Ukunyamekela abaguli

Umxholo

• I-Medicare igubungela i-hospice
• I-Medicare igubungela nini i-hospice?
• Kanye kanye yintoni egqunyiweyo?
• Kuthekani ngonyango lweemeko ezingahambelani nesifo esinganyangekiyo?
• Ngaba umntu onesifo sengqondo esixhalabisayo uya kulungela isibonelelo seMedicare hospice?
• Ngaba kuya kubakho ukukopishwa okanye ukutsalwa?
• Yintoni engagutyungelwanga yiMedicare?
• I-Medicare ayizukugubungela naluphi na unyango ukunyanga isigulo
• I-Medicare ayizukugubungela iinkonzo ezivela kumboneleli we-hospice ezingalungiselelwanga liqela lakho lokunyamekela abaguli
• I-Medicare ayizukugubungela igumbi kunye nebhodi
• I-Medicare ayizukugubungela ukhathalelo olufumanayo kwiziko lesibhedlele sangaphandle
• Uza kuhlawula ixesha elingakanani iinkonzo zonyango?
• Zeziphi iindawo zonyango lwe-Medicare ezibandakanya ukhathalelo lwe-hospice?
• Yintoni iHospice?
• Yahluke njani i-hospice kunonophelo oludambisayo?
• Ixabisa malini inkathalo?
• Umgca wezantsi

Ukwenza izigqibo malunga nokukhathalela abantu abagulela ukufa, nokuba kungenxa yakho okanye umntu omthandayo, akukho lula. Ukufumana iimpendulo ngokuthe ngqo malunga neendleko ze-hospice kunye nendlela onokuyihlawula ngayo kunokwenza isigqibo esinzima sicace gca.

I-Medicare igubungela i-hospice

I-Medicare yoqobo (i-Medicare Part A kunye ne-Medicare Part B) ihlawulela ukhathalelo lwe-hospice logama umboneleli wakho we-hospice evunyiwe yi-Medicare.

I-Medicare ihlawula ukhathalelo lwe-hospice nokuba unayo okanye awunayo isicwangciso se-Medicare Advantage (i-HMO okanye i-PPO) okanye esinye isicwangciso sezempilo se-Medicare.

Ukuba ufuna ukufumanisa ukuba ngaba umboneleli wakho we-hospice uvunyiwe, ungabuza ugqirha wakho, isebe lezempilo likarhulumente, umbutho waseburhulumenteni, okanye umlawuli wesicwangciso sakho, ukuba unayo isicwangciso esongezelelweyo seMedare.

Unokukhangela iimpendulo ezithile malunga nokuba zeziphi izibonelelo, ababoneleli kunye neenkonzo ezigutyungelwe kukhathalelo lwe-hospice. Oovimba bolwazi baya kukunceda uphendule le mibuzo.

I-Medicare igubungela nini i-hospice?

I-Medicare igubungela i-hospice kwangoko xa ugqirha eqinisekisa ukuba umntu okhuselwe yiMedicare unesifo esithi, ukuba siqhubeka ngaphandle kokuphazanyiswa, senze ukuba kungalindeleki ukuba umntu aphile ixesha elingaphezulu kweenyanga ezi-6.

Ukufumana le ngxelo, kufuneka usayine ingxelo eqinisekisa:

• ufuna ukhathalelo lokuthomalalisa
• awuzimisele ukuqhubeka nokufuna unyango ukuze unyange isigulo
• ukhetha ukhathalelo lwe-hospice endaweni yezinye iinkonzo ezivunyiweyo ze-Medicare ukunyanga ukugula kwakho

Kanye kanye yintoni egqunyiweyo?

I-Medicare yoqobo ihlawula uluhlu olubanzi lweenkonzo, ukubonelela, kunye nemigqaliselo enxulumene nokugula okubangele ukuba ufune ukhathalelo lwe-hospice. Oko kubandakanya:

• iinkonzo zonyango kunye nezobuhlengikazi
• iinkonzo zomzimba, zomsebenzi kunye nezonyango
• izixhobo zonyango, njengezihambahamba kunye neebhedi
• iingcebiso ngezondlo
• izixhobo zonyango kunye nezixhobo
• amayeza kagqirha kufuneka uphelise iimpawu okanye iintlungu zokulawula
• ukhathalelo lwexesha elifutshane lokukunceda ulawule iintlungu okanye iimpawu
• iinkonzo zentlalontle kunye neengcebiso malunga nosizi kwisigulana kunye nosapho
• ukhathalelo lwexeshana elifutshane (ukuya kuthi ga kwiintsuku ezintlanu ngexesha) ukuvumela umnakekeli wakho ukuba aphumle, ukuba ukhathalelwa ekhaya
• ezinye iinkonzo, ukubonelela, kunye namayeza afunekayo ukuphatha iintlungu okanye iimpawu zolawulo ezinxulumene nokugula okungapheliyo

Ukufumana umboneleli wokhathalelo lwe-hospice kwindawo yakho, zama oku kufunyanwa yiarhente kwi-Medicare.

Kuthekani ngonyango lweemeko ezingahambelani nesifo esinganyangekiyo?

Ukuba ufumana izibonelelo ze-hospice, i-Medicare Part A (i-Medicare yasekuqaleni) iya kuhlawula ezinye izifo kunye neemeko onokuba nazo. Intlawulo ye-inshurensi efanayo kunye nokutsalwa kuya kusebenza kolo nyango njengoko kuya kusebenza ngokwesiqhelo.

Ungasigcina isicwangciso sakho se-Medicare Advantage ngelixa ufumana izibonelelo ze-hospice. Kuya kufuneka uhlawule iipremiyamu kolo gubungela.

Ngaba umntu onesifo sengqondo esixhalabisayo uya kulungela isibonelelo seMedicare hospice?

Kuphela ukuba ixesha lokuphila lingaphantsi kweenyanga ezi-6. Isifo sengqondo esiyingozi sisifo esihamba kancinci. Kumanqanaba okugqibela, umntu onesifo sengqondo esixhalabisayo unokuphulukana namandla okusebenza ngokwesiqhelo kwaye afune ukhathalelo lwemihla ngemihla. I-Hospice iya kugutyungelwa kuphela, nangona kunjalo, xa ugqirha eqinisekisa ukuba umntu unelungelo lokuphila iinyanga ezi-6 okanye ngaphantsi. Oko kuhlala kuthetha ukuba isifo sesibini esifana nenyumoniya okanye i-sepsis senzekile.

Ngaba kuya kubakho ukukopishwa okanye ukutsalwa?

Iindaba ezimnandi zezokuba azikho izinto ezitsalwayo zokhathalelo lwe-hospice.

Eminye imigqaliselo kunye neenkonzo zinokuba neekopisha. Imigqaliselo yamayeza eentlungu okanye ukukhululeka kwempawu inokuthwala i-copay eyi- $ 5. Kungakho ipesenti ye-5 yepayipi yokunyamekela abaguli xa ungeniswe kwindawo evunyiweyo, ukuze abakhathaleli bakho baphumle. Ngaphandle kwala matyala, awuzukuhlawulela ukhathalelo lwakho lwehosisi.

Yintoni engagutyungelwanga yiMedicare?

I-Medicare ayizukugubungela naluphi na unyango ukunyanga isigulo

Oko kubandakanya unyango kunye nonyango olungiselelwe ukuba lunyange. Ukuba uthatha isigqibo sokuba ufuna unyango ukunyanga ukugula kwakho, unokuyeka ukhathalelo lwe-hospice kwaye uqhubeke nonyango.

I-Medicare ayizukugubungela iinkonzo ezivela kumboneleli we-hospice ezingalungiselelwanga liqela lakho lokunyamekela abaguli

Naluphi na ukhathalelo olufumanayo kufuneka lubonelelwe ngumboneleli okhethe wena kunye neqela lakho. Nokuba ufumana iinkonzo ezifanayo, i-Medicare ayizukuhlawula iindleko ukuba umboneleli akunguye kunye neqela lakho le-hospice eligama. Usenokutyelela ugqirha wakho oqhelekileyo okanye umboneleli wezempilo ukuba ubakhethile ukuba bajonge ukhathalelo lwakho lwe-hospice.

I-Medicare ayizukugubungela igumbi kunye nebhodi

Ukuba ufumana ukhathalelo lwe-hospice ekhaya, kwikhaya labongikazi, okanye kwiziko lokunyamekela abaguli, i-Medicare ayinakuhlawula iindleko zegumbi kunye nebhodi. Kuxhomekeka kuncedo, ezo ndleko zingadlula kwi- $ 5,000 ngenyanga.

Ukuba iqela lakho le-hospice lithatha isigqibo sokuba ufuna i ixesha elifutshane hlala ngaphakathi kwiziko lonyango okanye kwindawo yokhathalelo lokuphefumla, i-Medicare iya kukugubungela ukuhlala okwexeshana. Unokuba unetyala lokuhlawula imali yokuhlawula ixesha elifutshane, nangona kunjalo. Kwiimeko ezininzi, loo ntlawulo yipesenti ezi-5 zeendleko, zihlala zingekho ngaphezulu kwe- $ 10 ngosuku.

I-Medicare ayizukugubungela ukhathalelo olufumanayo kwiziko lesibhedlele sangaphandle

Ayizukuhlawula ukuthuthwa kweenqwelo yezigulana ukuya esibhedlele okanye naziphi na iinkonzo ozifumana kwisibhedlele esingaphandle, njengegumbi lexakeka, ngaphandle kokuba hayi inxulumene nesifo sakho esinganyangekiyo okanye ngaphandle kokuba kwenziwe amalungiselelo liqela lakho labagula kakhulu.

Uza kuhlawula ixesha elingakanani iinkonzo zonyango?

Ukuba wena (okanye othandekayo) ufumana ukunakekelwa kwe-hospice, oko kuthetha ukuba ugqirha wakho uqinisekisile ukuba ixesha lokuphila kwakho liinyanga ezi-6 okanye ngaphantsi.Kodwa abanye abantu bayakuchasa oko bakulindeleyo. Ekupheleni kweenyanga ezi-6, i-Medicare iya kuhlala ihlawula ukhathalelo lwe-hospice ukuba uyayifuna. Umlawuli wezonyango okanye ugqirha wakho uya kudinga ukudibana nawe buqu, kwaye uphinde uqinisekise ukuba ixesha lokuphila alikho ngaphezulu kweenyanga ezi-6.

I-Medicare iya kuhlawula ixesha leentsuku ezingama-90 zokuxhamla. Emva koko, unokuphinda uqinisekise ngenani elingenamda leentsuku ezingama-60 zezibonelelo. Ngalo naliphi na ixesha lesibonelelo, ukuba ufuna ukutshintsha umboneleli wakho wehosisi, unelungelo lokwenza njalo.

Zeziphi iindawo zonyango lwe-Medicare ezibandakanya ukhathalelo lwe-hospice?

• Icandelo lezaMayeza A. Icandelo A lihlawulela iindleko zasesibhedlele, ukuba ufuna ukungeniswa ukhathalelo lweempawu okanye ukunika abanonopheli ikhefu elifutshane.
• Icandelo leMedare B. Icandelo B ligubungela iinkonzo zonyango kunye nezobuhlengikazi, izixhobo zonyango kunye nezinye iinkonzo zonyango.
• Icandelo leMedare C (Uncedo). Naziphi na izicwangciso ze-Medicare Advantage onazo ziya kuhlala zisebenza logama nje uhlawula iipremiyamu, kodwa ngekhe uzifune ngeendleko zakho ze-hospice. Amayeza oqobo ahlawulela ezo. Izicwangciso zakho zeCandelo leMedare C zisenokusetyenziselwa ukuhlawulela unyango olungahambelani nokugula okungapheliyo.
• Unyango lweMedare (iMedigap). Naziphi na izicwangciso zeMedigap onazo zinokukunceda kwiindleko ezinxulumene neemeko ezingahambelani nesifo esingapheliyo. Awuyi kuzidinga ezi zibonelelo ukukunceda ngeendleko ze-hospice, kuba ezo zihlawulwa yi-Medicare yoqobo.
• Icandelo leMedare D. Icandelo lakho le-Medicare Icandelo D lokugubungela amayeza liya kuhlala lisebenza ukukunceda uhlawule amayeza angahambelani nesifo esingapheliyo. Ngaphandle koko, amayeza okunceda ukunyanga iimpawu okanye ukulawula iintlungu zesifo esinganyangekiyo agutyungelwe yinzuzo yakho ye-Medicare hospice.

Yintoni iHospice?

I-Hospice lunyango, iinkonzo kunye nokhathalelo lwabantu abagulayo nabangalindelwanga ukuba baphile ixesha elingaphezu kweenyanga ezi-6.

khuthaza abantu abane-terminal diagnostic ukuba baqwalasele ukungena kwi-hospice kwangoko kwiinyanga ezi-6. I-Hospice ibonelela ngezibonelelo ezicacileyo kunye neenkxaso ezixabisekileyo, kungekuphela nje kwizigulana kodwa nakwiintsapho zazo. Ezinye zezibonelelo zezi:

• ukubonakaliswa okumbalwa kosulelo kunye nezinye iingozi ezinxulumene notyelelo esibhedlele
• iindleko eziphantsi zizonke ezinxulunyaniswa nesifo esisisiseko
• izixhobo zokuphucula ukhathalelo kunye nenkxaso kubongi
• ukufikelela kwiinkonzo zokhathalelo lobungcali

Yahluke njani i-hospice kunonophelo oludambisayo?

Injongo yokhathalelo oludlamkileyo kukuphucula umgangatho wobomi ngelixa ujongene nesigulo. Unonophelo olunyanzelekileyo lunokuqala mzuzu xa ufumanisa ukuba unesifo, nokuba ulindelwe ukuba uchache ngokupheleleyo. Uya kuqhubeka ufumana ukhathalelo lokuthomalalisa kude kube ngoku awusayifuni.

Ngokwe-National Institute of Aging, umahluko ophambili phakathi kwe-hospice kunye nokhathalelo lwe-palliative kukuba ukhathalelo lwepalliative likuvumela ukuba ugcine ufumana unyango ukunyanga ukugula kwakho. Kukhathalelo lwe-hospice, iimpawu zakho kunye neentlungu ziya kuqhubeka nokunyangwa, kodwa unyango olujolise ekunyangeni isigulo luya kuyeka.

Ukuba kuyacaca kwiqela lezonyango ukuba unyango alusebenzi kwaye isigulo sakho sisiphelo, unokutshintsha ukusuka kukhathalelo lokuthomalalisa ngenye yeendlela ezimbini. Ukuba ugqirha wakho ukholelwa ukuba awungekhe uphile ngaphezulu kweenyanga ezi-6, wena kunye nabanikezeli benkathalo banokuthatha isigqibo sokutshintshela kukhathalelo lwe-hospice. Olunye ukhetho kukuqhubeka nokunyamekela (kubandakanya unyango olujolise ekunyangeni isigulo) kodwa kugxilwe ekunyamekeleni ukhathalelo (okanye ukuphela kobomi).

Ixabisa malini inkathalo?

Iindleko zokunyamekela i-hospice zixhomekeke kuhlobo lokugula kunye nokuba izigulana zakuqala zingena kwi-hospice. Ngo-2018, uMbutho wee-Actuaries uqikelele ukuba abaguli abagula ngumhlaza bafumana i-Medicare Part A kunye neCandelo B izibonelelo ezifikelela kwi-44,030 yeedola kwiinyanga ezintandathu zokugqibela zobomi babo.

Eli nani liquka indleko zonyango lwezigulana ezingalaliswayo, ukongeza kunyango lwasekhaya. Olunye uphononongo lubonise ukuba umndilili weendleko zeMedical kwizigulana ezibhedlele kwiintsuku ezingama-90 zokugqibela zobomi yayiyi- $ 1,075 nje.

• Thatha umzuzwana uqiniseke ukuba uyayiqonda indlela esebenza ngayo iMedicare.
• Ziqhelanise namaxesha obhaliso.
• Sebenzisa olu luhlu lokutshekisha ukuqinisekisa ukuba unolwazi oludingayo lokufaka isicelo.
• Nje ukuba uqokelele ulwazi olufunayo, gcwalisa usetyenziso lwe-Intanethi. Unokufuna ukunciphisa iziphazamiso kunye nokuphazamiseka okungenani imizuzu engama-30.

Umgca wezantsi

Ukuba unayo i-Medicare yokugubungela eyokuqala kwaye ucinga ngononophelo lwe-hospice, isibonelelo se-Medicare esibhedlele siya kuhlawula iindleko zokhathalelo lwe-hospice.

Uya kudinga ugqirha ukuze aqinisekise ukuba ixesha lakho lokuphila alikho ngaphezulu kweenyanga ezi-6, kwaye kuyakufuneka utyikitye ingxelo yokuvuma ukhathalelo lwe-hospice kunye nokumisa unyango olujolise ekunyangeni isigulo. Ukuba uhlangabezene nezo mfuno, ugqirha wakho nokhathalelo lokonga, imigqaliselo, kunye nolunye uluhlu lwezinye iinkonzo zenkxaso ziya kugutyungelwa.

Enye into ebalulekileyo ekufuneka uyiqaphele: I-Medicare yoqobo ayihlawuli igumbi kunye nebhodi yezigulana ze-hospice, ke ukuhlala ixesha elide kwikhaya labongikazi okanye kwiziko labongikazi elinobuchule alinakugutyungelwa njengenxalenye yesibonelelo se-hospice.

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.