Ingabe i-Medicare Cover Cover Rehab?

-Delile

• Ukutholakala kwemithi yokwelashwa kabusha kwamaphaphu
• Yiziphi izidingo engidinga ukuhlangabezana nazo ukuze ngimbozwe?
• Yiziphi izindleko okufanele ngizilindele?
• Ingxenye yeMedare B
• Ingxenye yeMedicare C
• I-Medigap
• Ingabe ukuvuselelwa kwamaphaphu kungifanele?
• Ukuthatha

• Ukuvuselelwa kwamapulmonary uhlelo lokugula ngaphandle olunikeza ukwelashwa, imfundo, nokusekelwa kwabantu abane-COPD.
• Ukufunda izindlela zokuphefumula ezifanele kanye nokuzivocavoca umzimba kuyizinto ezibalulekile zokuvuselelwa kwamaphaphu.
• Kunezinqubo ezithile okufanele uhlangane nazo ze-Medicare ukumboza izinsizakalo zakho zokuvuselela amaphaphu.
• I-Medicare Part B izokhokha ama-80% wezindleko zalezi zinsizakalo, inqobo nje uma ufanelekela ukutholakala.

Uma unesifo esingapheliyo esibi sokuphazamiseka kwamaphaphu (COPD), i-Medicare Part B izokhokha izindleko eziningi zokuvuselelwa kwamaphaphu.

Ukuvuselelwa kwamapulmonary wuhlelo olubanzi, olusebenza ngaphandle lweziguli oluhlanganisa imfundo nokuzivocavoca nokuxhaswa kontanga. Ngesikhathi sokuvuselelwa kwamaphaphu, uzofunda kabanzi nge-COPD nomsebenzi wamaphaphu. Uzofunda nokuzivocavoca umzimba okwenzelwe ukukusiza ukuthi uthole amandla futhi uphefumule kahle.

Ukuxhaswa kontanga kuyingxenye ebalulekile yokuvuselelwa kwamaphaphu. Ukubamba iqhaza emakilasini eqembu kunikeza ithuba lokuxhumana futhi ufunde kwabanye abantu ababelana ngesimo sakho.

Uhlelo lokuvuselelwa kwamaphaphu lungenza umehluko omkhulu kwikhwalithi yempilo kubantu abane-COPD.Funda ukuze ufunde kabanzi mayelana nokuthi i-Medicare ihlanganisa ini, ukuthi ungakufanelekela kanjani ukutholakala, nokuningi.

Ukutholakala kwemithi yokwelashwa kabusha kwamaphaphu

Abamukeli be-Medicare bahlanganiswa ngezinsizakalo zokuvuselelwa kwamaphaphu eziphuthumayo ngokusebenzisa i-Medicare Part B. Ukuze ufaneleke, kufanele ube nokudluliselwa okuvela kudokotela ophatha i-COPD yakho. Ungafinyelela ezinsizakalweni zokuvuselela amaphaphu ehhovisi likadokotela wakho, emtholampilo ozimele, noma esikhungweni sabangalaliswa esibhedlela.

Uma unecebo le-Medicare Advantage (Medicare Part C), ukumbozwa kwakho kwe-pulmonary rehab kuzoba okungenani kulingana nokuthi ungathola ini nge-Medicare yasekuqaleni. Kodwa-ke, izindleko zakho zingahluka, kuya ngohlelo onalo. Kungadingeka ukuthi usebenzise odokotela noma izikhungo ezithile ngaphakathi kwenethiwekhi yohlelo lwakho.

I-Medicare imboza izikhathi ezingama-36 zokuvuselela amaphaphu. Kodwa-ke, udokotela wakho angakwazi ukucela ukumbozwa kuze kube yizikhathi ezingama-72 uma kuthathwa njengezidingo zokwelashwa ukuze unakekelwe.

Yiziphi izidingo engidinga ukuhlangabezana nazo ukuze ngimbozwe?

Ukuze ufaneleke ukumbozwa ngokuvuselelwa kwamaphaphu, kufanele uqale ubhalise kwi-Medicare yasekuqaleni (izingxenye A no-B) futhi ube usesikhathini ngezinkokhelo zakho ze-premium. Ungabhaliswa futhi ohlelweni lweMedicare Advantage (Ingxenye C).

Udokotela okwelapha i-COPD kufanele akudlulisele ekuvuselelweni kwamaphaphu futhi asho ukuthi lezi zinsizakalo ziyadingeka ukwelapha isimo sakho.

Ukukala ukuthi i-COPD yakho inzima kangakanani, udokotela wakho uzonquma isigaba sakho se-GOLD (Global Initiative for Chronic Obstructive Lung Disease). Amazinga esiteji we-COPD GOLD yile:

• isigaba 1 (simnene kakhulu)
• isigaba 2 (ngokulinganisela)
• isigaba 3 (ezinzima)
• isigaba 4 (sibi kakhulu)

I-Medicare ikubheka njengofanelwe ukuvuselelwa kwamaphaphu uma i-COPD yakho isigaba 2 kuya esigabeni 4.

Ukuze uthole ukufakwa okuphezulu, qiniseka ukuthi udokotela wakho kanye nesikhungo sokuvuselela bamukela isabelo seMedicare. Ungasebenzisa leli thuluzi ukubheka udokotela noma indawo evunyelwe yi-Medicare eseduze nawe.

Yiziphi izindleko okufanele ngizilindele?

Ingxenye yeMedare B

Nge-Medicare Part B, uzokhokha imali ekhishwa minyaka yonke engama- $ 198, kanye ne-premium yenyanga. Ngo-2020, iningi labantu likhokha u- $ 144.60 ngenyanga ngeNgxenye B.

Uma usuhlangabezane neNgxenye B edonswayo, ubhekene kuphela nama-20% wezindleko ezivunyelwe yi-Medicare zokuvuselelwa kwakho kwamaphaphu. Izinsizakalo ozithola endaweni yokuthola iziguli ezingalalisiwe esibhedlela zingadinga nokuthi kukhokhwe imali ekhokhwa esibhedlela ngaso sonke isikhathi sesikhathi sokuya lapho uya khona.

Kwezinye izimo, udokotela wakho angancoma ukuthi ube nezikhathi eziningi zokuvuselela kunokuba iMedicare izimisele ukuyikhokhela. Uma kunjalo, ungazitholela izindleko zonke zamaseshini angeziwe.

Ingxenye yeMedicare C

Uma unecebo le-Medicare Advantage, amanani akho okudonswa, ama-copay kanye nama-premium angahluka. Xhumana nohlelo lwakho ngqo ukuthola ukuthi uzokhokhiswa malini ngalezi zinsizakalo ukuze ungamangali kamuva.

I-Medigap

Izinhlelo zeMedigap (Medicare supplement) zingahlanganisa ezinye izindleko ezingaphandle kwe-pocket ezivela kwi-Medicare yasekuqaleni. Uma unesimo esingelapheki, iMedigap ingahle izuzise ukugcina izindleko zakho zokuphuma ephaketheni ziphansi. Ungaqhathanisa izinhlelo zeMedigap zokuthola ezisebenza kangcono esimeni sakho.

Ingabe ukuvuselelwa kwamaphaphu kungifanele?

I-COPD yiqembu lezifo ezingalapheki, eziqhubekayo zamaphaphu. Izifo ezivame kakhulu eziwela ngaphansi kwe-COPD zifaka i-bronchitis engapheli ne-emphysema.

Ukuvuselelwa kwepulmonary kunezinzuzo eziningi futhi kungakusiza ufunde ukuphatha izimpawu zakho ze-COPD. Kungakusiza futhi ukuthi wenze ushintsho lwendlela yokuphila ukuze unciphise izimpawu zakho noma ukukhula kwesifo kancane kancane.

Lezi zinhlelo zokuvuselela zenzelwe ukuthuthukisa ikhwalithi yempilo nokuzimela kwalabo abaphila ne-COPD. Bayacelwa ukuthi banikeze ukusekelwa okuhlukile, okususelwa ebufakazini, nokusekelwa okuhlukahlukene okubandakanya:

• inqubo yokuzivocavoca enqunywe udokotela
• uhlelo lokwelashwa olwenzelwe umuntu ngamunye
• imfundo nokuqeqeshwa ekuphathweni kwezimpawu, imishanguzo nokusetshenziswa komoya-mpilo
• ukuhlolwa kwengqondo
• ukuhlolwa kwemiphumela

Ezinye izinhlelo zokuvuselela amaphaphu zingabandakanya:

• ukuqondiswa kokudla okunomuntu uqobo
• ukusiza ngokuphathwa kwengcindezi
• uhlelo lokuyeka ukubhema
• ukusekelwa kontanga nokuxhumana nezinye iziguli ze-COPD

URehab angakunika ithuba lokuhlangana futhi uxhumane nabanye abantu ababhekene neCOPD. Lolu hlobo lohlelo lokusekela lungabaluleka kakhulu.

Ukuthatha

• Ukuvuselelwa kwamaphaphu kungasiza kakhulu kubantu abane-COPD. Inikeza ngemfundo ehlukile, ukwesekwa namasu okuphatha izimpawu ze-COPD.
• Uzombozwa ngezikhathi zokuvuselelwa kwamaphaphu, uma udokotela ovunyelwe yi-Medicare ekunikeza ngokudluliswa okudingekayo kwalezi zinsizakalo.
• Gcina wazi ukuthi izindleko zingahluka ngokuya ngohlobo lwecebo le-Medicare onalo.