Ingabe i-Medicare Cover Cover Pneumonia Shots?

-Delile

• Ukutholakala kwemithi ye-pneumonia
• Ukuhlanganiswa kwengxenye B
• Ukuhlanganiswa kwengxenye C
• Ibiza malini imigomo ye-pneumonia?
• Uyini umuthi wokugomela i-pneumonia?
• Iyini inyumoniya?
• Izimpawu zepneumonia ye-pneumococcal
• Ukuthatha

• Imishanguzo ye-pneumococcal ingasiza ukuvimbela ezinye izinhlobo zokutheleleka kwe-pneumonia.
• Imihlahlandlela yakamuva ye-CDC iphakamisa ukuthi abantu abaneminyaka engama-65 nangaphezulu kufanele bathole umuthi wokugoma.
• I-Medicare Part B ihlanganisa u-100% wazo zombili izinhlobo zemithi yokugoma ye-pneumonia etholakalayo.
• Izinhlelo zeMedicare Part C kumele futhi zihlanganise yomibili imigomo ye-pneumonia, kepha imithetho yenethiwekhi ingasebenza.

I-pneumonia ukutheleleka okuvamile okubandakanya iphaphu elilodwa noma womabili. Ukuvuvukala, ubomvu, noketshezi kungakha emaphashini, kwenze kube nzima ukuphefumula. Ngokusho kweCenters for Disease Control and Prevention (CDC), abantu bavakashela igumbi labezimo eziphuthumayo unyaka nonyaka ngenxa yenyumoniya.

Imishanguzo ye-pneumococcal ingavimbela ukutheleleka okuvamile kwamagciwane kusuka I-Streptococcus pneumoniae. Kunezinhlobo ezimbili zemithi yokugomela i-pneumonia etholakalayo ukuvikela izinhlobo ezithile zaleli bhaktheriya.

Ngenhlanhla, uma une-Medicare Part B noma i-Part C, uzombozwa ngazo zombili izinhlobo zemithi yokugoma ye-pneumococcal.

Ake sibhekisise imigomo ye-pneumonia nokuthi i-Medicare iwafaka kanjani.

Ukutholakala kwemithi ye-pneumonia

Imishanguzo eminingi yokuvikela imbozwe ngaphansi kweNgxenye D, ingxenye yezidakamizwa kadokotela eyiMedicare. I-Medicare Part B ihlanganisa imigomo ethile ethile, njengemithi yokugoma ye-pneumonia. Izinhlelo zeMedicare Advantage, kwesinye isikhathi ezibizwa ngeNgxenye C, ziphinde zihlanganise imigomo ye-pneumonia, kanye neminye imigomo ongayidinga.

Uma ubhalise kwi-Medicare yasekuqaleni (Ingxenye A noNgxenye B), noma uhlelo lweNgxenye C, uyafaneleka ukuthola imishanguzo ye-pneumonia. Njengoba kunezinhlobo ezimbili zemigomo yokugomela i-pneumonia, wena nodokotela wakho nizonquma ukuthi ngabe nidinga umuthi owodwa noma womabili yini. Sizongena emininingwaneni yezinhlobo ezimbili ezihlukile ngemuva kwesikhashana.

Ukuhlanganiswa kwengxenye B

I-Medicare Part B ihlanganisa izinhlobo ezilandelayo zemithi yokugoma:

• umuthi wokugomela umkhuhlane (umkhuhlane)
• umuthi wokugomela i-hepatitis B (kulabo abasengozini enkulu)
• imigomo ye-pneumococcal (yebhaktheriya I-Streptococcus pneumoniae)
• ukudubula ngqi (ukwelashwa ngemuva kokuchayeka)
• amarabi adutshulwa (ukwelashwa ngemuva kokuchayeka)

Ingxenye B imvamisa ikhokha izindleko ezingama-80% uma uvakashela abahlinzeki abavunyelwe yi-Medicare. Kodwa-ke, azikho izindleko eziphuma ephaketheni zemithi yokugoma embozwe yiNgxenye B. Lokho kusho ukuthi, uzokhokha u- $ 0 ngomuthi wokugoma, inqobo nje uma umhlinzeki emukela ukunikezwa kwe-Medicare.

Abahlinzeki abamukela isabelo bayavumelana namanani avunyelwe yi-Medicare, ngokuvamile aphansi kunamanani ajwayelekile. Abahlinzeka ngemithi kungaba odokotela noma osokhemisi. Ungathola umhlinzeki ovunyelwe yi-Medicare lapha.

Ukuhlanganiswa kwengxenye C

I-Medicare Part C, noma izinhlelo ze-Medicare Advantage, yizinhlelo zomshuwalense wangasese ezinikeza izinzuzo eziningi ezifanayo nezingxenye zokuqala ze-Medicare A no-B kanye nezinye izinketho ezingeziwe. Ngokomthetho, izinhlelo zeMedicare Advantage ziyadingeka ukuthi zinikeze okungenani inani elilinganayo lokutholakala njengeMedicare yasekuqaleni, ngakho-ke uzophinde ukhokhe u- $ 0 ngemithi yokugomela i-pneumonia ngalezi zinhlelo.

Izinhlelo zeMedicare Advantage ngokuvamile zinemikhawulo edinga ukuthi usebenzise abahlinzeki bezinsizakalo abakunethiwekhi yohlelo. Hlola uhlu lwakho lohlelo lwabahlinzeki be-in-network ngaphambi kokwenza i-aphoyintimenti yokugonywa ukuqinisekisa ukuthi zonke izindleko zizokhokhwa.

Ibiza malini imigomo ye-pneumonia?

I-Medicare Part B ihlanganisa i-100% yezindleko zemithi yokugoma ye-pneumococcal ngaphandle kokukhokha noma ezinye izindleko. Hlola ukuthi umhlinzeki wakho wamukela isabelo se-Medicare ngaphambi kokuvakasha ukuze kuqinisekiswe ukumbozwa okugcwele.

Izindleko zohlelo lweNgxenye B ngo-2020 zifaka imali ekhokhwa ngenyanga engu- $ 144.60 kanye nemali ebanjwayo engu- $ 198.

Kunezinhlelo eziningi ezahlukahlukene zeMedicare Advantage ezinikezwa izinkampani zomshuwalense wangasese. Ngamunye uza nezindleko ezihlukile. Buyekeza izinzuzo nezindleko zohlelo ngalunye ngesabelomali sakho esithile nezidingo zakho engqondweni ukuze wenze ukukhetha okuhle kakhulu ngesimo sakho.

Uyini umuthi wokugomela i-pneumonia?

Okwamanje kunezinhlobo ezimbili zemithi yokugoma ye-pneumococcal emboza izinhlobo ezahlukene zohlobo oluvamile lwama-bacteria (I-Streptococcus pneumoniae) okungaholela enyumoniya. Lolu hlobo lwamabhaktheriya lubeka ubungozi ezinganeni ezincane kepha futhi lungaba yingozi kulabo asebekhulile noma abenze buthaka amasosha omzimba.

Imithi yokugoma emibili yilena:

• umuthi wokugoma we-pneumococcal conjugate (PCV13 noma Prevnar 13)
• umuthi wokugoma we-pneumococcal polysaccharide (PPSV23 noma iPneumovax 23)

Ngokuya ngemininingwane yakamuva, ikomidi eleluleka nge-CDC lemikhuba yokugoma lincoma ukuthi abantu abaneminyaka engama-65 nangaphezulu kufanele bathole isibhamu iPneumovax 23.

Kodwa-ke, yomibili imijovo yokugoma ingadingeka ezimweni ezithile lapho kunengozi enkulu khona. Lezi zimo zingabandakanya:

• uma uhlala ekhaya labahlengikazi noma endaweni yokunakekela isikhathi eside
• uma uhlala endaweni enezingane eziningi ezingagonyiwe
• uma uhambela izindawo ezinesibalo esikhulu sezingane ezingagonyiwe

Nakhu ukuqhathanisa phakathi kwemithi yokugoma emibili etholakalayo:

Imithi yokugomela i-pneumonia ingavikela ukutheleleka okungathi sína kusuka ezinkingeni ezivame kakhulu zamagciwane e-pneumococcal.

Ngokusho kuka, kubantu abadala abaneminyaka engama-65 nangaphezulu, umuthi wokugomela i-PCV13 unezinga elisebenza ngama-75% kanti umuthi wokugoma we-PPSV23 unezinga elisebenza ngo-50% kuye ku-85% ngokuvikela abantu ezifweni ze-pneumococcal.

Xoxa ngezingozi zakho nodokotela wakho ukuze anqume ukuthi ngabe uzidinga zombili i-PCV13 ne-PPSV23 noma uma ukudubula okukodwa kwanele. Ingxenye B izomboza zombili izibhamu uma kudingeka futhi inikezwe okungenani unyaka owodwa ngokuhlukana. Kubantu abaningi, isibhamu esisodwa se-PPSV23 sanele.

Imiphumela emibi yemigomo yokugomela i-pneumococcal ngokuvamile imnene. Kubandakanya:

• ubuhlungu endaweni yomjovo
• ukuvuvukala
• imfiva
• ikhanda

Iyini inyumoniya?

Ukutheleleka kwe-pneumococcal okubangelwa I-Streptococcus pneumoniae kungaba mnene futhi kuvame njengokungenwa yizindlebe noma ukungenwa yisinus. Kodwa-ke, lapho ukutheleleka kusakazeka kwezinye izingxenye zomzimba, kungaba kubi kakhulu futhi kubangele inyumoniya, i-meningitis, ne-bacteremia (amabhaktheriya asemithanjeni yegazi).

Abanye abantu basengozini enkulu yokutheleleka nge-pneumonia. Babandakanya izingane ezineminyaka engaphansi kwemibili ubudala, abadala abaneminyaka engama-65 nangaphezulu, labo abanamasosha omzimba abuthakathaka, nalabo abanezinye izimo zezempilo ezingamahlalakhona njengesifo sikashukela, i-COPD, noma i-asthma.

I-pneumonia ingasakazeka kalula ngokuthimula, ukukhwehlela, ukuthinta indawo enegciwane, nokuba sezindaweni ezinamazinga aphezulu okutheleleka njengezibhedlela. Ngokusho kwe-, cishe umuntu omdala oyedwa kwabangu-20 ubulawa yi-pneumococcal pneumonia (ukutheleleka kwamaphaphu) uma bekuthola.

Izimpawu zepneumonia ye-pneumococcal

Ngokusho kwe-American Lung Association, izimpawu ze-pneumococcal pneumonia zingafaka:

• umkhuhlane, amakhaza, ukujuluka, ukuqhaqhazela
• ukukhwehlela
• ukuphefumula kanzima
• ubuhlungu besifuba
• ukulahlekelwa isifiso sokudla, isicanucanu nokuhlanza
• ukukhathala
• ukudideka

Funa usizo lwezokwelashwa khona manjalo uma kunzima ukuphefumula, izindebe eziluhlaza okwesibhakabhaka noma izingalo zeminwe, ubuhlungu besifuba, umkhuhlane omkhulu, noma ukukhwehlela okukhulu okunamafinyila.

Ngokuhambisana nemithi yokugoma, ungakhulisa imizamo ngokugeza izandla njalo, ukudla ukudla okunempilo, nokunciphisa ukuvezwa kwabantu abagulayo uma kungenzeka.

Ukuthatha

• Ukutheleleka kwe-pneumococcal kuvamile futhi kungahle kusuka kokuncane kuya kokubi.
• Imishanguzo ye-pneumonia yehlisa ingozi yokuthola izifo ezivamile ze-pneumococcal.
• I-Medicare Part B ihlanganisa i-100% yezindleko zezinhlobo ezimbili ezahlukene zomuthi wokugomela i-pneumonia.
• Khuluma nodokotela wakho uma ucabanga ukuthi udinga ukuthatha yomibili imigomo. I-PCV13 inikezwa kuqala, ilandelwe yi-PPSV23 okungenani unyaka owodwa kamuva.