Ukuqonda Izindleko Zokushintshwa Kwamadolo: Kuyini kuMthethosivivinywa?

-Delile

• Kungani izindleko zehluka
• Yini enikela ezindlekweni?
• Izikweletu eziningi
• Izindleko ezimaphakathi
• Amacala okugula
• Izaphulelo
• Imithi
• Umshuwalense wangasese
• Buza udokotela wakho
• Amacala abangalaliswa ngaphandle
• Ukuqonda isikweletu sakho
• Ukulungiselela iPresurgical
• Ukuhlala esibhedlela nokuhlinzwa
• Ukunakekelwa kwe-Posturgical
• Amanani
• Izindleko ezingeziwe
• Izinsiza kusebenza
• Izinsizakalo zokunakekelwa ekhaya
• Ukulungiswa kwasekhaya
• Izinketho zokonga imali
• Avelaphi la macala?

Izindleko iphuzu elibalulekile okufanele ulicabangele lapho ucabanga ngokuhlinzwa okuphelele kokushintsha amadolo. Kubantu abaningi, imishwalense yabo izokhokhela izindleko, kepha kungahle kube nezindleko ezingeziwe.

Lapha, ungathola okuningi mayelana nezindleko zokuhlinzwa okufakwa esikhundleni samadolo.

Kungani izindleko zehluka

Izindleko zokushintshwa kwedolo zingahluka kakhulu, kuya ngokuthi uhlala kuphi, yimuphi umtholampilo owusebenzisayo, impilo yakho yonke, nezinye izinto.

Yini enikela ezindlekweni?

Umthethosivivinywa wokugcina wesibhedlela uzoncika ezintweni eziningi, ezibandakanya:

• Inani lezinsuku ozihlala esibhedlela. Lokhu kuzoncika ekutheni ukuguqulwa kwamadolo kwakho kuphelele, kuyingxenye, noma kungamazwe amabili.
• Uhlobo lokufakelwa nokuhlinzwa. Lokhu kufaka phakathi okokufaka okwenziwe nokusetshenziswa kwanoma yiziphi izinsimbi zokuhlinza ezenziwe ngokwezifiso noma ubuchwepheshe obukhethekile bekhompyutha.
• Izimo esezikhona. Ungadinga ukunakekelwa okwengeziwe esibhedlela noma ezinye izindlela zokuqapha ngesikhathi sokuhlinzwa.
• Isikhathi esichithwa egumbini lokuhlinza. Uma umonakalo uyinkimbinkimbi, kungathatha isikhathi eside ukusebenza, futhi lokhu kuzobiza kakhulu.
• Ukunakekelwa okungalindelekile noma okokusebenza. Uma kwenzeka izinkinga, ungadinga ukunakekelwa okwengeziwe.

Izikweletu eziningi

Kuzovame ukuba nezikweletu eziningi ngemuva kokuhlinzwa kokufakwa emadolweni, kufaka phakathi lezo ze:

• ukunakekelwa esibhedlela
• konke ukwelashwa okuvela kudokotela ohlinzayo ngenkathi esesibhedlela
• eminye imisebenzi nezinqubo ezenziwa ngabasebenzi bekamelo lokusebenza

Eminye imisebenzi nezindleko kufaka phakathi umsebenzi owenziwe ngudokotela obulala izinzwa, abasizi abahlinza, abelaphi bomzimba nabanye.

Izindleko ezimaphakathi

Ngokusho kwendatshana ka-2013 e-AARP, izibhedlela zase-U.S. Zikhokhisa u- $ 50,000, ngokwesilinganiso, ngokushintshwa kwamadolo ngokuphelele (TKR). Ukushintshwa kwamadolo okuyingxenye (PKR) kubiza cishe amaphesenti ayishumi kuya kwangu-20 ngaphansi kwe-TKR. Umshuwalense wakho wezempilo kanye neMedicare kuzokhokha iningi lezindleko, kepha kusazoba nezinkokhelo okufanele zenziwe.

Muva nje, iBlue Cross Blue Shield ilinganiselwe ngonyaka we-2019 ukuthi izindleko ezijwayelekile zenqubo yokufaka amadolo esingalalisiwe yayingu- $ 30,249, uma kuqhathaniswa ne- $ 19,002 njengesiguli esingalalisiwe.

Isizathu esikhulu ukuthi i-PKR idinga ukuhlala isikhashana esibhedlela: isilinganiso sezinsuku ezingama-2.3, uma kuqhathaniswa nezinsuku ezingama-3.4 ze-TKR.

Khumbula ukuthi izindleko zasesibhedlela azibonisi inani olikhokhayo ephaketheni. Ungafunda kabanzi ngezindleko eziphuma ephaketheni ngezansi.

Amacala okugula

Amacala okuphulukisa iziguli yilezo ezenzeka ngenkathi usesibhedlela.

Izinkokhelo ezivela kudokotela ohlinzayo nakwabanye abahlinzeki bezempilo zingangeza cishe isilinganiso esingu- $ 7,500 esikhokhweni sesibhedlela esiyisisekelo ngenqubo, kepha lokhu kuzoya ngomtholampilo nakwezinye izinto.

Izaphulelo

Izibhedlela kwesinye isikhathi zizohlinzeka ngezaphulelo uma ungenayo umshuwalense wezempilo noma ungamboziwe yiMedicare. Buza mayelana nesaphulelo noma uhlelo lokukhokha ngaphambi kokuhlela ukuhlinzwa kwakho uma ungenayo imishwalense. Kufanele uzame ukulinganisa izindleko zakho kusengaphambili ukuthi unawo yini umshuwalense noma cha.

Imithi

Uma usufinyelele emalini yakho ekhishwayo, iMedicare ikhokha amaphesenti ayi-100 amacala eziguli ahlobene nenqubo nokuhlala esibhedlela. Izinhlelo zomshuwalense wangasese zixoxisana kuqala ngemali nezibhedlela nabahlinzeki. Imvamisa bakhokha kuphela iphesenti lamanani esewonke.

Umshuwalense wangasese

Umshuwalense wangasese uyehluka, futhi kubalulekile ukubuyekeza uhlelo lwakho lwezinzuzo ngaphambi kokuhlela ukushintshwa kwedolo.

Hlola amaphuzu alandelayo ngaphambi kokwenza isinqumo sakho:

• yakho ebanjwayo
• Yibaphi abahlinzeki abakunethiwekhi yakho yomshuwalense
• okuhlinzeka ngomshwalense wakho owuhlinzekayo

Buza udokotela wakho

Ngaphambi kokuhlela ukuhlinzwa, khuluma nodokotela wakho, ummeleli wesibhedlela, nomhlinzeki wakho womshuwalense ukuthola ukuthi yiziphi izindleko ezijwayelekile endaweni yakho nokuthi iziphi izaphulelo ezingasebenza.

Amacala abangalaliswa ngaphandle

Izinqubo zokwelashwa kanye nezindleko zesibhedlela kuzoba izindleko zakho ezinkulu.

Kodwa futhi uzodinga ukukhokhela izinsizakalo zeziguli ezingakalali ngaphambi nangemva kwenqubo yakho. Ukuphulukiswa kwezifo kusho izinsizakalo ezenzeka uma ungekho esibhedlela.

Lezi zindleko ezingeziwe zifaka:

• izindleko zangaphambi nangemva kokuhlinzwa kusuka ekuvakasheni kwehhovisi nasemsebenzini waselebhu
• ukwelashwa ngokomzimba
• ukuvakashelwa okulandelayo nodokotela wakho ohlinzayo lapho ululama

I-Medicare imvamisa ikhokha amaphesenti angama-80 wezindleko zenkonzo yokugula kwamalungu ayo. Izinhlelo zomshuwalense wangasese ziyahlukahluka.

Kufanele ulindele ukuthi kudonswe imali kanye nama-copay ukuze afakwe kunoma yiziphi iziguli ezigula ngaphandle noma ezivakashelwa ehhovisi ngaphambi nangemva kokuhlinzwa kwakho.

Ukuqonda isikweletu sakho

Izikweletu ziyahlukahluka, kodwa nakhu ongakulindela ngokuvamile uma ungashintshwa ngamadolo:

Ukulungiselela iPresurgical

Isigaba sokuhlolwa kwaphambi kokuhlinzwa siqukethe ukubonisana noma ukuvakashelwa kwehhovisi, ukusebenza ngeso lengqondo kanye nomsebenzi waselebhu. Umsebenzi webhu uvame ukufaka umsebenzi wegazi, amasiko, nokuhlolwa kwephaneli.

Inani lezinsizakalo ezilindelekile nezindleko eziphelele ziyahluka ngokutholakala komshuwalense kanye neqembu leminyaka.

Isibonelo, umuntu oneminyaka engaphezu kwengama-65, ovame ukumbozwa yi-Medicare, ngokuvamile udinga umsebenzi omningi welebhu kunomuntu ongaphansi kweminyaka engama-65. Lokhu kungenxa yokuthi umuntu omdala osekhulile kungenzeka abe nezimo esezikhona okumele ziqondwe ngokugcwele ngesikhathi sokuhlolwa kwezokwelapha.

Ukuhlala esibhedlela nokuhlinzwa

Uzothola izikweletu ezihlukile ze-TKR. Njengoba kushiwo ngenhla, isibhedlela sizokukhokhisa ngokuhlala kwakho, isikhathi osichitha egumbini lokuhlinza, nezinye izinsizakalo zesibhedlela, izimpahla, nemishini esetshenzisiwe.

Abahlinzeki bazokukhokhela izindleko zenqubo ezibandakanya amasevisi ahlinzekwa udokotela ohlinzayo, kanye ne:

• izinzwa
• imijovo
• izinsizakalo zezifo
• usizo lokuhlinza, isibonelo, ukusebenza kobuchwepheshe obusizwa ikhompyutha noma obunye ubuchwepheshe
• ukwelashwa ngokomzimba
• ukudidiyela ukunakekelwa

Khumbula ukuthi ezinye izinto eziningi zingathinta izindleko nezindleko ezihlobene nenqubo.

Izinkinga zingathinta noma ngubani, kepha abantu abanezimo esezikhona bangaba sengozini enkulu. Uma kwenzeka izinkinga, ungadinga ukunakekelwa okwengeziwe, futhi lokhu kuzokwengeza kwisikweletu sakho.

Isifo sikashukela, ukukhuluphala ngokweqile, kanye ne-anemia konke kuyizibonelo zezimo ebezikhona.

Ukunakekelwa kwe-Posturgical

Ukuvuselelwa nokuvuselelwa kufaka phakathi:

• izinsizakalo zokwelashwa kweziguli ezingaphandle
• noma yimaphi amathuluzi kanye nokwelashwa okusetshenziswa ngumelaphi womzimba
• ukulandelwa kweziguli

Amanani

Izindleko ezijwayelekile zokuphuma ephaketheni e-United States zihluka kakhulu. Kuzoya ngohlelo lwakho lomshuwalense.

Ezigulini ze-Medicare, izindleko ezingaphandle kwezikhwama zingaba ngamakhulu ama-dollar. Labo abanomshuwalense wangasese bangalindela ukuthi lezi zindleko zifinyelele ezinkulungwaneni.

Buyekeza uhlelo lwakho ngokucophelela uma unomshuwalense wangasese. Khumbula ukufaka amanani akho akhishwayo, i-copay, i-coinsurance, namanani aphuma ephaketheni amaningi.

Izindleko ezingeziwe

Izindleko zokunakekelwa nezinsizakalo ziyingxenye yezindleko nje kuphela.

Izinsiza kusebenza

Kungaba nezinkokhelo ezingeziwe zemishini ekhethekile, eyaziwa njengemishini yezokwelapha eqinile, njengomshini wokunyakaza oqhubekayo, i-walker, noma izinduku.

Izinsizakalo zokunakekelwa ekhaya

Izinhlelo eziningi zomshuwalense kanye neMedicare zihlanganisa lawa madivayisi. Kodwa-ke, zingavela njengezindleko ezengeziwe kwisikweletu sakho sesibhedlela noma kwenye inkokhelo.

Ungadinga futhi ukwelashwa okwengeziwe komzimba noma umhlengikazi ekhaya lakho.

Lindela ukukhokha ephaketheni uma umshwalense wakho ungazibandakanyi izinsizakalo zokunakekelwa kwasekhaya.

Kuzoba nezindleko ezingeziwe uma ungakwazi ukubuyela ekhaya ngokushesha futhi udinga ukuchitha isikhathi endaweni yokuvuselela noma yokuhlengikaza ukuthola ukunakekelwa okwengeziwe.

Ukulungiswa kwasekhaya

Ungadinga ukufaka izinto zokuphepha ekhaya lakho, njenge:

• imigoqo yokuphepha kanye nomzila
• ibhentshi lokugeza
• isikhuphukeli esihlalweni sangasese esinezingalo

Khumbula ukuthola imali engenayo elahlekile uma uthatha ikhefu emsebenzini uyohlinzwa noma usalulama. Khuluma nomqashi wakho nomhlinzeki womshuwalense ukuthola ukuthi ngabe uyafaneleka yini kunoma yiziphi izinketho zomshuwalense wokukhubazeka ezifaka isikhathi sokuphumula emsebenzini.

Umshuwalense wokukhubazeka uhlobo lomshwalense okhokhela umholo oyingxenye kubasebenzi abangakwazi ukusebenza ngenxa yokulimala noma ukukhubazeka. Kungafaka isikhathi sokuphumula osidingayo ngokuhlinzwa okufana nama-TKRs.

Funda kabanzi mayelana nokuthi ungalilungisela kanjani ikhaya lakho ukululama.

Izinketho zokonga imali

Abanye abantu bakhetha ukuhlinzwa phesheya kwezilwandle. Izindleko zingaphansi kakhulu emazweni afana neMexico, India, noma iTaiwan. Kodwa-ke, ungachitha izinkulungwane zamaRandi ngamathikithi endiza, amahhotela, nezindleko ezihlobene.

Uma ucabanga ukuthatha lo mzila, qiniseka ukuthi isikhungo sinokugunyazwa kwamazwe yi-Joint Commission International ngaphambi kokuvuma inqubo.

Uma kunjalo, lokhu kusho ukuthi odokotela abahlinzayo bayavunyelwa nokuthi izinsiza kanye nokufakelwa kufinyelela emazingeni aphakeme kakhulu.

Ngokwazi izindleko kusengaphambili, ungagwema ukumangala - nobunzima obukhona - phansi komugqa.

Avelaphi la macala?

Umthethosivivinywa wokushintshwa kwamadolo ngokuphelele unezindleko zombili zangaphambi nangemva kokuhlinzwa, kanye nentengo yokuhlinzwa uqobo, ngamacala ahlanganisa:

• ukuvakashelwa udokotela kanye nomsebenzi webhu
• ukuhlinzwa nesikhathi osichitha egumbini lokuhlinza, kufaka phakathi izindleko ze-anesthesia namanye amathuluzi asetshenzisiwe
• ukuhlala kwakho esibhedlela
• ukuvakasha kodokotela ngemuva kokuhlinzwa
• ukwelashwa ngokomzimba