Izibonelelo zokuhlawula izibonelelo zokuNyango (Uncedo lwexesha elide)
Ngelixa iindawo zokunakekelwa kwabahlengikazi (ezibhekiswe kumakhaya angamahlengikazi, amaziko okuvuselela iindawo ezincinci, okanye amaziko okunakekelwa kwexesha elide) zibiza, zihlala zibiza kakhulu kunokuba ziqeshe iiyure ezingama-24 ekhaya. Ezi zakhiwo zinokubonelela ngononophelo lwangexesha elide, kodwa baninzi banikezela ukubuyiswa kwexesha elifutshane ngenjongo yokubuyela ekhaya. Ukuba wena okanye othandekayo wakho ufuna ukunyamekela kwikhaya lononophala, uhlawula ukwazi iindlela zakho zokuhlawula phambili.
Izinketho zokuhlawula ikhaya lokunyamekela (uncedo lwabahlengikazi abanezakhono) unonophelo lubandakanya oku kulandelayo:
1) I-Medicare
I-Medicare yintlawulo ye-federal eya kuhlawula indleko yenani elincinci leentsuku zokuvuselela izigulane kwiziko lokunesi. Oku kudla ngokuba yi-"re-acute rehab" okanye "ukunakekelwa kwangasemva." Abantu abaninzi bafumana ixesha elifutshane, ukulungiswa kwezigulane zihlala zibangelwa ukuphuka kwe-hip , i-stroke, okanye imeko yesifo senhliziyo, nangona kukho ezinye izizathu ezininzi umntu onokudinga ukunyangwa komzimba, umsebenzi, okanye intetho, kwaye ngoko ke kufinyelele le ngxelo.
Ukuba ufanelekile kwi-Medicare, kufuneka ube ngaphezu kweminyaka engama-65 ubudala, ube nokukhubazeka okubhalwe phantsi, okanye ube nesifo se-renals.
Ukuba ufanelekile, i-Medicare inikezela ngokugqithiseleyo iindleko zekhaya labongikazi, kodwa kubalulekile ukwazi ukuba le ngxelo iphela nje ixesha elifutshane kwaye ifumaneka kuphela phantsi kweemeko ezithile. I-Medicare ayihlawulanga ngononophelo lwezibonelelo zononophelo ngononophelo ngokuqhubekayo.
Indlela yokufikelela kwi-Medicare Coverage
Inzuzo yezeMali ye-Medicare ayikho into oyifake isicelo okanye ufake ibango elichaza intswelo yakho. Uyafaneleka ngokuzenzekelayo kwezi nzuzo ukuba unayo i-Medicare Part A kunye ne-Medicare Part B. Ngokuqhelekileyo, ukuba ufumana inzuzo yeNtlalo yeNhlalakahle okanye inzuzo yeBhodi yeRhafu yeRhafu, uza kubanjelwa phantsi kwe-Medicare Part A kunye neCandelo B.
Ziziphi iindleko eziza kugulisa?
I-Medicare iya kubhala isantya sohla ngemihla ukuba ufumane unyango olusisigulane , unyango lwabasebenzi , kunye / okanye unyango lwentetho . I-Medicare ibuye ihlanganise amayeza akho, unyango kunye neenkonzo zonyango ngeli xesha.
Ziziphi iiMeko phantsi kweyiphi i-Medicare eya kuhlawula le nkathalo?
Kufuneka uhlangabezane nale miqathango ilandelayo:
Isibhedlele seSuku se-3
Kufuneka ube nohambo lwesibhedlele lweentsuku ezintathu oluthatyathwa ngokuthi "unogulane" uhlala esibhedlele. Kuthetha ukuthini ukuba ukuba ukwahlulwa nje njengesigulane "sokubheka", iMeditare ayiyi kubhalela iinkonzo zonyango lokulungisa abahlengikazi.
Ukongezelela, ukuba ukulaliswa kwakho esibhedlele kwahlulwa njengesigulane kodwa wawukuphela kwimizuzu emibini (ixesha abasebenzisa ukulolonga ngolunye usuku), i-Medicare ayiyi kugubungela ukulungiswa kwezifo.
Kufuneka ucele esibhedlele ukuba ukuhlala kwakho kuthathwa njengesifo sengqondo okanye ukubonwa, kunye nokuqinisekisa ukuba udibene nemfuneko yokuhlala kwemihla emithathu ukuze ufikelele kwiinzuzo zeMyrirensi yokuvuselela izigulane.
Izidingo zexesha
Ukuba udibana neentsuku ezintathu ukuhlala kwisibhedlele, ungasebenzisa i-Medicare inzuzo emva kokuhlala esibhedlele ngokudlulisela ngqo kwiziko lokunakekelwa kwabahlengikazi.
Nangona kunjalo, unako ukufikelela kule Nqanaba leMedricare uncedo ukuya kwiintsuku ezingama-30 emva kokubhedleleka esibhedlele. Umzekelo, oku kuthetha ukuba unokwenza isigqibo sokuya ekhaya esivela esibhedlele emva kokuba uqhutywe utyando, kwaye emva kweeveki ezintathu emva koko, usenokukhetha ukwamkelwa kwisibonelelo sokubuyisela kunye nokufikelela kwi-Medicare inzuzo ukuze uhlale uhlala kunye nonyango ehlawulwa yi-Medicare. Isizathu sokuba ungene kwisiko lononophelo lwezakhono kufuneka ube yimeko efanayo naleyo owabhedlele kuyo.
Criteria
Ngesinye kwisiko lononophelo lwezonyango, kufuneka uqhubeke nokuhlangabezana neendlela zokugada ii-Medicare.
Le khrayitheriya isekelwe kuvavanyo lwe-Medicare Data Set (MDS) apho abasebenzi kufuneka baqhube ngokuphindaphindiweyo ngexesha elimiselweyo ukuze baqinisekise ukusebenza kwakho. I-MDS yoluvavanyo olunzulu oluzaliswe ngabasebenzi basezindaweni ezahlukeneyo ezibandakanya uongikazi, iinkonzo zondlo, imisebenzi kunye nomsebenzi wentlalo. Ilinganisa amakhono akho akhoyo kunye nenkqubela yakho kwiinjongo zakho.
Ukuba uyaqhubeka nokufuna unonophelo olunezakhono, njengokwenyama, yomsebenzi, okanye unyango lwentetho, okanye unyameko olunikeziwe okanye olulawulwa ngabahlengikazi abanelayisenisi, i-Medicare iya kuhlawula isifo sakho sokuvuselela izifo. Ngokukhawuleza ukuba awuyidingi le nkathalo ngokwe-MDS, uya kufumana isaziso esibhaliweyo esikucebisayo ukuba i-Medicare ayiyi kuphinda ihlawule ukukhupha ezi nkonzo.
Ngaba unyango luya kuhlawula ixabiso elipheleleyo?
Impendulo emfutshane: Kuxhomekeka kwithuba elide ufumana unonophelo kwiziko loongikazi.
Impendulo engapheliyo: I-Medicare iya kubandakanya iipesenti eziyi-100 zeentsuku zokuqala zokuvuselela kwiziko lokunakekelwa kwexesha elide, nje kuphela xa uqhubeka uhlangabezana neendlela ezichanekileyo ngexesha leentsuku ezingama-20 ukuze ufanele ukufumana loo ngxelo.
Ukuqala ngomhla we-21, uya kuba noxanduva lokuhlawulwa ngokubambisana ngosuku kwaye emva koko uMathera uya kuhlawula intsalela yentlawulo ngosuku ukuya kwiintsuku eziyi-100.
Unokuthenga i-inshorensi yokuhlawula ukuhlawula le ntlawulo-ntlawulo ngokuthenga umgaqo-nkqubo ongezelelweyo (obizwa ngokuba yi-inshurensi yaseMedigap). Imigaqo-nkqubo eninzi yokuncedisa inkokhelo epheleleyo yokuhlawula i-co-intlawulo ukwenzela ukuba iphele ekungekho iindleko ezingaphandle kwe-post-re-rest rehabilitation.
Ngaba i-Medicare isoloko ikhupha iiNyanga ezili-100 zeZakhono zokuBuyiselwa kweziNyango ezingenasifo?
Abantu abaninzi bangaphantsi kweengcamango zobuxoki ukuba i-Medicare iza kubonelela ngokuzenzekelayo iintsuku ezili-100 zesikhungo sokunesikiya esinempilo / ukukhutshwa kwakhona. I-Medicare iya kunika le ntlawulo kwiintsuku eziyi-100, kodwa ngenxa yemigaqo ecacisiweyo, abantu abaninzi bafumana kuphela iintsuku ezimbalwa okanye iiveki zalo myalezo. Akukho sikhokelo malunga nenani leentsuku eziza kuhlawulwa yi-Medicare kule nzuzo; Kunoko, kuxhomekeke kwiimfuno zomntu ngamnye kunye nokuhlolwa kwabo kwe-MDS.
Ngamanye amaxesha umntu angasebenzisa njani lo Mhlomulo weMithi?
I-Medicare iya kuhlawula i-coverage home nursing ngaphezu kweyodwa. Ukuze ufikelele le ngcaciso xa sele usetyenzisile ngaphambili, kufuneka ube neentsuku ezingama-60 apho ungayisebenzisi khona, kwaye uya kulungele kwakhona. Ngamanye amazwi, Ukuba iintsuku ezingama-60 zingadlulanga ngaphandle kwakho usebenzisa i-Medicare inzuzo kwisibhedlele okanye kwisibonelelo sokunesi, uncedo luvuselela kwaye luphinde lufumaneke.
Ziziphi Izixhobo Eziza Kuza Kuza Kuhlawula Ukuhlawulwa Kwezonyango?
Isibonelelo soononophala abanezakhono kufuneka siqinisekiswe yi-Medicare ukubonelela lolu hlobo lonyango. Unokuphinda uhlalutye uluhlu lwamakhaya asebehlengikazi kwi-Medicare.gov, kunye nokubona indlela inqanaba ngalinye elilinganisiweyo ngayo. Ukukhetha nokuphanda isibonelelo kunokuba ngumsebenzi onzima, kodwa kukho izibonelelo ezininzi ezikhoyo ukunceda.
2) IziCwangciso zeMpilo zeMpilo
Abanye abantu baye bakhetha isicwangciso seMveli kwaye kunoko bakhetha oko kubizwa ngokuba yi-Medicare Advantage plan. Le ngxelo ye-Medicare elawulwa elinye iqela esikhundleni seburhulumente wephondo. Izicwangciso ze-Medicare Benevantage (ezibizwa ngokuba yi-Medicare Part C) zibonelela ngeendlela ezifanayo xa kuthelekiswa nesicwangciso seMveli seMveli, kunye nemibandela embalwa:
- Ezinye iiplani ze-Advantage ayifuni ukuhlala esibhedlele kwisithuba seentsuku ezintathu. Baya kunika inkxaso yezemali kwiziko loongikazi abanekhono nangona umntu athe wangeniswa kwikhaya lakhe okanye uhlala esibhedlele esingaphantsi kweentsuku ezintathu.
- Ezinye iiplani ze-Advantage zinezixhobo ezithile ezizicingayo kwi-network (okanye zikhethiweyo) kunye nezinye ezichazwe njengenethiwekhi . Ukuba isibonelelo esinonophelo sokuncedisa ukuba ungene kwi-intanethi yokuvuselela, akusikho inethiwekhi yesicwangciso sakho seNzuzo, iinkonzo zakho akunakunqandwa okanye zingabhekiswa kwizinga elincinci.
- Iiplani ezininzi ezixhamlayo zifuna ukugunyazwa kwangaphambili ngesicwangciso se-inshurensi enkonzo yakho, ukuba i-Medicare yendabuko ayifuni oku. Oku kugunyazisiweyo kwangaphambili kubandakanya ikhaya labahlengikazi okanye isibhedlele ukuthumela ulwazi lwakho lwezokwelapha kwisicwangciso se-inshurensi apho kuhlaziywa khona. Isicwangciso seNzuzo siya kwenza isigqibo malunga nokuba ngaba baya kukwenza okanye bangayi kuguqulwa ukuvuselelwa kwakho kwiziko lokunesi. Ukuba ukugunyazwa kwangaphambili akuqhutywanga okanye ukuhlala kwakho akuvunyelwanga, isicwangciso seNzuzo asiyi kuhlawula ukunyamekela kwakho kwisibonelelo sokugula.
3) Inkonzo yomshuwalense wexesha elide
Inkcitho yomshuwalense wexesha elide yintyhuwalense enokuthenga ngayo ihlawulela ixesha elithile kwikhaya labahlengikazi / kwiziko loongikazi abanezakhono . Iindleko kunye nenani le-coverage lihluka kakhulu ngokwexesha elide lokuthenga kunye nokuba ngaba ukhetha ukufumana isigxina esipheleleyo okanye esincinane.
Ukongezelela, ezininzi iinkampani zonyango zonyango zangexesha elide zinoluhlu lweemeko okanye amayeza angenza umntu angafaneleki ukufumana ingxelo okanye ukwandisa iindleko kakhulu. Ezi zinto ziquka iimeko zeengxaki ezifana nesifo se-Alzheimer okanye esinye isifo sengqondo , isifo sika-Parkinson, iimeko zeentliziyo ezithile kunye nokusetyenziswa kwemithi ethile ye- psychotropic .
Ukuba ufaka isicelo se-inshorensi yenkathalo yangexesha elide xa usemncinci kwaye ngokuqhelekileyo unempilweni, uza kuhlawula iiprayimari kwixesha elide kodwa ngokuqhelekileyo isilinganiselo esincinane. Ukuba usebenza xa usukhulile xa kunokwenzeka ukwanda kweziko lokunakekelwa kwabantwana, inqanaba lakho lenyanga yomshuwalense wexesha elide luya kuba phezulu.
Ingaba i-inshorensi yexesha elide ikulungele ukuxhomekeka kukuxhomekeke kwizinto ezininzi, ngoko uya kufuna ukuthetha ne-inshente yakho ye-inshorensi malunga neendleko kunye neendlela zokunika ingxelo.
4) Uxilongo
Abantu abaninzi banamathele imali ekunyamekeleni kwabo ubomi, kodwa ngezinye iindleko zokunyamekela kwabo basebenzise imali ngokukhawuleza, nangona bazama ukucwangcisa kakuhle kwaye balondoloze imali yabo. Ukuba izibonelelo zakho zemali sele ziphelile, unokufaka isicelo seMedicaid .
I-Medicaid yinkxaso karhulumente karhulumente elawulwa yiphondo ngalinye kulabo abaye bachitha imali. Umntu kufuneka afaneleke ngemali (ngokufumana ngaphantsi kwama-$ 2,000 kwii-asethi ezibalwayo) kwaye afaneleke ukufumana imithi (ngokudibana nomgangatho wokuvavanywa kwenkathalo ebonisa ukuba ufuna ngokwenene ukunakekelwa ekhaya, kunokuba uncedise ubomi okanye ukunakekelwa ekhaya .)
I-Medicaid nayo inamalungiselelo okuthintela ukusweleka komntu kwiqabane lomhlala-phantsi ohlala ekhaya oza kuhlala ehlala kwikhaya lakhe okanye kwelinye indawo (njengendawo yokuhlala ezizimeleyo okanye indawo yokuhlala yokuhlala).
5) IiNkonzo zoNcedo zoLawulo lweeNkulumbuso kunye neNtlanganiso
Ukuba wena kunye / okanye iqabane lakho lingumlindi, unokufumana uncedo lwezemali ngolawulo lwabalandeli bezilwanyana. Kufuneka uhambise isicelo esingathabatha malunga neenyanga ezintathu ukucutshungulwa. Emva kokuvunywa, uya kufumana inzuzo yenyanga nganye ngomntu owakhonza. Le mali ingasetyenziselwa ukukunceda ukuhlawula ekhaya lononophelo lwabahlengikazi.
6) Inkokhelo yangasese (ngaphandle kwePokhethi)
Enye indlela yokuhlawula ukunyamekela kwisiko kukuhlawula ipokothini, okanye oko kudla ngokuba kubizwa njengomvuzo wabucala . Ukuhlawula ngasese kwiinkonzo zonyango ngokuqhelekileyo kuthetha ukuba unokhetho oluninzi malunga naluphi na indawo ozikhethayo, kuba ezininzi iinkonzo zikhetha ukuhlawulwa kwabazimeleyo okanye abathengi beMedare, kunokuba iMedicaid.
Ukuhlawula ngasese kumaziko oongikazi kuyabiza, ngeendleko ezinokuhlala zihamba ukusuka kwi $ 250- $ 350 ngosuku (nangaphezulu) ukunyamekela. Oku kungasondela kwii-$ 80,000 ukuya kwii-125,000 / ngonyaka, kwaye oko kungenenxa yecumbi elizimeleyo (eyabelwe). Amanye amaziko anikezela ngamagumbi abucala ukuba abe nemali eyongezelelweyo ngosuku.
ILizwi
Ukucwangcisa phambili kwaye ukwazi izikhetho zakho kunokuba luncedo kakhulu xa unokujamelana nokuhlawulwa kwenkxaso yononophelo yolondolozo. Ukongezelela, ezinye ii-arhente zoluntu kunye namakhaya omakhaya anamakhaya anamakhaya anamakhaya anikahlengikazi banamalungu abasebenzi abakukunceda ukufikelela ezi ngenelo.
Nangona iindleko zokunakekelwa kwezindlu zasebekhulile zibalulekile, sithemba ukuba kuyaqinisekisa ukuba kukho iindlela ezahlukeneyo ezikhoyo zokuncedisa ezo ndleko ukuba, njengabaninzi, awukwazi ukuhlawula iindleko ezipheleleyo zalo nkathalo.
> Imithombo:
> Medicare.gov. Ikhaya laseKhuselwane. https://www.medicare.gov/nursinghomecompare/search.html?
> Medicare.gov. Ndingayihlawulela njani ukunyamekela ekhaya? https://www.medicare.gov/what-medicare-covers/part-a/paying-for-ing-home-care.html
> Isebe lezeMpilo laseMzantsi Afrika kunye neNkonzo zoLuntu. LongTermCare.gov. Ngubani ohlawula ukunyamekelwa kwexesha elide? https://longtermcare.acl.gov/the-basics/who-pays-for-term-care.html
> Isebe lezeMpilo laseMzantsi Afrika kunye neNkonzo zoLuntu. LongTermCare.gov. LweMida. \ https://longtermcare.acl.gov/medicare-medicaid-more/medicare.html