Ingxamisekile! Ngaba icandelo leMedicare liGumbi eliNgxamisekileyo leGumbi lokuTyelela?

Umxholo

• Ngaba icandelo leMedicare A likutyelela i-ER?
• Yintoni ifomu YENYANGA?
• Uthini umahluko phakathi kwee-copays kunye ne-coinsurance?
• Ngawaphi amalungu oNyango lwe-Medicare agubungela ukhathalelo lwe-ER ukuba awungeniswa esibhedlele?
• Icandelo leMedare B
• Icandelo lonyango Medic C
• IMedigap
• Icandelo leMedare D
• Iinkonzo onokuzifumana kwi-ER
• Ixabisa malini utyelelo oluqhelekileyo kwi-ER?
• Kuthekani ukuba i-ambulensi indizisele kwi-ER?
• Ndifanele ndiye nini kwi-ER?
• Ukuthatha

Icandelo le-Medicare Icandelo A ngamanye amaxesha libizwa ngokuba yi "inshurensi yesibhedlele," kodwa ligubungela kuphela iindleko zegumbi likaxakeka (ER) ukutyelela ukuba ungeniswe esibhedlele ukunyanga ukugula okanye ukwenzakala okukuzise kwi-ER.

Ukuba utyelelo lwakho lwe-ER alufakwanga phantsi kweCandelo leMedicare A, unokufumana ingxelo ngeMedicare Part B, C, D, okanye iMedigap, kuxhomekeke kwisicwangciso sakho esithile.

Funda ukuze ufunde kabanzi malunga neCandelo A lokugubungela ukutyelelwa kwe-ER, kubandakanya nokuba yintoni enokuthi okanye ingenakugutyungelwa, kunye nezinye iindlela zokugubungela onokuthi ube nazo.

Ngaba icandelo leMedicare A likutyelela i-ER?

Ukuba uphathwa kwaye ukhululwe kwisebe likaxakeka ngaphandle kokungeniswa esibhedlele njengesigulana, amathuba okuba i-Medicare Part A ayizukugubungela utyelelo lwakho lwe-ER.

Nokuba uhlala kwi-ER ubusuku bonke, icandelo leMedicare A likuthatha njengesigulana esingaphandle ngaphandle kokuba ugqirha ubhala umyalelo wokukungenisa esibhedlele njengonyango.

Uninzi lwexesha, kuya kufuneka ungeniswe njengesigulana esibulalayo kubusuku obulandelelanayo beMedare yeCandelo A ukukhusela utyelelo lwakho.

Yintoni ifomu YENYANGA?

Ifomu yakho YENYANGA iya kuchaza ukuba kutheni uhlala esibhedlele njengesigulana esingaphandle kwaye luluphi unonophelo onokulufuna xa ugoduka. Ukufumana iNYANGA yenye yeendlela zokuxelela ukuba leliphi icandelo le-Medicare elinokuhlawula inxalenye ye-ER bill yakho.

Ukuba ugqirha uyakwamkela esibhedlele emva kotyelelo lwe-ER kwaye uhlala esibhedlele kangangeemini ezimbini okanye nangaphezulu, iCandelo leMedicare A lihlawula ukuhlala kwakho esibhedlele esibhedlele kunye neendleko zokunyanga ngaphandle kotyelelo lwakho lwe-ER.

Uya kuhlala unoxanduva lokutsalwa kwemali yakho, i-coinsurance, kunye ne-copayments. Ukuba awuqinisekanga nokuba uphathwa njengesigulana okanye isigulana esingalaliswayo, cela ugqirha akunike unyango. Ukuba unesicwangciso seMedigap, sinokuhlawula inxalenye yekhopay yakho okanye i-coinsurance.

Uthini umahluko phakathi kwee-copays kunye ne-coinsurance?

• Iikopi ziimali ezisisigxina ozihlawulela inkonzo yezonyango okanye ukutyelela iofisi Xa undwendwela i-ER, unokuba neepopayi ezininzi ngokusekwe kwinani leenkonzo ozifumanayo. Kuxhomekeke kwindlela ohlawula ngayo isibhedlele, awunakutyala ikopi kude kube lixesha emva kotyelelo lwakho.
• UQinisekiso yipesenti yetyala oyinoxanduva lwayo. Ngokwesiqhelo, i-Medicare ifuna ukuba uhlawule iipesenti ezingama-20 zeendleko zokhathalelo lwakho.

Ngawaphi amalungu oNyango lwe-Medicare agubungela ukhathalelo lwe-ER ukuba awungeniswa esibhedlele?

Icandelo leMedare B

Iindaba ezimnandi zezokuba i-Medicare Part B (i-inshurensi yezonyango) ngokubanzi ihlawulela utyelelo lwakho lwe-ER nokuba wenzakele, uhlaselwe kukugula ngesiquphe, okanye isigulo sithatha unyawo.

I-Medicare Icandelo B ngokubanzi lihlawula iipesenti ezingama-80 zeendleko zakho. Unoxanduva lweepesenti ezingama-20 ezisele. Ngo-2021, iSahlulo B sonyaka esinqunyulweyo singama-203.

Icandelo lonyango Medic C

Amacandelo e-Medicare Part C (i-Medicare Advantage) nawo ahlawula i-ER kunye neendleko zononophelo ezingxamisekileyo. Nangona iinxalenye ze-Medicare B kunye no-C zihlala zihlawula ukutyelelwa kwe-ER, uya kuba noxanduva lokutsalwa kwemali yakho, i-coinsurance, kunye ne-copayments ukongeza kwiipremiyamu zakho zanyanga zonke zezi zicwangciso.

IMedigap

Ukuba unayo iMedigap (i-inshurensi yokuxhasa i-Medicare) ukongeza kwisicwangciso sakho seCandelo B, inokukunceda ubhatale iipesenti ezingama-20 zeendleko zokundwendwela i-ER.

Icandelo leMedare D

Icandelo lonyango i-Medicare Icandelo D kukugubungela amayeza. Ukuba unikwa nawaphi na amayeza e-IV ngelixa ukwi-ER, icandelo leMedicare B okanye C liya kuhlala liwagubungela.

Nangona kunjalo, ukuba ufuna amayeza oqhele ukuwathabatha ekhaya kwaye anikwa sisibhedlele ngelixa ukwi-ER, oko kuthathwa njengesiyobisi esizimeleyo. Ukuba iyeza olinikiweyo luluhlu lwakho lwamayeza e-Medicare Part D, iCandelo D linokuhlawulela loo mayeza.

Iinkonzo onokuzifumana kwi-ER

Unokufumana iintlobo ezahlukeneyo zeenkonzo onokuzidinga ngexesha lotyelelo lwe-ER, kubandakanya:

• Uvavanyo olungxamisekileyo ngoogqirha omnye okanye nangaphezulu
• iimvavanyo zelebhu
• X-reyi
• ukuskena okanye ukujonga
• unyango okanye uqhaqho
• izinto zonyango kunye nezixhobo, njengeentonga
• amayeza

Ezi nkonzo kunye nokubonelelwa kunokuhlawulwa kunye okanye ngokwahlukeneyo, kuxhomekeke kwisibhedlele osityelelayo.

Ixabisa malini utyelelo oluqhelekileyo kwi-ER?

Uqikelelo lokuba abantu abazizigidi ezili-145 batyelela igumbi lezongxamiseko minyaka le, kungaphezulwana nje kwezigidi ezili-12.5 zabo bangeniswa esibhedlele ngenxa yokhathalelo lwezigulana ezingalaliswayo ngenxa yoko.

ISebe lezeMpilo kunye neNkonzo zoLuntu (i-HHS) lithi isixa semali esiphakathi sabantu esihlawulelwe ukutyelelwa kwe-ER ngo-2017 sasiyi- $ 776. Imali ekufuneka uyihlawule iya kwahluka ngokuxhomekeka apho uhlala khona, imeko onyangelwa yona, kunye nesigcino esibonelelwa sisicwangciso sakho.

Kuthekani ukuba i-ambulensi indizisele kwi-ER?

Icandelo leMedicare B liya kuhlawula ukukhwela i-ambulensi ukuya kwi-ER ukuba impilo yakho inokubeka emngciphekweni ngokuhamba ngenye indlela.

Umzekelo, ukuba wenzakele kwaye ukhathalelwe kwi-ambulensi kungasindisa ubomi bakho, i-Medicare ingakuhlawulela ukuba uhanjiswe nge-ambulensi uye kwiziko lonyango elikufutshane.

Ukuba ukhetha ukunyangwa kwindawo ekude, unokuba noxanduva lokwahluka kweendleko zothutho phakathi kwezi zibonelelo zibini.

Ndifanele ndiye nini kwi-ER?

Ukuba wena okanye umntu obathandayo uhlangabezana nayo nayiphi na le miqondiso kunye neempawu, kuya kufuneka ufune ukhathalelo kwi-ER kwangoko:

• imiqondiso yokubetha, njengokuthetha ngokungacacanga, ukuba buthathaka kwelinye icala, okanye ukugoba kobuso
• iimpawu zesifo sentliziyo, ezinje ngesifuba, ukuphefumla kancinci, isiyezi, ukubila okanye ukugabha
• iimpawu zokuphelelwa ngamanzi emzimbeni, kubandakanya ukubetha kwentliziyo okukhawulezayo, ukuba nesiyezi, ukuxhuzula kwezihlunu, kunye nokunxanwa okukhulu

Xa usiya kwi-ER, qiniseka ukuba uthatha naluphi na ulwazi lwe-inshurensi, kunye noluhlu lwawo nawaphi na amayeza akhoyo.

Ukuthatha

Ukuba wena okanye umntu omthandayo ufuna ukuya kwi-ER, kubalulekile ukwazi ukuba i-Medicare Part A ayiquki ngokubanzi ukutyelelwa kwe-ER ngaphandle kokuba isiguli samkelwe esibhedlele ukuze sifumane unyango.

I-Medicare Icandelo B kunye nezicwangciso ze-Medicare Advantage (i-Medicare Part C) zihlala zigubungela iipesenti ezingama-80 zeendleko zeenkonzo ze-ER, kodwa abaguli banoxanduva lokufumana imali, iimali ezikhutshelweyo kunye nokuncitshiswa kwemali.

Eli nqaku lahlaziywa ngo-Novemba 13, 2020 ukubonisa ulwazi lwango-2021 lonyango.

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.