Yisimo esiphuthumayo! Ngabe i-Medicare Part A Ikhava Yesiguli Esiphuthumayo Iyavakasha?

-Delile

• Ingabe i-Medicare Part A ikhava ye-ER iyavakasha?
• Yini ifomu le-MOON?
• Uyini umehluko phakathi kwama-copays nokuqinisekiswa kwemali?
• Yiziphi izingxenye zeMedicare ezimboza ukunakekelwa kwe-ER uma ungangeniswa esibhedlela?
• Ingxenye yeMedare B
• Ingxenye yeMedicare C
• I-Medigap
• Ingxenye yeMedare D
• Imisebenzi ongayithola kwa-ER
• Kubiza malini ukuvakashelwa okujwayelekile ku-ER?
• Kuthiwani uma i-ambulensi ingilethe ku-ER?
• Kufanele ngiye nini ku-ER?
• Ukuthatha

I-Medicare Part A kwesinye isikhathi ibizwa ngokuthi "umshuwalense wesibhedlela," kepha ihlanganisa kuphela izindleko zokuvakashelwa kwegumbi lezimo eziphuthumayo (ER) uma ungeniswa esibhedlela ukwelapha ukugula noma ukulimala okukulethe ku-ER.

Uma ukuvakasha kwakho kwe-ER kungamboziwe ngaphansi kwe-Medicare Part A, ungakwazi ukuthola ukumbozwa nge-Medicare Part B, C, D, noma iMedigap, ngokuya ngohlelo lwakho oluthile.

Funda ukuze ufunde kabanzi mayelana nokufakwa kwengxenye A yokuvakashelwa kwe-ER, kufaka phakathi okungenziwa noma okungenakumbozwa, nezinye izinketho zokubika ongaba nazo.

Ingabe i-Medicare Part A ikhava ye-ER iyavakasha?

Uma welashwa futhi wakhululwa emnyangweni ophuthumayo ngaphandle kokungeniswa esibhedlela njengesiguli esingalaliswayo, kungenzeka ukuthi iMedicare Part A ngeke ikukhiphe ukuvakasha kwakho kwe-ER.

Ngisho noma uhlala ku-ER ubusuku bonke, iMedicare Part A ikubheka njengesiguli ngaphandle uma udokotela ebhala umyalelo wokukungenisa esibhedlela njengokwelashwa.

Isikhathi esiningi, kufanele ungeniswe njengesiguli esingalaliswayo semini yasebusuku emibili elandelanayo ye-Medicare Part A ukumboza ukuvakasha kwakho.

Yini ifomu le-MOON?

Ifomu lakho lenyanga lizochaza ukuthi kungani uhlala esibhedlela njengomuntu olaliswa ngaphandle nokuthi yikuphi ukunakekelwa ongakudinga lapho uya ekhaya. Ukuthola INYANGA kungenye yezindlela zokutshela ukuthi iyiphi ingxenye ye-Medicare engakhokha ingxenye ye-ER bill yakho.

Uma udokotela ekungenisa esibhedlela ngemuva kokuvakasha kwe-ER futhi uhlala esibhedlela ubusuku obubili noma ngaphezulu, iMedicare Part A ikhokhela ukuhlala kwakho esibhedlela okungalalisiwe kanye nezindleko zokugula okuguliswa ekuvakasheni kwakho kwe-ER.

Usazoba nesibopho sokudonswa kwemali yakho, ukubonelelwa ngemali, kanye nama-copayments. Uma ungenaso isiqiniseko sokuthi uphathwa njengesiguli noma isiguli esingalaliswayo, cela udokotela akunelaphe. Uma unecebo leMedigap, lingakhokha ingxenye ye-copay yakho noma i-coinsurance.

Uyini umehluko phakathi kwama-copays nokuqinisekiswa kwemali?

• Amakhophi amanani alungisiwe owakhokhela insizakalo yezokwelapha noma ukuvakashelwa kwehhovisi. Uma uvakashela i-ER, ungahle ube namakhophi amaningi ngokuya ngenani lezinsizakalo ozitholayo. Ngokuya ngokuthi izikweletu zesibhedlela zisebenza kanjani, ungahle ungakhokhi ama-copay kuze kufike isikhathi esithile ngemuva kokuvakasha kwakho.
• Coinsurance yiphesenti lesikweletu osibophezele kulo. Imvamisa, iMedicare idinga ukuthi ukhokhe amaphesenti angama-20 wezindleko zokunakekelwa kwakho.

Yiziphi izingxenye zeMedicare ezimboza ukunakekelwa kwe-ER uma ungangeniswa esibhedlela?

Ingxenye yeMedare B

Izindaba ezimnandi ukuthi iMedicare Part B (umshwalense wezokwelapha) uvamise ukukhokhela ukuvakashelwa kwakho kwe-ER ukuthi ngabe ulimele yini, uba nokugula okungazelelwe, noma ukugula kuya ngokubi.

I-Medicare Part B ngokuvamile ikhokha amaphesenti angu-80 wezindleko zakho. Unesibopho samaphesenti angu-20 asele. Ngo-2021, ukukhishwa kwengxenye B yonyaka kungu- $ 203.

Ingxenye yeMedicare C

Izinhlelo zeMedicare Part C (Medicare Advantage) nazo zikhokhela izindleko ze-ER nezokunakekelwa okuphuthumayo. Noma izingxenye zeMedicare B no-C zivame ukukhokhela ukuvakashelwa kwe-ER, usazobophezeleka ekubanjweni kwemali yakho, ekuqinisekisweni kwemali yakho, nakuma-copayments ngaphezu kwama-premium wakho wenyanga walezi zinhlelo.

I-Medigap

Uma uneMedigap (umshwalense wokwengeza we-Medicare) ngaphezu kohlelo lwakho lweNgxenye B, ingakusiza ukuthi ukhokhe amaphesenti akho angama-20 wezindleko zokuvakasha kwe-ER.

Ingxenye yeMedare D

I-Medicare Part D iwukusetshenziswa kwezidakamizwa kadokotela. Uma unikezwa noma yimiphi imishanguzo ye-IV ngenkathi uku-ER, i-Medicare ingxenye B noma C izovama ukuyifaka.

Kodwa-ke, uma udinga umuthi ovame ukuwuthatha ekhaya futhi unikezwa isibhedlela ngenkathi uku-ER, lokho kuthathwa njengesidakamizwa esizisebenzelayo. Uma umuthi owunikezwayo usohlwini lwakho lwezidakamizwa i-Medicare Part D, Ingxenye D ingayikhokhela leyo mithi.

Imisebenzi ongayithola kwa-ER

Ungathola izinhlobo eziningana zezinsizakalo ongazidinga ngesikhathi sokuvakasha kwe-ER, kufaka phakathi:

• ukuhlolwa okuphuthumayo ngodokotela oyedwa noma ngaphezulu
• ukuhlolwa kwelebhu
• Ama-X-ray
• ukuskena noma ukuhlolwa
• izinqubo zokwelashwa noma zokuhlinzwa
• izinto zokwelashwa nemishini, njengezinduku
• imithi

Lezi zinsizakalo nokunikezwa kungakhokhiswa ndawonye noma ngokwehlukana, kuya ngesibhedlela osivakashelayo.

Kubiza malini ukuvakashelwa okujwayelekile ku-ER?

Kulinganiselwa ukuthi abantu abayizigidi eziyi-145 bavakashela igumbi labezimo eziphuthumayo minyaka yonke, kuthi abangaphezu kuka-12.5 million babo bangeniswe esibhedlela ukuze bathole ukunakekelwa kweziguli ezingalalwanga ngenxa yalokho.

UMnyango Wezempilo kanye Nezinsizakalo Zabantu (HHS) uthi inani eliphakathi labantu abakhokhele ukuvakasha kwe-ER ngo-2017 lalingama- $ 776. Inani okufanele ulikhokhe lizohluka ngokuya ngokuthi uhlala kuphi, isimo olashelwa sona, kanye nokutholakala kohlelo lwakho.

Kuthiwani uma i-ambulensi ingilethe ku-ER?

I-Medicare Part B izokhokhela i-ambulensi yokugibela iye e-ER uma impilo yakho ingaba sengozini ngokuhamba ngenye indlela.

Isibonelo, uma ulimele futhi ukunakekelwa kwi-ambulensi kungasindisa impilo yakho, abakwaMedicare bazokukhokhela ukuthi uthuthwe yi-ambulensi uye esikhungweni sezokwelapha esifanelekile esiseduze.

Uma ukhetha ukwelashwa esikhungweni esikude, ungabhekana nomehluko wezindleko zokuhamba phakathi kwalezi zindawo zombili.

Kufanele ngiye nini ku-ER?

Uma wena noma othandekayo uhlangabezana nanoma yiziphi zalezi zimpawu, kufanele ufune ukunakekelwa ku-ER ngokushesha:

• izimpawu zokushaywa unhlangothi, njengokukhuluma okungaqondakali, ukuba buthakathaka kolunye uhlangothi, noma ukwehla kobuso
• izimpawu zokuhlaselwa yisifo senhliziyo, njengokuqaqamba kwesifuba, ukuphefumula okuncane, isiyezi, ukujuluka noma ukugabha
• izimpawu zokoma emzimbeni, kufaka phakathi ukushaya kwenhliziyo okusheshayo, isiyezi, amajaqamba, nokoma okukhulu

Uma uya ku-ER, qiniseka ukuthi uthatha noma yiluphi ulwazi lomshwalense, kanye nohlu lwemithi yamanje.

Ukuthatha

Uma wena noma othandekayo udinga ukuya ku-ER, kubalulekile ukwazi ukuthi iMedicare Part A ayihlanganisi ngokujwayelekile ukuvakashelwa kwe-ER ngaphandle kokuthi isiguli singeniswe esibhedlela siyokwelashwa.

Izinhlelo ze-Medicare Part B kanye ne-Medicare Advantage (Medicare Part C) zivame ukumboza amaphesenti angama-80 wezindleko zezinsizakalo ze-ER, kepha iziguli zibhekene nokukhokhelwa kwemali, ukukhokhelwa kwemali kanye nokudonswa kwemali.

Lo mbhalo uvuselelwe ngoNovemba 13, 2020, ukukhombisa imininingwane ye-2021 Medicare.

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.