Ngaba unyango lweCaractact luyanyanga?

Umxholo

• Kubiza malini ukwenza utyando ngamehlo?
• Zithini iindleko ngeMedicare?
• Zeziphi iindawo zonyango lwe-Medicare ezigquma utyando?
• Icandelo lezaMayeza A
• Icandelo leMedare B
• Icandelo lonyango Medic C
• Icandelo leMedare D
• Izicwangciso zokongeza amayeza (iMedigap)
• Ungazi njani ukuba iindleko zakho ziya kuba yintoni ngaphambi kotyando lwamehlo?
• Zeziphi ezinye izinto ezinokuchaphazela ukuba uhlawula malini?
• I-cataract kunye ne-cataract operation
• Umgca wezantsi

Utyando lweCataract yinkqubo eqhelekileyo yamehlo. Kuqhaqho olukhuselekileyo ngokubanzi kwaye kugutyungelwe yiMedicare. Ngaphezulu kwama-50 eepesenti abantu baseMelika abaneminyaka engama-80 okanye nangaphezulu banesifo sokukrala kwamehlo okanye baye bahlinzwa ngamehlo.

I-Medicare yinkqubo yaseburhulumenteni yase-US ekhathalela iimfuno zempilo zabantu abaneminyaka engama-65 nangaphezulu. Ngelixa i-Medicare ingagubungeli ukujonga umbono oqhelekileyo, iyagubungela utyando lwe-cataract kubantu abangaphezu kweminyaka engama-65.

Kuya kufuneka uhlawule iindleko ezongezelelweyo ezinje ngesibhedlele okanye iifizi zeklinikhi, iimali ezixhuzulwayo, kunye neentlawulo zokubambisana.

Ezinye iintlobo ze-inshurensi yezempilo ye-Medicare inokugubungela ngaphezulu kunezinye. Iindidi ezahlukeneyo zoqhaqho olwenziwe ngamehlo nazo zineendleko ezahlukeneyo.

Kubiza malini ukwenza utyando ngamehlo?

Zimbini iintlobo eziphambili zoqhaqho lwamehlo. I-Medicare igubungela utyando kokubini kwinqanaba elifanayo. Ezi ntlobo zibandakanya:

• Iphacoemulsification. Olu hlobo lusebenzisa i-ultrasound ukophula ilensi enamafu ngaphambi kokuba isuswe kwaye kufakwe ilensi ye-intraocular lens (IOL) ukufaka ilensi enamafu.
• Ngaphandle. Olu hlobo lususa ilensi enamafu kwisiqwenga esinye, kwaye i-IOL ifakwa endaweni yelensi enamafu.

Ugqirha wamehlo wakho uya kugqiba ukuba loluphi uhlobo lotyando olulungele wena.

NgokweAmerican Academy of Ophthalmology (AAO) ngo-2014, indleko ngokubanzi zotyando lwamehlo kwiliso elinye ngaphandle kweinshurensi yayimalunga ne- $ 2,500 yemirhumo yotyando, umrhumo weziko lotyando ngaphandle, umrhumo we-anesthesiologist, i-lens yokufaka, kunye neenyanga ezintathu yokunyamekela emva kokuhlinzwa.

Nangona kunjalo, la maxabiso aya kwahluka ngurhulumente kunye nemeko ethile kunye neemfuno zomntu.

Zithini iindleko ngeMedicare?

Iindleko ezichanekileyo zotyando lwe-cataract ziya kuxhomekeka:

• Isicwangciso sakho seMedicare
• uhlobo lotyando olifunayo
• uthatha ixesha elingakanani
• apho utyando khona (eklinikhi okanye esibhedlele)
• ezinye iimeko zonyango onazo
• iingxaki ezinokubakho

Iindleko eziqikelelweyo zotyando lwe-cataract zinokuba *:

• Kwiziko lotyando okanye eklinikhi, ixabiso lilonke lixabisa i $ 977. I-Medicare ihlawula i-781 yeedola, kwaye indleko yakho yi- $ 195.
• Esibhedlele (isebe lezonyango), indleko zizonke zi- $ 1,917. I-Medicare ihlawula i- $ 1,533 kwaye iindleko zakho yi- $ 383.

Ngokwe-Medicare.gov, ezi ntlawulo azibandakanyi iifizi zoogqirha okanye ezinye iinkqubo ezinokuba yimfuneko. Ziyimilinganiselo yesizwe kwaye ingahluka ngokuxhomekeke kwindawo.

Zeziphi iindawo zonyango lwe-Medicare ezigquma utyando?

I-Medicare igubungela utyando olusisiseko lwe-cataract kubandakanya:

• ukususwa kwamehlo
• ukufakelwa kwelensi
• Isibini seendondo zamehlo okanye iseti yeelensi zonxibelelwano emva kwenkqubo

I-Medicare yoqobo yahlulwe yangamacandelo amane aphambili: A, B, C, kunye no-D. Unokuthenga iMedigap, okanye isongezo, isicwangciso. Icandelo ngalinye ligubungela uhlobo olwahlukileyo lweendleko zokhathalelo lwempilo. Utyando lwakho lwe-cataract lunokugqunywa ngamacandelo aliqela kwisicwangciso sakho seMedicare.

Icandelo lezaMayeza A

Icandelo leMedicare A ligubungela iindleko zonyango kunye nezibhedlele. Ngelixa kwiimeko ezininzi kungekho sibhedlele sifunekayo kutyando lwe-cataract, ukuba ufuna ukwamkelwa esibhedlele, oku kuya kuba phantsi kweCandelo A.

Icandelo leMedare B

Icandelo leMedicare B ligubungela izigulana ezingalaliswayo kunye nezinye iindleko zonyango. Ukuba une-Medicare yoqobo, utyando lwe-cataract luya kugqunywa phantsi kweCandelo B. Icandelo B likwagubungela ukuqeshwa kogqirha njengokubonana nogqirha wakho wamehlo ngaphambi nasemva kotyando lwamehlo.

Icandelo lonyango Medic C

Icandelo lonyango i-Medicare Part C (i-Advantage Plans) ligubungela iinkonzo ezifanayo nezahlulo zoNyango lwe-Medicare A no-B. Kuxhomekeke kwisiCwangciso seNzuzo osikhethayo, konke okanye inxenye yotyando lwakho lwamehlo luzakugutyungelwa.

Icandelo leMedare D

Icandelo D ligubungela amayeza athile amiselweyo. Ukuba ufuna amayeza kagqirha emva kotyando lwakho lwamehlo, inokugqunywa yiCandelo leMedicare D. Ukuba amayeza akho awekho kuluhlu oluvunyiweyo, kungafuneka uhlawule ngaphandle kwepokotho.

Amanye amayeza ahambelana notyando lwakho anokugutyungelwa iCandelo B ukuba athathelwa ingqalelo iindleko zonyango. Umzekelo, ukuba ufuna ukusebenzisa amathontsi wamehlo athile kuphela ngaphambi kotyando lwakho, anokugutyungelwa iCandelo B.

Izicwangciso zokongeza amayeza (iMedigap)

Izicwangciso zokuncedisa kwiMedare (iMedigap) zigubungela iindleko ezithile ezingafakwanga yiMedicare yoqobo. Ukuba unesicwangciso seMedigap, tsalela umnxeba umboneleli wakho wezempilo ukuba ufumanise ukuba zeziphi iindleko ezigubungelayo. Ezinye izicwangciso zeMedigap zigubungela ezitsalwayo kunye nokubhatala imali kumacandelo eMedare A kunye no-B.

Ungazi njani ukuba iindleko zakho ziya kuba yintoni ngaphambi kotyando lwamehlo?

Ukuchonga into onokuyidinga ukuba uyihlawule ukuphuma epokothweni ngotyando lwakho lwamehlo, uya kudinga ulwazi kugqirha wamehlo nakwinkonzo yakho ye-Medicare.

Unokucela ugqirha wakho okanye umboneleli we-inshurensi le mibuzo ilandelayo ukukunceda ekuchongeni iindleko zakho zokuphuma epokothweni zotyando lwamehlo:

• Ngaba uyayamkela iMedicare?
• Ngaba le nkqubo iya kwenziwa kwiziko lotyando okanye esibhedlele?
• Ngaba ndiza kuba sisigulana esinganyangekiyo okanye isigulana esingaphandle kwesi sigulo?
• Ngawaphi amayeza amiselweyo endiya kuwadinga ngaphambi nasemva kotyando lwamehlo?
• Ithini ikhowudi ye-Medicare okanye igama elithile lenkqubo oceba ukuyenza? (Ungayisebenzisa le khowudi okanye igama ukujonga iindleko kwinkqubo yokujonga ixabiso lamaMedicare.)

Ugqirha wakho unokukwazi ukukuxelela ukuba yeyiphi ipesenti yoqhaqho olugutyungelweyo kunye nento oza kuba nayo ngaphandle kwe-pocket.

Ukuba uthenge i-Medicare Advantage okanye esinye isicwangciso ngomboneleli wabucala we-inshurensi, umboneleli wakho unokukuxelela iindleko zakho ezilindelwe ngaphandle kwepokotho.

Zeziphi ezinye izinto ezinokuchaphazela ukuba uhlawula malini?

Imali echanekileyo oza kuyihlawula ngaphandle kwe-pocket iya kugqitywa yi-Medicare yakho yokugubungela kunye nezicwangciso ozikhethayo. Eminye imiba yokugubungela eya kuthi ichonge iindleko zakho zokuphuma epokothweni zibandakanya:

• izicwangciso zakho zonyango
• utsalo lwakho
• imida yakho ephume epokothweni
• ukuba unayo enye i-inshurensi yezempilo
• ukuba unayo iMedicaid
• ukuba icandelo leMedicare D ligubungela amayeza owadingayo
• ukuba unezinye iimeko zonyango ezenza inkqubo ibe nzima ngakumbi

Ukuba uligqala, izibonelelo zakho ze-VA zinokufikeleleka ngakumbi kuqhaqho lwamehlo.

I-cataract kunye ne-cataract operation

Ifom yekati xa ilensi ecacileyo yamehlo akho esiba lukhuni okanye enamafu. Iimpawu zecaract zibandakanya:

• umbono onamafu
• ukungaboni kakuhle okanye ukungaboni kakuhle
• imibala ephelelweyo okanye etyheli
• umbono kabini
• kunzima ukubona ebusuku
• ukubona iihalos ezijikeleze izibane
• uvakalelo ekukhanyeni okuqaqambileyo kunye nelitha
• utshintsho kumbono

Utyando lweCataract lususa ilensi enamafu kwaye ilensi entsha yenziwa ngotyando. Olu tyando lwenziwa ngugqirha wamehlo, okanye ugqirha wamehlo. Utyando lweCataract ngesiqhelo yinkqubo yokunyanga ngaphandle. Oku kuthetha ukuba awuzukuhlala esibhedlele ubusuku bonke.

Umgca wezantsi

Utyando lweCataract yinkqubo eqhelekileyo egutyungelwa yiMedicare. Nangona kunjalo, i-Medicare ayihlawuli yonke into kwaye iMedigap ayinakwenza ukuba kungabi nazindleko kwaphela.

Kuya kufuneka uhlawule imali exhuzulweyo, intlawulo kunye, i-inshurensi kunye nomrhumo weprimiyamu. Unokuba noxanduva lwezinye iindleko ukuba ufuna uqhaqho olungaphezulu kolusu okanye uneengxaki zempilo.

Ulwazi olukule webhusayithi lunokukunceda ekwenzeni izigqibo malunga neinshurensi, kodwa ayenzelwanga ukunika iingcebiso malunga nokuthengwa okanye ukusetyenziswa kwayo nayiphi na i-inshurensi okanye iimveliso zeinshurensi. I-Healthline Media ayihambelani neshishini leinshurensi nangayiphi na indlela kwaye ayinayo ilayisensi njengenkampani yeinshurensi okanye umvelisi kulo naliphi na igunya laseMelika. I-Healthline Media ayikhuthazi okanye ixhase nabani na onokuthi enze ishishini leinshurensi.

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