Ngabe i-Medicare Ikhokhela Ukuphila Okusizwayo?

-Delile

• Ngabe i-Medicare ikufaka nini ukuphila okusizwayo?
• Yiziphi izingxenye zekhava leMedicare ezisiza ukunakekelwa kokuphila?
• Ingxenye yeMedicare A
• Ingxenye yeMedare B
• Ingxenye yeMedicare C
• Ingxenye yeMedare D
• I-Medigap
• Yiziphi izinhlelo zeMedicare ezingaba ngcono kakhulu uma wazi wena noma othandekayo engadinga ukunakekelwa kokuphila okusizwayo ngo-2020?
• Cabanga ngezidingo zokunakekelwa kwezempilo
• Kuyini okuphilayo okusizwayo?
• Kusiza malini ukunakekelwa kokuphila?
• Okubalulekile

Njengoba sikhula, singadinga usizo olwengeziwe ngemisebenzi yethu yansuku zonke. Kulezi zimo, ukuhlala okusizwayo kungaba yinto ongayikhetha.

Ukuphila okusizwayo uhlobo lokunakekelwa kwesikhathi eside okusiza ukuqapha impilo yakho nokusiza ngemisebenzi yansuku zonke ngenkathi kuthuthukiswa ukuzimela.

I-Medicare ngokuvamile ayihlanganisi ukunakekelwa kwesikhathi eside njengokuphila okusizwayo.

Funda njengoba sixoxa ngeMedicare, impilo esiziwayo, nezinketho zokusiza ukukhokhela ezinye zalezi zinsizakalo.

Ngabe i-Medicare ikufaka nini ukuphila okusizwayo?

I-Medicare ikhokhela ukunakekelwa kwesikhathi eside kuphela uma udinga izinsizakalo zabahlengikazi abanekhono ukwesekelwa ekuphileni kwansuku zonke futhi udinga ukwelashwa emsebenzini, ukunakekelwa kwamanxeba, noma ukwelashwa ngokomzimba, okutholakala ekhaya lasebekhulile, kulandela ukwamukelwa esibhedlela. Ukuhlala kulezi zikhungo kuvalwa kuphela isikhathi esifushane (kufika ezinsukwini eziyi-100).

Izindawo zokuhlala ezisizwayo zihlukile kunezikhungo zabahlengikazi ezinamakhono. Abantu abaphila ngokulekelelwa bavame ukuzimela kakhulu kunalabo abasemakhaya asebekhulile kepha basanikezwa ukugadwa kwamahora angama-24 futhi basizwe ngemisebenzi efana nokugqoka noma ukugeza.

Lolu hlobo lokunakekelwa okungelona olwezokwelapha lubizwa ngokuthi ukunakekelwa kwabantwana. I-Medicare ayihlanganisi ukunakekelwa kokugcinwa. Kodwa-ke, uma uhlala esikhungweni sokuhlala esisiziwe, kungahle kube khona izinto i-Medicare esazozihlanganisa, kufaka phakathi:

• ezinye izinsizakalo ezihlobene nezempilo noma zokuvimbela ezempilo
• imithi yakho kadokotela
• izinhlelo zokuphila kahle noma zokuqina
• ukuthuthwa lapho kubekwa khona udokotela

Yiziphi izingxenye zekhava leMedicare ezisiza ukunakekelwa kokuphila?

Ake sihlolisise kancane ukuthi yiziphi izingxenye zeMedicare ezingafaka amasevisi angahlanganiswa nokuhlala kwakho okusizwayo.

Ingxenye yeMedicare A

Ingxenye A ngumshwalense wesibhedlela. Ifaka izinhlobo zokunakekelwa ezilandelayo:

• ukuhlala esibhedlela
• i-inpatient ihlala esikhungweni sempilo yengqondo
• indawo yokuhlala yabahlengikazi enamakhono
• ukunakekelwa kwe-hospice
• ukunakekelwa kwempilo ekhaya

Ingxenye A ayihlanganisi izinsizakalo zokugcinwa kwezingane ezihilelekile ekusizweni kokuphila.

Ingxenye yeMedare B

Ingxenye B wumshwalense wezokwelapha. Ihlanganisa:

• ukunakekelwa kweziguli
• ukunakekelwa okudingekayo kwezokwelapha
• ukunakekelwa okuthile kokuvikela

Yize lezi zinsizakalo zinganikezwa endaweni yokuhlala esiziwe, kungenzeka kusadingeka uzisebenzise. Eqinisweni, ezinye izindawo zokuhlala ezisizwayo zingasiza ukuxhumanisa izinsizakalo zezokwelapha nomhlinzeki wakho wezokunakekelwa kwempilo.

Izibonelo zezinto ezimbozwe yiNgxenye B zifaka:

• izivivinyo ezithile zaselebhu
• imithi yokugoma, njengaleyo yomkhuhlane kanye ne-hepatitis B
• ukuhlolwa kwesifo senhliziyo
• ukwelashwa ngokomzimba
• ukuhlolwa komdlavuza, njengaleyo yomdlavuza webele, wesibeletho, noma wombala obomvu
• izinsizakalo zokuhlinzeka nge-dialysis
• imishini yesifo sikashukela nempahla
• ukwelashwa ngamakhemikhali

Ingxenye yeMedicare C

Izinhlelo ze-Part C zibizwa nangokuthi izinhlelo ze-Advantage. Banikezwa yizinkampani zomshuwalense ezizimele ezivunyelwe yiMedicare.

Izinhlelo ze-Part C zifaka phakathi izinzuzo ezinikezwe ezingxenyeni A no-B futhi kwesinye isikhathi ukumbozwa kweminye imisebenzi, efana nokubona, ukuzwa kanye namazinyo. Izindleko nokumbozwa kungahluka ngohlelo ngalunye.

Njengo-Original Medicare (izingxenye A no-B), amapulani engxenye C awahlanganisi ukuphila okusizwayo.Kodwa-ke, zisengabandakanya amasevisi athile uma uhlala endaweni yokuhlala esiziwayo engazifaki, njengezinto zokuhamba kanye nokuqina noma imisebenzi yempilo.

Ingxenye yeMedare D

Ingxenye D ukumbozwa kwezidakamizwa kadokotela. NjengeNgxenye C, izinkampani zomshuwalense ezizimele zinikela ngalezi zinhlelo. Ukuphakama nezindleko kungahluka ngohlelo ngalunye.

I-Medicare Part D ihlela ukumboza imithi evunyelwe noma ngabe uhlala kuphi. Uma uhlala endaweni yokuhlala esiziwayo futhi uthatha imishanguzo efakwe kuhlu kadokotela, Ingxenye D izobasiza.

I-Medigap

Ungase futhi ubone iMedigap ebizwa ngokuthi umshwalense wokungezelela. IMedigap isiza ukumboza izinto i-Original Medicare engazenzi. Kodwa-ke, iMedigap ngokuvamile ayihlanganisi ukunakekelwa kwesikhathi eside, njengokuphila okusizwayo.

Yiziphi izinhlelo zeMedicare ezingaba ngcono kakhulu uma wazi wena noma othandekayo engadinga ukunakekelwa kokuphila okusizwayo ngo-2020?

Ngakho-ke, yini ongayenza uma wena noma umuntu omthandayo edinga ukunakekelwa okusizwayo ngonyaka ozayo? Kunezinyathelo ezithile ongazithatha ukusiza ukunquma okufanele ukwenze.

Cabanga ngezidingo zokunakekelwa kwezempilo

Noma iMedicare ingakufihli okusizakalayo ngokwako, usazodinga ukunakekelwa kwezempilo nezinsizakalo. Qiniseka ukuthi ubuyekeza izinketho zakho zohlelo ngaphansi kwe-Medicare ngaphambi kokukhetha uhlelo.

Khumbula ukuthi izinhlelo ze-Part C (Advantage) zinganikela ngokumbozwa okwengeziwe, okufana nombono, amazinyo nokuzwa. Futhi zingafaka ezinye izinzuzo, njengobulungu bejimu nokuthuthwa lapho kubekwa khona udokotela.

Uma wazi ukuthi uzodinga ukumbozwa ngemithi kadokotela, khetha uhlelo lwengxenye D. Ezimweni eziningi, Ingxenye D ifakiwe ezinhlelweni zeNgxenye C.

Njengoba izindleko ezithile kanye nokufakwa ezingxenyeni C no-D kungahluka kuhlelo lokuhlela, kubalulekile ukuqhathanisa izinhlelo eziningi ngaphambi kokukhetha eyodwa. Lokhu kungenziwa kusiza seMedicare.

I-Medicare ayikubandakanyi ukuphila okusizwayo, ngakho-ke kuzodingeka unqume ukuthi uzokukhokhela kanjani. Kunezindlela eziningi ongakhetha kuzo:

• Kuphuma ephaketheni. Uma ukhetha ukukhokha ephaketheni, uzokhokha zonke izindleko zokunakekelwa kokuphila okusizwayo ngokwakho.
• I-Medicaid. Lolu uhlelo oluhlanganyelwe lukahulumeni nolwesifundazwe olunikeza ukunakekelwa kwezempilo kwamahhala noma ngezindleko eziphansi kubantu abafanelekile. Izinhlelo kanye nezidingo zokufaneleka zingahluka ngezwe. Funda kabanzi ngokuvakashela iwebhusayithi yeMedicaid.
• Umshuwalense wokunakekelwa kwesikhathi eside. Lolu uhlobo lomshwalense ohlanganisa ukunakekelwa kwesikhathi eside, kubandakanya ukunakekelwa kwabantwana.

Kuyini okuphilayo okusizwayo?

Ukuphila okusizwayo kuwuhlobo lokunakekelwa kwesikhathi eside kubantu abadinga usizo ngemisebenzi yabo yansuku zonke kodwa abadingi usizo oluningi noma ukunakekelwa kwezokwelapha njengalokho okunikezwa esikhungweni sabahlengikazi abanekhono (ikhaya labahlengikazi).

Izindawo zokuhlala ezisizwayo zingatholakala njengezindawo zokuzimela zodwa noma njengengxenye yekhaya labahlengikazi noma umphakathi womhlalaphansi. Izakhamizi zivame ukuhlala emafulethini noma emakamelweni azo futhi zikwazi ukufinyelela ezindaweni ezahlukahlukene ezijwayelekile.

Ukuphila okusizwayo kufana nebhuloho phakathi kokuhlala ekhaya nokuhlala ekhaya lasebekhulile. Igxile ekuhlanganiseni izindlu, ukuqapha ezempilo, kanye nosizo ngokunakekelwa komuntu siqu, kuyilapho izakhamizi zigcina ukuzimela ngangokunokwenzeka.

Izinsizakalo ezinikezwa endaweni yokuhlala esiziwayo zivame ukufaka izinto ezinjengalezi:

• Ukugadwa nokuqashwa kwamahora angama-24
• usizo ngemisebenzi yansuku zonke, njengokugqoka, ukugeza noma ukudla
• ukudla okunikezwa endaweni yokudlela yeqembu
• ukuhlelwa kwezinsizakalo zezokwelapha noma zezempilo zabahlali
• ukuphathwa kwemithi noma izikhumbuzo
• izinsizakalo zokugcina izindlu nezokuwasha
• imisebenzi yokuzijabulisa nokuphila kahle
• amalungiselelo ezokuthutha

Kusiza malini ukunakekelwa kokuphila?

Kulinganiselwa ukuthi izindleko eziphakathi nonyaka zokuphila okusizwayo. Izindleko zingaba ngaphezulu noma ngaphansi kunalokhu. Kungancika ezintweni ezahlukahlukene, kufaka phakathi:

• indawo yesikhungo
• indawo ethile ekhethiwe
• izinga lomsebenzi noma ukugadwa okudingekayo

Njengoba iMedicare ingakukhokhi ukuphila okusizwayo, izindleko zivame ukukhokhwa ephaketheni, ngeMedicaid, noma ngomshwalense wokunakekelwa kwesikhathi eside.

Uma othandekayo ebhalisela i-Medicare ngonyaka ozayo, landela lawa macebiso amahlanu ukuze ubasize babhalise:

• Bhalisela. Abantu abangakaqoqeli izinzuzo Zokuphepha Komphakathi kuzodingeka babhalise.
• Qaphela ukubhaliswa okuvulekile. Lokhu kusuka ngo-Okthoba 15 kuya kuDisemba 7 minyaka yonke. Othandekayo wakho angabhalisa noma enze izinguquko ezinhlelweni zakhe ngalesi sikhathi.
• Xoxani ngezidingo zabo. Izidingo zawo wonke umuntu zezempilo nezokwelapha zehlukile. Yiba nengxoxo nomuntu omthandayo mayelana nokuthi yiziphi lezi zidingo ngaphambi kokuthatha isinqumo ngohlelo.
• Yenza ukuqhathanisa. Uma othandekayo wakho ebuka izingxenye ze-Medicare C noma D, qhathanisa amapulani amaningi ahlinzekwa endaweni yabo. Lokhu kungabasiza bathole izinzuzo ezihlangabezana nezidingo zabo zezokwelapha nezezezimali.
• Nikeza imininingwane. Ukuphathwa Kwezokuphepha Komphakathi kungacela ukuthi unikeze imininingwane ngobudlelwano bakho nothandekayo wakho. Ukwengeza, othandekayo wakho udinga ukusayina uhlelo lokusebenza lwe-Medicare uqobo.

Okubalulekile

Ukuphila okusizwayo kuyisinyathelo phakathi kokuhlala ekhaya nokuhlala ekhaya lasebekhulile. Ihlanganisa ukuqapha kwezokwelapha nokusiza ngemisebenzi yansuku zonke ngenkathi ihlinzeka ngokuzimela ngangokunokwenzeka.

I-Medicare ayihlanganisi impilo yokusizwa. Kodwa-ke, kubalulekile ukukhumbula ukuthi i-Medicare isengahlanganisa ezinye izinsizakalo zezempilo ozidingayo, ezinjengokunakekelwa kweziguli ezingalaliswayo, imishanguzo kadokotela, nezinto ezifana namazinyo nokubona.

Izindleko zokuphila okusizwayo zingahluka ngokuya ngendawo yakho nezinga lokunakekelwa olidingayo. Ukunakekelwa okuphilayo okusizwayo kuvame ukukhokhelwa ukuphuma ephaketheni, ngeMedicaid, noma ngenqubomgomo yomshuwalense wokunakekelwa kwesikhathi eside.

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.

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