Kodi Medicare Imagwira Ntchito Zokhudza Ntchito Zantchito?

Zamkati

• Kuphimba kwa Medicare ndi telehealth
• Kodi Medicare Part B imaphimba chiyani?
• Kodi Medicare Part C imaphimba chiyani?
• Zimagwira bwanji?
• Mtengo
• Ukadaulo
• Ndingadziwe bwanji ngati ndili woyenera kubisidwa?
• Malo ovomerezeka
• Malo
• Dongosolo lazithandizo za Medicare chronic care management (CCM)
• Kukulitsa kufalikira kwa Medicare pa telehealth
• ESRD
• Sitiroko
• Mabungwe othandizira chisamaliro (ACOs)
• Maulendo olowera ndi maulendo a E
• Ubwino wa telehealth
• Kutenga

Medicare imagwira ntchito zosiyanasiyana zamankhwala komanso zokhudzana ndiumoyo, kuphatikiza telehealth. Telehealth imagwiritsa ntchito ukadaulo wolumikizirana pakompyuta kulola kuyendera maulendo ataliatali ndi maphunziro. Pitirizani kuwerenga kuti mudziwe zambiri za telehealth, mbali ziti za Medicare zomwe zimafotokoza, ndi zina zambiri.

Kuphimba kwa Medicare ndi telehealth

Medicare ili ndi magawo angapo omwe aliyense amapereka mtundu wosiyanasiyana wophimba. Mbali zazikuluzikulu ndi monga:

• Medicare Part A (inshuwaransi ya chipatala)
• Medicare Part B (inshuwaransi ya zamankhwala)
• Medicare Part C (Zothandiza mapulani)
• Medicare Part D (Kuphunzira mankhwala osokoneza bongo)

Telehealth imaphimbidwa ndi gawo la Medicare B ndi C. Tithandizira izi pansipa.

Kodi Medicare Part B imaphimba chiyani?

Medicare Gawo B limafotokoza ntchito zina zama telefoni. Pamodzi, Medicare Part A ndi Part B nthawi zina amatchedwa choyambirira Medicare.

Ulendo wokaona zamalonda umachitiridwa chimodzimodzi ngati kuti mwapita kukaona odwala mwachipatala. Mitundu yantchito yothandizira ndalama zomwe zimaphimbidwa ndi izi:

• kuyendera ofesi
• zokambirana
• chithandizo chamankhwala

Zitsanzo zina za akatswiri azaumoyo omwe amatha kupereka ma telehealth ndi awa:

• madokotala
• othandizira adotolo
• madokotala
• akatswiri azachipatala
• namwino wovomerezeka
• akatswiri odyetsa
• akatswiri ovomerezeka pazakudya
• ogwira ntchito zachipatala

Nthawi zina, mutha kulandira chithandizo chamankhwala kunyumba kwanu. Kwa ena, muyenera kupita kuchipatala.

Kodi Medicare Part C imaphimba chiyani?

Medicare Part C amatchedwanso Medicare Advantage. Makampani a inshuwaransi apadera amagulitsa mapulani a Gawo C. Gawo C limaphatikizapo kufotokozera chimodzimodzi monga Medicare yoyambirira koma itha kuphatikizanso phindu lina.

Mu 2020, kusintha kunapangidwa ku Gawo C lomwe lingalole kuti lipereke ma telehealth ambiri kuposa Medicare yoyambirira. Zosinthazi zikuphatikiza kuchuluka kwa mwayi wopeza chithandizo chamankhwala kuchokera kunyumba m'malo mofuna kupita kuchipatala.

Zowonjezera zimatha kusiyanasiyana kutengera dongosolo lanu la Gawo C. Onetsetsani dongosolo lanu kuti muwone mtundu wa ma telehealth omwe amaperekedwa.

M'munsimu muli zitsanzo za nthawi yomwe telehealth ingagwiritsidwe ntchito:

• maphunziro kapena maphunziro, monga njira zophunzirira kuwunika matenda ashuga
• kukonza chisamaliro cha matenda osachiritsika
• kupeza kukambirana ndi katswiri yemwe sali m'dera lanu
• chithandizo chamankhwala
• zowunikira, monga zovutikira kapena vuto lakumwa mowa
• kukonzekera kukonzekera
• mankhwala othandizira
• kulandira thandizo kuti musiye kusuta
• kupeza kuyezetsa zaumoyo

Zimagwira bwanji?

Nanga telehealth imagwira ntchito bwanji ndi Medicare? Tiyeni tiwone izi mwatsatanetsatane.

Mtengo

Ngati muli ndi Gawo B, mudzakhala ndi udindo wolipira ndalama za 20% pamtengo wothandizidwa ndi telehealth. Kumbukirani kuti muyenera kukumana koyamba ndi Gawo B lanu, lomwe ndi $ 198 la 2020.

Madongosolo a Gawo C amafunika kuti apereke chiphaso chofanana ndi choyambirira cha Medicare. Komabe, mudzafunika kulumikizana ndi omwe amakupatsani dongosolo musanagwiritse ntchito ntchito za telehealth kuti muwonetsetse kuti ntchito inayake yaphimbidwa.

Ukadaulo

Nthawi zambiri mumalandira chithandizo chamankhwala kuchipatala. Komabe, nthawi zina amatha kugwiritsidwa ntchito kunyumba.

Kuti mugwiritse ntchito zamankhwala kunyumba, muyenera kuwonetsetsa kuti muli ndi ukadaulo wofunikira, kuphatikiza:

• kupeza intaneti kapena zambiri zamagetsi
• kompyuta, laputopu, foni yam'manja, kapena piritsi
• imelo adilesi yanu kuti wothandizira zaumoyo wanu athe kukumana nanu ndikutumizirani ulalo pa tsamba lamsonkhano wa vidiyo kapena pulogalamu yofunikira

Zida izi zimalola kulumikizana ndi nthawi yeniyeni, mbali ziwiri, ma audio / makanema ndi omwe amakuthandizani.

Yesani ukadaulo wanu wa teleconferencing ndi mnzanu kapena abale anu musanapite koyamba pa telehealth. Izi zikuthandizani kuthetsa mavuto aliwonse musanayese kugwiritsa ntchito mautumikiwa ndi akatswiri azaumoyo.

Ndingadziwe bwanji ngati ndili woyenera kubisidwa?

Mukalembetsa ku Medicare yoyambirira, mudzakhala oyenerera kulandira chithandizo chamankhwala.

Mutha kukhala woyenera ku Medicare ngati muli ndi zaka 65 kapena kupitirira, muli ndi matenda am'magazi (ESRD) kapena ALS, kapena ngati simungathe kugwira ntchito chifukwa chaulema.

Malo ovomerezeka

Anthu omwe ali ndi gawo la B nthawi zambiri amafunika kupita kuchipatala kuti akalandire chithandizo chamankhwala. Fufuzani ndi pulani yanu kuti mudziwe ngati mungapite kumalo ovomerezeka kukacheza. Mitundu iyi ndi iyi:

• maofesi a dokotala
• zipatala
• malo oyamwitsa aluso
• malo azachipatala amisili
• zipatala za kumidzi
• zipatala zofunikira kwambiri
• zipatala zochokera kuchipatala
• zipatala zoyenerera, zomwe zimapatsidwa ndalama ndi mabungwe omwe amapereka chithandizo chamankhwala kwa iwo omwe sangakwanitse

Malo

Mtundu wa telehealth services womwe mungalandire ndi Medicare woyambirira ungadalire komwe muli. Izi zikutanthauza kuti muyenera kukhala kudera lomwe lili kunja kwa Metropolitan Statistical Area kapena kumidzi ya Health Professional Shortage Area.

Maderawa amatsimikiziridwa ndi mabungwe aboma. Mutha kuwona kuyenerera kwanuko patsamba la Health Resources and Services Administration.

Kumbukirani kuti mitundu yokhayo ya omwe amakupatsani chithandizo chamankhwala ndikusankhidwa ndiomwe amakwaniritsidwa. Ngati simukutsimikiza ngati china chake chaphimbidwa, kambiranani ndi omwe amakupatsani inshuwaransi musanayambe ntchito zamalonda.

Dongosolo lazithandizo za Medicare chronic care management (CCM)

Pulogalamu yothandizira ma CCM ilipo kwa anthu omwe ali ndi Medicare yoyambirira omwe ali ndi matenda awiri kapena kupitilira apo omwe akuyembekezeka kutha miyezi 12 kapena kupitilira apo.

Ntchito za CCM zimakupatsani mwayi wopanga zosankha mwakukonda kwanu. Dongosolo ili limawona:

• thanzi lanu
• mtundu wa chisamaliro chomwe mukufuna
• othandizira anu osiyanasiyana azaumoyo
• mankhwala omwe mukumwa
• ntchito zamagulu omwe mukufuna
• zolinga zanu zaumoyo
• ndondomeko yogwirizira chisamaliro chanu

Ntchito za CCM zimaphatikizaponso kuthandizira kasamalidwe ka mankhwala ndi mwayi wofika 24/7 kwa akatswiri azaumoyo. Izi zitha kuphatikizira ntchito zamalonda. Kuyankhulana kudzera patelefoni, imelo, kapena masamba aodwala ndi gawo limodzi la ndondomekoyi.

Ngati mukufuna kugwiritsa ntchito ntchito za CCM, funsani omwe akukuthandizani ngati akukuthandizani.

Pakhoza kukhalanso zolipiritsa pamwezi pazantchito izi kuphatikiza gawo lanu lochotseredwa komanso chitsimikizo cha ndalama, chifukwa chake fufuzani dongosolo lanu. Ngati muli ndi inshuwaransi yowonjezera, itha kukuthandizani kulipirira ndalama zolipiridwa mwezi uliwonse.

Kukulitsa kufalikira kwa Medicare pa telehealth

Lamulo la Bajeti la Bipartisan la 2018 lidakulitsa chithandizo chamankhwala kwa iwo omwe ali ndi Medicare. Pali zochitika zina zomwe mungakhale omasuka kutsatira malamulo a Medicare okhudzana ndi telehealth. Tiyeni tiwone bwino:

ESRD

Ngati muli ndi ESRD ndipo mukulandira kunyumba dialysis, mutha kulandira chithandizo chamankhwala apanyumba kaya kunyumba kapena kuchipatala chanu. Zoletsa zakomwe zikukhudzana ndi telehealth zimachotsedwanso.

Komabe, muyenera kuti nthawi ndi nthawi mumacheza ndi omwe amakuthandizani azaumoyo mukamayambira kunyumba ndi dialysis. Maulendowa amayenera kuchitika kamodzi pamwezi kwa miyezi itatu yoyambirira kenako miyezi itatu iliyonse kupita mtsogolo.

Sitiroko

Mapulogalamu a Telehealth atha kukuthandizani kuti muwunikenso mwachangu, matenda, ndi chithandizo cha stroke. Chifukwa chake, ntchito za telehealth zitha kugwiritsidwa ntchito sitiroko yayikulu ngakhale mutakhala kuti.

Mabungwe othandizira chisamaliro (ACOs)

Ma ACO ndi magulu a othandizira azaumoyo omwe amagwira ntchito limodzi kuti athetse chisamaliro cha anthu omwe ali ndi Medicare. Chisamaliro choterechi chidzaonetsetsa kuti ngati mukudwala kapena muli ndi thanzi labwino, mudzalandira chisamaliro chomwe mukufuna.

Ngati muli ndi Medicare ndikugwiritsa ntchito ACO, tsopano ndinu oyenera kulandira chithandizo chamankhwala kunyumba. Kuletsa kwamalo sikugwira ntchito.

Maulendo olowera ndi maulendo a E

Medicare imafotokozanso zina zowonjezera zomwe zikufanana kwambiri ndi maulendo a telehealth. Izi zimapezeka kwa onse opindula ndi Medicare mdziko lonselo, mosasamala kanthu komwe ali.

• Malowedwe enieni. Awa ndi mauthenga achidule kapena makanema omwe mumafunsa kuchokera kwa omwe amakuthandizani kuti mupewe kuyendera maofesi mosafunikira.
• E-maulendo. Izi zimakupatsirani njira ina yolumikizirana ndi omwe amakuthandizani kudzera pachipatala cha odwala.

Monga ulendo wapa telehealth, mudzangokhala ndi gawo la 20% ya mtengo wowerengera kapena kuchezera E. Kuti mupange ma check-ins kapena E-maulendo, muyenera kaye mulankhule ndi omwe amakuthandizani pa zaumoyo.

Mu Marichi 2020, World Health Organisation ndipo yalengeza kuti ndi mliri wa COVID-19, matenda omwe amayambitsidwa ndi koronavirus ya 2019.

Poganizira izi, zasintha zina pantchito zantchito zandalama zomwe Medicare idachita. Zosinthazi zidapangidwa kuti zithandizire kupewa kufala kwa kachilomboka, makamaka kwa iwo omwe ali pachiwopsezo chodwala kwambiri.

Kuyambira pa Marichi 6, 2020, zosintha izi zikuchitika kwakanthawi:

• Othandizira a Medicare amatha kulandira chithandizo chamankhwala kuchokera kuntchito zamtundu uliwonse, kuphatikiza m'nyumba zawo.
• Zoletsa zakomweko zimachotsedwa, chifukwa chake omwe amapindula ndi Medicare kulikonse mdziko muno atha kugwiritsa ntchito ntchito za telehealth.
• Othandizira azaumoyo tsopano atha kusiya kapena kuchepetsa kugawana mitengo pazama TV omwe amalipiridwa ndi mapulogalamu azaumoyo monga Medicare.
• Simufunikanso kukhala ndiubwenzi wolimba ndi wothandizira zaumoyo kuti mugwiritse ntchito ntchito za telehealth.

Ubwino wa telehealth

Telehealth ili ndi maubwino angapo. Choyamba, zitha kuthandiza kuteteza omwe adzapindule ndi Medicare panthawi yamavuto. Izi zakhala zowona makamaka panthawi ya mliri wa COVID-19 koma zitha kukhalanso zabwino panthawi yachimfine.

Telehealth imathandizanso kuchepetsa ntchito zaumoyo. Mwachitsanzo, zinthu monga kutsatira pafupipafupi ndikuwunika zovuta zomwe zimachitika nthawi zambiri zimatha kuchitika pogwiritsa ntchito telehealth. Izi zitha kuchepetsa kuchuluka kwa kuchezera kwa anthu omwe ali ndi vuto laumoyo.

Telehealth ikhozanso kuthandizanso ngati muli kumidzi, malo ovuta kufikira, kapena malo okhala ndi zida zochepa. Amapereka mwayi wokalandira mwayi kwa akatswiri azaumoyo kapena akatswiri omwe mwina sangakhale m'dera lanu.

Ngakhale telehealth imapereka maubwino angapo, sikuti aliyense amadziwa kuti ndi njira ina. Kafukufuku wocheperako wa 2020 pamalo opangira dialysis adapeza kuti 37 peresenti yokha ya omwe adatenga nawo gawo adamva za telehealth. Izi zikuwonetsa kuti kuyesetsa kumafunikira kukulitsa kuzindikira.

Kutenga

Telehealth ndipamene thandizo lazachipatala lakutali limaperekedwa pogwiritsa ntchito ukadaulo, monga videoconferencing. Medicare imakhudza mitundu ina ya telehealth, ndipo zikuwoneka kuti kufalitsa kumeneku kuchulukirachulukira.

Medicare Part B imakhudza zamatsenga zikagwiritsidwa ntchito popita kuofesi, psychotherapy, kapena kufunsa. Ndi akatswiri ena azachipatala okha ndi malo omwe amapezeka. Medicare Part C itha kukupatsirani zowonjezera, koma izi zimatha kusiyanasiyana ndi dongosolo lanu.

Nthawi zambiri, pamakhala zoletsa zakomwe ntchito za Medicare zophimbidwa ndi ma telehealth. Komabe, izi zakulitsidwa ndi 2018 Bipartisan Budget Act ndi mliri wa COVID-19.

Ngati mukufuna kulandira chithandizo cha telehealth, lankhulani ndi omwe amakuthandizani pa zaumoyo. Adzakudziwitsani ngati angawapatse komanso momwe angapangire nthawi yokumana.

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.