.60 kanti imali ekhishwa minyaka yonke ye-Medicare Part B ingu- $ 198. Lapho lawo maprimiyamu nokudonswayo sekukhokhiwe, iMedicare ikhokha amaphesenti angama-80 wezindleko bese ukhokha amaphesenti angama-20.

Ngezinsizakalo zokuqeqeshwa kwe-dialysis yasekhaya, i-Medicare ngokujwayelekile ikhokha imali eyisamba esikhungweni sakho se-dialysis ukwengamela ukuqeqeshwa kwe-dialysis yasekhaya.

Ngemuva kokuthi kufinyelelwe ingxenye ekhishwa minyaka yonke engxenyeni B, iMedicare ikhokha amaphesenti angama-80 emali, kanti amaphesenti angama-20 asele kungumsebenzi wakho.

Ukudla okudlela endlini

Iningi lezindlela zokwelashwa, kufaka phakathi i-dialysis, efaka isifo sesifo sokuphela kwesiteji (ESRD) noma ukwehluleka kwezinso kumbozwe yiMedicare.

Imininingwane ephathelene nokutholakala kokwelashwa, izinsiza kanye nokunikezwa, kanye nesabelo sakho sezindleko kungabuyekezwa nawe ngethimba lakho lokunakekelwa kwezempilo, okubandakanya:

• odokotela
• abahlengikazi
• abasebenzi bezenhlalakahle
• ochwepheshe be-dialysis

Ngeminye imininingwane cabanga ngokuvakashela i-Medicare.gov, noma ushayele ku-1-800-MEDICARE (1-800-633-4227).

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.