Ngaba i-Medicare igubungela ii-Aides zeMpilo yaseKhaya?

Umxholo

• Zithini izinto ezincedisa ekhaya?
• Unyango lwe-Medicare lulugubungela nini ukhathalelo lwempilo ekhaya?
• Zithini iindleko zoncedo lwezempilo ekhaya?
• Zeziphi izicwangciso zeMedicare ezingangcono kuwe ukuba uyazi ukuba ufuna iinkonzo zempilo yasekhaya?
• Icandelo A
• Icandelo B
• Icandelo C
• Izicwangciso zokuncedisa kwiMedare okanye iMedigap
• Umgca wezantsi

Iinkonzo zempilo yasekhaya zivumela umntu ukuba ahlale kwikhaya lakhe ngelixa efumana unyango olufunekayo okanye ukhathalelo olunobuchule. I-Medicare igubungela imiba ethile yezi nkonzo zempilo yasekhaya, kubandakanya unyango ngokwasemzimbeni kunye nasemsebenzini kunye nokhathalelo lobuchule.

Nangona kunjalo, i-Medicare ayigubungeli zonke iinkonzo zempilo zasekhaya, ezinje ngononophelo lwexesha, ukunikezelwa kwesidlo, okanye ukhathalelo lokugcina-uninzi lwezi nkonzo luwela phantsi koncedo lwezempilo lwasekhaya.

Qhubeka ufunda ukuze ufumane malunga neenkonzo ezigutyungelweyo phantsi kweMedicare, kunye nendlela abanokuncedisa ngayo ezempilo ekhaya okanye bangaweli phantsi kolu luhlu.

Zithini izinto ezincedisa ekhaya?

Uncedo lwempilo yasekhaya ngabaqeqeshi bezempilo abanceda abantu emakhayeni abo xa bekhubazekile, benesifo esinganyangekiyo, okanye befuna uncedo olongezelelekileyo.

Abancedisi banokunceda kwimisebenzi yokuphila kwansuku zonke, njengokuhlamba, ukunxiba, ukuya kwigumbi lokuhlambela, okanye ezinye izinto ezenziwa ekhaya. Kulabo bafuna uncedo ekhaya, uncedo lwezempilo lwasekhaya lunokubaluleka.

Nangona kunjalo, bahlukile kweminye imisebenzi yezempilo yasekhaya, enokubandakanya abongikazi bempilo yasekhaya, abanyangi bomzimba, kunye nabanyangi abanikezela ngenkathalo yezonyango kunye nezakhono ezifuna uqeqesho olukhethekileyo kunye nokuqinisekiswa.

Ngokwe-Bureau of Labor Statistics yase-US, inqanaba eliqhelekileyo lemfundo ngoncedo lwempilo yekhaya yidiploma yamabanga aphakamileyo okanye efanayo.

Abanye abantu banokusebenzisa igama elithi "uncedo lwezempilo lwasekhaya" ukuchaza yonke imisebenzi ebonelela ngononophelo ekhaya, kodwa umncedisi wezempilo wasekhaya wahlukile kwezobuchwephesha kumongikazi wezempilo wasekhaya okanye ugqirha wezonyango.

Lo mahluko ungundoqo xa kuziwa ekuqondeni ukuba yintoni iMedare kwaye ayizukugubungela xa kufikwa kukhathalelo lwasekhaya. I-Medicare ayihlawuleli uninzi lweenkonzo eziphantsi kweenkonzo zoncedo lwezempilo. Oku kubandakanya:

• ujikelezo lwexesha lonke
• ukuhanjiswa kokutya ekhaya okanye uncedo ngokutya
• iinkonzo zekhaya, ezinjengokuhlamba iimpahla, ukucoca, okanye ukuthenga
• ukhathalelo lomntu, njengokuncedisa ukuhlamba, ukunxiba okanye ukusebenzisa igumbi lokuhlambela

Ukuba iinkonzo zokhathalelo lobuqu ezivela kumncedisi wempilo yekhaya kuphela kokhathalelo oludingayo, i-Medicare ayihlali igubungela ezi. Benza iinkonzo zonyango ekhaya.

Unyango lwe-Medicare lulugubungela nini ukhathalelo lwempilo ekhaya?

Icandelo le-Medicare A (iinkonzo zesibhedlele) kunye ne-Medicare Icandelo B (iinkonzo zonyango) zigubungela imiba ethile yempilo yasekhaya.

Ngokufanelekileyo, impilo yasekhaya inokuluqinisa ukhathalelo lwakho kwaye ithintele ukwamkelwa kwakhona esibhedlele. Kukho amanyathelo kunye neemeko zokulungela ukhathalelo lwempilo lwasekhaya:

• Kuya kufuneka ube phantsi konyango lukagqirha oye wakwenzela isicwangciso esibandakanya ukhathalelo lwempilo ekhaya. Ugqirha wakho kufuneka aphonononge isicwangciso rhoqo ukuqinisekisa ukuba isakunceda.
• Ugqirha wakho kufuneka aqinisekise ukuba ufuna ukhathalelo lobuchule kunye neenkonzo zonyango. Ukufuna le nkathalo, ugqirha wakho kufuneka athathe isigqibo sokuba imeko yakho iya kuphucula okanye igcine ngeenkonzo zekhaya zasekhaya.
• Ugqirha wakho kufuneka aqinisekise ukuba ubuyela ekhaya. Oku kuthetha ukuba kunzima kakhulu okanye kunzima kuwe ukuba ushiye ikhaya lakho.

Ukuba uhlangabezana nale mfuno, ii-Medicare ze-A kunye ne-B zingahlawula iinkonzo zezempilo zasekhaya, kubandakanya:

• ukhathalelo lwezakhono olunesiqingatha, olunokubandakanya ukhathalelo lwenxeba, ukhathalelo lwecatheter, ukubeka esweni imiqondiso ebalulekileyo, okanye unyango olufakwa ngaphakathi (njengeyeza lokubulala iintsholongwane)
• unyango lomsebenzi
• ulungiso lwenyama
• iinkonzo zentlalo zonyango
• ulwimi lwezifo

Ngokuka-Medicare.gov, i-Medicare ihlawula "iinkonzo zoncedo lwempilo yexeshana okanye okwexeshana." Oku kuyaqondakala ukuba kuyadida.

Kuthetha ukuba umsebenzi wezempilo wasekhaya unokubonelela ngeenkonzo zokhathalelo lomntu anikezelwa ngumncedisi wezempilo wasekhaya. Umahluko kukuba, ukuze ubuyiselwe imali, kufuneka ube ufumana iinkonzo zobongikazi abanezakhono.

Zithini iindleko zoncedo lwezempilo ekhaya?

Ukuba ugqirha wakho uthathe amanyathelo okukunceda ukuba ufaneleke ukufumana iinkonzo zempilo zasekhaya, baya kukunceda uqhagamshelane ne-arhente yezempilo yasekhaya.

Le mibutho kufuneka ikunike inkcazo yento eyenziwa yiMedicare kwaye ayifihli kwiSaziso soMxhamli kwangaphambili. Ngokufanelekileyo, oku kuyanceda ukunciphisa iindleko zokumangalisa kuwe.

Xa i-Medicare ivuma iinkonzo zekhaya lakho, awunakuhlawula nto ngeenkonzo zonyango lwasekhaya, nangona unokuba noxanduva lweepesenti ezingama-20 zemali evunyiweyo ye-Medicare yezixhobo zonyango ezizinzileyo (ezinokubandakanya ukubonelela ngonyango, ukubonelela ngononophelo lwenxeba , kunye nezixhobo zokunceda.

Ngokwesiqhelo kukho umda weentsuku ezingama-21 ukuba ungafumana ixesha elingakanani ngaphandle kweenkonzo ezingabizi mali. Nangona kunjalo, ugqirha wakho unokwandisa lo mda ukuba banokuqikelela ukuba iimfuno zakho zempilo yasekhaya zingaphela nini.

Zeziphi izicwangciso zeMedicare ezingangcono kuwe ukuba uyazi ukuba ufuna iinkonzo zempilo yasekhaya?

I-Medicare yahlulahlula iinkonzo zayo ngokwamaqela oonobumba abohlukeneyo, kubandakanya namacandelo e-Medicare A, B, C (Medicare Advantage), kunye no-D (ukumiselwa kweziyobisi).

Icandelo A

Icandelo lonyango i-Medicare yinxalenye ebonelela ngesibhedlele. Icandelo leMedicare A likhululekile kubantu abaninzi xa bona okanye amaqabane abo besebenzela ubuncinci iikota ezingama-40 behlawula irhafu ye-Medicare.

Nangona iCandelo A “ligubungela esibhedlele,” lisagubungela iinkonzo zezempilo zasekhaya kuba zinokuba kukuqhubekeka kokhathalelo obulifumana esibhedlele kwaye kubalulekile ekufumaneni kwakhona.

Icandelo B

Icandelo leMedicare B yinxalenye ebandakanya iinkonzo zonyango. Wonke umntu kwiCandelo B uhlawula ipremiyamu, kwaye abanye abantu bangahlawula ngaphezulu ngokusekelwe kumvuzo wabo. Icandelo B lihlawulela ezinye zeenkonzo zekhaya, kubandakanya nezixhobo zonyango.

Icandelo C

Icandelo leMedicare C likwabizwa ngokuba yiMedicare Advantage. Kwahlukile kwi-Medicare yesiko kuba idibanisa iinxalenye ze-A, B, ngamanye amaxesha i-D (ukumiselwa kweziyobisi), kwaye ngamanye amaxesha iinkonzo ezongezelelweyo, kuxhomekeke kwisicwangciso sakho.

Imizekelo yeziCwangciso zeNzuzo ye-Medicare ibandakanya umbutho wolondolozo lwempilo (i-HMO) okanye umbutho womboneleli okhethiweyo (PPO). Ukuba unazo ezi ndidi zesicwangciso, kuyakufuneka ufumane iinkonzo zempilo yakho yasekhaya kwiarhente isicwangciso sakho esikhethekileyo.

Ezinye izicwangciso ze-Medicare Advantage zibonelela ngakumbi ngeenkonzo zempilo yasekhaya, kwaye olu lwazi kufuneka lubandakanywe kwinkcazo yakho yezibonelelo.

Izicwangciso zokuncedisa kwiMedare okanye iMedigap

Ukuba unayo i-Medicare yasekuqaleni (iinxalenye ze-A kunye ne-B, kungekhona i-Medicare Advantage), unokukwazi ukuthenga isicwangciso sokuncedisa i-Medicare, esibizwa ngokuba yiMedigap.

Ezinye izicwangciso zeMedigap zihlawulela iindleko ze-coinsurance kwiCandelo B, elinokukunceda ukuba uhlawule iinkonzo zempilo zasekhaya. Nangona kunjalo, ezi zicwangciso aziboneleli ngenkonzo eyandisiweyo yenkonzo yezempilo ekhaya.

Abanye abantu bakhetha ukuthenga i-inshurensi yokhathalelo lwexesha elide, engeyonxalenye yeMedicare. Le migaqo-nkqubo inokunceda ukugubungela iinkonzo zononophelo lwempilo yasekhaya kunye nexesha elide kuneMedicare. Nangona kunjalo, imigaqo-nkqubo iyahluka kwaye imele iindleko ezongezelelweyo kubantu abadala.

Umgca wezantsi

I-Medicare ayihlawuli iinkonzo zoncedo lwezempilo ekhaya xa kungekho lungelo lonyulo. Ukuba ugqirha wakho uthi ufuna ukhathalelo lwezakhono, unokukwazi ukufumana iinkonzo zokhathalelo lomntu ngelixa ufumana ukhathalelo olunobuchule.

Eyona ndlela ilungileyo kukunxibelelana nogqirha wakho kunye ne-arhente yezempilo yasekhaya ukuze uqonde ukuba zeziphi iindleko kwaye azikho ezigutyungelweyo kunye nexesha elingakanani.

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.