Ngabe Ukuphathwa Kwezinhlungu Kwezokwelapha Kuyasiza?

-Delile

• Yini i-Medicare ehlanganisa ukuphathwa kobuhlungu?
• Ingxenye yeMedare B
• Ingxenye yeMedare D
• Ukuphathwa kobuhlungu ngesikhathi sokwelashwa kweziguli
• Ukufaneleka kokumbozwa
• Izindleko zeMedicare Part A
• Izindleko zeMedicare Part C
• Ukwelashwa kwabangaphandle
• Ukufaneleka kokumbozwa
• Izindleko zeMedicare Part B
• Imithi
• Imithi kadokotela
• Izidakamizwa ze-Over-the-counter (OTC)
• Kungani ngingadinga ukuphathwa kobuhlungu?
• Ezinye izindlela zokuphathwa kobuhlungu
• Ukuthatha

• I-Medicare ihlanganisa izindlela zokwelashwa nezinsizakalo ezahlukahlukene ezisetshenziselwa ukuphathwa kobuhlungu.
• Imithi elawula ubuhlungu ihlanganiswa ngaphansi kwe-Medicare Part D.
• Izindlela zokwelapha nezinsizakalo zokuphathwa kobuhlungu zimbozwe ngaphansi kwe-Medicare Part B.
• Izinhlelo zeMedicare Advantage nazo zimboza okungenani imithi kanye nezinsizakalo ezifanayo njengezingxenye B noD.

Igama elithi "ukuphathwa kobuhlungu" lingafaka izinto eziningi ezahlukene. Abanye abantu bangadinga ukuphathwa kobuhlungu besikhashana ngemuva kokuhlinzwa noma ukulimala. Abanye bangadinga ukuphatha ubuhlungu besikhathi eside besimo esifana ne-arthritis, i-fibromyalgia, noma amanye ama-syndromes obuhlungu.

Ukuphathwa kobuhlungu kungabiza ngakho-ke ungahle uzibuze ukuthi i-Medicare iyakufihla yini. I-Medicare ihlanganisa izindlela eziningi zokwelashwa nezinsizakalo ozozidinga zokuphathwa kobuhlungu.

Funda ukuze ufunde ukuthi iziphi izingxenye zeMedicare ezimboza izindlela zokwelashwa nezinsizakalo ezahlukahlukene, izindleko ongazilindela, nokuningi ngezindlela eziningi izinhlungu ezingaphathwa ngazo.

Yini i-Medicare ehlanganisa ukuphathwa kobuhlungu?

I-Medicare inikeza ukumbozwa kokwelashwa okuningi nezinsizakalo ezidingekayo ukuphatha izinhlungu. Nakhu ukubuka konke kwezingxenye ezikumbozayo nokuthi yiziphi izindlela zokwelashwa ezifakiwe.

Ingxenye yeMedare B

I-Medicare Part B, umshuwalense wakho wezokwelapha, izobheka izinsizakalo ezilandelayo ezihlobene nokuphathwa kobuhlungu:

• Ukuphathwa kwemithi. Ngaphambi kokudingeka kungadingeka ngaphambi kokuthi ugcwalise imishanguzo yezinhlungu. Unganikezwa nenani elilinganiselwe.
• Izinsizakalo zokuhlanganiswa kwezempilo. Kwesinye isikhathi, abantu abanezinhlungu ezingapheli nabo bangaba nezinkinga zokukhathazeka nokudangala. I-Medicare ihlanganisa izinsizakalo zezempilo zokuziphatha ukusiza ukuphatha lezi zimo.
• Ukwelashwa ngokomzimba. Kuzo zombili izingqinamba ezibuhlungu nezingapheli, ukwelashwa ngokomzimba kungabekwa ngudokotela wakho ukusiza ukuphatha ubuhlungu bakho.
• Ukwelashwa emsebenzini. Lolu hlobo lwezokwelapha lusiza ekubuyiseleni emisebenzini yakho ejwayelekile yansuku zonke ongeke ukwazi ukuyenza ngenkathi usezinhlungwini.
• Ukuxhaphaza umgogodla we-Chiropractic. Ingxenye B ihlanganisa ukulawulwa okulinganiselwe komgogodla uma kunesidingo kwezokwelapha ukulungisa ukuhlukunyezwa.
• Ukuphuza ngokweqile ukuhlolwa nokululekwa ngokomqondo. Kwesinye isikhathi, ubuhlungu obungapheli bungaholela ekusebenziseni kabi izidakamizwa. I-Medicare ihlanganisa ukuhlolwa nokululekwa kwalokhu futhi.

Ingxenye yeMedare D

I-Medicare Part D (ukunikezwa kwemithi kadokotela) izokusiza ukukhokhela imishanguzo nezinhlelo zakho zokuyilawula. Izinhlelo zokuphathwa kwemithi yokwelashwa ziyambozwa futhi zinganikeza usizo lokuhamba ngezidingo zezempilo eziyinkimbinkimbi. Imvamisa, imishanguzo yezinhlungu ze-opioid, efana ne-hydrocodone (Vicodin), i-oxycodone (i-OxyContin), i-morphine, i-codeine, ne-fentanyl, inikezwa ukusiza ukukhulula izimpawu zakho.

Ukuphathwa kobuhlungu ngesikhathi sokwelashwa kweziguli

Ungathola ukuphathwa kobuhlungu uma uyisiguli esingalaliswayo esibhedlela noma esikhungweni sokunakekelwa kwesikhathi eside ngenxa yezizathu ezilandelayo:

• ingozi yemoto noma ukulimala okukhulu
• ukuhlinzwa
• ukwelashwa kwesifo esibi (isibonelo, umdlavuza)
• ukunakekelwa kokuphela kokuphila (i-hospice)

Ngenkathi ungeniswa esibhedlela, ungadinga izinsizakalo ezahlukahlukene noma izindlela zokwelapha ukuphatha izinhlungu zakho, kufaka phakathi:

• i-epidural noma eminye imijovo yomgogodla
• imithi (kokubili i-narcotic ne-non-narcotic)
• ukwelashwa emsebenzini
• ukwelashwa ngokomzimba

Ukufaneleka kokumbozwa

Ukuze ufanelekele ukumbozwa, kufanele ubhalise ohlelweni lokuqala lweMedicare noma uhlelo lweMedicare Part C (Medicare Advantage). Ukuhlala kwakho esibhedlela kufanele kubonakale kudingekile ngokwezokwelapha ngudokotela futhi isibhedlela kufanele sibambe iqhaza kwiMedicare.

Izindleko zeMedicare Part A

I-Medicare Part A ingumshwalense wakho wesibhedlela. Ngenkathi ungeniswa esibhedlela, uzoba nesibopho sezindleko ezilandelayo ngaphansi kweNgxenye A:

• $1,408 kudonswa isikhathi ngasinye senzuzo ngaphambi kokufakwa kokufakwa
• $0 i-coinsurance yesikhathi ngasinye senzuzo ezinsukwini zokuqala ezingama-60
• $352 i-coinsurance ngosuku ngalunye lwenzuzo yezinsuku ezingama-61 kuya kwezingu-90
• $704 i-coinsurance ngosuku ngalunye “lwenqolobane yesikhathi sokuphila” ngemuva kosuku lwama-90 esikhathini ngasinye senzuzo (kufika ezinsukwini ezingama-60 esikhathini sokuphila kwakho)
• Amaphesenti ayi-100 wezindleko ngaphezu kwezinsuku zakho zokugcina isikhathi sokuphila

Izindleko zeMedicare Part C

Izindleko ezingaphansi kohlelo lweMedicare Part C zizohluka futhi kuzoya ngokuthi unaluphi uhlelo nokuthi ukhethe ukwaziswa okungakanani. Ukumboza onakho ngaphansi kohlelo C lwengxenye C kufanele okungenani kube okulingana nalokho okushiwo yiMedicare yangempela.

Ukwelashwa kwabangaphandle

Ezinye izinhlobo zokuphathwa kobuhlungu bokugula zibuye zimbozwe ngaphansi kwe-Medicare Part B. Lokhu kufaka izinto ezinjenge:

• ukuphathwa kwemithi
• ukuphathwa komgogodla, uma kunesidingo kwezokwelapha
• imijovo yokugula (imijovo ye-steroid, imijovo ye-epidural)
• i-transcutaneous electrical nerve stimulation (TENS) yezinhlungu ngemuva kwenqubo yokuhlinzwa
• i-autogenous epidural blood graft (i-blood patch) yezinhlungu zekhanda ngemuva kompompi we-epidural noma womgogodla

Ukufaneleka kokumbozwa

Ngaphambi kokuthi lezi zinsizakalo nezinqubo zimbozwe, udokotela obhaliswe yi-Medicare kufanele aqinisekise ukuthi ziyadingeka ngokwezokwelapha ukwelapha isimo sakho.

Izindleko zeMedicare Part B

Ngaphansi kweMedicare Part B, unesibopho sokukhokha:

• An $198 imali ebanjwayo yonyaka, okumele ihlangatshezwe unyaka nonyaka ngaphambi kokuba kuhlinzekelwe noma yiziphi izinsizakalo ezidingekayo kwezokwelapha
• Iphrimiyamu yakho yanyanga zonke, okuyi- $144.60 kubantu abaningi ngo-2020

Imithi

Imithi kadokotela

I-Medicare Part D ihlinzeka ngemithi kadokotela. Zombili izingxenye D nezinye izinhlelo zeMedicare Part C / Medicare Advantage zihlanganisa imishanguzo eminingi engabelwa ukuphathwa kobuhlungu. Lezi zinhlelo zingabandakanya nezinhlelo zokuphathwa kokwelashwa uma unezidingo eziyinkimbinkimbi zokunakekelwa kwezempilo.

Imithi ejwayelekile engasetshenziswa ekuphathweni kobuhlungu ifaka, kepha ayikhawulelwanga ku:

• imishanguzo yobuhlungu be-narcotic efana ne-Percocet, i-Vicodin, noma i-oxycodone
• i-gabapentin (umuthi wezinhlungu wezinzwa)
• i-celecoxib (umuthi olwa nokuvuvukala)

Le mithi itholakala ngamafomu ejwayelekile nawomkhiqizo. Imithi ehlanganisiwe izoncika kuhlelo lwakho oluthile. Izindleko zizohluka kusuka ohlelweni lokuhlela, njengoba inani lokutholakala kwemithi ehlukile lizohluka. Izindleko zizoncika kwifomula yohlelo lwakho ngawodwana, esebenzisa uhlelo lwezigaba ukuhlanganisa izidakamizwa zibe yizindleko eziphezulu, eziphakathi neziphansi.

Kubalulekile ukuya kumhlinzeki wezempilo obambe iqhaza nasekhemisi ukuthola imiyalo yakho ye-Medicare Part D. Engxenyeni C, kufanele usebenzise abahlinzeki be-in-network ukuqinisekisa izinzuzo ezigcwele.

Umhlinzeki wakho wezokunakekelwa kwempilo kufanele akunikeze izinketho ezahlukahlukene zokwelapha ubuhlungu bakho, hhayi nje imishanguzo ye-narcotic. Ngokwanda kwama-opioid overdoses ezikhathini zamuva, kugcizelelwa kakhulu ukusetshenziswa kwe-narcotic ephephile.

Kungakuhle ukuthola umbono wesibili ukubona ukuthi ezinye izinketho ezingezona ezezidakamizwa, njengokwelapha ngokomzimba, zingakusiza ngesimo sakho.

Izidakamizwa ze-Over-the-counter (OTC)

Imithi ye-OTC engasetshenziselwa ukuphathwa kobuhlungu ifaka:

• acetaminophen
• ibuprofen
• umabhebhana
• ama-lidocaine patches noma eminye imithi yokwelapha

I-Medicare Part D ayihlanganisi imishanguzo ye-OTC, kuphela imithi kadokotela. Ezinye izinhlelo ze-Part C zingafaka isabelo sale mithi. Hlola ngohlelo lwakho mayelana nokumbozwa futhi ugcine lokhu engqondweni lapho uthenga uhlelo lweMedicare.

Kungani ngingadinga ukuphathwa kobuhlungu?

Ukuphathwa kobuhlungu kufaka ukwelashwa, izindlela zokwelashwa, kanye nezinsizakalo ezisetshenziselwa ukwelapha ubuhlungu obukhulu nobungapheli. Ubuhlungu obunzima buvame ukuhlotshaniswa nokugula okusha noma ukulimala. Izibonelo zobuhlungu obukhulu zifaka:

• ubuhlungu ngemuva kokuhlinzwa
• ubuhlungu ngemuva kwengozi yemoto
• amathambo aphukile noma iqakala
• ubuhlungu bokuqhekeka

Izibonelo zezimo ezibuhlungu ezingapheli zifaka:

• ubuhlungu bomdlavuza
• i-fibromyalgia
• isifo samathambo
• amadiski e-herniated emhlane wakho
• ubuhlungu obungapheli

Ezinye izindlela zokuphathwa kobuhlungu

Ngaphezu kwemithi yezinhlungu nokwelashwa ngokomzimba, kunezinye izindlela zokulawula ubuhlungu obungapheli. Abantu abaningi bathola ukukhululeka ngezindlela ezilandelayo zokwelapha:

• i-acupuncture, empeleni manje ehlanganiswa ngaphansi kwe-Medicare yabantu abanezinkinga ngezinhlungu ezisezingeni eliphansi
• I-CBD noma amanye amafutha abalulekile
• ukwelashwa okubandayo noma okushisa

Eziningi zalezi azimboziwe yi-Medicare kepha hlola ngecebo lakho elithile ukubona ukuthi ngabe ukwelashwa kuhlanganisiwe yini.

Ukuthatha

• Izindlela zokwelashwa nezinsizakalo zokuphathwa kobuhlungu ngokuvamile zimbozwa yizinhlelo eziningi zeMedicare uma ziqinisekiswa njengezidingo zezempilo ngumhlinzeki wezokunakekelwa kwempilo.
• Ukutholakala kwe-Medicare Advantage kungahluka kusuka kuhlelo lokuhlela, ngakho-ke qiniseka ukuthi ubuza nomhlinzeki wakho womshuwalense mayelana nokuthi yini ehlanganiswe ngaphansi kohlelo lwakho oluthile.
• Kunezinye izinketho eziningi ongazihlola ukuphatha ubuhlungu ngaphandle kwemithi yezinhlungu ze-narcotic.

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.