Yini iMedare ekhokha maqondana nezindleko zezihlalo ezinamasondo?

-Delile

• Ngabe iMedicare ihlanganisa nini izihlalo ezinamasondo?
• Uhlobo luni lwesihlalo sabakhubazekile oluzofakwa yiMedicare?
• Izihlalo ezinamasondo ezenziwa ngesandla
• Izikuta zamandla
• Izihlalo ezinamasondo ezinamandla
• Ingabe i-Medicare ikhava ukuphakama kwesiguli?
• Kuthiwani ngempambuko yesihlalo sabakhubazekile?
• Yiziphi izindleko zokuphuma ephaketheni zezihlalo ezinamasondo uma une-Medicare?
• Yiziphi izinhlelo zeMedicare ezingaba ngcono kuwe uma wazi ukuthi udinga isihlalo sabakhubazekile?
• Ngabe iMedicare iyazikhokhela ezinye izinsiza zokuhamba?
• Okubalulekile

• I-Medicare iyazikhokhela izindleko zokuqasha noma ukuthenga izihlalo ezinamasondo kwezinye izimo.
• Kufanele uhlangabezane nezidingo ezithile zeMedicare.
• Qiniseka ukuthi udokotela wakho nenkampani ekuhlinzeka ngesihlalo sakho sabakhubazekile bobabili bavunyelwe yi-Medicare.

Uma isimo sempilo sikuvimbela ukuba uhambe ngokukhululeka endlini yakho futhi induku noma i-walker nje ayanele, isihlalo esinamasondo singaba yimpendulo ezindabeni zakho zokuhamba.

I-Medicare Part B ihlanganisa izinhlobo eziningi zezihlalo ezinamasondo inqobo nje uma uhlangabezana nemibandela ethile yangaphambi kwesikhathi.

I-Medicare ingxenye B ikhokhela izihlalo ezinamasondo uma unezinkinga zokuhamba ngaphakathi ikhaya lakho. Ngeke ikukhokhele isihlalo esinamasondo uma unenkinga yokuhamba nje ngaphandle ikhaya lakho.

Ngabe iMedicare ihlanganisa nini izihlalo ezinamasondo?

I-Medicare Part B izokhokha iningi lezindleko zesihlalo sakho sabakhubazekile uma udokotela wakho wokunakekela oyinhloko (i-PCP) noma umhlinzeki wezokunakekelwa kwezempilo ekunakekela ngesimo esithinta ukuhamba kwakho abhale i-oda elilodwa. I-oda likadokotela wakho kufanele likwenze kucace ukuthi:

• Isimo sezokwelapha sibangela izingqinamba zokuhamba okukuvimbela ukuthi unakekele izidingo zakho zansuku zonke. Isibonelo, isimo sakho sempilo sikugcina ungakwazi ukufika endlini yangasese noma ekhishini ngokuphepha, noma ngabe usebenzisa izinduku, isihambahamba, noma induku.

• Uyakwazi ukusebenzisa ngokuphepha uhlobo lwemishini oyicelayo, noma unomuntu ekhaya lakho ohlale ekhona ukuze akusize usebenzise isihlalo sabakhubazekile lapho usidinga.

• Udokotela wakho nomhlinzeki wemishini yezokwelapha bobabili bangabahlinzeki abagunyaziwe beMedare. Kukhona uhlu lwabahlinzeki, futhi ungacela udokotela wakho nenkampani enikezela ngemishini ukuthi iqiniseke ukuthi bagunyazwe yi-Medicare.

• Ungayisebenzisa ngokuphepha le divayisi ekhaya lakho ngaphandle kokubeka engozini ukulimala noma izingozi ngenxa yezitezi ezingalingani, izithiyo ezisendleleni yakho, noma iminyango emincane kakhulu esihlalweni sakho sabakhubazekile.

Imithetho yokuthi ungasithola kanjani isihlalo esinamasondo ingashintsha okwesikhashana uma uMongameli wase-U.S., UMnyango Wezempilo kanye Nezinsizakalo Zabantu, noma umbusi wakho wezwe ememezela isimo esiphuthumayo noma inhlekelele endaweni yangakini. Ukuthola ukuthi ukunye yalezo zindawo, ungashayela i-1 (800) MEDICARE (800-633-4227). Ungathola futhi imininingwane kuwebhusayithi ye-Federal Emergency Management Agency (FEMA) noma kuwebhusayithi ye-HHS Public Health Emergency.

Uhlobo luni lwesihlalo sabakhubazekile oluzofakwa yiMedicare?

Izihlalo ezinamasondo zibhekwa njengezinto zokwelashwa ezihlala isikhathi eside (i-DME). Kunezinhlobo ezintathu eziyisisekelo zezihlalo ezinamasondo: izihlalo ezinamasondo ezihamba ngesandla, izikuta zamandla nezihlalo ezinamasondo.

Yiluphi uhlobo lwesihlalo esinamasondo i-Medicare oluzolimboza kuncike esimweni sakho somzimba kanye nezincomo zikadokotela wakho.

Izihlalo ezinamasondo ezenziwa ngesandla

Uma uqine ngokwanele ukuthi ungangena futhi uphume esihlalweni sabakhubazekile futhi usebenzise esisodwa uma udinga, lolu hlobo lwesihlalo esinamasondo lungaba yisinqumo esihle kuwe.

Noma ungenawo amandla omzimba aphezulu wokusebenzisa isihlalo sabakhubazekile, usengakulungela ukuthola uma kukhona othile ekhaya nawe ongakusiza ungene futhi uphume kuyo, futhi ngubani ongakusiza ukuthi usisebenzise ngokuphepha .

Uma izinkinga zakho zokuhamba zingezesikhashana - uma, ngokwesibonelo, uke wahlinzwa waguqulwa ngamadolo futhi ulindele ukuthi uphinde uhambe futhi maduzane - ungahle uthande ukucabanga ngokuqasha okokusebenza esikhundleni sokukuthenga.

Izikuta zamandla

Uma ungeke ukwazi ukusebenzisa ngokuphepha isihlalo esinamasondo, uMedicare angakhokhela isithuthuthu esinamandla. Ukuze ufanelekele isikuta samandla, kuzodingeka ukuthi uvakashele wena nodokotela wakho ukuze uqinisekise ukuthi unamandla anele wokungena uphume uwedwa futhi uzibambe ume lapho usishayela.

Njengoba kunjalo ngezihlalo ezinamasondo ezihamba ngesandla, ungahle uthande ukunquma ukuthi ukuqasha kuyindlela engcono yini kunokuthenga imishini ngqo.

1. Bheka udokotela wakho ukuze uthole incwadi kadokotela yesihlalo sabakhubazekile.
2. Thola ukuthi ngabe uhlangabezane nemali yakho ebanjwayo edonswa minyaka yonke ukuze wazi ukuthi yini ongalindela ukuyikhokhela ngesihlalo sakho esinamasondo.
3. Xhumana nomhlinzeki we-DME obhalise nge-Medicare.
4. Cela umphakeli wakho we-DME ukuthi athumele isicelo sokugunyazwa kwangaphambilini uma kudingeka.
5. Uma isicelo sakho sinqatshiwe, sebenzisana nodokotela wakho kanye nomhlinzeki we-DME ukunikeza imininingwane eyengeziwe edingwa yiMedicare.

Izihlalo ezinamasondo ezinamandla

Ukuze uthole isihlalo esinamasondo esinamandla, udokotela wakho uzodinga ukukuhlola mathupha. Ngemuva kokuhlolwa kwakho, udokotela wakho uzodinga ukubhala i-oda ethi uyakwazi ukusebenzisa isihlalo esinamasondo esinamandla ngokuphepha futhi uchaze ukuthi kungani usidinga.

Izinhlobo ezithile zezihlalo ezinamasondo ezinamandla zidinga "ukugunyazwa kwangaphambili" ngaphambi kokuthi usithole. Lokho kusho ukuthi udinga ukugunyazwa yi-Medicare ngaphambi kokuthi uthenge noma uqashe idivayisi. Isicelo sokuqala sokugunyazwa kufanele sisekelwe yi-oda evela kudokotela wakho kanye namafomu ahlinzekwa ngumhlinzeki wakho wezinto zokwelashwa.

Kuphakathi kokuthi wena noma umhlinzeki wakho wezinto zokwelashwa ungahambisa imibhalo edingekayo kuDurable Medical Equipment Medicare Administrative Contractor (DME MAC). Kufanele ube nesinqumo esivela ku-DME MAC cishe ezinsukwini eziyi-10 ngemuva kokufaka isicelo.

Uma i-Medicare ingavumi ukuthenga kwakho, unelungelo lokufaka isikhalazo ngaleso sinqumo. Wena noma umhlinzeki wakho wezinto zokwelashwa ungachaza ngokuningiliziwe ukuthi kungani udinga ukuthi idivayisi isebenze ekhaya lakho.

Ukubona izinhlobo ezingama-33 zezikuta zamandla nezihlalo ezinamasondo ezidinga ukugunyazwa kwangaphambili, hlola uhlu lwamanje lapha.

Ingabe i-Medicare ikhava ukuphakama kwesiguli?

Uma udokotela wakho ekholelwa ukuthi uzodinga ukukusiza ukuthi usuke embhedeni uye esihlalweni sakho sabakhubazekile, iMedicare Part B izokhipha amaphesenti angama-80 aleyo ndleko. Uzoba nesibopho samaphesenti angama-20 asele ezindleko.

I-Medicare ichaza i-lift njengemishini yezokwelapha ehlala njalo (i-DME).

Kuthiwani ngempambuko yesihlalo sabakhubazekile?

Noma i-ramp yesihlalo sabakhubazekile ingadingeka kwezokwelapha, iMedicare Part B ayicabangi ukuthi umgwaqo wezokwelapha ohlala isikhathi eside unemishini yokwelashwa, ngakho-ke izindleko zerampu yesihlalo sabakhubazekile azimboziwe. Uma ufuna ukufaka umgwaqo wesihlalo sabakhubazekile, kuzodingeka ukuthi ukhokhele lokho uwedwa.

Yiziphi izindleko zokuphuma ephaketheni zezihlalo ezinamasondo uma une-Medicare?

I-Medicare Part B ikhokha amaphesenti angama-80 ezindleko zesihlalo sabakhubazekile ngemuva kokuthi uhlangane nemali yakho ekhishwayo yonyaka. Uzokhokha amaphesenti angama-20 wezindleko ngaphezu kwama-premium wakho wonyaka we-Medicare. Ungase futhi ube nezindleko ze-copay ezihambisana nanoma ikuphi ukuvakashelwa odokotela okudingekayo ukuthola isihlalo sakho sabakhubazekile.

Kwezinye izingxenye zezwe, abahlinzeki be-DME badingeka ukuthi babambe iqhaza ohlelweni lokubhida ngokuncintisana, olusiza ukugcina izindleko zilawuleka. Kodwa-ke, lolo hlelo lokubhida lokuncintisana lumiswe okwesikhashana kuze kube nguJanuwari 1, 2021.

Ngaleli gebe lesikhashana, kubaluleke kakhulu ikakhulukazi ukuthi wazi amasu wokukhangisa anolaka asetshenziswa abanye abahlinzeki be-DME. Uma unanoma yimiphi imibuzo noma ukukhathazeka mayelana nomhlinzeki we-DME, noma ngomuntu ofike ekhaya lakho ezozama ukukuthengisela i-DME, ungashayela Inombolo Yocingo Lokukhwabanisa yeHHS Office of Inspector General ku 1-800-HHS-TIPS ( 1-800-447-8477) noma ukubike ku-inthanethi.

Yiziphi izinhlelo zeMedicare ezingaba ngcono kuwe uma wazi ukuthi udinga isihlalo sabakhubazekile?

Uma ucabanga ukuthi uzodinga isihlalo sabakhubazekile ngo-2020 futhi ufanelekile ukuthola iMedicare, kuzodingeka unqume ukuthi yiluphi uhlelo oluzohlangabezana kangcono nezidingo zakho.

I-Medicare Part A ihlanganisa ukulaliswa esibhedlela. Uma udinga isihlalo sabakhubazekile ngesikhathi uhlala esibhedlela noma ngenkathi usekhaya labahlengikazi, isikhungo sizokunikeza esisodwa.

I-Medicare Part B ihlanganisa izinsizakalo zezokwelapha. Ngaphansi kwengxenye B, izihlalo ezinamasondo zimbozwa njengezinto zokwelashwa ezihlala isikhathi eside.

I-Medicare Part C ibizwa nangokuthi i-Medicare Advantage. Njengoba izinhlelo zeMedicare Advantage zidingeka ukumboza izinzuzo ezifanayo neMedicare yangempela (izingxenye A no-B), izihlalo ezinamasondo zimbozwe ngaphansi kwalezi zinhlelo. Izinzuzo nezidingo ezithile zizohluka kusuka ohlelweni lokuhlela.

I-Medicare Part D iwukusetshenziswa kwezidakamizwa kadokotela. Noma udinga udokotela noma i-oda likadokotela ukuthola isihlalo sabakhubazekile, azimboziwe ngaphansi kwale ngxenye yeMedicare.

IMedigap (ama-Medicare supplements) yizinhlelo zokungezelela ukukusiza ukuthi ukhokhele izindleko uMedicare angazikhokhi. Ezinye izinhlelo zeMedigap zingakusiza ukuthi ukhokhele ezinye noma zonke izindleko zesihlalo sabakhubazekile.

Ngabe iMedicare iyazikhokhela ezinye izinsiza zokuhamba?

I-Medicare Part B ikhokhela amaphesenti angama-80 wezindleko zabahambahambayo, ama-rollers, izinduku, kanye nezinduku (ngemuva kokuthi kukhishwe imali yakho). Uzodinga ukukhokha amanye amaphesenti angama-20 wezindleko. Njengesihlalo sabakhubazekile, udokotela wakho uzodinga ukubhala i-oda ethi idivaysi yokuhamba iyadingeka ngokwezokwelapha kuwe.

Okubalulekile

Uma unesimo sempilo esikhawulela ukuhamba kwakho ekhaya lakho futhi sikugcine ungakwazi ukunakekela izidingo zakho zansuku zonke, iMedicare Part B izokhokha amaphesenti angama-80 wezindleko. Uzoba nesibopho sokukhokha amaphesenti angu-20 wezindleko, kanye nemali yakho ekhishwayo, izinkokhelo ze-premium, nanoma yimaphi ama-copayments ahlobene.

Izinzuzo zeMedicare zimboza izihlalo ezinamasondo ezihamba ngesandla, izikuta zamandla, nezihlalo ezinamasondo. Kubalulekile ukuqinisekisa ukuthi udokotela wakho nomhlinzeki wakho wezinto zokwelashwa bobabili babhalise kwi-Medicare ngaphambi kokuba uthole isihlalo sabakhubazekile.

Umhlinzeki wakho wezokunakekelwa kwempilo uzodinga ukubhala i-oda echaza ukuthi kungani udinga le divayisi, futhi umphakeli wakho wezinto zokwelashwa kungadingeka ukuthi ahambise amafomu engeziwe ngokuya ngohlobo lwesihlalo esinamasondo osidingayo.

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.