Ukunakekelwa Kweziguli: Yini Eyimbozwa YiMedicare?

-Delile

• I-Medicare ihlanganisa i-hospice
• Ngabe i-Medicare ihlanganisa nini i-hospice?
• Yini ngempela ehlanganisiwe?
• Kuthiwani ngokwelashwa kwezimo ezingahlobene nokugula okungapheli?
• Ngabe umuntu onesifo sokuwohloka komqondo uzokwazi yini ukuthola umhlomulo we-Medicare hospice?
• Ngabe kuzoba nama-copay noma ama-deductibles?
• Yini engamboziwe yi-Medicare?
• I-Medicare ngeke ihlanganise noma yiziphi izindlela zokwelapha ukwelapha ukugula
• I-Medicare ngeke ihlanganise izinsizakalo ezivela kumhlinzeki we-hospice engahlelwanga yithimba lakho lokunakekela abagulela ukufa
• I-Medicare ngeke ihlanganise igumbi nokugibela
• I-Medicare ngeke ikwazi ukunakekela ukunakekelwa okutholayo esikhungweni sesibhedlela esingalaliswayo
• Kuzoze kube nini iMedicare ikhokhela izinsizakalo ze-hospice?
• Yiziphi izingxenye zemedicare ezibandakanya ukunakekelwa kwe-hospice?
• Yini i-hospice?
• Ngabe i-hospice yehluke kanjani ekunakekelweni okunciphisayo?
• Kubiza malini ukunakekelwa kwe-hospice?
• Okubalulekile

Ukwenza izinqumo mayelana nokunakekelwa kwe-hospice, kungaba ngokwakho noma umuntu omthandayo, akulula. Ukuthola izimpendulo eziqondile mayelana nokuthi yiziphi izindleko ze-hospice nokuthi ungazikhokhela kanjani kungenza isinqumo esinzima sicace kancane.

I-Medicare ihlanganisa i-hospice

I-Original Medicare (i-Medicare Part A ne-Medicare Part B) ikhokhela ukunakekelwa kwe-hospice inqobo nje uma umhlinzeki wakho we-hospice evunyelwe yi-Medicare.

I-Medicare ikhokhela ukunakekelwa kwe-hospice noma ngabe unayo uhlelo lwe-Medicare Advantage (i-HMO noma i-PPO) noma olunye uhlelo lwezempilo lwe-Medicare.

Uma ufuna ukuthola ukuthi ngabe umhlinzeki wakho we-hospice uvunyelwe yini, ungabuza udokotela wakho, umnyango wakho wezempilo kahulumeni, inhlangano kahulumeni yokunakekela abagulayo, noma umphathi wakho wohlelo, uma unohlelo lokulekelela lweMedicare.

Ungahle ufune izimpendulo ezithile mayelana nokuthi iziphi izinsiza, abahlinzeki, nezinsizakalo ezihlanganiswe nokunakekelwa kwe-hospice. Lo mthombo uzokusiza ukuphendula leyo mibuzo.

Ngabe i-Medicare ihlanganisa nini i-hospice?

I-Medicare ihlanganisa i-hospice ngokushesha nje lapho udokotela eqinisekisa ukuthi umuntu ombozwe yi-Medicare unokugula okuthi uma kuqhubeka kungaphazanyiswa, kwenze kungabi lula ukuthi lowo muntu aphile isikhathi eside kunezinyanga eziyisithupha.

Ukuze uthole lokhu kufakwa, kufanele usayine isitatimende esiqinisekisa:

• ufuna ukunakekelwa okunciphisayo
• awuhlosile ukuqhubeka nokufuna izindlela zokwelapha ukugula
• ukhetha ukunakekelwa kwe-hospice esikhundleni sezinye izinsizakalo ezivunyelwe yi-Medicare ukwelapha ukugula kwakho

Yini ngempela ehlanganisiwe?

I-Original Medicare ikhokhela izinsiza ezahlukahlukene, izimpahla, nemiyalo ehlobene nokugula okubangele ukuthi ufune ukunakekelwa kwe-hospice. Lokho kufaka:

• udokotela nezinsizakalo zabahlengikazi
• izinsizakalo zokwelashwa ngokomzimba, zomsebenzi, nezenkulumo
• imishini yezokwelapha, njengezihambahamba nemibhede
• ukwelulekwa ngokudla
• izinto zokwelashwa nemishini
• imishanguzo kadokotela oyidingayo ukuze unciphise izimpawu noma ubuhlungu bokulawula
• ukunakekelwa kweziguli zesikhashana esifushane ukukusiza ukuphatha izinhlungu noma izimpawu
• izinsizakalo zomsebenzi wezenhlalakahle nokwelulekwa ngosizi kuzo zombili iziguli nomndeni
• ukunakekelwa kwesikhathi esifushane (kufika ezinsukwini ezinhlanu ngesikhathi) ukuvumela umnakekeli wakho aphumule, uma unakekelwa ekhaya
• ezinye izinsizakalo, ukuhlinzekwa, kanye nemithi edingekayo ukuphatha izinhlungu noma izimpawu zokulawula ezihlobene nokugula okungapheli

Ukuze uthole umhlinzeki wokunakekelwa kwe-hospice endaweni yakho, zama lo mtholi we-ejensi kusuka eMedicare.

Kuthiwani ngokwelashwa kwezimo ezingahlobene nokugula okungapheli?

Uma uthola izinzuzo ze-hospice, i-Medicare Part A (i-Medicare yasekuqaleni) isazokhokhela ezinye izifo nemibandela ongahle ube nayo. Izinkokhelo ezifanayo zomshuwalense kanye nezimali ezidonswayo zizosebenza kulezo zindlela zokwelashwa njengoba kuzovame ukusebenza.

Ungagcina uhlelo lwakho lwe-Medicare Advantage ngenkathi uthola izinzuzo ze-hospice. Kumele ukhokhe ama-premium akhokhelwa lokho.

Ngabe umuntu onesifo sokuwohloka komqondo uzokwazi yini ukuthola umhlomulo we-Medicare hospice?

Kuphela uma isikhathi sokuphila singaphansi kwezinyanga eziyisithupha. I-Dementia ukugula okuqhubeka kancane. Ezigabeni zakamuva, umuntu onesifo sokuwohloka komqondo angalahlekelwa amandla okusebenza ngokujwayelekile futhi adinge ukunakekelwa nsuku zonke. I-Hospice izombozwa kuphela, noma kunjalo, lapho udokotela eqinisekisa ukuthi umuntu unempilo yokuphila yezinyanga eziyi-6 noma ngaphansi. Lokho kuvame ukusho ukuthi ukugula kwesibili njenge-pneumonia noma i-sepsis kwenzeke.

Ngabe kuzoba nama-copay noma ama-deductibles?

Izindaba ezimnandi ukuthi azikho izimali ezibanjwayo zokunakekelwa kwe-hospice.

Eminye imiyalo kanye nezinsizakalo zingaba namakhophi. Imiyalo yemithi yezinhlungu noma ukukhululeka kwezimpawu ingaphatha i- $ 5 copay. Kungaba nephesenti elingu-5% lokunakekelwa kokuphefumula ngaphakathi uma wamukelwa esikhungweni esivunyelwe, ukuze abanakekeli bakho baphumule. Ngaphandle kwalezo zimo, ngeke kudingeke ukhokhele ukunakekelwa kwakho kwe-hospice.

Yini engamboziwe yi-Medicare?

I-Medicare ngeke ihlanganise noma yiziphi izindlela zokwelapha ukwelapha ukugula

Lokho kufaka phakathi kokubili ukwelashwa nemithi kadokotela ehloselwe ukukuphulukisa. Uma uthatha isinqumo sokuthi ufuna ukwelashwa ukwelapha ukugula kwakho, ungayeka ukunakekelwa kwe-hospice bese ulandela leyo ndlela yokwelashwa.

I-Medicare ngeke ihlanganise izinsizakalo ezivela kumhlinzeki we-hospice engahlelwanga yithimba lakho lokunakekela abagulela ukufa

Noma yikuphi ukunakekelwa okutholayo kufanele kunikezwe ngumhlinzeki we-hospice okhethwe nguwe nethimba lakho. Noma uthola izinsizakalo ezifanayo, i-Medicare ngeke izokhokhela izindleko uma umhlinzeki kungeyena wena neqembu lakho labagula kakhulu elibizwa ngalo. Usengavakashela udokotela wakho ojwayelekile noma umhlinzeki wezokunakekelwa kwezempilo uma ubakhethile ukuthi babheke ukunakekelwa kwakho kwe-hospice.

I-Medicare ngeke ihlanganise igumbi nokugibela

Uma uthola ukunakekelwa kwe-hospice ekhaya, ekhaya lasebekhulile, noma esikhungweni sezibhedlela ezigulela ngaphakathi, i-Medicare ngeke ikwazi ukukhokhela izindleko zekamelo nebhodi. Ngokuya ngesikhungo, lezo zindleko zingadlula u- $ 5,000 ngenyanga.

Uma iqembu lakho labagula kakhulu linquma ukuthi udinga i isikhathi esifushane hlala ngaphakathi esibhedlela esikhungweni sezokwelapha noma esikhungweni sokunakekelwa okuphefumulayo, iMedicare izokhipha lokho kuhlala kwesikhashana. Ungase ukhokhe inkokhelo ye-coinsurance yalokhu kuhlala kwesikhashana, noma kunjalo. Ezimweni eziningi, leyo nkokhelo ingamaphesenti ama-5 wezindleko, imvamisa ingeqi ku- $ 10 ngosuku.

I-Medicare ngeke ikwazi ukunakekela ukunakekelwa okutholayo esikhungweni sesibhedlela esingalaliswayo

Ngeke ikukhokhele ukuthuthwa kwe-ambulensi iye esibhedlela noma nganoma iziphi izinsizakalo ozitholayo endaweni yokulala esibhedlela, njengegumbi lezimo eziphuthumayo, ngaphandle uma hhayi okuhlobene nokugula okungaguli noma ngaphandle kokuthi kuhlelwe ithimba lakho labagula kakhulu.

Kuzoze kube nini iMedicare ikhokhela izinsizakalo ze-hospice?

Uma wena (noma othandekayo) uthola ukunakekelwa kwe-hospice, lokho kusho ukuthi udokotela wakho uqinisekisile ukuthi isikhathi sakho sokuphila siyizinyanga eziyisithupha noma ngaphansi. Kepha abanye abantu bayakwenqaba okulindelwe. Ekupheleni kwezinyanga eziyisithupha, i-Medicare izoqhubeka nokukhokhela ukunakekelwa kwe-hospice uma uyidinga. Umqondisi wezokwelapha esibhedlela noma udokotela wakho uzodinga ukuhlangana nawe mathupha, bese uphinde uqinisekise ukuthi isikhathi sokuphila asikabi ngaphezu kwezinyanga eziyisithupha.

I-Medicare izokhokha izikhathi ezimbili zezinsuku ezingama-90. Ngemuva kwalokho, ungaphinda uqinisekise kabusha ngenombolo engenamkhawulo yezikhathi zezinzuzo ezingama-60. Nganoma yisiphi isikhathi senzuzo, uma ufuna ukushintsha umhlinzeki wakho we-hospice, unelungelo lokwenza kanjalo.

Yiziphi izingxenye zemedicare ezibandakanya ukunakekelwa kwe-hospice?

• Ingxenye yeMedicare A. Ingxenye A ikhokhela izindleko zesibhedlela, uma kungadingeka ukuthi ungeniswe ukuze unakekele izimpawu noma unikeze abanakekeli ikhefu elifushane.
• I-Medicare Ingxenye B. Ingxenye B ihlanganisa izinsizakalo zezokwelapha nezobuhlengikazi, okokusebenza kwezokwelapha, kanye nezinye izinsizakalo zokwelashwa.
• I-Medicare Part C (Inzuzo). Noma yiziphi izinhlelo ze-Medicare Advantage onazo zizohlala zisebenza inqobo nje uma ukhokha amaprimiyamu, kodwa ngeke uzidinge izindleko zakho ze-hospice. I-Original Medicare ikhokhela labo. Izinhlelo zakho ze-Medicare Part C zisengasetshenziselwa ukukhokhela imishanguzo engahlobene nokugula okungapheli.
• Isengezo seMedicare (iMedigap). Noma yiziphi izinhlelo zeMedigap onazo zingasiza ngezindleko ezihlobene nezimo ezingahlobene nokugula okubulalayo. Ngeke uzidinge lezi zinzuzo ukukusiza ngezindleko ze-hospice, ngoba lezo zikhokhelwa yi-Medicare yasekuqaleni.
• Ingxenye yeMedicare D. Ukutholakala komuthi wakho we-Medicare Part D kusazosebenza ukukusiza ukukhokhela imithi engahlobene nokugula okungapheli. Ngaphandle kwalokho, imishanguzo yokusiza ukwelapha izimpawu noma ukuphatha ubuhlungu besifo esibulalayo ihlanganiswa ngenzuzo yakho ye-Medicare hospice.

Yini i-hospice?

I-Hospice iyindlela yokwelashwa, izinsizakalo, nokunakekelwa kwabantu abanesifo futhi okungalindelekile ukuthi baphile isikhathi eside kunezinyanga eziyisithupha.

khuthaza abantu abanesifo esingalapheki ukuthi bacabangele ukungena ezibhedlela ekuqaleni kwewindi lezinyanga eziyi-6. I-Hospice inikeza izinzuzo ezicacile nokusekelwa okuyigugu, hhayi ezigulini kuphela kodwa nasemindenini yazo. Ezinye izinzuzo yilezi:

• ukuvezwa okumbalwa kwezifo kanye nezinye izingozi ezihambisana nokuvakashelwa esibhedlela
• izindleko eziphansi jikelele ezihambisana nokugula okuyimbangela
• izinsizakusebenza zokwenza ngcono ukunakekelwa nokusekelwa kwabanakekeli
• ukufinyelela kwizinsizakalo zokunakekelwa kochwepheshe

Ngabe i-hospice yehluke kanjani ekunakekelweni okunciphisayo?

Inhloso yokunakekelwa okunciphisayo ukuthuthukisa impilo yakho ngenkathi ubhekene nokugula. Ukunakekelwa kwe-palliative kungaqala lapho uthola ukuthi unesifo, noma ngabe kulindeleke ukuthi ululame ngokuphelele. Ngokuqinisekile uzoqhubeka nokuthola ukunakekelwa okunciphisayo kuze kube yilapho ungasakudingi.

Ngokusho kweNational Institute on Aging, umehluko omkhulu phakathi kwe-hospice nokunakekelwa okunciphisayo ukuthi ukunakekelwa kwe-palliative kukuvumela ukuthi uhlale uthola ukwelashwa ukwelapha ukugula kwakho. Ekunakekelweni kwe-hospice, izimpawu zakho nobuhlungu bakho kuzoqhubeka nokwelashwa, kepha ukwelashwa okuhlose ukwelapha ukugula kuzomisa.

Uma kucaca ethimbeni lezokwelapha ukuthi ukwelashwa akusebenzi futhi ukugula kwakho kungapheli, ungaguquka usuke ekunakekelweni okunciphisayo ngenye yezindlela ezimbili. Uma udokotela wakho ekholelwa ukuthi ngeke uphile izinyanga ezingaphezu kwezingu-6, wena nabahlinzeki bakho bokunakekela ninganquma ukushintshela ekunakekelweni kwe-hospice. Enye indlela ukuqhubeka nokunakekelwa okunciphisayo (kufaka phakathi izindlela zokwelashwa ezihloselwe ukwelapha ukugula) kepha ngokugxila okwandayo ekunakekelweni kokunethezeka (noma kokuphela kwempilo).

Kubiza malini ukunakekelwa kwe-hospice?

Izindleko zokunakekelwa kwe-hospice zixhomeke ohlotsheni lokugula nokuthi iziguli zokuqala zingena kanjani ezibhedlela. Ngo-2018, iSocial of Actuaries ilinganisela ukuthi iziguli ezinesifo somdlavuza zithole izinzuzo zeMedicare Part A neNgxenye B ezifinyelela ku- $ 44,030 ezinyangeni eziyisithupha zokugcina zempilo yazo.

Leso sibalo sihlanganisa izindleko zokwelashwa kweziguli ezingalaliswanga, ngaphezu kokunakekelwa kwabantu abagulela ukufa ekhaya. Olunye ucwaningo lukhombisile ukuthi izindleko ezijwayelekile zeMedicare zeziguli ezigulela ukufa phakathi nezinsuku ezingama-90 zokuphila zazingama- $ 1,075 nje kuphela.

• Thatha isikhashana uqiniseke ukuthi uyaqonda ukuthi iMedicare isebenza kanjani.
• Zijwayele ngezikhathi zokubhalisa.
• Sebenzisa lolu hlu lokuhlola ukuze uqiniseke ukuthi unolwazi oludingayo ukulusebenzisa.
• Lapho usuqoqe imininingwane oyidingayo, gcwalisa uhlelo oluku-inthanethi. Ungahle uthande ukunciphisa iziphazamiso nokuphazamiseka okungenani imizuzu engama-30.

Okubalulekile

Uma unokutholakala kokuqala kwe-Medicare futhi ucabangela ukunakekelwa kwe-hospice, inzuzo ye-Medicare ye-hospice izokhokhela izindleko zokunakekelwa kwe-hospice.

Uzodinga udokotela ukuqinisekisa ukuthi isikhathi sakho sokuphila asidluli izinyanga eziyisithupha, futhi kuzodingeka usayine isitatimende esamukela ukunakekelwa kwe-hospice nokumisa ukwelashwa okuhlose ukwelapha ukugula. Uma uhlangabezane nalezo zidingo, udokotela wakho nokunakekelwa kwabahlengikazi, imiyalelo, kanye nolunye uhla lwezinye izinsizakalo zokusekelwa kuzombozwa.

Okukodwa okubalulekile okumele kuqashelwe: I-Original Medicare ayikhokheleli igumbi kanye nebhodi leziguli ezinakekela abagulayo, ngakho-ke ukuhlala isikhathi eside ekhaya lasebekhulile noma esikhungweni sabahlengikazi abanamakhono ngeke kuhlanganiswe njengengxenye yenzuzo ye-hospice.

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.