Ngaba uhlawula ntoni uMedare kwiNdleko zeZitulo zamavili?

Umxholo

• Ngaba i-Medicare igubungela nini izitulo ezinamavili?
• Ngaba loluphi uhlobo lwesitulo esinamavili esiya kugutyungelwa nguMedicare?
• Izitulo ezihamba ngesandla
• Isithuthuthu esinamandla
• Izihlalo ezinamavili ezinamandla
• Ngaba i-Medicare igubungela isigulana?
• Kuthekani ngerampu yesitulo esinamavili?
• Zithini iindleko zokuphuma epokothweni kwizitulo ezinamavili ukuba unayo iMedicare?
• Zeziphi izicwangciso zeMedicare ezingangcono kuwe ukuba uyazi ukuba ufuna isitulo esinamavili?
• Ngaba i-Medicare ihlawula olunye uncedo lokuhamba?
• Umgca wezantsi

• I-Medicare iyabhatala iindleko zokurenta okanye zokuthenga izitulo ezinamavili kwezinye iimeko.
• Kuya kufuneka uhlangane neemfuno ezithile zeMedicare.
• Qiniseka ukuba ugqirha wakho kunye nenkampani ebonelela ngesihlalo sakho esinamavili zombini ziyavunywa ziMedicare.

Ukuba imeko yezonyango ikugcina ungahambisi ngokukhululekileyo kwindlu yakho kwaye induku okanye ukuhamba nje akwanelanga, isitulo esinamavili sinokuba yimpendulo kwimicimbi yakho yokuhamba.

I-Medicare Icandelo B ligubungela iindidi ngeendidi zezihlalo zabakhubazekileyo okoko nje uhlangabezana neemeko ezithile zangaphambili.

Icandelo leMedicare B lihlawula izihlalo ezinamavili xa unemicimbi yokuhamba ngaphakathi ikhaya lakho. Ayizukuhlawula isitulo esinamavili ukuba unengxaki yokuhamba nje ngaphandle ikhaya lakho.

Ngaba i-Medicare igubungela nini izitulo ezinamavili?

Icandelo leMedicare B liya kugubungela uninzi lweendleko zesitulo sakho esinamavili ukuba ngaba ugqirha wakho wokhathalelo oluphambili (i-PCP) okanye umboneleli wezempilo ekunyanga ngemeko echaphazela ukuhamba kwakho ubhala iodolo enye. Umyalelo kagqirha wakho kufuneka uyenze icace into yokuba:

• Imeko yezonyango ibangela imiba yokuhamba ekuthintelayo ekubeni unakekele iimfuno zakho zemihla ngemihla. Umzekelo, imeko yakho yezonyango ikugcina ungakwazi ukuya kwigumbi lokuhlambela okanye ekhitshini ngokukhuselekileyo, nokuba usebenzisa iintonga, ukuhambahamba, okanye induku.

• Uyakwazi ukusebenza ngokukhuselekileyo uhlobo lwezixhobo ozicelayo, okanye unomntu ekhayeni lakho ohlala ekulungele ukukunceda usebenzise isitulo esinamavili xa usidinga.

• Ugqirha wakho kunye nomthengisi wezixhobo zonyango bobabini banikezela ngeMedare egunyazisiweyo. Kukho uluhlu lwababoneleli, kwaye ungacela ugqirha wakho kunye nenkampani ukuba ikunike izixhobo ukuze uqiniseke ukuba zigunyazisiwe lonyango.

• Ungasisebenzisa ngokukhuselekileyo esi sixhobo ekhayeni lakho ngaphandle kokubeka engozini ukwenzakala okanye iingozi ngenxa yemigangatho engalinganiyo, imiqobo endleleni yakho, okanye iminyango emxinwa kakhulu kwisitulo sakho esinamavili.

Imigaqo yendlela yokufumana isitulo esinamavili inokutshintsha okwethutyana ukuba uMongameli wase-US, iSebe lezeMpilo kunye neNkonzo zoLuntu, okanye irhuluneli yakho yelizwe ibhengeza imeko engxamisekileyo okanye intlekele kwindawo yakho. Ukufumanisa ukuba ukwenye yezo ndawo, ungatsalela umnxeba kwi-1 (800) MEDICARE (800-633-4227). Unokufumana ulwazi kwiwebhusayithi ye-Federal Emergency Management Agency (FEMA) iwebhusayithi okanye kwiwebhusayithi yeHHS yezeMpilo kaXakeka.

Ngaba loluphi uhlobo lwesitulo esinamavili esiya kugutyungelwa nguMedicare?

Izitulo ezinamavili zithathwa njengezinto ezomeleleyo zonyango (i-DME). Zintathu izinto ezisisiseko zezihlalo ezinamavili: izitulo ezinamavili, izithuthuthu ezinamandla kunye nezitulo ezinamavili.

Luluphi uhlobo lwesitulo esinamavili esiza kulusebenzisa kuxhomekeka kwimeko yakho yomzimba kunye neengcebiso zikagqirha wakho.

Izitulo ezihamba ngesandla

Ukuba womelele ngokwaneleyo ukuba ungangena kwaye uphume kwisitulo esinamavili esisikhokelo kwaye usebenzise enye xa ufuna njalo, olu hlobo lwesitulo esinamavili lunokuba lukhetho olufanelekileyo kuwe.

Nokuba awunawo amandla omzimba aphezulu wokusebenzisa isitulo esinamavili esisikhokelo, usenokufanelekela esinye ukuba kukho umntu ekhaya onokuthi akuncede ungene kwaye uphume kuwo, kwaye ngubani onokukunceda usebenzise ngokukhuselekileyo .

Ukuba imiba yokuhamba kwakho yeyethutyana- ukuba, umzekelo, uye wahlinzwa ngokutshintsha kwamadolo kwaye ulindele ukuba uphinde uhambe ngokukhawuleza-unokufuna ukuqasha izixhobo endaweni yokuthenga.

Isithuthuthu esinamandla

Ukuba awukwazi ukusebenzisa isitulo esinamavili ngesandla, iMedicare inokuhlawula isithuthuthu esinamandla. Ukulungela isithuthuthu esinamandla, kuya kufuneka undwendwele ngokwakho ugqirha ukuze uqiniseke ukuba womelele ngokwaneleyo ukuba ungangena kwaye uphume ngokwakho kwaye uzibambe nkqo ngelixa uqhuba.

Njengokuba kunjalo ngezihlalo ezinamavili ezandla, unokufuna ukuthatha isigqibo sokuba ngaba ukurenta yeyona ndlela ibhetele kunokuthenga izixhobo ngokuthe ngqo.

1. Jonga ugqirha wakho ukuze ufumane ipriskripshini kwisitulo esinamavili.
2. Fumanisa ukuba ukhe wadibana nenciphiso yakho yonyaka ukuze wazi ukuba ungalindela ukuhlawulela isitulo esinamavili.
3. Nxibelelana nomthengisi we-DME obhalise kwi-Medicare.
4. Cela umthengisi wakho we-DME angenise isicelo sokugunyaziswa kwangaphambili ukuba siyadingeka.
5. Ukuba isicelo sakho saliwe, sebenza nogqirha wakho kunye nomthengisi we-DME ukubonelela ngolwazi olongezelelweyo ngeemfuno zeMedare.

Izihlalo ezinamavili ezinamandla

Ukufumana isitulo esinamavili, ugqirha wakho kuya kufuneka akuvavanye buqu. Emva koviwo lwakho, ugqirha wakho kuya kufuneka abhale iodolo esithi uyakwazi ukusebenzisa isitulo esinamavili ngokukhuselekileyo kwaye uchaze ukuba kutheni usidinga.

Iindidi ezithile zezitulo ezinamavili zamandla zifuna “ugunyaziso lwangaphambili” ngaphambi kokuba usifumane. Oko kuthetha ukuba ufuna imvume ye-Medicare ngaphambi kokuba wenze ukuthenga okanye ukurenta isixhobo. Isicelo sesigunyaziso kwangaphambili kufuneka sixhaswe yi-odolo evela kugqirha wakho kunye neefom ezibonelelwa ngumboneleli ngezixhobo zonyango.

Nokuba nguwe okanye umboneleli wezixhobo zonyango unakho ukungenisa amaxwebhu afunekayo kwiKontraktha yoLawulo lweeMpahla zoNyango oluQinisekileyo (i-DME MAC). Kuya kufuneka uthathe isigqibo esivela kwi-DME MAC malunga neentsuku ezili-10 emva kokuba ufake isicelo.

Ukuba i-Medicare ayikuvumeli ukuthengwa kwakho, unelungelo lokufaka isibheno kweso sigqibo. Wena okanye umboneleli ngezixhobo zonyango unokuchaza ngakumbi ukuba kutheni ufuna ukuba isixhobo sisebenze ekhayeni lakho.

Ukubona iindidi ezingama-33 zesikuta sombane kunye nezihlalo ezinamavili ezinamandla ezifuna ukugunyaziswa kwangaphambili, jonga uluhlu lwangoku apha.

Ngaba i-Medicare igubungela isigulana?

Ukuba ugqirha wakho ukholelwa ukuba uyakufuna ukukunceda ukusuka ebhedini uye kwisitulo esinamavili, i-Medicare Part B iyakugubungela iipesenti ezingama-80 zezo ndleko. Uya kuba noxanduva lwepesenti ye-20 eseleyo yeendleko.

I-Medicare ichaza ilifti njengezixhobo zonyango ezizinzileyo (i-DME).

Kuthekani ngerampu yesitulo esinamavili?

Nangona i-ramp ye-wheelchair ingaba yimfuneko yonyango, i-Medicare Part B ayithathi ingqalelo i-wheelchair ramp izixhobo zonyango ezizinzileyo, ngoko ke indleko yesitulo sabakhubazekile ayihlanganisiwe. Ukuba ufuna ukufaka i-wheelchair ramp, kuyakufuneka uyihlawulele ngokwakho.

Zithini iindleko zokuphuma epokothweni kwizitulo ezinamavili ukuba unayo iMedicare?

I-Medicare Icandelo B lihlawula iipesenti ezingama-80 zeendleko zesitulo esinamavili emva kokuba udibene nokuncitshiswa kwakho konyaka. Uya kuhlawula iipesenti ezingama-20 zeendleko ukongeza kwiipremiyamu zakho zonyaka zeMedicare. Unokuba neendleko zepayipi ezinxulumene naluphi na utyelelo logqirha oluyimfuneko ukufumana isitulo sakho esinamavili.

Kweminye imimandla yelizwe, abathengisi be-DME bayacelwa ukuba bathathe inxaxheba kwinkqubo yokukhuphisana ngexabiso, enceda ukugcina iindleko zilawulwa. Nangona kunjalo, le nkqubo yokubhida kukhuphiswano iye yanqunyanyiswa okwethutyana kude kube nguJanuwari 1, 2021.

Ngexesha lesithuba sokwexeshana, kubaluleke ngakumbi ngakumbi ukuba ubazi ubuchule bokuthengisa obunobukrakra obuqhutywa ngabanye babanikezeli be-DME. Ukuba unayo nayiphi na imibuzo okanye inkxalabo malunga nomnikezeli we-DME, okanye malunga nomntu oza ekhayeni lakho eze kuthengisa i-DME, ungatsalela umnxeba kwinombolo yomnxeba yobuqhophololo ye-HHS Ofisi yoMhloli Jikelele nge-1-800-HHS-TIPS ( 1-800-447-8477) okanye uyixele kwi-intanethi.

Zeziphi izicwangciso zeMedicare ezingangcono kuwe ukuba uyazi ukuba ufuna isitulo esinamavili?

Ukuba ucinga ukuba uza kudinga isitulo esinamavili ngo-2020 kwaye ufanelekile kwi-Medicare, kuyakufuneka uthathe isigqibo sokuba loluphi uhlobo lwesicwangciso oluza kukhawulelana neemfuno zakho.

Icandelo leMedicare A ligubungela ukulaliswa esibhedlele. Ukuba ufuna isitulo esinamavili ngexesha lokuhlala esibhedlele okanye ngelixa uhlala kwikhaya lokunyamekela, indawo leyo iya kukubonelela ngayo.

Icandelo leMedicare B ligubungela iinkonzo zonyango. Phantsi kweCandelo B, izitulo ezinamavili zigutyungelwe njengesixhobo sonyango esomeleleyo.

Icandelo leMedicare C likwabizwa ngokuba yiMedicare Advantage. Kuba izicwangciso ze-Medicare Advantage ziyafuneka ukugubungela izibonelelo ezifanayo njenge-Medicare yoqobo (iinxalenye A no-B), izitulo ezinamavili zigutyungelwe phantsi kwezi zicwangciso. Izibonelelo ezithile kunye neemfuno ziya kwahluka ngokwesicwangciso sokucwangcisa.

Icandelo lonyango i-Medicare Icandelo D kukugubungela amayeza. Nangona ufuna iphepha likagqirha okanye iodolo kagqirha ukuze ufumane isitulo esinamavili, azikho phantsi kweli candelo leMedicare.

IMedigap (izongezo zeMedicare) zizongezo kwizicwangciso zokukunceda uhlawule iindleko ezingafakwanga yiMedicare. Ezinye izicwangciso zeMedigap zinokukunceda uhlawule ezinye okanye zonke iindleko zesitulo esinamavili.

Ngaba i-Medicare ihlawula olunye uncedo lokuhamba?

I-Medicare Icandelo B lihlawula iipesenti ezingama-80 zeendleko zabahambahambayo, ii-rollators, iintonga, kunye neekhuni (emva kokuba ihlawulwe ihlawulwe). Kuya kufuneka uhlawule ezinye iipesenti ezingama-20 zeendleko. Kanye nje ngesitulo esinamavili, ugqirha wakho kuya kufuneka abhale iodolo esithi isixhobo sokuhamba siyimfuneko kuwe.

Umgca wezantsi

Ukuba unesimo sempilo esikuthintela ukuhamba kwakho ekhayeni lakho kwaye sikugcine ekubeni ungakwazi ukukhathalela iimfuno zakho zemihla ngemihla, i-Medicare Part B iya kugubungela iipesenti ezingama-80 zeendleko. Uya kuba noxanduva lokuhlawula ama-20 eepesenti endleko, kunye nokutsalwa kwakho, iintlawulo zepremiyamu, kunye nayo nayiphi na into ehambelana nayo.

Izibonelelo zeMedicare zigubungela izitulo ezinamavili, izithuthuthu ezinamandla kunye nezihlalo ezinamavili. Kubalulekile ukuqinisekisa ukuba ugqirha wakho kunye nomthengisi wezixhobo zonyango bobabini babhalise kwi-Medicare ngaphambi kokuba ufumane isitulo esinamavili.

Umboneleli wakho wokhathalelo lwempilo kuyakufuneka abhale i-odolo echaza ukuba kutheni usidinga esi sixhobo, kwaye umboneleli wakho ngezixhobo zonyango unokungenisa iifom ezongezelelweyo ngokuxhomekeke kuhlobo lwesitulo esinamavili osifunayo.

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.