Luyini Uhlelo Lokuvikela Isifo Sikashukela?

-Delile

• Luthini Uhlelo Lokuvikela Isifo Sikashukela?
• Yikuphi ukumbozwa okunikezwa yiMedicare ngalezi zinsizakalo?
• Ukusabalala kwe-Medicare Part B
• Ukutholakala kwe-Medicare Advantage
• Yiziphi izinsizakalo ezinikezwa ngalolu hlelo?
• Isigaba 1: Izikhathi eziyinhloko
• Isigaba 2: Izikhathi zokugcinwa okuyisisekelo
• Isigaba 3: Izikhathi zesondlo eziqhubekayo
• Ngubani olungele lolu hlelo?
• Ngibhalisa kanjani ohlelweni?
• Ngingathola kanjani okuningi kuhlelo?
• Yini enye embozwe ukunakekelwa kwesifo sikashukela ngaphansi kweMedicare?
• Ukuthatha

• Uhlelo lwe-Medicare Diabetes Prevention Programme lungasiza abantu abasengozini yesifo sikashukela sohlobo 2.
• Lolu uhlelo lwamahhala lwabantu abafanelekayo.
• Kuzokusiza ukulandela indlela yokuphila enempilo futhi wehlise ubungozi besifo sikashukela.

Isifo sikashukela singesinye sezinkinga ezivame kakhulu kwezempilo e-United States. Eqinisweni, abantu abadala baseMelika babenesifo sikashukela kusukela ngo-2010. Kubantu abaneminyaka engama-65 noma ngaphezulu, lelo nani ligxumela ngaphezu komunye kwabangu-4.

I-Medicare, kanye nezinye izinhlangano zezempilo ezifana neCenters for Disease Control and Prevention (CDC), inikela ngohlelo olubizwa nge-Medicare Diabetes Prevention Program (MDPP). Yenzelwe ukusiza abantu abasengozini yesifo sikashukela ukuyivimba.

Uma ufaneleka, ungajoyina lolu hlelo mahhala. Uzothola izeluleko, ukwesekwa, namathuluzi owadingayo ukuze uphile impilo enempilo futhi wehlise nethuba lokuthola isifo sikashukela.

Luthini Uhlelo Lokuvikela Isifo Sikashukela?

I-MDPP yakhelwe ukusiza abahlomuli be-Medicare abanezimpawu ze-prediabetes bathuthukise imikhuba enempilo yokuvikela uhlobo lwesifo sikashukela sohlobo lwe-2. I-Centers for Medicare and Medicaid Services (CMS) yengamela lolu hlelo ezingeni likahulumeni.

Kusukela ngo-2018, i-MDPP inikezwe abantu abafanelekela ukuthola iMedicare. Yakhiwa ngokuphendula inani elikhulayo labantu baseMelika abanesifo sikashukela.

Izinombolo ziphakeme kakhulu kubantu baseMelika abaneminyaka engama-65 nangaphezulu. Eqinisweni, kusukela ngo-2018, amaphesenti angama-26.8 aseMelika angaphezu kweminyaka engama-65 ayenesifo sikashukela. Leyo nombolo kulindeleke ukuthi iphindwe kabili noma iphindwe kathathu.

Isifo sikashukela siyisifo esingelapheki - futhi siyabiza. Ngo-2016 kuphela, i-Medicare yachitha ama- $ 42 billion ekunakekelweni kwesifo sikashukela.

Ukusiza abahlomulayo nokonga imali, kwasungulwa uhlelo lokulinga olubizwa ngeDiabetes Prevention Programme (DPP). Ivumele iMedicare ukuthi ichithe imali ekuvikeleni isifo sikashukela, ngethemba lokuthi lokhu kuzosho imali encane esetshenziswe kamuva ekwelapheni isifo sikashukela.

I-DPP igxile ekuqondisweni kwe-CDC ekwehliseni ubungozi besifo sikashukela kubantu abane-prediabetes. Izindlela zazihlanganisa ukufundisa abantu ababhalise ku-DPP ukuthi:

• shintsha indlela abadla ngayo
• ukwandisa ukusebenza kwabo ngokomzimba
• yenza izinqumo zokuphila okunempilo jikelele

Uhlelo lwasekuqaleni lwasebenza iminyaka emi-2 ezindaweni eziyi-17 futhi lwaba impumelelo enkulu. Kusize ababambiqhaza ukuthi banciphise isisindo, banciphise amathuba abo okuba nesifo sikashukela, futhi babe nokungeniswa esibhedlela okumbalwa. Futhi, igcine imali yeMedicare ekwelashweni.

Ngo-2017, lolu hlelo lwandiswa lwaba yi-MDPP yamanje.

Yikuphi ukumbozwa okunikezwa yiMedicare ngalezi zinsizakalo?

Ukusabalala kwe-Medicare Part B

I-Medicare Part B umshuwalense wezokwelapha. Ngokubambisana neMedicare Part A (umshuwalense wesibhedlela), kwenza lokho okwaziwa njengeMedicare yasekuqaleni. Ingxenye B ihlanganisa izinsizakalo ezifana nokuvakasha kukadokotela, izinsizakalo zeziguli ezingaphandle, nokunakekelwa kokuvikela.

Ukunakekelwa kokuzivikela kumbozwe ngokuphelele kubantu ababhalise kwi-Medicare. Lokhu kusho ukuthi ngeke udinge ukukhokha amaphesenti angama-20 alezi zindleko, njengoba ubungenza ngezinsizakalo eziningi zeNgxenye B.

Ukunakekelwa kokuvimbela kufaka izinhlelo nezinhlelo ezahlukahlukene zokukusiza uhlale uphilile, kufaka phakathi:

• ukuvakashelwa kahle
• ukuyeka ukubhema
• Imigomo
• ukuhlolwa komdlavuza
• ukuhlolwa kwezempilo yengqondo

Njengazo zonke izinsizakalo zokuvimbela, i-MDPP ngeke ikubize lutho uma nje uhlangabezana nezidingo zokufaneleka (okuxoxwe ngazo ngezansi) futhi usebenzise umhlinzeki ovunyelwe.

Ufanelekela i-MDPP kanye kuphela ngesikhathi sokuphila kwakho; IMedicare ngeke iyikhokhele okwesibili.

Ukutholakala kwe-Medicare Advantage

I-Medicare Advantage, eyaziwa nangokuthi i-Medicare Part C, iyindlela ekuvumela ukuthi uthenge uhlelo enkampanini yomshuwalense yangasese esebenza ne-Medicare. Zonke izinhlelo ze-Medicare Advantage ziyadingeka ukuthi zinikeze ukumbozwa okufanayo ne-Medicare yasekuqaleni.

Izinhlelo eziningi ze-Advantage zengeza ukumbozwa okwengeziwe, okufana:

• ukunakekelwa kwamazinyo
• ukunakekelwa kombono
• izinsiza zokuzwa nokuhlolwa
• imishanguzo kadokotela
• izinhlelo zokufaneleka

Izinhlelo zeMedicare Advantage nazo zinikela ngezinsizakalo zokuvikela mahhala. Kepha ezinye izinhlelo zinenethiwekhi, futhi kuzodingeka uhlale kunethiwekhi ukuze uthole ukumbozwa okugcwele. Uma indawo ye-MDPP onentshisekelo kuyo ingekho kwinethiwekhi, ungahle udinge ukuthi ukhokhe ezinye noma zonke izindleko uphume nazo ephaketheni.

Uma kungukuphela kwendawo ye-MDPP endaweni yakho, uhlelo lwakho kungenzeka lusayimboza ngokugcwele. Uma unenketho yendawo yenethiwekhi, noma kunjalo, indawo engaphandle kwenethiwekhi ngeke imbozwe. Ungashayela umhlinzeki wohlelo lwakho ngqo ngemininingwane yokumbozwa.

Njengengxenye B, ungambozwa i-MDPP kanye kuphela.

Yiziphi izinsizakalo ezinikezwa ngalolu hlelo?

Izinsizakalo ozithola ku-MDPP zizofana noma ngabe usebenzisa yiphi ingxenye yeMedicare.

Lolu hlelo lweminyaka emibili luhlukaniswe izigaba ezintathu. Esigabeni ngasinye, uzobe uzibekele imigomo futhi uzothola ukwesekwa ukukusiza ukuhlangabezana nayo.

Isigaba 1: Izikhathi eziyinhloko

Isigaba 1 sithatha izinyanga zokuqala eziyi-6 obhalise ngazo ku-MDPP. Ngalesi sigaba, uzoba nezikhathi zeqembu eziyi-16. Ngayinye izokwenzeka kanye ngesonto cishe ihora.

Izikhathi zakho zizoholwa ngumqeqeshi we-MDPP. Uzofunda amathiphu okudla okunempilo, ukuqina komzimba, nokunciphisa umzimba. Umqeqeshi uzokala nesisindo sakho esimisweni ngasinye ukulandelela intuthuko yakho.

Isigaba 2: Izikhathi zokugcinwa okuyisisekelo

Phakathi nezinyanga ezingu-7 kuya ku-12, uzobe usesigabeni 2. Uzoba khona okungenani amaseshini ayisithupha ngalesi sigaba, noma uhlelo lwakho lunganikela ngokuningi. Uzothola usizo oluqhubekayo ngokuthuthukisa imikhuba enempilo, futhi isisindo sakho sizoqhubeka nokulandelwa.

Ukuze uhambise isigaba sesi-2 esedlule, kuzodingeka ubonise ukuthi uthuthuka ohlelweni. Ngokuvamile, lokhu kusho ukuya okungenani kweseshini eyodwa ezinyangeni eziyi-10 kuya kwezi-12 nokukhombisa ukwehla kwesisindo okungenani kwamaphesenti ama-5.

Uma ungenzi inqubekela phambili, i-Medicare ngeke ikukhokhele ukuze udlulele esigabeni esilandelayo.

Isigaba 3: Izikhathi zesondlo eziqhubekayo

Isigaba 3 yisigaba sokugcina sohlelo futhi sithatha unyaka ongu-1. Lo nyaka uhlukaniswe ngezikhathi ezine zezinyanga ezi-3 lilinye, ezibizwa ngezikhawu.

Uzodinga ukuhambela okungenani amaseshini amabili esikhathini ngasinye futhi uqhubeke nokuhlangabezana nezinhloso zokwehlisa isisindo ukuze uqhubeke ohlelweni. Uzoba nezikhathi okungenani kanye ngenyanga, futhi umqeqeshi wakho uzoqhubeka akusize njengoba ujwayela indlela odla ngayo kanye nendlela ophila ngayo.

I-Medicare ivumela abahlinzeki ukuthi banikele ngezikhathi zokwenza izimonyo kepha ayidingi lokho. Lokhu kusho ukuthi kukumhlinzeki wakho.

Umhlinzeki wakho we-MDPP kufanele akwazise uma ubhalisa ukuthi yiziphi izinketho zakho uma uphuthelwa yiseshini. Abanye abahlinzeki bangakuvumela ukuthi ujoyine elinye iqembu ngobusuku obuhlukile, kanti abanye bangase banikeze umuntu ngamunye noma izikhathi ezibonakalayo.

Ngubani olungele lolu hlelo?

Ukuze uqale i-MDPP, udinga ukuthi ubhalise kwi-Medicare Part B noma ku-Part C. Kuzofanela ukuthi uhlangabezane nezinye izindlela ezengeziwe. Ukuze ubhalise, awukwazanga ukuba:

• utholakale enesifo sikashukela, ngaphandle uma ngabe isifo sikashukela sokukhulelwa
• kutholakale ukuthi unesifo sokuqeda isifo sezinso (ESRD)
• babhalise ku-MDPP ngaphambili

Uma uhlangabezana nalezi zidingo, kuzodingeka ukhombise ukuthi unezimpawu ze-prediabetes. Lokhu kufaka phakathi inkomba yomzimba (BMI) engaphezulu kwama-25 (noma ngaphezulu kwama-23 kubahlanganyeli abakhomba njenge-Asia). I-BMI yakho izobalwa kusukela kusisindo sakho ngezikhathi zakho zokuqala.

Uzodinga nomsebenzi webhu okhombisa ukuthi une-prediabetes. Ungasebenzisa omunye wemiphumela emithathu ukuze ufaneleke:

• ukuhlolwa kwe-hemoglobin A1c ngemiphumela yamaphesenti angu-5.7 kuya kumaphesenti angu-6.4
• Ukuhlolwa kokuhlolwa kwe-plasma glucose ngemiphumela engu-110 kuye ku-125 mg / dL
• ukuhlolwa kokubekezelelana ngomlomo ngomlomo ngemiphumela engu-140 kuya ku-199 mg / dL

Imiphumela yakho izodinga ukusuka ezinyangeni eziyi-12 ezedlule futhi kufanele ube nokuqinisekiswa kukadokotela wakho.

Ngibhalisa kanjani ohlelweni?

Esinye sezinyathelo zakho zokuqala zokubhalisa kufanele kube ukukhuluma nodokotela wakho ngezimpawu zakho ze-prediabetes. Udokotela wakho angaqinisekisa i-BMI yakho yamanje bese e-oda umsebenzi webhu ozowudinga ngaphambi kokujoyina uhlelo.

Ngemuva kwalokho ungasesha izinhlelo endaweni yangakini usebenzisa le mephu.

Qiniseka ukuthi noma yiluphi uhlelo olisebenzisayo luvunyelwe yi-Medicare. Uma unohlelo lweMedicare Advantage (Ingxenye C), uzofuna ukuqinisekisa ukuthi uhlelo lukunethiwekhi.

Akufanele uthole isikweletu salezi zinsizakalo. Uma wenza kanjalo, ungaxhumana neMedicare khona manjalo ngokushayela u-800-Medicare (800-633-4227).

Ngingathola kanjani okuningi kuhlelo?

Kubalulekile ukulungela izinguquko ezizoza ne-MDPP. Ungahle udinge ukwenza izinguquko endleleni yakho yokuphila, kufaka phakathi:

• ukupheka ukudla okuningi ekhaya
• ukudla ushukela omncane, amafutha, ne-carbohydrate
• ukuphuza i-soda encane nezinye iziphuzo ezinoshukela
• ukudla kakhulu inyama nemifino
• ukuzivocavoca umzimba nokwenza umsebenzi omningi

Awudingi ukwenza zonke lezi zinguquko ngasikhathi sinye. Izinguquko ezincane ngokuhamba kwesikhathi zingenza umehluko omkhulu. Futhi, umqeqeshi wakho angakusiza ngokunikeza amathuluzi afana nezindlela zokupheka, amathiphu nezinhlelo.

Kungasiza futhi ukwenza oshade naye, ilungu lomndeni, noma umngane azibophezele kwezinye zalezi zinguquko nawe, noma ngabe zingekho ku-MDPP. Isibonelo, ukuba nomuntu ohamba naye nsuku zonke noma opheka naye kungakugqugquzela phakathi kweseshini.

Yini enye embozwe ukunakekelwa kwesifo sikashukela ngaphansi kweMedicare?

I-MDPP ihloselwe ukuvimbela isifo sikashukela. Uma usuvele unesifo sikashukela noma usithuthukisa ngokuhamba kwesikhathi, ungathola ukumbozwa ngezidingo ezahlukahlukene zokunakekelwa. Ngaphansi kwengxenye B, ukumbozwa kufaka:

• Ukuhlolwa isifo sikashukela. Uthola ukumbozwa kokuhlolwa kabili minyaka yonke.
• Ukuphathwa kwesifo sikashukela. Ukuzilawula kukufundisa indlela yokujova i-insulin, ukuqapha ushukela wegazi lakho, nokuningi.
• Izimpahla zesifo sikashukela. Ingxenye B ifaka izinto ezifana nemichilo yokuhlola, ama-glucose monitors kanye namaphampu e-insulin.
• Ukuhlolwa kwezinyawo nokunakekelwa. Isifo sikashukela singathinta impilo yezinyawo zakho. Ngalesi sizathu, uzokhokhelwa ukuhlolwa kwezinyawo njalo ezinyangeni eziyisithupha. I-Medicare izokhokhela nokunakekelwa nokunikezwa, njengezicathulo ezikhethekile noma ama-prostheses.
• Ukuhlolwa kwamehlo. I-Medicare izokukhokhela ukuze uhlolwe i-glaucoma kanye ngenyanga, ngoba abantu abanesifo sikashukela basengozini enkulu.

Uma une-Medicare Part D (ukutholakala kwezidakamizwa kadokotela), ungathola nokutholakala kwe:

• imishanguzo elwa nesifo sikashukela
• insulini
• izinaliti, imijovo, nezinye izinto

Noma yiluphi uhlelo lweMedicare Advantage luzohlanganisa zonke izinsizakalo ezifanayo neNgxenye B, futhi eziningi zifaka ezinye zezinto ezihlanganiswe yingxenye D futhi.

Ukuthatha

Uma une-prediabetes, i-MDPP ingakusiza uvikele uhlobo lwesifo sikashukela sohlobo 2. Khumbula ukuthi:

• Ukubamba iqhaza kwi-MDPP kumahhala uma ufanelekile.
• Ungaba ku-MDPP kanye kuphela.
• Udinga ukuba nezinkomba zama-prediabetes ukuze ufaneleke.
• I-MDPP ingakusiza wenze izinguquko zokuphila ngendlela enempilo.
• I-MDPP ihlala iminyaka emi-2.

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.