Ukuqhuba phantsi: Ngaba i-Medicare igubungela amazinyo?

Umxholo

• Unonophelo lwamazinyo luhlawulwa nini lonyango lokuqala?
• Uncedo lweMedicare (Icandelo C) kunye nokugubungela amazinyo
• Ngaba ukugubungela iMedigap kuyanceda ukuhlawulela iinkonzo zamazinyo?
• Ixabisa malini uvavanyo lwamazinyo oluqhelekileyo?
• Zeziphi izicwangciso zeMedicare ezingangcono kuwe ukuba uyazi ukuba ufuna iinkonzo zamazinyo?
• Ukuthelekisa izicwangciso zeMedicare zokugubungela amazinyo
• Olunye ukhetho lokugubungela amazinyo
• Kutheni kubalulekile ukufumana ukogquma amazinyo njengoko usiya ukhula
• Umgca wezantsi

Indawo zokuqala zeMedare A (ukhathalelo lwasesibhedlele) kunye no-B (ukhathalelo lonyango) azibandakanyi ukugubungela amazinyo. Oko kuthetha ukuba yoqobo (okanye "yeklasikhi") i-Medicare ayihlawuli iinkonzo zesiqhelo ezinje ngovavanyo lwamazinyo, ukucoca, ukukhupha izinyo, imijelo yeengcambu, ukufakelwa, izithsaba kunye neebhlorho.

Amayeza e-Medicare A kunye no-B awazibandakanyi izinto zamazinyo ezifana neepleyiti, amazinyo emboleko, izixhobo zeethambo, okanye abagcini.

Nangona kunjalo, ezinye izicwangciso ze-Medicare Advantage, ezibizwa ngokuba yi-Medicare Part C izicwangciso, zibandakanya ukukhutshwa. Isicwangciso ngasinye sineendleko ezahlukeneyo kunye neenkcukacha zokuba isibonelelo singasetyenziswa njani.

Funda ukuze ufumane okungakumbi malunga nokukhethwa kwamazinyo akho ngokusebenzisa i-Medicare.

Unonophelo lwamazinyo luhlawulwa nini lonyango lokuqala?

Ngelixa i-Medicare yoqobo ingagubungeli ukhathalelo lwamazinyo, kukho izinto ezithile eziphawulekayo ngaphandle. Ukuba ufuna ukhathalelo lwamazinyo ngenxa yokugula okanye yokwenzakala efuna ukuhlala esibhedlele, unyango lwamazinyo lunokugqunywa.

Umzekelo, ukuba uyawa kwaye uqhekeze umhlathi wakho, iyeza lokuvuselela amathambo emhlathini wakho.

Ezinye iinkqubo ezintsonkothileyo zamazinyo nazo ziyagutyungelwa ukuba ngaba zenziwa esibhedlele, kodwa nokuba zikhuselwe yiCandelo A okanye iCandelo B kuya kugqitywa ukuba ngubani onika inkonzo.

I-Medicare inokuhlawulela ukhathalelo lwakho ukuba ufuna iinkonzo zamazinyo ngenxa yomhlaza womlomo okanye esinye isifo esigutyungelweyo.

Ukongeza, i-Medicare inokuhlawula ukukhutshwa kwezinyo ukuba oogqirha bakho bacinga ukuba kunyanzelekile ukuba lisuswe izinyo ngaphambi kotyando lwentliziyo, unyango ngemitha, okanye enye inkqubo egqunyiweyo.

Uncedo lweMedicare (Icandelo C) kunye nokugubungela amazinyo

Izicwangciso ze-Medicare Advantage zinikezelwa ziinkampani zeinshurensi zabucala ezivunyiweyo yiMedicare. Ezi zicwangciso ziyenye indlela yonyango lokuqala. Bahlala behlawulela iinkonzo ezingagutyungelwanga ngamacandelo oqobo eMedare A kunye no-B.

Ngolu hlobo lwesicwangciso, unokufuna ukuhlawula ipremiyamu yenyanga okanye intlawulo yeemali zemali. Kuya kufuneka ujonge ukuba ugqirha wakho wamazinyo ukwisicwangciso senethiwekhi ukuze inkonzo igqunywe.

Kukho iindlela ezininzi zokufumanisa ukuba isicwangciso esithile seMedicare Advantage sigubungela ukhathalelo lwamazinyo. I-Medicare ineSixhobo sokuFumana isiCwangciso seMedare esibonisa zonke izicwangciso ezikhoyo kwindawo yakho kunye nezinto abazigubungelayo, kubandakanya ukuba bayabhatala amazinyo. Uninzi lwezicwangciso zokuLuncedo zibandakanya izibonelelo zamazinyo.

Ukuchonga ukuba ngaba isicwangciso sakho sangoku se-Medicare Part C sibandakanya ukogqunywa kwamazinyo, ungathetha nommeli ovela kwi-inshurensi okanye ufunde iinkcukacha eziqulathwe kuXwebhu loBungqina (EOC) olufumene xa ubhalise kwisicwangciso.

Ngaba ukugubungela iMedigap kuyanceda ukuhlawulela iinkonzo zamazinyo?

Ngokubanzi, ukugubungela iMedigap kukunceda ubhatalele iikopi kunye nokutsalwa okunxulumene neenkonzo ezigutyungelwe yonyango lwantlandlolo. Uninzi lwexesha, iMedigap ayinikezeli ngeenkonzo ezongezelelweyo njengokhathalelo lwamazinyo.

Ixabisa malini uvavanyo lwamazinyo oluqhelekileyo?

Kuxhomekeka kwindawo ohlala kuyo, ukucoca amazinyo kunye noviwo kungabiza phakathi kwe- $ 75 ukuya kwi-200 yeedola. Ezo ndleko zinokuphakama xa ufuna ukucoca okunzulu okanye i-X-ray.

Zeziphi izicwangciso zeMedicare ezingangcono kuwe ukuba uyazi ukuba ufuna iinkonzo zamazinyo?

Kuba uninzi lweenkonzo zamazinyo kunye nokubonelelwa azigutyungelwanga yiCandelo leMedicare A kunye neCandelo B, Ukuba uyazi ukuba unokufuna ukhathalelo lwamazinyo kunyaka olandelayo, icebo leMedicare Advantage (Icandelo C) linokuba lukhetho olufanelekileyo.

Xa usenza esi sigqibo, qiniseka ukuba uthathela ingqalelo iimfuno zakho zexesha elizayo kunye nembali yamazinyo yosapho. Ukuba ucinga ukuba kukho ithuba onokufuna ukufakelwa okanye amazinyo emboleko kwixa elizayo, loo nto ke yenza nesigqibo sakho.

Ukuthelekisa izicwangciso zeMedicare zokugubungela amazinyo

Olunye ukhetho lokugubungela amazinyo

Unokufuna kwakhona ukuqaphela ukukhutshwa kwamazinyo ngaphandle kweMedicare. Unokukhetha, njenge:

• I-inshurensi yamazinyo ezimele yodwa. Ezi zicwangciso zifuna ukuba uhlawule ipremiyamu eyahlukileyo yokugubungela.
• Umlingane okanye iqabane lakho lixhasa isicwangciso seinshurensi. Ukuba kunokwenzeka ukuba ubhalisele ukugubungela phantsi kwesicwangciso samazinyo seqabane, inokuba yinto ebiza kakhulu.
• Amaqela esaphulelo samazinyo. Ezi aziboneleli nge-inshurensi, kodwa zivumela amalungu ukuba afumane iinkonzo zamazinyo ngexabiso eliphantsi.
• Unyango. Ngokuxhomekeke kwimeko ohlala kuyo kunye nemeko yakho yezemali, unokufanelekela ukunakekelwa kwamazinyo ngeMedicaid.
• IPASILE. Le yinkqubo enokukunceda ufumane ukhathalelo olulungelelanisiweyo kwindawo ohlala kuyo, kubandakanya neenkonzo zamazinyo.

Kutheni kubalulekile ukufumana ukogquma amazinyo njengoko usiya ukhula

Unonophelo oluhle lwamazinyo lubalulekile ekugcineni impilo yakho yonke kunye nokuba sempilweni kwakho. Ucoceko olubi lwamazinyo lunxulunyaniswe nokudumba okungapheliyo, isifo seswekile, iimeko zentliziyo, kunye nobunye ubunzima bempilo.

Kwaye uphononongo luye lwabonisa ukuba abantu ngamanye amaxesha bayalutyeshela ukhathalelo lwabo lwamazinyo njengoko bekhula, rhoqo kuba ukhathalelo lwamazinyo lunokubiza.

I-National Institute of Dental and Craniofacial Research iqikelela ukuba iipesenti ezingama-23 zabantu abadala khange babenalo uviwo lwamazinyo kule minyaka mi-5 idlulileyo. Eli nani liphezulu phakathi kwabantu base-Afrika baseMelika nabaseSpain naphakathi kwabo bafumana umvuzo omncinci.

Olunye uvoto lwelizwe olwenziwe ngo-2017 luveze ukuba iindleko zezona sizathu zixhaphakileyo sokuba abantu bangafuni uncedo lobungcali ekunyamekeleni amazinyo abo. Ukanti ukhathalelo olulungileyo lokuthintela kunokukunceda uphephe iingxaki zamazinyo ezibi kakhulu kwixa elizayo.

Ngeso sizathu, licebo elihle ukuqaphela isicwangciso esifikelelekayo esiza kugubungela iinkonzo zamazinyo ozifunayo njengoko usiya ukhula.

• Inyathelo 1: Chonga ukufaneleka. Ukuba unomntu othandekayo ophakathi kweenyanga ezi-3 zokuba yi-65, okanye onesiphene okanye isifo se-renal sokugqibela, kusenokwenzeka ukuba bakulungele ukugubungela iMedicare.
• Inyathelo 2: Thetha malunga neemfuno zabo. Nazi ezinye zezinto ekufuneka uziqwalasele xa usenza isigqibo sokuba uyafuna na ukuba ukhethe i-Medicare yoqobo okanye isicwangciso se-Medicare Advantage:
  • Kubaluleke kangakanani ukugcina oogqirha babo bangoku?
  • Loluphi unyango amayeza abaluthathayo?
  • Ngaba banokunyamekela kangakanani amazinyo kunye nombono?
  • Bangakanani abakwaziyo ukuchitha kwiipremiyamu zenyanga kunye nezinye iindleko?

• Inyathelo 3: Ziqonde iindleko ezinxulumene nokulibaziseka kokubhalisa. Ukuba uthatha isigqibo sokungabhaliseli umntu omthandayo kwiCandelo B okanye kwiCandelo D, kuya kufuneka uhlawule izohlwayo okanye iindleko eziphezulu kamva.
• Inyathelo 4: Ndwendwela ssa.gov ukubhalisa. Ngokwesiqhelo awudingi maxwebhu, kwaye yonke inkqubo ithatha malunga nemizuzu eli-10.

Umgca wezantsi

Ukugcina amazinyo kunye neentsini zisempilweni njengoko uneminyaka yobudala kubalulekile ekugcineni impilo yakho yomzimba iyonke.

Amayeza okuqala e-A kunye no-B awahlawuleli iinkonzo zamazinyo, kubandakanya neemviwo zesiqhelo, ukukhutshwa kwamazinyo, imijelo yengcambu, kunye nezinye iinkonzo zamazinyo ezisisiseko. Kananjalo abagubungeli ukubonelelwa ngamazinyo njengamazinyo okufakelwa kunye nebrashi.

Kukho okwahlukileyo, nangona kunjalo: Ukuba ufuna utyando olunzima lwamazinyo, okanye ukuba ufuna iinkonzo zamazinyo ngenxa yokugula okugubungeleyo okanye ukonzakala, i-Medicare inokuhlawula unyango lwakho.

Uninzi lweMedicare Advantage (Icandelo C) lucebisa ukubonelela ngamazinyo, kodwa kungafuneka uhlawule ipremiyamu yenyanga okanye usebenzise oogqirha bamazinyo kwinethiwekhi ukuze bafumane ithuba lokufumana ingxelo.

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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