Ngaba unyango lwamayeza luyalugubungela unyango?

Umxholo

• Icandelo le-Medicare A kunye nokunakekelwa kwempilo yengqondo
• Unyango lwe-Medicare Icandelo B kunye nokunakekelwa kwezempilo kwabagula ngaphandle
• Iinkonzo zempilo yengqondo
• Icandelo le-Medicare Icandelo D kunye nokugubungela amayeza amayeza
• Yiyiphi i-Medicare yasekuqaleni engagubungeliyo
• Yise kude

I-Medicare inceda ukufihla ukhathalelo lwempilo yezonyango.

Inokunceda ekugubungeleni amayeza amiselweyo anokufuneka kunyango lwempilo yengqondo.

Qhubeka ufunda ukuze ufunde ngakumbi malunga nokuba zeziphi iinkonzo zokhathalelo lwempilo yengqondo ezigutyungelweyo phantsi kweMedare, kwaye yintoni engekhoyo.

Icandelo le-Medicare A kunye nokunakekelwa kwempilo yengqondo

Icandelo lonyango i-Medicare Part A (isibhedlele i-inshurensi) linceda ukujongana neenkonzo zonyango lwezigulo zengqondo kwizibhedlele ngokubanzi okanye isibhedlele sabagula ngengqondo

I-Medicare isebenzisa ixesha lesibonelelo ukulinganisa ukusebenzisa kwakho iinkonzo zesibhedlele. Ixesha lokuxhamla liqala usuku lokungeniswa esibhedlele kwaye liphela emva kweentsuku ezingama-60 zilandelelana zokungakhathalelwa esibhedlele.

Ukuba ungeniswe kwakhona esibhedlele emva kweentsuku ezingama-60 zokungalaliswa esibhedlele, ixesha elitsha lokuxhamla liyaqala.

Kwizibhedlele ngokubanzi, akukho mda kwinani lamaxesha oncedo onokuba nawo kukhathalelo lwempilo yengqondo. Kwisibhedlele sabagula ngengqondo, uneentsuku ezili-190 zokuphila.

Unyango lwe-Medicare Icandelo B kunye nokunakekelwa kwezempilo kwabagula ngaphandle

Icandelo le-Medicare Icandelo B (i-inshurensi yezonyango) ligubungela iinkonzo ezininzi ezinikezelwa lisebe lezigulana ezingalaliswayo kunye neenkonzo zonyango ezingaphandle kwesibhedlele, njengokundwendwela:

• iiklinikhi
• iiofisi zonyango
• iiofisi zoogqirha
• amaziko empilo yengqondo yoluntu

Nangona i-coinsurance kunye ne-deductibles inokufaka isicelo, iCandelo B linceda ukuhlawulela iinkonzo ezinje:

• Ukuvavanywa koxinzelelo (1x ngonyaka)
• Uvavanyo lwengqondo
• iimvavanyo zokuqonda isifo
• unyango lomntu ngamnye kunye neqela
• iingcebiso kusapho (lokunceda kunyango lwakho)
• ukuvavanya ukuqinisekisa ukufaneleka nokuchaphazeleka kweenkonzo nonyango
• ukulaliswa esibhedlele ngokuyinxalenye (inkqubo elungelelanisiweyo yeenkonzo zengqondo zonyango)
• Ukuphononongwa komngcipheko wokudakumba (ngexesha lokwamkelwa kwakho kutyelelo lothintelo lonyango)
• ukutyelelwa qete ngonyaka (elithuba elihle lokuthetha nogqirha wakho malunga nempilo yakho yengqondo)

Iinkonzo zempilo yengqondo

Icandelo leMedicare B linceda ukufihla iinkonzo zempilo yengqondo kunye nokutyelela nababoneleli ngononophelo lwempilo abamkela "isabelo", okanye isixa esivunyiweyo. Igama "ukwabiwa" lithetha ukuba umboneleli weenkonzo zempilo yengqondo uyavuma ukuhlawulisa isixa semali esivunyiweyo ngeenkonzo. Kuya kufuneka ubuze umboneleli ukuba bayayamkela na “isabelo” ngaphambi kokuvuma iinkonzo. Kukulungele ukuba umboneleli ngenkonzo yezempilo yengqondo akwazise ukuba awamkeli sabelo, nangona kunjalo, kuya kufuneka uqinisekise oku ngaphambi kokutyikitya nasiphi na isivumelwano kunye nomboneleli.

Unokufuna ukutyelela amaziko eMedicare kunye neeNkonzo zeMedicaid 'uGqirha Thelekisa, ukufumana ugqirha owamkela iinkonzo zeMedicare. Uluhlu lweengcali okanye iqela lezenzo kwiindawo ezizodwa kunye neendawo ozichazayo, kunye neenkcukacha ezicacileyo, iimephu kunye nezikhokelo zokuqhuba ziyafumaneka.

Iindidi zoqeqesho kwezempilo ezibandakanyiweyo zibandakanya:

• oogqirha
• oogqirha bengqondo
• oogqirha bengqondo
• oonontlalontle bezonyango
• iingcali zabahlengikazi bezonyango
• abancedisi boogqirha
• Abongikazi

Icandelo le-Medicare Icandelo D kunye nokugubungela amayeza amayeza

Icandelo lonyango i-Medicare Part D (ukumiselwa kweziyobisi ngugqirha) zizicwangciso eziqhutywa ziinkampani zabucala ezivunyiweyo yiMedicare. Kuba isicwangciso ngasinye sinokuhluka ngokugubungela kunye neendleko, kubalulekile ukwazi iinkcukacha zesicwangciso sakho kunye nendlela esisebenza ngayo kunyango lokhathalelo lwempilo yengqondo.

Uninzi lwezicwangciso zinoluhlu lweziyobisi olucwangcisiweyo. Nangona ezi zicwangciso zingafuneki ukugubungela onke amayeza, uninzi luyafuneka ukugubungela amayeza anokusetyenziselwa ukhathalelo lwempilo yengqondo, njenge:

• iziyobisi
• ii-anticonvulsants
• Unyango lwengqondo

Ukuba ugqirha wakho ukumisela iyeza elingafakwanga kwisicwangciso sakho, wena (okanye ummeli wakho, ofana nommiseli) unokucela ukumiselwa kokugubungela kunye / okanye ngaphandle.

Yiyiphi i-Medicare yasekuqaleni engagubungeliyo

Iinkonzo zokhathalelo lwempilo yengqondo azifakwanga phantsi kwamacandelo e-Medicare A no-B zezi:

• igumbi labucala
• ukonga umsebenzi wabucala
• kwigumbi likamabonakude okanye kwifowuni
• izidlo
• izinto zobuqu (intlama yamazinyo, iireyinti, iikawusi)
• ukuthuthwa ukuya okanye ukusuka kwiinkonzo zononophelo lwempilo yengqondo
• ukuvavanywa kwezakhono zomsebenzi okanye uqeqesho olungeyonxalenye yonyango lwempilo yengqondo
• amaqela enkxaso (njengoko ahlukaniswe nonyango lwengqondo lweqela, eligutyungelweyo)

Yise kude

I-Medicare inceda ukufihla ukhathalelo lwempilo yengqondo kunye nokugula kwezi ndlela zilandelayo:

• Icandelo A lincedisa ekuguleni iinkonzo zempilo yengqondo.
• ICandelo B linceda ekugubungeleni iinkonzo zempilo yengqondo notyelelo kubaboneleli ngononophelo.
• ICandelo D linceda ekugubungeleni amayeza kukhathalelo lwempilo yengqondo.

Qiniseka ukuba ujonga iinkcukacha malunga nohlobo kunye nobungakanani benkxaso kunye nomnikezeli wakho ukufumanisa ukuba zeziphi iinkonzo ezithile ezigutyungelweyo kunye nokuba zeziphi iqondo.

Umzekelo, kwi-Medicare yokuhlawula iindleko, bonke ababoneleli ngempilo yengqondo kufuneka bamkele isixa esivunyiweyo seenkonzo zononophelo lwempilo njengentlawulo epheleleyo.

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.