Ukuhlinzwa Kwemithi Nokuhlinzwa Komlomo: Yini Okumboziwe?

-Delile

• Ngabe iMedicare ikufihla nini ukuhlinzwa ngomlomo?
• Yiziphi izinhlelo zeMedicare ezingaba ngcono kuwe uma wazi ukuthi udinga ukuhlinzwa ngomlomo?
• I-Medicare Part C (i-Medicare Advantage)
• Ingxenye yeMedicare A
• Ingxenye yeMedare B
• Ingxenye yeMedare D
• I-Medicare Supplement (iMedigap)
• Yiziphi izindleko zokuphuma ephaketheni zokuhlinzwa ngomlomo uma une-Medicare?
• Yiziphi izinsizakalo zamazinyo ezenziwa yiMedicare?
• I-Original Medicare (izingxenye A no-B)
• Izinhlelo ze-Medicare Advantage (izinhlelo zokwengeza ze-Medicare)
• I-Medicare Coverage yezinsizakalo zamazinyo
• Okubalulekile

Uma ufanele iMedicare futhi ucabangela ukuhlinzwa ngomlomo, unezinketho zokusiza ukumboza izindleko.

Ngenkathi i-Medicare yasekuqaleni ingazibandakanyi izinsizakalo zamazinyo ezidingeka ngqo kwezempilo yezinyo noma yezinsini, ingahlanganisa ukuhlinzwa ngomlomo kwezimo zezokwelapha. Amanye amacebo we-Medicare Part C (Medicare Advantage) nawo ahlinzeka ngembozo yamazinyo.

Ake sihlole ukuthi iziphi izinhlobo zokuhlinzwa ngomlomo ezimbozwa yi-Medicare nokuthi kungani.

Ngabe iMedicare ikufihla nini ukuhlinzwa ngomlomo?

Ukuhlinzwa ngomlomo kwesinye isikhathi kuyadingeka njengengxenye yohlelo lokwelashwa kwesimo sezokwelapha, njengomdlavuza noma isifo senhliziyo. Kulezi zimo, ukuhlinzwa ngomlomo kungahlukaniswa njengenqubo edingekayo kwezokwelapha.

Njengoba isimo ngasinye sihlukile, khuluma nodokotela wakho noma ubuyekeze inqubo ethile yohlelo lwakho, ukuze unqume ukuthi ukuhlinzwa kwakho ngomlomo kuzofakwa yini yi-Medicare yasekuqaleni.

I-Original Medicare (Medicare Part A) izokhokha izindleko zokuhlinzwa ngomlomo kulezi zimo ezikhonjiswe ngokwezokwelapha:

• Ukukhishwa kwezinyo elonakele noma eligulayo kungadingeka kwezokwelapha ngaphambi kokuqala ukwelashwa ngemisebe. Lokhu kungasiza ukunciphisa ingozi yokufa kwe-mandibular (bone).
• Ukugwema ukuthola ukutheleleka ngomlomo, ukukhishwa kwezinyo elonakele noma eligulayo kungadingeka ngaphambi kokufakelwa komzimba.
• Uma unomhlathi ophukile futhi udinga ukuhlinzwa ukuze uwulungise noma uwubuyisele, i-Medicare izokhokha lezo zindleko.
• I-Medicare izophinde ihlanganise ukuhlinzwa ngomlomo uma umhlathi wakho udinga ukulungiswa noma ukubuyiselwa ngemuva kokususwa kwesimila.

Yiziphi izinhlelo zeMedicare ezingaba ngcono kuwe uma wazi ukuthi udinga ukuhlinzwa ngomlomo?

I-Medicare Part C (i-Medicare Advantage)

Uma wazi ukuthi uzodinga ukuhlinzwa ngomlomo ukuze uthole impilo yamazinyo, uhlelo lweMedicare Advantage (Medicare Part C) oluhlanganisa izinqubo ezijwayelekile zamazinyo lungaba ngcono kuwe.

Kodwa-ke, akuyona yonke uhlelo lwe-Medicare Advantage olubandakanya izinsizakalo zamazinyo.

Ingxenye yeMedicare A

Uma wazi ukuthi uzodinga ukuhlinzwa ngomlomo okudingekayo ukuze welaphe isimo sezempilo, ungathola ukumbozwa ngaphansi kwe-Medicare Part A uma uyisiguli esisesibhedlela.

Ingxenye yeMedare B

Uma udinga ukuthi kwenziwe ukuhlinzwa ngomlomo okudingekayo ngokwezokwelapha, i-Medicare Part B ingakumboza.

Ingxenye yeMedare D

Imithi edingekayo njengaleyo yokwelapha ukutheleleka noma ubuhlungu izombozwa ngaphansi kwe-Medicare Part D, ngaphandle kokuthi inikezwe ngemithambo.

Uma unikezwa imithi esimweni sesibhedlela enikezwa ngemithambo yegazi, Ingxenye B izokhokhela lezo zindleko. Iningi lezinhlelo zeMedicare Advantage lihlanganisa nezindleko zemithi.

I-Medicare Supplement (iMedigap)

IMedigap ingamboza izindleko zakho zokudonswa kwemali nezindleko zemali yengxenye yakho uma uhlinzeka ngomlomo odinga ukwelashwa esibhedlela. IMedigap ayizihlanganisi lezi zindleko zokuhlinzwa ngomlomo ezidingekayo kwimpilo yamazinyo kuphela.

Yiziphi izindleko zokuphuma ephaketheni zokuhlinzwa ngomlomo uma une-Medicare?

Uma unenqubo yokuhlinza ngomlomo engabhekwa njengedingekile kwezokwelapha, uzozithola zonke izindleko ezihambisana nayo.

Uma inqubo yakho yokuhlinzwa ngomlomo iyadingeka ngokwezokwelapha, kusenezindleko ongase uzikhokhe. Ngokwesibonelo:

• Amakhophi. I-Medicare izokhipha amaphesenti angama-80 ezindleko ezivunyelwe yi-Medicare zokuhlinzwa ngomlomo okudingekayo ngokwezempilo, inqobo nje uma kwenziwa ngumhlinzeki ovunyelwe yi-Medicare. Lokhu kufaka phakathi ama-X-ray namanye amasevisi ongawadinga. Uma inqubo yakho yenziwa esibhedlela futhi ungenawo umshwalense owengeziwe weMedigap, uzoba nesibopho samaphesenti angama-20 wezindleko.
• Iyadonswa. Kubantu abaningi, iMedicare Part B inemali ekhishwa minyaka yonke engama- $ 198 okumele ihlangatshezwe ngaphambi kwanoma yiziphi izinsizakalo, kufaka phakathi ukuhlinzwa ngomlomo okudingekayo.
• Iphrimiyamu yanyanga zonke. I-Medicare Part B inezinga elijwayelekile, lenyanga yonke le-premium lama- $ 144.60. Lokhu kungaba kuncane kuwe uma okwamanje uthola izinzuzo zokuphepha kwezenhlalo, noma kungakubiza kakhulu ngokuya ngeholo lakho lamanje.
• Imithi. Kufanele ube ne-Medicare Part D noma olunye uhlobo lokutholakala kwezidakamizwa ukuze uthole konke noma ingxenye yezindleko zemithi yakho embozwe. Uma ungenakho ukutholakala kwezidakamizwa, uzoba nesibopho sezindleko zanoma imiphi imithi edingekayo.

Yiziphi izinsizakalo zamazinyo ezenziwa yiMedicare?

I-Original Medicare (izingxenye A no-B)

I-Medicare ayihlanganisi izinsizakalo eziningi ezijwayelekile zamazinyo njengokuhlanza, ukugcwalisa, ukukhipha, amazinyo okufakelwa noma ukuhlinzwa ngomlomo. Kodwa-ke, ukuhlinzwa ngomlomo kungambozwa uma kunesidingo kwezokwelapha.

Izinhlelo ze-Medicare Advantage (izinhlelo zokwengeza ze-Medicare)

Ezinye izinhlelo ze-Medicare Advantage zifaka ukumbozwa kwezinsizakalo zamazinyo. Uma ungathanda ukumbozwa ngamazinyo, qhathanisa amapulani ahlinzekwa esifundazweni sakho, bese ubheka izinhlelo ezibandakanya amazinyo. I-Medicare inesitholi sohlelo ukukusiza uqhathanise izinqubomgomo ze-Medicare Advantage ezinikezwa endaweni yakho.

I-Medicare Coverage yezinsizakalo zamazinyo

Okubalulekile

Izinsizakalo ezijwayelekile zamazinyo nezinqubo zokuhlinzwa ngomlomo ezidingekayo kuphela empilweni yamazinyo azimboziwe yi-Medicare yasekuqaleni. Kepha ukuhlinzwa ngomlomo okudingekayo empilweni yezinyo noma yezinsini kungahlanganiswa nezinhlelo ezithile zeMedicare Advantage.

Uma udinga ukuhlinzwa ngomlomo okudingekayo ngokwezokwelapha ngenxa yezizathu zezempilo, i-Medicare yasekuqaleni ingakhokhela inqubo. Noma kunjalo, ungahle ube nezindleko zokukhokha.

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.