Ngabe i-Medicare iwuvala yini umuthi wokugomela iShingles?

-Delile

• Yiziphi izingxenye zeMedicare ezimboza umuthi wokugomela ama-shingles?
• Ubiza malini umuthi wokugomela ama-shingles?
• Amathiphu okonga izindleko
• Usebenza kanjani umuthi wokugomela ama-shingles?
• Shingrix
• Zostavax
• I-Shingrix vs. Zostavax
• Yini ama-shingles?
• Ukuthatha

• I-Centers for Disease Control and Prevention (CDC) incoma abantu abadala abanempilo abaneminyaka engama-50 nangaphezulu ukuthi bathole umuthi wokugomela i-shingles.
• I-Original Medicare (Ingxenye A neNgxenye B) ngeke ihlanganise umuthi wokugoma.
• Izinhlelo zeMedicare Advantage noma zeMedicare Part D zingahlanganisa zonke noma ingxenye yezindleko zomuthi wokugomela i-shingles.

Njengoba ukhula, maningi amathuba okuthi uthole ama-shingles. Ngenhlanhla, kukhona umuthi wokugoma ongavimbela lesi simo.

I-Medicare Part A ne-Part B ngeke zihlanganise imigomo ye-shingles (kukhona emibili ehlukene). Kodwa-ke, ungakwazi ukuthola ukumbozwa ngohlelo lwe-Medicare Advantage noma lwe-Medicare Part D.

Qhubeka ufunde ukuze uthole ukuthi ungakuthola kanjani ukumbozwa kweMedicare ngemithi yokugomela oshaka noma uthole usizo lwezezimali uma uhlelo lwakho lungahlanganisi umuthi wokugoma.

Yiziphi izingxenye zeMedicare ezimboza umuthi wokugomela ama-shingles?

I-Original Medicare, Ingxenye A (ukumbozwa kwesibhedlela) kanye neNgxenye B (ukumbozwa kwezokwelashwa), ayihlanganisi umuthi wokugomela ama-shingles. Kodwa-ke, kunezinye izinhlelo zeMedicare ezingabandakanya okungenani ingxenye yezindleko. Lokhu kufaka phakathi:

• Ingxenye yeMedicare C. Eyaziwa nangokuthi i-Medicare Advantage, i-Medicare Part C uhlelo ongaluthenga ngenkampani yomshwalense yangasese. Inganikela ngezinzuzo ezengeziwe ezingamboziwe yiMedicare yangempela, kufaka phakathi nezinsizakalo ezithile zokuvimbela. Izinhlelo eziningi zeMedicare Advantage zibandakanya ukumbozwa kwezidakamizwa kadokotela, okuzohlanganisa umuthi wokugomela amashoba.
• Ingxenye yeMedicare D. Le yingxenye yemithi kadokotela ehlanganisa imishanguzo futhi ihlanganisa “imishanguzo etholakalayo ezentengiselwano.” I-Medicare idinga izinhlelo ze-Part D ukumboza ama-shingles shot, kepha inani eliyihlanganisayo lingahluka kakhulu ohlelweni lokuhlela.

Kunezinyathelo ezimbalwa ongazithatha ukuqinisekisa ukuthi umuthi wokugoma we-shingles uyahlanganiswa uma une-Medicare Advantage ngokutholakala kwezidakamizwa noma i-Medicare Part D:

• Shayela udokotela wakho ukuthola ukuthi bangakwazi yini ukukhokhisa uhlelo lwakho lweNgxenye D ngqo.
• Uma udokotela wakho engakwazi ukukhokhisa uhlelo lwakho ngqo, cela udokotela wakho ukuthi axhumane nekhemisi eliku-in-network. Ikhemisi lingakwazi ukukunikeza umuthi wokugoma bese likhokhisa uhlelo lwakho ngqo.
• Faka ifayili lakho lokugoma ukuze ubuyiselwe imali ngohlelo lwakho uma ungakwazi ukwenza enye yezinketho ezingenhla.

Uma kufanele ufayele ukubuyiselwa imali, kuzodingeka ukhokhe inani eligcwele lesibhamu lapho usithola. Uhlelo lwakho kufanele lukukhokhele, kepha inani elihlanganisiwe lizohluka ngokuya ngohlelo lwakho nokuthi ikhemisi lalikunethiwekhi yakho.

Ubiza malini umuthi wokugomela ama-shingles?

Inani olikhokhela umuthi wokugomela ama-shingles lizoya ngokuthi uhlelo lwakho lwe-Medicare luhlanganisa malini. Khumbula ukuthi uma une-Medicare yasekuqaleni kuphela futhi ungenayo imishanguzo kadokotela oyisebenzisayo nge-Medicare, ungakhokha inani eligcwele lomuthi wokugoma.

Ama-Medicare drug plans aqoqa imithi yawo ngezigaba. Lapho umuthi uwela khona emgqeni unganquma ukuthi kubiza kangakanani. Iningi lezinhlelo zezidakamizwa zeMedicare lihlanganisa okungenani amaphesenti angama-50 entengo yokuthengisa yezidakamizwa.

I-Shingrix (inikezwe njengezibhamu ezimbili):

• I-copay ekhishwayo: kumahhala ku- $ 158 ngesibhamu ngasinye
• Ngemuva kokudonswa kwemali kuhlangatshezwe: kumahhala ku- $ 158 ngokudubula ngakunye
• Ibanga legebe lomgodi / lokumboza le-donut: likhululekile ku- $ 73 ngokudubula ngakunye
• Ngemuva komgodi wamadonathi: $ 7 kuye ku- $ 8

I-Zostavax (inikezwe njengesibhamu esisodwa):

• I-copay edonsiwe: kumahhala ku- $ 241
• Ngemuva kokudonswa kwemali kuhlangatsheziwe: kumahhala ku- $ 241
• Ibanga legebe lomgodi / lokumboza: mahhala lifike ku- $ 109
• Ngemuva komgodi wamadonathi: $ 7 kuye ku- $ 12

Ukuthola kahle ukuthi uzokhokha malini, buyekeza ifomula yohlelo lwakho noma uthinte uhlelo lwakho ngqo.

Amathiphu okonga izindleko

• Uma ufanelekela i-Medicaid, hlola ihhovisi le-Medicaid lesifundazwe sakho mayelana nokutholakala komuthi wokugomela i-shingles, ongaba mahhala noma unikezwe ngemali ephansi.
• Bheka usizo lwamakhambi kadokotela namakhuphoni kumawebhusayithi asiza ngezindleko zemithi. Izibonelo zifaka i-GoodRx.com neNeedyMeds.org. Lezi zingosi zingakusiza nokuthi ufune isivumelwano esingcono kakhulu sokuthi ungawuthola kuphi umuthi wokugoma.
• Thinta ngqo umenzi womuthi wokugoma ukuze ucele izaphulelo ezingaba khona noma izaphulelo. IGlaxoSmithKline ikhiqiza umuthi wokugomela iShingrix. UMerck wenza iZostavax.

Usebenza kanjani umuthi wokugomela ama-shingles?

Njengamanje, kunemithi emibili yokugoma evunyelwe yi-Food and Drug Administration (FDA) ukuvimbela ama-shingles: umuthi wokugoma i-zoster bukhoma (i-Zostavax) kanye nomuthi wokugoma kabusha we-zoster (Shingrix). Ngayinye isebenza ngezindlela ezihluke kancane ukuvimbela ama-shingles.

Shingrix

I-FDA ivume i-Shingrix ngo-2017. Ngumuthi wokugoma onconyelwe wokuvimbela ama-shingles. Umuthi wokugoma uqukethe amagciwane angasebenzi, okwenza kubekezeleleke kakhulu kubantu abanamasosha omzimba abuthaka.

Ngeshwa, iShingrix ivame ukubuyela emuva emuva ngenxa yokuthandwa kwayo. Ungaba nobunzima bokuyithola, noma ngabe uhlelo lwakho lwe-Medicare luyikhokhela.

Zostavax

I-FDA yavuma i-Zostavax ukuvimbela ama-shingles ne-postherpetic neuralgia ngo-2006. Umuthi wokugoma ngumuthi wokugoma ophilayo, okusho ukuthi uqukethe amagciwane ancishisiwe. Umuthi wokugomela isimungumungwane, mumps, kanye ne-rubella (MMR) uhlobo olufanayo lomuthi wokugoma obukhoma.

I-Shingrix vs. Zostavax

Yini ama-shingles?

Ama-shingles ayisikhumbuzo esibuhlungu sokuthi i-herpes zoster, igciwane elibanga ingxibongo, likhona emzimbeni. Kulinganiselwa ukuthi abantu baseMelika abaneminyaka engama-40 nangaphezulu babe nenkukhu (yize abaningi bengakhumbuli benayo).

I-Shingles ithinta cishe ingxenye eyodwa kwezintathu zabantu abake baba nenkukhu, okuholela ekushisweni, ekushosheni nasekudubuleni ubuhlungu bezinzwa. Izimpawu zingahlala amasonto ama-3 kuye kwayi-5.

Ngisho noma ukuqubuka nobuhlungu bezinzwa kuhamba, usengathola i-postherpetic neuralgia. Lolu uhlobo lobuhlungu obuhlala lapho kuqala khona ukuqubuka kwamashingles. I-postherpetic neuralgia ingadala lezi zimpawu ezilandelayo:

• ukukhathazeka
• ukudana
• izinkinga zokuqedela imisebenzi yansuku zonke
• izinkinga zokulala
• ukuncipha komzimba

Uma usumdala, maningi amathuba okuthi ube ne-neuralgia yangemva kokubhalwa komzimba. Yingakho ukuvimbela ama-shingles kungabaluleke kakhulu.

Ukuthatha

• I-Medicare Advantage ne-Medicare Part D kufanele ihlanganise okungenani ingxenye ethile yezindleko zomuthi wokugomela i-shingles.
• Buza udokotela wakho ngaphambi kokuthola umuthi wokugoma ukuthola ukuthi uzokhokhiswa kanjani.
• I-CDC incoma umuthi wokugomela iShingrix, kodwa awutholakali ngaso sonke isikhathi, ngakho-ke hlola ihhovisi likadokotela wakho noma ikhemisi kuqala.

Funda le ndatshana ngeSpanishi