Kodi Medicare Amaphimba Chiyani Ngati Muli ndi Dementia?

Zamkati

• Kodi Medicare imasamalira chisamaliro cha dementia?
• Kodi Medicare imaphimba malo ogwiritsira ntchito odwala kapena odwala matenda opatsirana pogonana?
• Zipatala
• Malo oyamwitsa aluso (SNFs)
• Kodi Medicare imaphimba chisamaliro chanyumba cha dementia?
• Kodi Medicare imaphimba kuyesa kwa dementia?
• Kodi Medicare imaphimba malo osungira anthu odwala matenda amisala?
• Ndi magawo ati a Medicare omwe amateteza chisamaliro cha dementia?
• Kuphunzira kwa Medicare ndi gawo
• Ndani ali woyenera kulandira chithandizo cha Medicare pa chisamaliro cha dementia?
• Kodi dementia ndi chiyani?
• Mfundo yofunika

• Medicare imalipira zina mwazomwe zimakhudzana ndi chisamaliro cha dementia, kuphatikiza kugona kwa odwala, chithandizo chamankhwala kunyumba, ndi mayeso ofunikira.
• Malingaliro ena a Medicare, monga mapulani a zosowa zapadera, amayang'aniridwa makamaka kwa anthu omwe ali ndi matenda osatha monga dementia.
• Medicare sikuti imasamalira chisamaliro cha nthawi yayitali, monga yomwe imaperekedwa kunyumba yosungira anthu okalamba kapena malo okhala othandizira.
• Pali zinthu zomwe zilipo, monga mapulani a Medigap ndi Medicaid, omwe atha kuthandiza kuthandizira chisamaliro chodwala matenda amisala omwe sanatchulidwe ndi Medicare.

Dementia ndi mawu omwe amagwiritsidwa ntchito kutanthauza dziko lomwe kuganiza, kukumbukira, komanso kupanga zisankho zasokonekera, kusokoneza zochitika za tsiku ndi tsiku. Matenda a Alzheimer ndi mawonekedwe amisala. Medicare ndi pulogalamu ya inshuwaransi yazaumoyo yomwe imakhudza mbali zina za chisamaliro cha matenda aumtima.

Akuti anthu aku America ali ndi matenda a Alzheimer kapena matenda ena amisala. Pafupifupi 96 peresenti ya anthuwa ali ndi zaka 65 kapena kupitirira.

Pitilizani kuwerenga kuti muphunzire magawo omwe chisamaliro cha dementia Medicare chimakwirira ndi zina zambiri.

Kodi Medicare imasamalira chisamaliro cha dementia?

Medicare imalipira zina, koma osati zonse, za mitengo yokhudzana ndi chisamaliro cha dementia. Izi zikuphatikiza:

• inpatient amakhala kuzipatala monga zipatala ndi malo oyamwitsa aluso
• chithandizo chamankhwala kunyumba
• chisamaliro cha odwala
• kuwunika kwazidziwitso
• mayeso oyenerera kuti adziwe matenda amisala
• Mankhwala osokoneza bongo (Gawo D)

Anthu ambiri omwe ali ndi matenda amisala amafunikira chisamaliro cha nthawi yayitali chomwe chimaphatikizapo chisamaliro chakusunga. Kusamalira okalamba kumafunikira kuthandizidwa ndi zochitika tsiku ndi tsiku monga kudya, kuvala, komanso kusamba.

Medicare sikuti imasamalira chisamaliro cha nthawi yayitali. Sichikuphimba chisamaliro chakusunga.

Komabe, palinso zinthu zina zomwe zingakuthandizeni kulipirira chisamaliro cha nthawi yayitali komanso chosunga. Izi zikuphatikiza zinthu monga Medicaid, Mapulogalamu a All-inclusive Care for Okalamba (PACE), ndi inshuwaransi yayitali yothandizira.

Kodi Medicare imaphimba malo ogwiritsira ntchito odwala kapena odwala matenda opatsirana pogonana?

Gawo la Medicare A limafotokoza malo ogona odwala m'malo opezeka zipatala komanso malo oyamwitsa aluso. Tiyeni tiwone izi mosamalitsa.

Zipatala

Medicare Gawo A limafikira kuchipatala. Izi zitha kuphatikizira malo monga zipatala zosamalira odwala, zipatala zakuchipatala, komanso zipatala zazitali. Ntchito zina zomwe zimachitika ndi izi:

• chipinda theka-payekha
• chakudya
• chisamaliro chapadera
• mankhwala omwe ndi gawo la chithandizo chanu
• zina zothandizira kuchipatala kapena zina

Pokhala kuchipatala chogona, Medicare Part A ipereka ndalama zonse masiku 60 oyamba. Kwa masiku 61 mpaka 90, mudzalipira ndalama za $ 352 tsiku lililonse. Pambuyo masiku 90 ngati wodwala, mudzakhala ndiudindo pazolipira zonse.

Mukalandira chithandizo chamankhwala kuchipatala, adzaphimbidwa ndi Medicare Part B.

Malo oyamwitsa aluso (SNFs)

Gawo la Medicare Part A limakhudzanso kukhala ku SNF. Awa ndi malo omwe amapereka chithandizo chamankhwala mwaluso chomwe chingaperekedwe ndi akatswiri azaumoyo monga madotolo, anamwino olembetsedwa, komanso othandizira.

Ngati dokotala angaganize kuti mukufuna chisamaliro cha tsiku ndi tsiku mutatha kuchipatala, angakulimbikitseni kuti mupite ku SNF. Kukhala kwanu kungaphatikizepo zinthu monga chipinda chochezera, chakudya, ndi mankhwala omwe amagwiritsidwa ntchito pamalowo.

Kwa masiku 20 oyamba mu SNF, Medicare Part A idzalipira zonse. Pambuyo masiku 20, muyenera kulipira ndalama za $ 176 tsiku lililonse. Ngati mwakhala pa SNF masiku opitilira 100, mumalipira zonse.

Kodi Medicare imaphimba chisamaliro chanyumba cha dementia?

Chisamaliro chapanyumba ndi pomwe akatswiri aluso kapena ntchito zamwino zimaperekedwa kunyumba. Ikuphatikizidwa ndi magawo awiri a Medicare A ndi B. Mautumikiwa nthawi zambiri amalumikizidwa ndi bungwe lazachipatala kunyumba ndipo atha kukhala:

• chisamaliro chamwino chanthawi yochepa
• ganyu kusamalira
• chithandizo chamankhwala
• chithandizo pantchito
• chithandizo cha chilankhulo
• chithandizo chamankhwala

Kuti muyenerere kulandira chithandizo chamankhwala kunyumba, izi ziyenera kukhala zowona:

• Muyenera kuwerengedwa kuti simunyamuka kupita kunyumba, kutanthauza kuti muli ndi vuto kuchoka panyumba popanda kuthandizidwa ndi munthu wina kapena chida chothandizira ngati njinga ya olumala kapena woyenda.
• Muyenera kuti mukulandira chithandizo chanyumba pansi pa pulani yomwe idawunikiridwa pafupipafupi ndi dokotala wanu.
• Dokotala wanu ayenera kutsimikizira kuti mukufuna chisamaliro chaluso chomwe chingaperekedwe kunyumba.

Medicare imayang'anira ntchito zonse zakuchipatala. Ngati mungafune zida zamankhwala monga wheelchair kapena bed bed, mudzakhala ndi gawo la 20% ya mtengo.

Kodi Medicare imaphimba kuyesa kwa dementia?

Medicare Part B imafotokoza mitundu iwiri ya maulendo abwinobwino:

• Ulendo wa "Welcome to Medicare", womwe udamalizidwa miyezi 12 yoyambirira kuchokera pomwe Medicare adalembetsa.
• Ulendo Wabwino Wapachaka kamodzi pa miyezi 12 iliyonse m'zaka zonse zotsatira.

Maulendowa akuphatikizanso kuwunika kwazidziwitso zakuwonongeka. Izi zimathandiza dokotala kuti ayang'ane zizindikiro za matenda a dementia. Kuti muchite izi, adotolo angagwiritse ntchito chimodzi kapena kuphatikiza izi:

• kuyang'anitsitsa mawonekedwe anu, machitidwe anu, ndi mayankho anu
• nkhawa kapena malipoti ochokera kwa inu kapena abale anu
• chida chodziwitsira kuzindikira

Kuphatikiza apo, Medicare Part B imatha kuyika mayeso omwe amawerengedwa kuti ndi othandiza kuti athe kuzindikira matenda amisala. Zitsanzo zina zimaphatikizapo zinthu monga kuyesa magazi ndi kulingalira kwa ubongo kudzera mu CT scan kapena MRI scan.

Kodi Medicare imaphimba malo osungira anthu odwala matenda amisala?

Hospice ndi mtundu wa chisamaliro chomwe chimaperekedwa kwa anthu omwe akudwala mwakayakaya. Kusamalira odwala kumayang'aniridwa ndi gulu losamalira odwala ndipo limatha kukhala ndi izi:

• ntchito zamankhwala ndi unamwino
• mankhwala othandizira kuchepetsa zizindikiro
• chisamaliro chapakatikati cha odwala chothandizira kuthana ndi zizindikilo
• zipangizo zamankhwala monga zoyenda ndi olumala
• amapereka ngati mabandeji kapena ma catheters
• upangiri wachisoni kwa inu kapena banja lanu
• chisamaliro cha kupumula kwakanthawi kochepa, komwe kumakhala kugona kwakanthawi kochepa kuti wodwala wanu wamkulu apumule

Medicare Part A idzafotokoza za chisamaliro cha odwala omwe ali ndi matenda a dementia ngati izi ndi zowona:

• Dokotala wanu watsimikiza kuti muli ndi chiyembekezo chokhala ndi moyo miyezi isanu ndi umodzi kapena kuchepera (ngakhale atha kusintha izi ngati kuli kofunikira).
• Mumavomereza kulandira chisamaliro chokhazikika pamtontho ndi kupumula kwa zipsinjo m'malo mosamalira kuchiritsa matenda anu.
• Mumasaina chikalata chosonyeza kuti mumasankha chisamaliro cha hospice mosiyana ndi njira zina zaku Medicare.

Medicare imalipira zonse zofunika kuchipatala, kupatula chipinda ndi bolodi. Mwinanso nthawi zina mumakhala ndi ngongole zazing'ono zamankhwala zilizonse zomwe zingakuthandizeni kuti muchepetse matenda.

Ndi magawo ati a Medicare omwe amateteza chisamaliro cha dementia?

Tiyeni tiwunikenso mwachidule magawo a Medicare omwe amafotokoza za chisamaliro cha dementia:

Kuphunzira kwa Medicare ndi gawo

Ndani ali woyenera kulandira chithandizo cha Medicare pa chisamaliro cha dementia?

Kuti muyenerere kulandira chithandizo chamankhwala am'magazi a Medicare, muyenera kukwaniritsa chimodzi mwazofunikira pakuyenerera kwa Medicare. Izi ndikuti ndinu:

• azaka 65 kapena kupitirirapo
• m'badwo uliwonse ndipo ali ndi chilema
• m'badwo uliwonse ndipo ali ndi matenda am'magazi (ESRD)

Komabe, palinso mapulani ena a Medicare omwe anthu omwe ali ndi matenda a dementia amatha kulandira. Pazochitikazi, pangafunike kuzindikira kuti ali ndi matenda aumtima:

• Zolinga zapadera (SNPs): SNPs ndi gulu lapadera la mapindu a Advantage omwe amakwaniritsa zosowa za anthu omwe ali ndi thanzi labwino, kuphatikizapo matenda amisala. Kukonzekera chisamaliro chimaphatikizidwanso nthawi zambiri.
• Ntchito zosamalira odwala (CCMR): Ngati muli ndi matenda a dementia komanso matenda osachepera amodzi, mutha kukhala oyenera kulandira CCMR. CCMR imaphatikizapo kukhazikitsa dongosolo la chisamaliro, mgwirizano wa chisamaliro ndi mankhwala, ndi mwayi wa 24/7 kwa akatswiri azaumoyo pazofunikira zaumoyo.

Kodi dementia ndi chiyani?

Dementia imachitika mukataya luso lakumvetsetsa monga kukumbukira, kuganiza, komanso kupanga zisankho. Izi zitha kukhudza kwambiri magwiridwe antchito ndi zochitika zatsiku ndi tsiku. Mwachitsanzo, munthu yemwe ali ndi matenda a dementia atha kukhala ndi vuto:

• kukumbukira anthu, zokumbukira zakale, kapena mayendedwe
• kugwira ntchito za tsiku ndi tsiku mosadalira
• kulumikizana kapena kupeza mawu oyenera
• kuthetsa mavuto
• kukhala olongosoka
• kutchera khutu
• kuwongolera malingaliro awo

Palibe mtundu umodzi wokha wamatenda amisala. Pali mitundu ingapo, iliyonse ili ndi mawonekedwe osiyanasiyana. Zikuphatikizapo:

• Matenda a Alzheimer
• Lewy kudwala thupi
• Dementia yakutsogolo
• Matenda a mtima
• Dementia wosakanikirana, womwe ndi kuphatikiza kwamitundu iwiri kapena kupitilira apo

Mfundo yofunika

Medicare imakhudza mbali zina za chisamaliro cha dementia. Zitsanzo zina zimaphatikizira kugona kwa odwala omwe ali ndi luso, chisamaliro chanyumba, komanso kuyezetsa koyenera kwamankhwala.

Kuonjezerapo, anthu omwe ali ndi matenda a dementia akhoza kulandira mapulani a Medicare omwe akugwirizana ndi zosowa zawo. Izi zikuphatikiza zinthu monga mapulani a zosowa zapadera ndi ntchito zosamalira odwala.

Ngakhale anthu ambiri omwe ali ndi vuto la misala amafunikira chisamaliro chamtundu wina, Medicare nthawi zambiri sichimakwirira izi. Mapulogalamu ena, monga Medicaid, atha kuthandiza kulipira mtengo wa chisamaliro cha nthawi yayitali.