Ingabe i-Medicare Cover Cover Oxygen Therapy?

-Delile

• Ingabe i-Medicare ihlanganisa ukwelashwa kwe-oxygen ekhaya?
• Izidingo eziyisisekelo zokumbozwa
• Isidingo sezokwelapha
• Izindleko
• Yimiphi imishini nezinsiza ezihlanganiswayo?
• Ngikufanelekela kanjani ukumbozwa?
• Kusebenza kanjani ukuqashwa kwemishini?
• Okuningi mayelana nokwelashwa komoya-mpilo
• Ukusebenzisa imikhiqizo ye-oxygen ngokuphepha
• Ukuthatha

• Uma ufanelekela i-Medicare futhi une-oda likadokotela le-oxygen, abakwaMedicare bazofaka okungenani ingxenye yezindleko zakho.
• I-Medicare Part B ihlanganisa ukusetshenziswa komoya-mpilo wasekhaya, ngakho-ke kufanele ubhalise kule ngxenye ukuthola ukumbozwa.
• Ngenkathi i-Medicare izosiza ukumboza izindleko zokwelashwa komoya-mpilo, kungenzeka usafanele ukhokhe ingxenye yalezo zindleko.
• I-Medicare kungenzeka ingazimbozi zonke izinhlobo zokwelashwa komoya-mpilo.

Lapho ungakwazi ukuphefumula, yonke into ingaba nzima kakhulu. Imisebenzi yansuku zonke ingazizwa iyinselele. Futhi, ezinye izinkinga eziningi zempilo zingavela emazingeni aphansi e-oksijini egazi, abizwa nge-hypoxemia.

Uma ukuthola kunzima ukuphefumula noma unesimo esinciphisa izinga lomoya-mpilo lomzimba wakho, ungahle udinge ukwelashwa komoya-mpilo ekhaya. Qhubeka ufunde ukuthola ukuthi ngabe iMedicare izosiza yini ukukhokhela izindleko zomoya-mpilo wasekhaya nokuthi yini okufanele uyenze ukuze uqiniseke ukuthi unayo imishini oyidingayo.

Ingabe i-Medicare ihlanganisa ukwelashwa kwe-oxygen ekhaya?

I-Medicare ihlanganisa ukwelashwa kwe-oxygen ekhaya ngaphansi kweNgxenye B. I-Medicare Ingxenye B ihlanganisa izindleko zokunakekelwa kweziguli ezingalapheki kanye nezindlela ezithile zokwelapha ekhaya.

Izidingo eziyisisekelo zokumbozwa

Ukuze izidingo zomoya-mpilo zasekhaya zimbozwe nge-Medicare, kufanele:

• bhalise kuNgxenye B
• unesidingo sezokwelapha se-oxygen
• thola i-oda likadokotela le-oxygen yasekhaya.

I-Centers for Medicare & Medicaid Services (CMS) ichaza ngokusobala izindlela ezithile okufanele zihlangatshezwe ukuze iMedicare imboze umoya-mpilo wasekhaya. Izidingo zifaka:

• ukumbozwa okufanele kwe-Medicare
• imibhalo yezokwelapha yesimo sezempilo esisebenzayo
• ilabhoratri neminye imiphumela yokuhlolwa eqinisekisa isidingo se-oxygen yasekhaya

Sizobheka imininingwane yokuthi ungakufanelekela kanjani ukumbozwa kamuva kule ndatshana.

Isidingo sezokwelapha

I-oksijeni yasekhaya ivame ukunikezwa ngezimo ezinjengokwehluleka kwenhliziyo kanye nesifo esingapheliyo se-pulmonary disease (COPD).

Isidingo sezokwelapha se-oksijeni yasekhaya sinqunywa ngokuhlola ukubona ukuthi ngabe isimo sakho sibangela i-hypoxemia. I-Hypoxemia yenzeka lapho unamazinga aphansi omoya-mpilo egazini lakho.

Izimo ezifana nokuphefumula okuncane ngaphandle kwamazinga aphansi e-oksijini cishe ngeke zimbozwe yi-Medicare.

I-oda likadokotela wakho kumele lifake imininingwane mayelana nokuxilongwa kwakho, ukuthi udinga i-oxygen engakanani, nokuthi uyidinga kangaki. I-Medicare ayivamisile ukumboza ama-oda we-PRN oxygen, okuyi-oxygen edingekayo ngendlela edingekayo.

Izindleko

Uma isimo sakho sihlangabezana nenqubo ye-CMS, kufanele uqale ugcwalise imali yakho ekhishwe eMedicare Part B. Leli inani lezindleko ezingaphandle kwezikhwama okufanele uzikhokhe ngaphambi kokuba i-Medicare iqale ukumboza izinto nezinsizakalo ezivunyiwe.

Ingxenye B ekhishwe ngo-2020 ingu- $ 198. Kufanele futhi ukhokhe imali ekhokhwa njalo ngenyanga. Ngo-2020, i-premium imvamisa ingu- $ 144.60 - noma ingahle ibe ngaphezulu, kuya ngeholo lakho.

Uma usuhlangane ne-Part B yakho ekhishwayo ngonyaka, i-Medicare izokhokha amaphesenti angama-80 ezindleko zemishini yakho yokuqasha i-oxygen ekhaya. Imishini yomoya-mpilo ibhekwa njengempahla ehlala isikhathi eside yezokwelapha (i-DME). Uzokhokha amaphesenti angama-20 wezindleko ze-DME, futhi kufanele uthole imishini yakho yokuqasha kumhlinzeki ovunyelwe yi-Medicare we-DME.

Izinhlelo zeMedicare Advantage (Ingxenye C) zingasetshenziselwa ukukhokhela imishini yokuqasha i-oxygen. Lezi zinhlelo zidingeka ngokomthetho ukumboza okungenani okuningi okuhlanganisa amakhava wangempela e-Medicare (izingxenye A no-B).

Ukutholakala kwakho ngqo nezindleko kuzoya ngohlelo lwe-Medicare Advantage olikhethayo, futhi ukukhetha kwakho kwabahlinzeki kungakhawulelwa kulabo abakunethiwekhi yohlelo.

Yimiphi imishini nezinsiza ezihlanganiswayo?

I-Medicare izokhipha ingxenye yezindleko zemishini yokuqasha enikezela, igcine, futhi ihambise umoya-mpilo. Kunezinhlobo eziningana zezinhlelo ze-oxygen ezikhona, kufaka phakathi igesi ecindezelwe, i-oxygen engamanzi, kanye nezigxili ze-oxygen ezithwalayo.

Nasi ukubuka konke kokuthi uhlelo ngalunye lusebenza kanjani:

• Izinhlelo zegesi ezicindezelwe. Lawa angama-oxygen concentrators amile anezinyawo ezingama-50 zokubhabha ezixhuma kumathangi amancane e-oxygen. Amathangi alethwa ekhaya lakho ngokuya ngenani lomoya-mpilo odingekayo ukwelapha isimo sakho. Umoya-mpilo uphuma ethangini ngedivayisi elawulayo elondoloza umoya-mpilo. Lokhu kuyivumela ukuthi ilethwe kuwe ngama-pulses kunokusakazwa okuqhubekayo.
• Izinhlelo zomoya-mpilo. Indawo yokugcina umoya-mpilo iqukethe i-oxygen engamanzi oyisebenzisela ukugcwalisa ithangi elincane, njengoba kudingeka. Uxhuma echibini ngamamitha angu-50 weshubhu.
• I-oxygen concentrator ephathekayo. Le inketho encane kunazo zonke, ehamba kakhulu futhi ingafakwa njengobhaka noma ihanjiswe ngamasondo. Lezi zingxenye zikagesi azidingi ukugcwaliswa kwamathangi futhi ziza nezinyawo eziyisi-7 kuphela zeshubhu. Kepha kubalulekile ukwazi ukuthi i-Medicare ihlanganisa ama-oxygen concentrators aphathekayo kuphela ezimweni ezithile kakhulu.

I-Medicare izomboza amayunithi e-oxygen amile ukuze asetshenziswe ekhaya. Lokhu kufakwa kuhlanganisa:

• ishubhu lomoya-mpilo
• impumulo yamakhala noma okokukhuluma
• oketshezi noma igesi oksijini
• ukunakekelwa, ukugcinwa, kanye nokulungiswa kweyunithi yomoya-mpilo

I-Medicare ibuye ihlanganise ezinye izindlela zokwelapha ezihlobene nomoya-mpilo, ukwelashwa okuqhubekayo okucindezelayo komoya (CPAP). Ukwelashwa kwe-CPAP kungadingeka kwizimo ezinjenge-obstructive sleep apnea.

Ngikufanelekela kanjani ukumbozwa?

Ake sihlole izindlela okufanele uhlangabezane nazo ze-Medicare ukumboza imishini yakho yokuqashwa komoya-mpilo ekhaya:

• Ukuqinisekisa ukuthi ukwelashwa kwakho komoya-mpilo kuhlanganiswa ngaphansi kwe-Medicare Part B, kufanele kutholakale ukuthi unesimo esifanelekile sezokwelapha futhi une-oda likadokotela lokwelashwa komoya-mpilo.
• Kufanele uvivinye okuthile okukhombisa isidingo sakho sokwelapha i-oxygen. Okunye ukuhlolwa kwegazi, futhi imiphumela yakho kufanele iwele ebangeni elicacisiwe.
• Udokotela wakho kufanele a-odole inani elithile, isikhathi, nobuningi beoksijini oyidingayo. Ama-oda e-oksijeni ngesisekelo esidingeka ngaso ngokuvamile awafanele ukutholakala ngaphansi kwe-Medicare Part B.
• Ukuze ufanelekele ukumbozwa, i-Medicare ingadinga nokuthi udokotela wakho akhombise ukuthi uke wazama ezinye izindlela zokwelapha, njengokuvuselelwa kwamaphaphu, ngaphandle kwempumelelo ephelele.
• Kufanele uthole imishini yakho yokuqasha nakuba umphakeli obamba iqhaza kwiMedicare futhi amukela isabelo. Ungathola abahlinzeki abavunyelwe yi-Medicare lapha.

Kusebenza kanjani ukuqashwa kwemishini?

Lapho ufanelekela ukwelashwa komoya-mpilo, i-Medicare ayikuthengeli ngqo leyo mishini. Esikhundleni salokho, ihlanganisa ukuqashwa kohlelo lwe-oxygen izinyanga ezingama-36.

Ngaleso sikhathi, unesibopho sokukhokha amaphesenti angama-20 emali yokuqasha. Imali yokuqasha ihlanganisa iyunithi le-oksijini, i-tubing, imaski kanye ne-cannula yamakhala, igesi noma i-oksijeni engamanzi, nezindleko zensizakalo nokugcinwa.

Lapho isikhathi sokuqala sokuqasha sezinyanga ezingama-36 sesiphelile, umphakeli wakho kudingeka aqhubeke nokuhlinzeka nokugcina okokusebenza kuze kube yiminyaka emi-5, inqobo nje uma usenaso isidingo sokwelashwa ngaso. Umphakeli usenemishini, kepha imali yanyanga zonke yokuqasha iphela ngemuva kwezinyanga ezingama-36.

Noma sekuphelile ukukhokha kokuqasha, abakwaMedicare bazoqhubeka nokukhokha isabelo sabo sezinto ezidingekayo ukusebenzisa imishini, njengokulethwa kwegesi noma oksijini oketshezi. Njengezindleko zokuqasha imishini, i-Medicare izokhokha amaphesenti angama-80 alezi zindleko eziqhubekayo zokuhlinzeka. Uzokhokha i-Medicare Part B yakho ekhishwayo, i-premium yenyanga, namaphesenti angama-20 wezindleko ezisele.

Uma usadinga ukwelashwa komoya-mpilo ngemuva kweminyaka emihlanu, kuzoqala inkathi entsha yokuqasha yezinyanga ezingama-36 nolayini wesikhathi seminyaka emihlanu.

Okuningi mayelana nokwelashwa komoya-mpilo

Ungadinga ukwelashwa komoya-mpilo ukwelapha esinye sezimo eziningi ezahlukahlukene.

Kwezinye izimo, ukuhlukumezeka noma ukugula okunzima kunganciphisa amandla akho okuphefumula ngempumelelo. Ngezinye izikhathi, isifo esinjenge-COPD singashintsha amakhemikhali amagesi asegazini lakho, sehlise inani lomoya-mpilo ongawusebenzisa umzimba wakho.

Nalu uhlu lwezimo ezithile ezingadinga ukuthi usebenzise ukwelashwa kwe-oxygen ngezikhathi ezithile noma okuqhubekayo ekhaya:

• I-COPD
• inyumoniya
• isifuba somoya
• ukuhluleka kwenhliziyo
• i-cystic fibrosis
• ukulala ubuthongo
• isifo samaphaphu
• ukuhlukumezeka kokuphefumula

Ukunquma ukuthi isimo sakho sidinga ukwelashwa kwe-oxygen ekhaya, udokotela wakho uzokwenza izivivinyo ezahlukahlukene ezilinganisa ukusebenza kokuphefumula kwakho. Izimpawu ezingaholela udokotela wakho ukuthi aphakamise lezi zivivinyo zifaka:

• ukuphelelwa umoya
• i-cyanosis, okuyithoni ephaphathekile noma eluhlaza okwesibhakabhaka esikhunjeni noma ezindebeni zakho
• ukudideka
• ukukhwehlela noma ukuphefumula
• ukujuluka
• ukuphefumula okusheshayo noma ukushaya kwenhliziyo

Uma unalezi zimpawu, udokotela wakho uzokwenza izivivinyo ezithile. Lokhu kungafaka imisebenzi yokuphefumula noma yokuvivinya umzimba, ukuhlolwa kwegesi yegazi, nezilinganiso zokugcwaliswa komoya-mpilo. Amathuluzi akhethekile angasetshenziswa ekuhlolweni komsebenzi, futhi ukuhlolwa kwegesi yegazi kudinga ukudonswa kwegazi.

Ukuhlolwa kokugcwaliswa komoya-mpilo nge-oximeter yokushaya emunweni wakho kuyindlela encane kakhulu yokuhlasela yokubheka izinga le-oxygen yakho.

Imvamisa, abantu abane-oxygen eyehlela phakathi kwamaphesenti angama-88 kanye namaphesenti angama-93 ku-oximeter ye-pulse bazodinga ukwelashwa komoya-mpilo, okungenani ngezikhathi ezithile. Imihlahlandlela yokuthi ingakanani i-oksijini ongayisebenzisa nokuthi izoncika kusimo sakho esithile.

Kwezinye izimo, udokotela wakho angakuyalela ukuvuselelwa kwamaphaphu ngaphezu kokwelapha i-oxygen.

Ukuvuselelwa kwamaphaphu kusiza abantu abanesimo esinjenge-COPD ukuthi bafunde ukusilawula futhi bajabulele impilo engcono. Ukuvuselelwa kwamapulmonary kuvame ukufaka imfundo ngamasu okuphefumula kanye namaqembu okusekela ontanga. Lokhu kwelashwa kweziguli kuvame ukumbozwa yiMedicare Part B.

Ukwelashwa kwe-oxygen kufanele kuphathwe njenganoma imuphi omunye umuthi. Udinga ukusebenza nodokotela wakho ukuthola ukwelashwa okulungile, isilinganiso, nobude besimo sakho esithile. Njengoba umoya-mpilo omncane kakhulu ungakulimaza, ne-oxygen eningi kakhulu nayo ingaba nezingozi. Kwesinye isikhathi, udinga kuphela ukusebenzisa i-oxygen isikhashana. Qiniseka ukuthi ukhuluma nodokotela wakho futhi ungene njalo uma udinga - noma ucabanga ukuthi ungadinga - ukwelashwa kwe-oxygen ekhaya.

Ukusebenzisa imikhiqizo ye-oxygen ngokuphepha

I-oksijeni igesi evutha kakhulu, ngakho-ke udinga ukuthatha izinyathelo ezithile zokuphepha lapho usebenzisa imishini yomoya-mpilo yasekhaya. Nawa amathiphu ambalwa:

• Ungabhemi noma usebenzise amalangabi avulekile nomaphi lapho i-oxygen yasekhaya isetshenziswa khona.
• Faka uphawu emnyango wakho ukuze izivakashi zazi ukuthi kukhona iyunithi le-oxygen lasekhaya elisetshenziswayo.
• Beka ama-alamu omlilo kulo lonke ikhaya lakho futhi uhlole njalo ukuthi ayasebenza yini.
• Qaphela lapho upheka.
• Qaphela ukuthi i-oxygen tubing nezinye izesekeli zingaletha ingozi yokuwa ngoba ungazikhubekisa.
• Gcina amathangi oksijini endaweni evulekile kodwa evikelekile.

Ukuthatha

• I-oksijeni kufanele isetshenziswe njalo ngaphansi kweso kanye nodokotela wakho.
• Qaphela lapho usebenzisa i-oxygen, bese ulandela zonke izindlela zokuphepha.
• Uma udinga i-oxygen yasekhaya futhi ubhalise engxenyeni B, i-Medicare kufanele ifake iningi lezindleko zakho.
• I-Medicare kungenzeka ingavali imishini ethile yomoya-mpilo, njengama-concentrator aphathekayo.
• Sebenza nodokotela wakho ukuthola ukwelashwa okungcono kakhulu kwesimo sakho nokusabalala.
• Hlala ukhuluma nodokotela wakho uma ucabanga ukuthi izidingo zakho zomoya-mpilo zishintshile.