Ngaba iDialysis igutyungelwe ngamayeza?

Umxholo

• Ukufaneleka kwamayeza
• Ukuba awubhalisi kwangoko
• Ukuba uku dialysis
• Ukuba ufumana ukufakelwa kwezintso
• Xa i-Medicare inshorensi iphela
• Iinkonzo zeDialysis kunye nezinto ezibonelelwa yiMedicare
• Ukuthwala iziyobisi
• Ndiza kuhlawula ntoni nge-dialysis?
• Yise kude

I-Medicare igubungela i-dialysis kunye nonyango oluninzi olubandakanya ukuphela kwesifo se-renal (ESRD) okanye ukusilela kwezintso.

Xa izintso zakho zingasakwazi ukusebenza ngokwendalo, umzimba wakho ungena kwi-ESRD. I-Dialysis yonyango lokunceda umzimba wakho usebenze ngokucoca igazi lakho xa izintso zakho ziyeke ukusebenza zodwa.

Kunye nokunceda umzimba wakho ugcine isixa esichanekileyo samanzi kunye nokulawula uxinzelelo lwegazi, idialysis inceda ukuphelisa inkunkuma eyingozi, ulwelo kunye netyuwa eyakha emzimbeni wakho. Nangona banokukunceda ukuba uphile ixesha elide kwaye uzive ungcono, unyango lwe-dialysis alunyango lokusilela kwezintso ngokusisigxina.

Qhubeka ufunda ukuze ufunde ngakumbi nge-dialysis yonyango kunye nokugubungela unyango, kubandakanya ukufaneleka kunye neendleko.

Ukufaneleka kwamayeza

Izidingo zokufaneleka kwi-Medicare zahlukile ukuba ukufaneleka kwakho kusekwe kwi-ESRD.

Ukuba awubhalisi kwangoko

Ukuba uyilungele iMedicare esekwe kwi-ESRD kodwa uliphose ixesha lakho lokuqala lokubhalisa, unokulungelwa kukufumana ingxelo kwakhona ukuya kuthi ga kwiinyanga ezili-12, nje ukuba ubhalisile.

Ukuba uku dialysis

Ukuba ubhalisa kwi-Medicare esekwe kwi-ESRD kwaye okwangoku ukwi-dialysis, i-Medicare yakho yokugubungela ihlala iqala ngomhla we-1 wonyango lwakho lwe-dialysis kwinyanga yesi-4. Umyinge ungaqala kwinyanga ye-1 ukuba:

• Ngexesha leenyanga ezintathu zokuqala zedisisi, uthatha inxaxheba kuqeqesho lwe-dialysis yasekhaya kwindawo eqinisekisiweyo ye-Medicare.
• Ugqirha wakho ubonisa ukuba kufuneka ulugqibe uqeqesho ukuze wenze unyango lwe-dialysis.

Ukuba ufumana ukufakelwa kwezintso

Ukuba ungeniswe kwisibhedlele esiqinisekisiweyo seMedicare sokufakelwa kwezintso kwaye ukufakelwa kwenzeka kwinyanga leyo okanye kwiinyanga ezi-2 ezizayo, iMedicare ingaqala ngaloo nyanga.

Ukufakwa kwe-Medicare kungaqala kwiinyanga ezi-2 ngaphambi kokufakwa kwakho ukuba ukufakelwa kulibazisekile ngaphezulu kweenyanga ezi-2 emva kokungeniswa esibhedlele.

Xa i-Medicare inshorensi iphela

Ukuba uvumelekile kuphela kwi-Medicare ngenxa yokusilela kwezintso ngokusisigxina, ukhuseleko lwakho luya kuyeka:

• Kwiinyanga ezili-12 emva kwenyanga unyango lwe-dialysis luyekisiwe
• Iinyanga ezingama-36 ezilandela inyanga unokufakelwa izintso

Ukugqunywa ngamayeza kuya kuqhubeka kwakhona ukuba:

• kwisithuba seenyanga ezili-12 emva kwenyanga, uyekile ukufumana idialysis, uqala nge-dialysis kwakhona okanye ukufakelwa kwezintso
• kwisithuba seenyanga ezingama-36 emva kwenyanga ufumana ukufakelwa kwezintso ufumana olunye ukufakelwa kwezintso okanye ukuqala nge-dialysis

Iinkonzo zeDialysis kunye nezinto ezibonelelwa yiMedicare

I-Medicare yoqobo (Icandelo le-inshurensi yesibhedlele kunye necandelo B leinshurensi yezonyango) ligubungela uninzi lweenkonzo kunye neenkonzo ezifunekayo kwi-dialysis, kubandakanya:

• Unyango lwe-dialpatient ye-inpatient: egqunywe licandelo leMedicare A
• Unyango lwangaphandle lwe-dialysis: olugqunywe liCandelo leMedicare B
• Iinkonzo zoogqirha bezonyango: zigutyungelwe yiCandelo leMedicare B
• uqeqesho lovavanyo lwasekhaya: olugqunywe liCandelo leMedicare B
• izixhobo zedialysis kunye nezinto ezibonelelweyo: ezigutyungelwe yiCandelo leMedicare B
• iinkonzo ezithile zenkxaso yasekhaya: ezigqunywe liCandelo leMedicare B
• uninzi lwamachiza okuba ngaphakathi kunye ne-dialysis yasekhaya: egutyungelwe yiCandelo leMedicare B
• ezinye iinkonzo kunye nokubonelelwa, ezinje ngeemvavanyo zaselebhu: ezigqunywe liCandelo leMedicare B

I-Medicare kufuneka igubungele iinkonzo zeenqwelo zezigulana ukuya nokubuya ekhayeni lakho ukuya kwiziko le-dialysis elikufutshane ukuba ugqirha wakho unikezela ngemiyalelo ebhaliweyo eqinisekisa ukuba iyimfuneko yonyango.

Iinkonzo kunye nokubonelelwa okungafakwanga yiMedicare kubandakanya:

• Intlawulo yabancedisi ekuncedeni nge-dialysis yasekhaya
• umvuzo olahlekileyo ngexesha loqeqesho lwe-dialysis yasekhaya
• indawo yokuhlala ngexesha lonyango
• igazi okanye iiseli ezibomvu zegazi ezifakwe kwi-dialysis yasekhaya (ngaphandle kokuba ifakwe kwinkonzo kagqirha)

Ukuthwala iziyobisi

Icandelo leMedicare B ligubungela iziyobisi ezingena ngenaliti kunye nokufakwa ngaphakathi kunye neebhayoloji kunye neefom zomlomo ezibonelelwa liziko le-dialysis.

ICandelo B aliquki amayeza afumaneka kuphela ngomlomo.

Icandelo leMedicare D, elithengwa ngenkampani yeinshurensi yabucala evunyiweyo yiMedicare, ibonelela ngonyango oluchazayo, ngokusekwe kumgaqo-nkqubo wakho, olugquma olu hlobo lwamayeza.

Ndiza kuhlawula ntoni nge-dialysis?

Ukuba ufumana i-dialysis emva kokungeniswa esibhedlele, i-Medicare Part A igubungela iindleko.

Iinkonzo zoogqirha bezonyango zigutyungelwe yiCandelo leMedare B.

Unoxanduva lokuhlawula iipremiyamu, iimali ezixhuzulwa minyaka le, ukuqinisekiswa kwemali kunye neepopays:

• Ukuxhuzulwa ngonyaka kwi-Medicare Part A yi- $ 1,408 (xa ungeniswe esibhedlele) ngo-2020. Oku kugubungela iintsuku zokuqala ezingama-60 zononophelo lwesibhedlele ngexesha lokuxhamla. Ngokutsho kwamaZiko ase-U.S. E-Medicare nakwiiNkonzo zeMedare, malunga neepesenti ezingama-99 zabaxhamli beMedareya abanayo i-premium yeCandelo A.
• Ngo-2020, i-premium yenyanga ye-Medicare Part B yi- $ 144.60 kwaye i-deductible yonyaka ye-Medicare Part B yi- $ 198. Nje ukuba ezo ziqendu zihlawulwe, i-Medicare ihlawula iipesenti ezingama-80 zeendleko kwaye uhlawula ama-20 eepesenti.

Ukufumana iinkonzo zoqeqesho lwe-dialysis ekhaya, i-Medicare ihlala ihlawula umrhumo othe tyaba kwiziko lakho le-dialysis ukongamela uqeqesho lwe-dialysis yasekhaya.

Emva kokuba iCandelo B lichithwe ngonyaka, i-Medicare ihlawula iipesenti ezingama-80 zomrhumo, kwaye iipesenti ezingama-20 ezisele zinoxanduva lwakho.

Yise kude

Uninzi lonyango, kubandakanya i-dialysis, ebandakanya ukuphela kwesifo se-renal (i-ESRD) okanye ukusilela kwezintso kugutyungelwe yiMedicare.

Iinkcukacha ngokubhekisele kunyango, iinkonzo kunye nokubonelelwa, kunye nesabelo sakho sendleko sinokujongwa kunye neqela lakho lokhathalelo lwempilo, olubandakanya:

• oogqirha
• abongikazi
• oonontlalontle
• iingcali ze-dialysis

Ngolwazi oluthe kratya jonga ukutyelela iMedicare.gov, okanye utsalele umnxeba ku-1-800-MEDICARE (1-800-633-4227).

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.