Ingabe Ukwelashwa Kwemvelo Kumbozwe Ngu-Medicare?

-Delile

• Ngabe i-Medicare ikufaka nini ukwelashwa ngokomzimba?
• Ukubheka kanye nezinkokhelo
• Yiziphi izingxenye zeMedicare ezimboza ukwelashwa ngokomzimba?
• Ingxenye A
• Ingxenye B
• Ingxenye C
• Ingxenye D
• I-Medigap
• Kubiza malini ukwelashwa ngokomzimba?
• Kulinganiselwa izindleko zakho eziphuma ephaketheni
• Yiziphi izinhlelo zeMedicare ezingaba ngcono uma wazi ukuthi udinga ukwelashwa ngokomzimba?
• Okubalulekile

I-Medicare ingasiza ukukhokhela ukwelashwa ngokomzimba (PT) okubhekwa njengokudingekile kwezokwelapha. Ngemuva kokuhlangana neNgxenye B yakho ekhishwe, eyi- $ 198 ka-2020, i-Medicare izokhokha amaphesenti angu-80 wezindleko zakho ze-PT.

I-PT ingaba yingxenye ebalulekile yokwelashwa noma yokululama kwezimo ezahlukahlukene. Igxila ekubuyiseleni ukusebenza, ukuqeda izinhlungu, nokukhuthaza ukunyuka kokuhamba.

Abelaphi bomzimba basebenza eduze nawe ukwelapha noma ukuphatha izimo ezahlukahlukene, kufaka phakathi kepha kungagcini ekulimaleni kwemisipha, unhlangothi, nesifo sikaParkinson.

Qhubeka ufunda ukuthola ukuthi iziphi izingxenye zeMedicare ezimboza i-PT nokuthi nini.

Ngabe i-Medicare ikufaka nini ukwelashwa ngokomzimba?

I-Medicare Part B izosiza ukukhokhela i-PT yesiguli esingalapheki edingeka ngokwezempilo. Isevisi ibhekwa njengesidingo sokwelashwa lapho idingeka ukuxilonga okunengqondo noma ukwelapha isimo noma ukugula. I-PT ingathathwa njengedingekile uku:

• thuthukisa isimo sakho samanje
• gcina isimo sakho samanje
• kancane ukuwohloka okuqhubekayo kwesimo sakho

Ukuze i-PT imbozwe, kufanele ibandakanye izinsizakalo ezinamakhono ezivela kochwepheshe abaqeqeshiwe njengokwelapha ngokomzimba noma udokotela. Isibonelo, into efana nokuhlinzeka ngokuzivocavoca okujwayelekile kokuqina komzimba ngeke ihlanganiswe njenge-PT ngaphansi kweMedicare.

Uchwepheshe wakho womzimba kufanele akunikeze isaziso esibhaliwe ngaphambi kokukunikeza nganoma yiziphi izinsizakalo ezingeke zambozwa ngaphansi kweMedicare. Ngemuva kwalokho ungakhetha ukuthi uyawafuna yini lawa masevisi.

Ukubheka kanye nezinkokhelo

Uma usuhlangane ne-Part B yakho ekhishwayo, eyi- $ 198 ka-2020, i-Medicare izokhokha amaphesenti angama-80 wezindleko zakho ze-PT. Uzoba nesibopho sokukhokha amaphesenti angu-20 asele. Akusekho i-cap ezindlekweni ze-PT ezokhokhelwa yi-Medicare.

Ngemuva kokuthi izindleko zakho eziphelele ze-PT zidlule umkhawulo othile, umelaphi wakho ngokomzimba uyadingeka ukuze aqinisekise ukuthi izinsizakalo ezinikezwayo zihlala zidingekile ngokwezempilo ngesimo sakho. Okwe-2020, lo mbundu ngu- $ 2,080.

Uchwepheshe wakho womzimba uzosebenzisa imibhalo ukukhombisa ukuthi ukwelashwa kwakho kuyadingeka kwezokwelapha. Lokhu kufaka phakathi ukuhlolwa kwesimo sakho nenqubekela phambili kanye necebo lokwelashwa ngolwazi olulandelayo:

• ukuxilongwa
• uhlobo oluthile lwe-PT ozoluthola
• izinhloso zesikhathi eside zokwelashwa kwakho kwe-PT
• inani lamaseshini we-PT ozowathola ngosuku olulodwa noma ngesonto elilodwa
• inani eliphelele lama-PT sessions adingekayo

Lapho inani eliphelele le-PT lidlula u- $ 3,000, kungenziwa ukubuyekezwa kwezokwelapha okuhlosiwe. Kodwa-ke, akuzona zonke izimangalo ezingaphansi kwale nqubo yokubuyekeza.

Yiziphi izingxenye zeMedicare ezimboza ukwelashwa ngokomzimba?

Ake sihlukanise izingxenye ezahlukahlukene zeMedicare nokuthi ukumbozwa okunikeziwe kuhlobene kanjani ne-PT.

Ingxenye A

I-Medicare Part A ngumshwalense wesibhedlela. Ifaka izinto ezifana:

• ukuhlala kweziguli ezindaweni ezifana nezibhedlela, izikhungo zezempilo yengqondo, izikhungo zokuhlumelelisa, noma izikhungo zabahlengikazi ezinamakhono
• ukunakekelwa kwe-hospice
• ukunakekelwa kwempilo ekhaya

Ingxenye A ingafaka izinsizakalo zokuvuselelwa kweziguli kanye nezinsizakalo ze-PT lapho zibhekwa njengezidinga ngokwezempilo ukwenza ngcono isimo sakho ngemuva kokulaliswa esibhedlela.

Ingxenye B

I-Medicare Part B umshuwalense wezokwelapha. Ibandakanya izinsizakalo zokwelashwa kweziguli ezidingekayo. Ingxenye B ingabuye ihlanganise ezinye izinsizakalo zokuvimbela.

I-Medicare Part B ihlanganisa i-PT edingekayo kwezokwelapha. Lokhu kufaka kokubili ukuxilongwa nokwelashwa kwezimo noma ukugula okuthinta amandla akho okusebenza.

Ungathola lolu hlobo lokunakekelwa kulezi zinhlobo zezikhungo ezilandelayo:

• amahhovisi ezokwelapha
• abelaphi abazimele ngasese
• iminyango yabangalaliswa esibhedlela
• izikhungo zokuhlumelelisa iziguli ezingalalisiwe
• izindawo zabahlengikazi abanamakhono (lapho i-Medicare Part A ingasebenzi)
• ekhaya (usebenzisa umhlinzeki ovunyelwe yi-Medicare)

Ingxenye C

Izinhlelo zeMedicare Part C zaziwa nangokuthi izinhlelo zeMedicare Advantage. Ngokungafani nezingxenye A no-B, zinikezwa izinkampani ezizimele ezivunyelwe yi-Medicare.

Izinhlelo ze-Part C zifaka ukumbozwa okuhlinzekwa izingxenye A no-B. Lokhu kufaka phakathi i-PT edingekayo kwezokwelapha. Uma unohlelo lwengxenye C, kufanele ubheke imininingwane ephathelene nanoma yimiphi imithetho eqondene nohlelo yezinsizakalo zokwelashwa.

Izinhlelo ze-Part C zingafaka futhi ezinye izinsizakalo ezingafakwanga ezingxenyeni A no-B, ezinjengamazinyo, umbono, nokutholakala kwezidakamizwa kadokotela (Ingxenye D). Okufakwe ohlelweni lwengxenye C kungahluka.

Ingxenye D

I-Medicare Part D iwukusetshenziswa kwezidakamizwa kadokotela. Ngokufana neNgxenye C, izinkampani ezizimele ezivunyelwe yiMedicare zinikela ngezinhlelo zeNgxenye D. Imithi ehlanganisiwe ingahluka ngohlelo.

Izinhlelo zeNgxenye D azihlanganisi i-PT. Kodwa-ke, uma imishanguzo kadokotela iyingxenye yokwelashwa kwakho noma uhlelo lokutakula, Ingxenye D ingawahlanganisa.

I-Medigap

IMedigap ibizwa nangokuthi umshwalense wokulekelela weMedicare. Lezi zinqubomgomo zidayiswa yizinkampani ezizimele futhi zingakhokhela ezinye izindleko ezingakhokhelwa izingxenye A no-B. Lokhu kungafaka:

• ukudonswa kwemali
• ama-copayments
• ukuqinisekiswa kwemali
• ukunakekelwa kwezokwelashwa lapho usohambweni olungaphandle kwe-United States

Yize iMedigap ingahle ingafaki i-PT, ezinye izinqubomgomo zingasiza ukumboza ama-copayments ahlobene noma ama-deductibles.

Kubiza malini ukwelashwa ngokomzimba?

Izindleko ze-PT zingahluka kakhulu futhi izinto eziningi zingathinta izindleko, kufaka phakathi:

• uhlelo lwakho lomshwalense
• uhlobo oluthile lwezinsizakalo ze-PT oludingayo
• isikhathi noma inani lamaseshini abandakanyeka ekwelashweni kwakho kwe-PT
• ngabe umelaphi wakho obizayo ubiza malini
• indawo okuyo
• uhlobo lwesikhungo osisebenzisayo

ICopay nayo ingaba yinto enkulu ezindlekweni ze-PT. Kwezinye izimo, i-copay yeseshini eyodwa ingaba. Uma udinga ukuba nezikhathi eziningi ze-PT, le ndleko ingangeza ngokushesha.

Ucwaningo oluvela ku-2019 luthole ukuthi izindleko ezijwayelekile ze-PT umuntu ngamunye obambe iqhaza kwakungu- $ 1,488 ngonyaka. Lokhu kwahluka ngokuxilongwa, ngezimo zemithambo yegazi kanye nezindleko ezihlanganyelwe zokuphindisela ziphakeme ngenkathi izimo ze-genitourinary ne-vertigo ziphansi.

Kulinganiselwa izindleko zakho eziphuma ephaketheni

Yize ungahle ungazi kahle ukuthi izokubiza malini i-PT, kungenzeka ukuthi uqhamuke nesilinganiso. Zama okulandelayo:

1. Khuluma nodokotela wakho womzimba ukuthola umbono wokuthi ukwelashwa kwakho kuzobiza malini.
2. Hlola ngohlelo lwakho lomshuwalense ukuthola ukuthi zingakanani lezi zindleko ezizokhokhwa.
3. Qhathanisa izinombolo ezimbili ukulinganisa inani ozodinga ukulikhokha uphuma ephaketheni. Khumbula ukufaka izinto ezinjengama-copays nama-deductibles kusilinganiso sakho.

Yiziphi izinhlelo zeMedicare ezingaba ngcono uma wazi ukuthi udinga ukwelashwa ngokomzimba?

Izingxenye ze-Medicare A no-B (Medicare yasekuqaleni) zimboza i-PT edingekayo kwezokwelapha. Uma wazi ukuthi uzodinga ukwelashwa ngokomzimba ngonyaka ozayo, ukuba nalezi zingxenye nje kungahlangabezana nezidingo zakho.

Uma ukhathazekile ngezindleko ezingeziwe ezingakhokhelwa izingxenye A no-B, ungahle uthande ukucabanga ngokwengeza uhlelo lweMedigap. Lokhu kungasiza ukukhokhela izinto ezinjenge-copays, ezingangezwa phakathi ne-PT.

Izinhlelo ze-Part C zifaka okuhlanganisiwe ezingxenyeni A no-B. Kodwa-ke, zingabandakanya nezinsizakalo ezingamboziwe yilezi zingxenye. Uma uzodinga ukumbozwa kwamazinyo, umbono, noma izinhlelo zokufaneleka ngaphezu kwe-PT, cabanga ngohlelo lwengxenye C.

Ingxenye D ifaka ukumbozwa kwezidakamizwa kadokotela. Ingangezwa ezingxenyeni A no-B futhi ivame ukufakwa ezinhlelweni zeNgxenye C. Uma usuvele uthatha imishanguzo kadokotela noma wazi ukuthi ingaba yingxenye yohlelo lwakho lokwelashwa, bheka uhlelo lweNgxenye D.

Okubalulekile

I-Medicare Part B ihlanganisa i-PT yesiguli uma kunesidingo kwezokwelapha. Kudingeka ngokwezokwelapha ukuthi i-PT oyitholayo iyadingeka ukuxilonga noma ukwelapha isimo sakho.

Ayikho i-cap ezindlekweni ze-PT ezokhokhelwa yi-Medicare. Kodwa-ke, ngemuva komkhawulo othile umelaphi wakho womzimba uzodinga ukuqinisekisa ukuthi izinsizakalo ozitholayo ziyadingeka kwezokwelapha.

Ezinye izinhlelo zeMedicare, njengeNgxenye C neMedigap, nazo zingakhokhela izindleko ezihambisana ne-PT. Uma ubheka okukodwa kwalokhu, khumbula ukuqhathanisa izinhlelo eziningi ngaphambi kokukhetha eyodwa ngoba ukumbozwa kungahluka ngohlelo.

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.