Kusamalira odwala: Kodi Medicare Ikuphimba Chiyani?

Zamkati

• Medicare imaphimba odwala
• Kodi Medicare imakhudza liti hospice?
• Ndi chiyani chomwe chikuphimbidwa?
• Nanga bwanji za chithandizo cha zinthu zomwe sizikugwirizana ndi matenda osachiritsika?
• Kodi munthu yemwe ali ndi matenda a dementia angayenerere kulandira chithandizo chamankhwala ku Medicare?
• Kodi padzakhala zolipira kapena zochotseredwa?
• Zomwe sizikuphimbidwa ndi Medicare?
• Medicare sichiphimba chithandizo chilichonse chamankhwala
• Medicare silingakwaniritse ntchito kuchokera kwa omwe amapereka omwe sanakonzedwe ndi gulu lanu losamalira odwala
• Medicare sichidzaphimba chipinda chokwanira
• Medicare sichidzaphimba chisamaliro chomwe mumalandira kuchipatala cha odwala
• Kodi Medicare ilipira nthawi yayitali bwanji pazantchito zosamalira odwala?
• Ndi mbali ziti za Medicare zomwe zimafunikira chisamaliro cha odwala?
• Kodi hospice ndi chiyani?
• Kodi hospice imasiyana bwanji ndi chisamaliro chochepa?
• Kodi chisamaliro cha hospice chimawononga ndalama zingati?
• Mfundo yofunika

Kupanga zisankho pankhani yosamalira odwala, kaya inuyo kapena munthu amene mumakonda, si kophweka. Kupeza mayankho achindunji pazomwe zimayendera odwala ndi momwe mungalipirire kungapangitse chisankho chovuta kumveka bwino.

Medicare imaphimba odwala

Medicare Yoyambirira (Medicare Part A ndi Medicare Part B) imalipira chisamaliro cha odwala malinga ngati wothandizirayo ali ovomerezeka ndi Medicare.

Medicare imalipira chisamaliro cha hospice ngati muli ndi dongosolo la Medicare Advantage (HMO kapena PPO) kapena dongosolo lina lathanzi la Medicare.

Ngati mukufuna kudziwa ngati wothandizira odwala akuvomerezedwa, mungafunse dokotala, dipatimenti yanu yazaumoyo, bungwe lakuchipatala, kapena woyang'anira mapulani anu, ngati muli ndi dongosolo lowonjezera la Medicare.

Mwinamwake mukuyang'ana mayankho enieni a malo, opereka chithandizo, ndi mautumiki omwe amapezeka mu chisamaliro cha odwala. Izi zidzakuthandizani kuyankha mafunso amenewa.

Kodi Medicare imakhudza liti hospice?

Medicare imakhudza malo osungira anthu odwala atangotsimikizira kuti wina yemwe ali ndi Medicare ali ndi matenda omwe, ngati angapitirire mosadodometsedwa, zimapangitsa kuti munthuyo akhale ndi moyo wopitilira miyezi isanu ndi umodzi.

Kuti mudziwe izi, muyenera kusaina chikalata chotsimikizira:

• mukufuna chisamaliro chothandizira
• simukufuna kupitiliza kufunafuna chithandizo chamankhwala
• mumasankha chisamaliro cha hospice m'malo mwazithandizo zina zovomerezeka ndi Medicare kuti muthane ndi matenda anu

Ndi chiyani chomwe chikuphimbidwa?

Medicare Yoyamba imalipira ntchito zosiyanasiyana, zopereka, ndi mankhwala okhudzana ndi matenda omwe adakupangitsani kuti mupeze chithandizo chamankhwala. Izi zikuphatikiza:

• madokotala ndi unamwino
• ntchito zothandizira, zakuthupi, komanso zoyankhula
• zipangizo zamankhwala, monga zoyenda ndi kama
• upangiri wathanzi
• mankhwala ndi zida
• mankhwala omwe mukufuna kulandira kuti muchepetse matenda kapena kupweteka
• chisamaliro chakanthawi chochepa chothandizira kuti muthane ndi ululu kapena zizindikilo
• ntchito zantchito ndi upangiri wachisoni kwa onse odwala komanso mabanja
• chisamaliro chakanthawi kochepa (mpaka masiku asanu panthawi) kulola kuti akusamalirani, ngati mukusamalidwa kunyumba
• ntchito zina, zopereka, ndi mankhwala amafunikira kuthana ndi zowawa kapena zowongolera zokhudzana ndi matenda osachiritsika

Kuti mupeze wothandizira odwala m'dera lanu, yesani wopezayo ku Medicare.

Nanga bwanji za chithandizo cha zinthu zomwe sizikugwirizana ndi matenda osachiritsika?

Ngati mukulandira zabwino za hospice, Medicare Part A (choyambirira Medicare) azilipirabe matenda ena ndi mikhalidwe yomwe mungakhale nayo. Malipiro omwewo a co-inshuwaransi ndi zochotseredwa zidzagwiritsidwanso ntchito pazithandizo zonse zomwe zingagwiritsidwe ntchito.

Mutha kusunga dongosolo lanu la Medicare Advantage pomwe mukulandira zabwino za hospice. Muyenera kulipira ndalama zoyambira pantchitoyo.

Kodi munthu yemwe ali ndi matenda a dementia angayenerere kulandira chithandizo chamankhwala ku Medicare?

Pokhapokha ngati moyo uli wochepera miyezi isanu ndi umodzi. Dementia ndimatenda omwe akuyenda pang'onopang'ono. M'magawo amtsogolo, munthu wodwala matenda amisala amatha kutha kugwira bwino ntchito ndikusowa chisamaliro cha tsiku ndi tsiku. Hospice imangophimbidwa, komabe, dokotala akatsimikizira kuti munthuyo amakhala ndi moyo wa miyezi 6 kapena kuchepera apo. Izi nthawi zambiri zimatanthauza kuti matenda achiwiri monga chibayo kapena sepsis adachitika.

Kodi padzakhala zolipira kapena zochotseredwa?

Nkhani yabwino ndiyakuti palibe zochotseredwa pazosamalira odwala.

Zolemba zina ndi ntchito zitha kukhala ndi zokopera. Malangizo a mankhwala opweteka kapena kupumula kwa chizindikiro atha kukhala ndi $ 5 copay. Pakhoza kukhala 5% ya copay yothandizira opumira kuchipatala ngati mungaloledwe kumalo ovomerezeka, kuti omwe akukusamalirani apumule. Kupatula zochitika izi, simuyenera kulipira chisamaliro cha hospice.

Zomwe sizikuphimbidwa ndi Medicare?

Medicare sichiphimba chithandizo chilichonse chamankhwala

Izi zimaphatikizapo mankhwala ndi mankhwala akuchipatala omwe cholinga chake ndikukuchiritsani. Ngati mungaganize kuti mukufuna chithandizo chamankhwala anu, mutha kusiya chisamaliro cha hospice ndikuchita izi.

Medicare silingakwaniritse ntchito kuchokera kwa omwe amapereka omwe sanakonzedwe ndi gulu lanu losamalira odwala

Chisamaliro chilichonse chomwe mungalandire chiyenera kuperekedwa ndi omwe amakupatsani chithandizo chomwe mungasankhe. Ngakhale mukulandira ntchito zomwezi, Medicare silingakwanitse kulipira ngati woperekayo si inuyo ndi gulu lanu la hospice lomwe mwatchulidwalo. Mutha kuchezabe dokotala wanu wanthawi zonse kapena wothandizira zaumoyo ngati mwasankha kuti aziyang'anira chisamaliro chanu.

Medicare sichidzaphimba chipinda chokwanira

Ngati mukulandira odwala kunyumba, kumalo osungira anthu okalamba, kapena kumalo operekera odwala odwala, Medicare sangakwanitse kulipira chipinda chogona. Kutengera ndi malowa, ndalamazo zimatha kupitilira $ 5,000 pamwezi.

Ngati gulu lanu lothandizira odwala litasankha kuti musankhe m'masiku ochepa patsogolo khalani kuchipatala kuchipatala kapena m'malo opumira, Medicare ithandizira kukhalako kwakanthawi kochepa. Mutha kukhala ndi ngongole yolipira ngongole yakanthawi kochepa, komabe. Nthawi zambiri, ndalamazo zimakhala 5% ya mtengo wake, nthawi zambiri osapitilira $ 10 patsiku.

Medicare sichidzaphimba chisamaliro chomwe mumalandira kuchipatala cha odwala

Silipira mayendedwe a ambulansi kupita kuchipatala kapena ntchito zilizonse zomwe mungalandire kuchipatala, monga chipinda chadzidzidzi, pokhapokha ayi zokhudzana ndi matenda anu osachiritsika kapena pokhapokha ngati atakonzedwa ndi gulu lanu la odwala.

Kodi Medicare ilipira nthawi yayitali bwanji pazantchito zosamalira odwala?

Ngati inu (kapena wokondedwa) mukulandira chisamaliro cha hospice, zikutanthauza kuti dokotala wanu watsimikizira kuti moyo wanu ndi miyezi 6 kapena kuchepera.Koma anthu ena amanyalanyaza ziyembekezo. Kumapeto kwa miyezi isanu ndi umodzi, Medicare ipitiliza kulipirira chisamaliro cha odwala ngati mukufuna. Wotsogolera kuchipatala kapena dokotala wanu ayenera kukumana nanu pamasom'pamaso, kenako kutsimikiziranso kuti chiyembekezo cha moyo sichidutsa miyezi isanu ndi umodzi.

Medicare amalipira masiku awiri opindulitsa masiku 90. Pambuyo pake, mutha kutsimikiziranso kuchuluka kopanda phindu kwamasiku 60. Nthawi iliyonse yopindulitsa, ngati mukufuna kusintha omwe akukuthandizani, muli ndi ufulu kutero.

Ndi mbali ziti za Medicare zomwe zimafunikira chisamaliro cha odwala?

• Medicare Gawo A. Gawo A limalipira kuchipatala, ngati mungafunike kuvomerezedwa kuti muzisamalira zizindikiro kapena kupatsa olera pang'ono.
• Medicare Gawo B. Gawo B limafotokoza ntchito zamankhwala ndi unamwino, zida zamankhwala, ndi ntchito zina zothandizira.
• Medicare Part C (Zopindulitsa). Ndondomeko iliyonse ya Medicare Advantage yomwe muli nayo idzakhalabe yogwira ntchito malinga ngati mukulipira malipiro, koma simudzawafuna kuti mugwiritse ntchito ndalama zothandizira odwala. Medicare Yoyamba imalipira iwo. Mapulani anu a Medicare Part C atha kugwiritsidwabe ntchito kulipira chithandizo chomwe sichikugwirizana ndi matenda.
• Mankhwala owonjezera a Medicare (Medigap). Malingaliro aliwonse a Medigap omwe mungakhale nawo atha kuthandiza pazinthu zokhudzana ndi mikhalidwe yosagwirizana ndi matenda osachiritsika. Simufunikanso maubwino awa kuti akuthandizireni ndalama zaku hospice, chifukwa zimalipiridwa ndi Medicare yoyambirira.
• Medicare Gawo D. Chithandizo chanu cha Medicare Part D chikhala chikugwirabe ntchito kukuthandizani kulipira mankhwala omwe sagwirizana ndi matenda osachiritsika. Kupanda kutero, mankhwala othandizira kuchiza kapena kuthana ndi ululu wa matenda osachiritsika amapezeka kudzera muubwino wothandizidwa ndi Medicare.

Kodi hospice ndi chiyani?

Hospice ndi chithandizo, chithandizo, komanso chisamaliro cha anthu omwe ali ndi matenda ndipo sayembekezeredwa kukhala ndi moyo wopitilira miyezi isanu ndi umodzi.

Limbikitsani anthu omwe ali ndi kachilombo koyambitsa matendawa kuti aganizire kulowa m'zipatala koyambirira kwa miyezi isanu ndi umodzi. Hospice imapereka maubwino omveka komanso othandizira, osati kwa odwala komanso mabanja awo. Zina mwazabwino ndi izi:

• kuwonetseredwa pang'ono ku matenda ndi zoopsa zina zomwe zimadza chifukwa chopita kuchipatala
• kutsitsa mitengo yonse yokhudzana ndi matendawa
• zothandizira kukonza ndi kuthandiza osamalira
• kupeza mwayi wothandizira pantchito yothandizira

Kodi hospice imasiyana bwanji ndi chisamaliro chochepa?

Cholinga cha chisamaliro chothandizira ndikuthandizira kukhala ndi moyo wabwino mukamadwala. Kusamalira odwala kungayambitse nthawi yomwe mwapezeka kuti muli ndi matenda, ngakhale mukuyembekezeredwa kuchira. Mosakayikira mupitiliza kulandira chisamaliro chothandizira mpaka simudzachifunanso.

Malinga ndi National Institute on Aging, kusiyana kwakukulu pakati pa hospice ndi chithandizo chochepetsera ndikuti chisamaliro chololeza chimakupatsani mwayi wolandila chithandizo kuti muchiritse matenda anu. Mukasamalira odwala, zizindikiro zanu ndi ululu wanu zipitilirabe, koma chithandizo chamankhwala chitha.

Ngati zidziwike kwa gulu lachipatala kuti mankhwala sakugwira ntchito ndipo matenda anu ndi osachiritsika, mutha kusintha kuchoka kuchipatala mwa njira imodzi. Ngati dokotala akukhulupirira kuti simungakhale ndi moyo wopitilira miyezi isanu ndi umodzi, inu ndi omwe akukuthandizani mutha kusankha kuti musinthe kupita kuchipatala. Njira ina ndikupitiliza chisamaliro chodekha (kuphatikiza chithandizo chamankhwala chomwe cholinga chake ndi kuchiritsa matendawa) koma ndikuwunika kwambiri chisamaliro (kapena kutha kwa moyo).

Kodi chisamaliro cha hospice chimawononga ndalama zingati?

Kuchuluka kwa chisamaliro cha odwala kumatengera mtundu wa matenda komanso momwe odwala oyambilira amalowera kuchipatala. Mu 2018, Society of Actuaries idaganizira kuti odwala omwe ali ndi khansa amalandila phindu la Medicare Part A ndi Part B pafupifupi $ 44,030 m'miyezi 6 yomaliza ya moyo wawo.

Chiwerengerochi chimaphatikizaponso mtengo wa kuchipatala, kuphatikizapo chithandizo chamankhwala kunyumba. Kafukufuku wina adawonetsa kuti ndalama zomwe amawononga a Medicare kwa odwala m'masiku 90 apitawo anali $ 1,075 okha.

• Tengani kamphindi kuti mutsimikizire kuti mukumvetsetsa momwe Medicare imagwirira ntchito.
• Dzizolowereni ndi nthawi yolembetsa.
• Gwiritsani ntchito mndandandawu kuti mutsimikizire kuti muli ndi zomwe mukufuna kutsatira.
• Mukatha kusonkhanitsa zomwe mukufuna, malizitsani kugwiritsa ntchito intaneti. Mungafune kuchepetsa zosokoneza ndi zosokoneza kwa mphindi zosachepera 30.

Mfundo yofunika

Ngati muli ndi chithandizo choyambirira cha Medicare ndipo mukuganizira za chisamaliro cha hospice, phindu la Medicare hospice lidzalipira mtengo wa chisamaliro cha hospice.

Mufunika dokotala kuti atsimikizire kuti chiyembekezo chanu chokhala ndi moyo sichapitilira miyezi isanu ndi umodzi, ndipo muyenera kusaina chikalata chovomera chisamaliro cha odwala komanso kusiya chithandizo chamankhwala. Ngati mwakwaniritsa zofunikirazi, dokotala wanu ndi chisamaliro cha unamwino, mankhwala, ndi ntchito zina zambiri zithandizidwa.

Chinthu chimodzi chofunikira kudziwa: Medicare Yoyambirira siyilipira malo ndi bolodi ya odwala, chifukwa chokhala nthawi yayitali m'nyumba yosungirako anthu okalamba kapena malo oyamwitsa anthu aluso sichingachitike ngati gawo lothandizira anthu odwala matendawa.

Zomwe zili patsamba lino zimatha kukuthandizani posankha nokha za inshuwaransi, koma cholinga chake si kupereka upangiri wokhudzana ndi kugula kapena kugwiritsa ntchito inshuwaransi kapena zinthu zilizonse za inshuwaransi. Healthline Media siyigulitsa bizinesi ya inshuwaransi mwanjira iliyonse ndipo siyololedwa kukhala kampani ya inshuwaransi kapena opanga madera aliwonse aku U.S. Healthline Media sivomereza kapena kuvomereza aliyense wachitatu yemwe angachite bizinesi ya inshuwaransi.