Ingabe Ukuhlinzwa Ukufakwa esikhundleni sehlombe kwe-Medicare?

-Delile

• Yiziphi izingxenye zeMedicare ezimboza ukushintshwa kwehlombe?
• I-Medicare Part A Ukusabalala
• Ukusabalala kwe-Medicare Part B
• Ukutholakala kwe-Medicare Part C
• Ukusabalala kwe-Medicare Part D
• Ukusabalala kweMedigap
• Ziyini izindleko zokuphuma ephaketheni zezinqubo ezihlanganisiwe?
• Izindleko zoqobo ze-Medicare
• Izindleko zeMedicare Part C
• Izindleko zeMedicare Part D
• Yini okufanele ngiyilindele ekuhlinzweni kokufakwa esikhundleni sehlombe?
• Ngaphambi kwenqubo
• Usuku lwenqubo
• Ngemuva kwenqubo
• Ezinye izindlela zokuhlinzwa
• Imijovo yeCortisone
• Ukwelashwa ngokomzimba
• Ukudambisa izinhlungu
• Ukwelashwa kwe-stem cell
• Ukuthatha

• Ukuhlinzwa okwenziwe ngamahlombe kungadambisa izinhlungu futhi kwandise ukuhamba.
• Le nqubo imbozwe yi-Medicare, inqobo nje uma udokotela wakho eqinisekisa ukuthi kuyadingeka kwezokwelapha.
• I-Medicare Part A ihlanganisa ukuhlinzwa kwabagulayo, kuyilapho i-Medicare Part B ihlanganisa izinqubo zokwelashwa kweziguli.
• Kungadingeka ukhokhe ezinye izindleko zokuphuma ephaketheni ngokuhlinzwa okufakwa esikhundleni sehlombe, noma ngabe kutholakala i-Medicare.

Ihlombe lakho liyisihlanganisi esiguqukayo esisengozini enkulu yokulimala nokuguga nokudabuka. Ihlombe elonakaliswe kabi lingathinta ikhwalithi yempilo yakho. Noma kunjalo, ukuhlinzekwa kwamahlombe okufakwa esikhundleni esivame ukuhlukaniswa njengokukhetha.

Ngoba iMedicare ngokuvamile ayikubandakanyi ukuhlinzwa okukhethiwe, ungahle ukhathazeke ngokuthi kuzodingeka uphile nobuhlungu noma ukhokhele ukuhlinzwa okuvela ephaketheni. Kodwa iMedicare, empeleni, izokhokhela ingxenye yezindleko uma udokotela wakho ethi ukuhlinzekwa kwamahlombe kuyadingeka kwezokwelapha esimweni sakho esithile.

Yiziphi izingxenye zeMedicare ezimboza ukushintshwa kwehlombe?

Ungadinga ukuhlinzekwa esikhundleni sehlombe ukulungisa ihlombe lakho noma ukunciphisa umonakalo owengeziwe kujoyini.

Udokotela wakho uzodinga ukuqinisekisa ukuthi ukuhlinzwa kwakho kuyadingeka ukuphulukisa noma ukuvimbela ukulimala okuqhubekayo okubangelwa yisifo, njengesifo samathambo. Lo dokotela kumele abhalise futhi avunyelwe yiMedicare.

Uhlobo lokuhlinzwa oludingayo luzoncika ezintweni eziningana, kufaka phakathi ubukhulu bomonakalo osehlombe lakho. Ezinye izinhlobo ezijwayelekile zokuhlinzwa kwehlombe zifaka:

• Ukuhlinzwa kwekhafu yeRotator. Ukulungiswa kwekhafu ye-Rotator kungenziwa nge-arthroscopically noma njengokuhlinzwa okuvulekile.
• Ukuhlinzwa kwe-labrum. Lokhu kuvame ukwenziwa nge-arthroscopically.
• Ukuhlinzwa kwesifo samathambo. Lokhu kwenziwa nge-arthroscopically kepha kungadinga ukuhlinzwa okuvulekile uma umonakalo ehlombe lakho unzima.
• Ukulungiswa kwamahlombe aqhekekile. Uhlobo lokuhlinzwa oludingekayo luzonqunywa indawo nobukhulu bokuqhekeka noma ukuphuka.

Okulandelayo, sizobheka ukuthi yini ehlanganiswe ngaphansi kwengxenye ngayinye ye-Medicare.

I-Medicare Part A Ukusabalala

Ukuhlinzwa okuvulekile kuyindlela ehlaselayo edinga ukuthi udokotela ohlinzayo enze imbobo enkulu ukuze alungise noma abeke ihlombe lakho esikhundleni.

Uma ukushintshwa kwehlombe lakho okuvulekile kudingekile kwezokwelapha, iMedicare Part A izokhokha ingxenye ethile yezindleko. Ingxenye A iyingxenye eyodwa ye-Medicare yasekuqaleni.

Ingxenye A izophinde ihlanganise noma imiphi imithi noma izindlela zokwelashwa ozithola ngesikhathi uhlala esibhedlela, indawo yokufundela abanamakhono, noma isikhungo sokuvuselela. Kepha kubalulekile ukwazi ukuthi kunemikhawulo yokuthi i-Medicare izokumboza ukuhlala isikhathi esingakanani kunoma yiluphi uhlobo lwesikhungo seziguli.

Ukusabalala kwe-Medicare Part B

Ukuhlinzwa ehlombe nakho kungenziwa nge-arthroscopically. Lolu hlobo lokuhlinzwa luhlasela kancane futhi luvamise ukwenziwa esibhedlela noma emtholampilo ohamba ngokukhululeka esibhedlela.

Uma ungena esikhundleni sehlombe le-arthroscopic, udokotela wakho uzokwenza ukusika okuncane ehlombe lakho bese ebeka ikhamera encane lapho. Ngokunye ukusikwa okuncane, udokotela ohlinzayo uzolungisa noma abeke ezinye izingxenye zehlombe lakho.

Uma ukuhlinzwa kwakho kwehlombe kwe-arthroscopic kudingekile ngokwezokwelapha, i-Medicare Part B izokhipha ingxenye yezindleko. Ingxenye B enye ingxenye ye-Medicare yasekuqaleni.

Ingxenye B ibuye ihlanganise lezi zinto nezinsizakalo futhi, uma kudingeka:

• konke ukuqokwa kodokotela bakho ngaphambi nangemva kokuhlinzwa
• ukwelashwa ngokomzimba ngemuva kokuhlinzwa, okuzodinga noma ngabe unhloboni yenqubo onayo
• noma imuphi umshini wezokwelapha ohlala isikhathi eside owudingayo ngemuva kokuhlinzwa, njengokufana nendwayimane

Ukutholakala kwe-Medicare Part C

Uma une-Medicare Part C (Medicare Advantage), uhlelo lwakho luzohlanganisa zonke izindleko ezikhokhelwa yi-Medicare yasekuqaleni (izingxenye A no-B). Ngokuya ngohlelo lwakho, kungabandakanya nemithi kadokotela.

Ukugcina izindleko zakho zokuphuma ephaketheni ziphansi, kubalulekile ukusebenzisa abahlinzeki be-in-network kanye namakhemisi uma unohlelo lwengxenye C.

Ukusabalala kwe-Medicare Part D

Noma imiphi imishanguzo obekelwe yona ukuthi uyiphuze ngemuva kokuhlinzwa, njengemithi yezinhlungu, izombozwa yi-Medicare Part D. Ingxenye D iwukusetshenziswa kwezidakamizwa okunikezwa nge-Medicare.

Uhlelo ngalunye lweNgxenye D lufaka ifomula. Lolu uhlu lwemithi ehlanganiswa yipulani kanye nephesenti lokutholakala ongakulindela.

Ukusabalala kweMedigap

Uma une-Medicare yangempela, ungahle ube nohlelo lweMedigap. Ngokuya ngohlelo lwakho, iMedigap ingafaka ezinye izindleko ezisele ezikhokhelwa ukuhlinzwa kwakho esikhundleni sehlombe. Lokhu kungafaka ama-copays akho, i-coinsurance, nama-deductibles.

IMedigap imboza ukukopishwa kwemithi ngeNgxenye D. Kodwa-ke, qaphela ukuthi izinhlelo eziningi azivunyelwe ukumboza i-Part B premium.

Ziyini izindleko zokuphuma ephaketheni zezinqubo ezihlanganisiwe?

Kungaba nzima ukulinganisa izindleko zakho ezingaphandle kwezikhwama ngaphambi kwenqubo yakho. Ihhovisi lokukhokhisa likadokotela wakho kufanele likwazi ukukunikeza isilinganiso esibhaliwe salokho ongakulindela. Lokhu kuvame ukufaka ububanzi bezindleko ezingaba khona, ngokuya ngamasevisi ongawadinga ngesikhathi nangemva nje kwenqubo.

Izindleko zoqobo ze-Medicare

Kukhona izindleko ezingaphandle kwephakethe ongazilindela, noma ngabe une-Medicare. Lokhu kufaka phakathi:

• Ngokuhlinzwa okungalaliswayo, isibhedlela sakho seziguli ezingalaliswa esibhedlela sidonswa ngo- $ 1,408. Lokhu kuhlanganisa izinsuku zokuqala ezingama-60 zokunakekelwa kwezibhedlela zeziguli ezimbozwe nge-Medicare esikhathini sokuzuza.
• Uma udinga ukuhlala isikhathi eside, uzokhokha inani lemali ekhokhelwa imali engu- $ 352 nsuku zonke kusukela osukwini 61 kuya kosuku lwama-90 esikhathini sokuzuza kanye no- $ 704 nsuku zonke nganoma yiziphi izinsuku zokulondoloza impilo oyisebenzisayo.
• Uma uhlala esikhungweni sabahlengikazi abanekhono, izindleko zakho zansuku zonke zokukhokhelwa kwemali kusukela ngosuku 21 kuye osukwini 100 esikhathini sokuzuza kungaba ngama- $ 176 ngosuku.
• Ekuhlinzweni kweziguli, unesibopho sokuhlangabezana neDepho B yakho ekhishwa minyaka yonke engu- $ 198, kanye ne-premium yakho yanyanga zonke, eyi- $ 144.60 yabantu abaningi ngo-2020.
• Uzokhokha amaphesenti angama-20 wezindleko ezigunyazwe yi-Medicare zenqubo yokwelashwa kweziguli.
• Uzobuye ukhokhe amaphesenti angama-20 wezindleko nganoma iyiphi imishini yezokwelapha ehlala njalo kanye nokuqokwa kokwelapha ngokomzimba.

Izindleko zeMedicare Part C

Uma une-Medicare Part C, izindleko zakho zizohluka ngokuya ngohlobo lwecebo onalo. Umshwalense wakho angakunika imininingwane etholakalayo kanye nemininingwane ye-copay ngaphambi kwesikhathi. Imvamisa, ungalindela ukukhokha uhlobo oluthile lwe-copay.

Akunandaba ukuthi uluphi uhlobo lohlelo lweCandelo C onalo, kuyadingeka ngokomthetho ukuthi uhlelo lwakho lumboze okungenani olunjengoMedicare wokuqala. Lokhu kufaka izindleko zokuhlinzwa ngaphakathi noma kokuhlinzwa.

Izindleko zeMedicare Part D

Uma une-Medicare Part D, izindleko zakho zizohluka ngokuya ngohlelo onalo. Ngokuqinisekile uzoba nezindleko ezithile ze-copay nganoma yimiphi imithi oyinikezwe.

Izindleko ngomuthi ngamunye zibekwa ngohlelo lwakho lwe-formulary kanye ne-tier system. Umhlinzeki wakho wohlelo angakwazisa ukuthi yini ongalindela ukuyikhokhela umuthi ngamunye ngaphambi kwesikhathi.

I-Medicare inenqubo yokubheka intengo yenqubo, engakusiza ukunquma izindleko zokuhlinzwa kweziguli. Ukuze uthole imiphumela enembile kunazo zonke, cela udokotela wakho ukuthi anikeze igama eliqondile lenqubo noma ikhodi yalolo hlobo lokuhlinzwa.

Yini okufanele ngiyilindele ekuhlinzweni kokufakwa esikhundleni sehlombe?

Ngaphambi kwenqubo

Isinyathelo sokuqala ukuqinisekisa ukuthi uphilile ngokwanele ukuba uhlinzwe esikhundleni samahlombe. Emasontweni ambalwa ngaphambi kosuku lwakho lokuhlinzwa, udokotela wakho uzohlela ukuhlolwa komzimba ukuze ahlole inhliziyo yakho nempilo yakho yonke. Ngaleso sikhathi, udokotela wakho angancoma ukuthi uyeke ukuthatha imishanguzo ethile, njengama-thinner egazi.

Ukuhlinzwa okulindelekile kungacindezela abantu abaningi. Zama ukuphumula ngangokunokwenzeka futhi ulale kahle izolo ebusuku.

Usuku lwenqubo

Udokotela wakho uzokwazisa lapho udinga ukuyeka ukudla nokuphuza ngaphambi kokuhlinzwa. Uma ujwayele ukuthatha imishanguzo yansuku zonke ekuseni, buza udokotela wakho ukuthi kufanele uyiphuze ngosuku lwenqubo.

Uma uhlinzwa ngokuvulekile, kufanele uzilungiselele ukuchitha izinsuku ezimbalwa esibhedlela. Letha noma yini ezokwenza uzizwe ukhululekile, njengencwadi enhle ongayifunda, ifoni yakho, kanye neshaja yefoni.

Cishe ihora ngaphambi kwenqubo, udokotela obulala izinzwa uzokuhlola. Uzohlangana futhi nodokotela wakho ohlinzayo, ozokuchazela inqubo ngokujulile. Sebenzisa lesi sikhathi ukubuza noma yimiphi imibuzo onayo.

Isikhathi esidingekayo sokuhlinzwa esikhundleni sehlombe siyahlukahluka, kepha imvamisa kuthatha amahora amabili kuya kwamathathu. Uzovuka egumbini lokutakula, lapho uzohlala khona isikhathi esithile.

Uma ukuhlinzwa kwakho kwenziwe ngesifo sokugula, uzothathwa uyiswe ekamelweni lakho ngemuva kokuchitha amahora amaningi ululama. Uma ukuhlinzwa kwakho kwenziwe ngokugula, uzodinga umuntu ozokulanda ngemuva kokuthi ukhishiwe.

Ngemuva kwenqubo

Njenganoma yikuphi ukuhlinzwa, ezinye izinhlungu noma ukungakhululeki kungalindelwa. Udokotela wakho uzokunikeza imithi yezinhlungu ukusiza. Ungayalwa ukuthi uthathe imithi yakho ngezikhathi ezithile noma ngaphambi kokuba izinga lakho lobuhlungu lenyuke. Ungatshelwa futhi ukuthi ufake iqhwa kuleyo ndawo.

Uzokhishwa ngengalo yakho endwayimeni, ongatshelwa ukuthi uyigqoke amasonto ambalwa.

Ukwelashwa ngokomzimba kuvame ukuqala ngokushesha, kwesinye isikhathi nangosuku lwenqubo. Ukusebenzisa ihlombe lakho njengoba kuqondisiwe kuzokusiza ukuthi ukwazi ukuhamba ngokushesha okukhulu. Udokotela wakho uzokunikeza incwadi kadokotela yokuqhubeka nokwelashwa ngokomzimba inqobo nje uma kudingeka

Ihlombe nengalo yakho kuzoqala ukuthuthuka kancane. Kungakapheli amasonto amabili kuya kwayisithupha, ungalindela ukuzwa nokubona intuthuko enkulu futhi ungaqala kabusha imisebenzi eminingi yansuku zonke.

Kungathatha isikhathi eside kuwe ukushayela imoto noma ukudlala imidlalo, noma kunjalo. Ungahle ungakwazi ukuphatha amaphakheji asindayo izinyanga ezimbalwa. Kungathatha futhi izinyanga eziyisithupha noma ngaphezulu ngaphambi kokuba uhambe ngokugcwele ehlombe lakho.

Ukushintshwa kwehlombe kungahlala iminyaka eyi-15 kuye kwengama-20.

Ezinye izindlela zokuhlinzwa

Ngaphandle kokuthi unokulimala okudinga ukulungiswa ngokushesha, njengethambo lehlombe eliphukile noma eliphukile, udokotela wakho angancoma ukuzama ezinye izindlela zokuhlinzwa kuqala.

Imijovo yeCortisone

Ama-Cortisone shots angasetshenziselwa ukuqeda izinhlungu nokuvuvukala kokuhlangana kwehlombe. Zivame ukuphathwa ehhovisi likadokotela futhi kufanele zinikezwe ngudokotela ovunyelwe yi-Medicare ukuze zimbozwe.

Iningi lePart D nePart C lihlela imijovo ye-cortisone. Ezinye izingxenye zomthethosivivinywa wakho, njengezindleko zokuphatha, zingahlanganiswa Ingxenye B.

Ukwelashwa ngokomzimba

Ukwelashwa ngokomzimba kungasiza ngobuhlungu, ukuhamba nokuqina kwejoyini.Izikhathi zokwelashwa ezidingekayo ngokomzimba zimbozwa yi-Medicare Part B, inqobo nje uma unencwadi kadokotela evela kudokotela ovunyelwe yi-Medicare. Kumele futhi usebenzise owelapha ngokomzimba ovunyelwe yi-Medicare.

Ukudambisa izinhlungu

Imithi kadokotela yezinhlungu ihlanganiswa yizinhlelo eziningi zeNgxenye D kanye nengxenye C. Ezinye izinhlelo zeNgxenye C ziphinde zihlanganise imithi yokwelashwa yezinhlungu.

Ukwelashwa kwe-stem cell

Lokhu kwelashwa kunganconyelwa ukukhipha imisipha ethile noma izinyembezi zemisipha. Kunganconywa futhi ngomonakalo we-cartilage. Kodwa okwamanje ayivunyelwe yi-FDA, okusho ukuthi ayimboziwe yinoma iyiphi ingxenye yeMedicare.

Ukuthatha

• Ukuhlinzwa okwenziwe ngamahlombe kungaba inketho eyodwa yokuqeda izinhlungu nokwandisa ukuhamba. Ungazama futhi izindlela zokwelapha ezingezona ezokwelapha.
• I-Medicare ihlanganisa izinqubo zokufaka esikhundleni sehlombe labangalaliswayo nabangalaliswayo, inqobo nje uma zibhekwa njengezidingekayo kwezokwelapha.
• Ingxenye ngayinye ye-Medicare izofaka izinqubo ezahlukahlukene, izinsizakalo, imishanguzo nezinto ongazidinga kuyo yonke inqubo.
• Izindleko zokuphuma ephaketheni ngokumbozwa kwasekuqaleni kweMedare ziqonde ngqo. NgeNgxenye C, Ingxenye D, noma ukumbozwa kweMedigap, ungahle uthande ukuqinisekisa amanani nezindleko zomhlinzeki wohlelo lwakho.