Kumvetsetsa Mtengo Wosintha Knee: Zili pati pa Bill?

Zamkati

• Chifukwa chiyani mitengo imasiyanasiyana
• Nchiyani chimathandizira pamtengo?
• Ngongole zingapo
• Avereji ya ndalama
• Milandu ya kuchipatala
• Kuchotsera
• Mankhwala
• Inshuwaransi yaumwini
• Funsani dokotala wanu
• Milandu yakunja
• Kumvetsetsa ndalama yanu
• Kukonzekera kwachitsulo
• Kukhala kuchipatala ndi opaleshoni
• Chisamaliro cha posturgical
• Chiwerengero
• Zowonjezera ndalama
• Zida
• Ntchito zosamalira kunyumba
• Zosintha kunyumba
• Zosankha kuti musunge ndalama
• Kodi milandu iyi ikuchokera kuti?

Mtengo ndi chinthu chofunikira kuganizira mukamaganizira za opaleshoni yonse ya mawondo. Kwa anthu ambiri, inshuwaransi yawo imalipira mtengo, koma pakhoza kukhala zowonjezerapo zina.

Apa, mutha kudziwa zambiri za mtengo wakuchitidwa opaleshoni yamondo.

Chifukwa chiyani mitengo imasiyanasiyana

Mtengo wogwiritsa ntchito bondo umatha kusiyanasiyana, kutengera komwe mumakhala, chipatala chomwe mumagwiritsa ntchito, thanzi lanu, ndi zina.

Nchiyani chimathandizira pamtengo?

Ndalama yomalizira kuchipatala idzadalira pazinthu zambiri, kuphatikizapo:

• Chiwerengero cha masiku omwe mumakhala mchipatala. Izi zimadalira ngati bondo lanu likusinthira kwathunthu, pang'ono, kapena mbali ziwiri.
• Mtundu wa makina opangira ndi opaleshoni. Izi zimaphatikizapo zinthu zomwe zimayikidwa ndi kugwiritsa ntchito zida zilizonse zopanga opaleshoni kapena ukadaulo wapakompyuta.
• Zinthu zomwe zidalipo kale. Mungafunike chisamaliro chowonjezera kuchipatala kapena zina zowasamalira pa opaleshoni.
• Nthawi yogwiritsidwa ntchito m'chipinda chogwiritsira ntchito. Ngati kuwonongeka kuli kovuta, zimatha kutenga nthawi kuti zigwire ntchito, ndipo izi zikhala zotsika mtengo kwambiri.
• Chisamaliro chosayembekezereka kapena zida. Ngati zovuta zikuchitika, mungafunike chisamaliro chowonjezera.

Ngongole zingapo

Nthawi zambiri pamakhala ngongole zambiri pambuyo pochitidwa opaleshoni yamondo, kuphatikiza ya:

• chisamaliro cha chipatala
• mankhwala onse ochokera kwa dokotalayo ali kuchipatala
• ntchito zina ndi njira zomwe ogwira ntchito m'chipinda chogwiritsira ntchito amagwirira ntchito

Ntchito zina ndi ndalama zake ndi ntchito yochitidwa ndi wochita dzanzi, othandizira opaleshoni, othandizira olimbitsa thupi, ndi ena.

Avereji ya ndalama

Malinga ndi nkhani ya mu 2013 ku AARP, U.S.zipatala zimalipira $ 50,000, pafupifupi, kuti awongolere bondo (TKR). Kusintha bondo pang'ono (PKR) kumawononga pafupifupi 10 mpaka 20% poyerekeza ndi TKR. Inshuwaransi yanu yazaumoyo ndi Medicare ndizomwe zimalipira ndalama zambiri, koma padzakhalabe zolipiritsa.

Posachedwa, Blue Cross Blue Shield idaganizira mu 2019 kuti mtengo wapafupipafupi wamankhwala olowera m'malo mwa mawondo anali $ 30,249, poyerekeza ndi $ 19,002 ngati wodwala kunja.

Chifukwa chachikulu ndichakuti PKR imafunikira kukhala mchipatala mwachidule: pafupifupi masiku 2.3, poyerekeza ndi masiku 3.4 a TKR.

Kumbukirani kuti zolipira kuchipatala sizikuwonetsa kuchuluka komwe mumalipira m'thumba. Mutha kudziwa zambiri zamtengo wapathumba pansipa.

Milandu ya kuchipatala

Milandu yothandizira odwala ndi omwe amapezeka mukakhala mchipatala.

Malipiro ochokera kwa dotolo ndi ena othandizira azaumoyo atha kuwonjezera ndalama pafupifupi $ 7,500 kuchipatala choyambirira cha ndondomekoyi, koma izi zimatengera chipatala ndi zina.

Kuchotsera

Mzipatala nthawi zina zimapereka kuchotsera ngati mulibe inshuwaransi yazaumoyo kapena simukuyang'aniridwa ndi Medicare. Funsani za kuchotsera kapena njira yolipirira musanakhazikitse opaleshoni yanu ngati mulibe inshuwaransi. Muyenera kuyesa kuwerengera ndalama zanu pasadakhale ngati mulibe inshuwaransi kapena ayi.

Mankhwala

Mukafika pa deductible yanu, Medicare imalipira 100% ya milandu yochiritsira yokhudzana ndi njira komanso kuchipatala. Mapulani a inshuwaransi yaumwini amakambirana kale ndalama ndi zipatala ndi omwe amapereka. Nthawi zambiri amangolipira peresenti ya zolipiritsa zonse.

Inshuwaransi yaumwini

Inshuwaransi yaumwini imasiyanasiyana, ndipo ndikofunikira kuti muwunikenso mapulani anu musanakonze bondo.

Chongani mfundo zotsatirazi musanapange chisankho:

• deductible wanu
• omwe amapereka omwe ali mumanetiwerensi anu
• zomwe zimapereka inshuwaransi yanu

Funsani dokotala wanu

Musanakonzekere opaleshoni, kambiranani ndi adotolo, oimira kuchipatala, ndi omwe amakupatsirani inshuwaransi kuti mudziwe kuchuluka kwa zolipiritsa mdera lanu komanso kuchotsera komwe kungagwiritsidwe ntchito.

Milandu yakunja

Njira zoperekera kuchipatala ndi zolipiritsa kuchipatala ndizomwe mumawononga kwambiri.

Koma mufunikiranso kulipira chithandizo chamankhwala musanadye komanso mutatha. Odwala akunja amatanthauza ntchito zomwe zimachitika mukakhala kuti simuli mchipatala.

Zowonjezera izi ndi izi:

• ndalama zisanachitike komanso zochokerapo kumayendedwe ku ofesi ndi ku lab ntchito
• chithandizo chamankhwala
• maulendo obwereza ndi dokotala wanu wa opaleshoni mukamachira

Medicare imalipira 80 peresenti ya zolipirira odwala kwa mamembala ake. Mapulani a inshuwaransi yaumwini amasiyanasiyana.

Muyenera kuyembekezera kuti ndalama zochotseredwa komanso ma copay azigwiritsidwa ntchito kwa aliyense wodwala kuchipatala kapena woyendera ofesi musanachite opaleshoni yanu kapena mutatha.

Kumvetsetsa ndalama yanu

Ngongole zimasiyanasiyana, koma Nazi zomwe mungayembekezere ngati mutasintha bondo:

Kukonzekera kwachitsulo

Gawo lowunika la oyang'anira amakhala ndi kufunsa kapena kuchezera ofesi, kulingalira, ndi ntchito yapa labu. Ntchito zapa labu nthawi zambiri zimaphatikizapo ntchito yamagazi, zikhalidwe, ndi mayeso am'magawo.

Chiwerengero cha ntchito zomwe akuyembekezeredwa ndi zolipiritsa zonse zimasiyanasiyana potengera inshuwaransi ndi zaka.

Mwachitsanzo, munthu wazaka zopitilira 65, yemwe nthawi zambiri amakhala ndi Medicare, amafunikira ntchito yambiri yapa labata kuposa munthu wazaka zopitilira 65. Izi ndichifukwa choti wachikulire amakhala ndi zinthu zomwe zidalipo kale zomwe zimayenera kumveka bwino pakuwunika kwachipatala.

Kukhala kuchipatala ndi opaleshoni

Mudzalandira ngongole zosiyana za TKR. Monga tafotokozera pamwambapa, chipatalacho chidzakulipirani ndalama zogona, nthawi yogwiritsira ntchito chipinda chothandizira, ndi zina zothandizira kuchipatala, zinthu, ndi zida zogwiritsidwa ntchito.

Operekera ndalama amakulipilirani kuti muzitsatira ndalama zomwe amathandizidwa ndi dotolo, komanso:

• mankhwala ochititsa dzanzi
• jakisoni
• ntchito zamatenda
• chithandizo cha opaleshoni, mwachitsanzo, kugwiritsa ntchito makompyuta othandizira kapena ukadaulo wina
• chithandizo chamankhwala
• mgwirizano wa chisamaliro

Kumbukirani kuti zinthu zina zambiri zingakhudze zolipiritsa ndi zolipiritsa zokhudzana ndi njirayi.

Zovuta zimatha kukhudza aliyense, koma anthu omwe ali ndi vuto lomwe likupezeka kale atha kukhala pachiwopsezo. Ngati zovuta zikuchitika, mungafunike chisamaliro chowonjezera, ndipo izi zikuwonjezera pa ngongole yanu.

Matenda a shuga, kunenepa kwambiri, ndi kuchepa kwa magazi m'thupi zonse ndi zitsanzo za zinthu zomwe zidalipo.

Chisamaliro cha posturgical

Kubwezeretsa ndi kukonzanso kumaphatikizapo:

• ntchito zothandizira odwala
• zida zilizonse ndi zochiritsira zomwe wochiritsira amagwiritsa ntchito
• kutsata kunja

Chiwerengero

Ndalama zowonongedwa mthumba ku United States zimakhala zambiri. Zidalira dongosolo lanu la inshuwaransi.

Kwa odwala a Medicare, ndalama zotulutsira mthumba zitha kukhala madola mazana. Iwo omwe ali ndi inshuwaransi yawokha akhoza kuyembekezera kuti ndalamazi zidzafika masauzande.

Unikani pulani yanu mosamala ngati muli ndi inshuwaransi yapadera. Kumbukirani kuti mumagwiritsa ntchito ndalama zomwe mumachotsa, copay, coinsurance, ndi max.

Zowonjezera ndalama

Mtengo wa chisamaliro ndi ntchito ndi gawo limodzi chabe la ndalama zonse.

Zida

Pakhoza kukhala zolipira zowonjezerapo pazida zapadera, zotchedwa zida zolimbitsa thupi, monga makina osunthira, oyenda, kapena ndodo.

Ntchito zosamalira kunyumba

Mapulani ambiri a inshuwaransi ndipo Medicare amatenga izi. Komabe, atha kuwoneka ngati ndalama zowonjezera pamalipiro anu achipatala kapena ndalama zina.

Mungafunenso mankhwala owonjezera kapena namwino m'nyumba mwanu.

Yembekezerani kulipira mthumba ngati inshuwaransi yanu siyikuphimba ntchito zanyumba.

Padzakhala ndalama zowonjezera ngati simungathe kubwerera kwanu nthawi yomweyo ndipo mukufunika kuthera nthawi yokonzanso kapena yosamalira okalamba kuti mukalandire thandizo lina.

Zosintha kunyumba

Mungafunike kuyika zida zachitetezo m'nyumba mwanu, monga:

• zotchinjiriza ndi njanji
• benchi yakusamba
• chokwera pampando wachimbudzi ndi mikono

Kumbukirani kuti mumapeza ndalama zambiri ngati mutapuma kuntchito kukachita opaleshoni kapena mukachira. Lankhulani ndi abwana anu ndi omwe amakupatsani inshuwaransi kuti muwone ngati mukuyenereradi inshuwaransi yomwe ingakulepheretseni kugwira ntchito.

Inshuwalansi ya olumala ndi mtundu wa inshuwaransi yomwe imalipira ndalama pang'ono kwa ogwira ntchito omwe sangathe kugwira ntchito chifukwa chovulala kapena kulumala. Zitha kuphimba nthawi yomwe mukufuna maopaleshoni monga ma TKRs.

Dziwani zambiri za momwe mungakonzekerere nyumba yanu kuti mupulumuke.

Zosankha kuti musunge ndalama

Anthu ena amasankha kukachita opaleshoni kunja. Mtengo ungakhale wotsika kwambiri m'maiko ngati Mexico, India, kapena Taiwan. Komabe, mutha kuwononga madola masauzande angapo pamatikiti apa ndege, mahotela, ndi zina zofananira.

Ngati mukuganiza zogwiritsa ntchito njirayi, onetsetsani kuti malowa avomerezedwa ndi Joint Commission International asanavomereze njirayi.

Ngati zingatero, izi zikutanthauza kuti madokotala ochita opaleshoni ndi ovomerezeka komanso kuti maofesi ndi ma prostheses amakwaniritsa bwino kwambiri.

Podziwa mtengo wake patsogolo, mutha kupewa zodabwitsa - komanso zovuta zomwe zingachitike - pamzere.

Kodi milandu iyi ikuchokera kuti?

Ndalama yosinthira bondo ili yonse isanachitike ndi kuchipatala, komanso mtengo wa opareshoniyo, ndi milandu kuphatikiza:

• madokotala akuyendera ndi labu
• opaleshoni ndi nthawi yomwe mumagwiritsa ntchito kuchipinda, kuphatikizapo zolipiritsa ndi mankhwala ena ogwiritsidwa ntchito
• kugona kwanu kuchipatala
• postsurgery dokotala akuyendera
• chithandizo chamankhwala