Ingakubiza Imali Eninzi kwaye ikukhusele ekubeni uvumelekile
Izibhedlele ziye zenza ingxabano yokwenza imali, enokubeka abagulane engozini kwimali kunye nempilo. Basebenzisa oko kwindlela efanelekileyo yokunceda izigulane ezingenakudinga ukuba zingeniswe esibhedlele, ebizwa ngokuthi "isimo sokujonga." Ixabisa izigulane imali kwiipokethi zazo kunye neerhafu zabo, kwaye zinokuchaphazela iziphumo zabo zonyango, nazo.
Ziziphi iimeko zokuqwalasela izibhedlele?
Xa izigulane ziya kwigumbi lexakeka , kukho isigqibo sokuba ngaba kufuneka bangeniswe esibhedlele okanye kungenjalo. Ezinye izigulane zithunyelwa ekhaya ngelo hlobo lonyango oluchanekileyo kunye nophelo olulandelayo. Abanye bavunyelwa ngokukhawuleza kuba bafuna ukuhlinzwa okanye ezinye iindlela zokuhlolwa okanye unyango. Abanye banokuba ngumda wecala, okanye bangadinga unyango ixesha elifutshane - yizo zi gulane ezinokufakwa kwisimo sokubheka.
Isibhedlele senza njani imali kwiNkcazo yokuGcina?
Ukuba isigulane sinikezwe isimo sokumamela, uthathwa njengelinye "isigulane" -sentsingiselo yokuba akavunyelwanga esibhedlele. Ingaba yinzuzo kwisibhedlele ukuba inikezele ukuba isimo sesigulane sesigulane ngaphandle kokumvuma ngokusemthethweni. Nantsi indlela:
- Ezinye iibhorensi, ezibandakanya i- Medicare , aziqwalasela isimo sokubheka njengento yokungeniswa kwaye ngoko ungafihla iindleko njengoko ziza kuba isigulane sasesibhedlele. Oko kuthetha ukuba isigulane sinokuhlawulwa imali ngokutyelela kwabo. Ukuhlawulwa kwemali kwithuba lokutyelela umhlalaphantsi kuphezulu kunokuba kuhlawulwe kwi-inshorensi yokuhlala isigulane esivumelekileyo, kuba, ke, iinkampani zomshuwalense zixubusha amaxabiso aphantsi kakhulu kwizigulane abazihlawulayo .
- I-Medicare ayibuyisele ngokupheleleyo izibhedlele kwizigulana eziye zavunywa zingakapheli iintsuku ezingama-30 zokushiya esibhedlele ngaphambili. Oko kuthetha ukuba ukuba isigulane seMedare esibhedlele, sithunyelwa ekhaya, kwaye sibuye siphinde sigqithe kwigumbi elingxamisekileyo kwisithuba seentsuku ezingama-30, isibhedlele siya kuhlawulwa. Ngokubeka isigulane kwisimo sokubheka, bangakuphepha le nhlawulo.
Ziziphi iingxaki zeNgcaciso zeNgcaciso zezigulane?
Kwiimeko xa le nkcazo ibukeka ibuhlungu kwizigulane, zikho izizathu ezimbalwa ezinokuba yingxaki.
- Iindleko ze-out-of-pocket ziphezulu. Oku kunjalo ngokukodwa kwizigulane ze- Medicare - ukuba azingeniswa esibhedlele, nokuba ngaba zihlala apho, isibhedlele sinokuzihlawulisa izinto ezininzi I-Medicare ayikufihla ukuba i-Part B isetyenziswe . Isibhengezo esandula (2014) sithi izigulane ze-Medicare mazivunyelwene ngokusemthethweni, kwaye zihlale esibhedlele ngobusuku obuphakathi ezimbini.
- Unonophelo lwonyango luya kutyhafiswa. Isibhedlele sihlala sisifutshane kakhulu kule mihla kuba ukuhlawulwa kwe-inshorensi kuphantsi kakhulu xa isigulane sidlulela kwindawo ethile ekunakekeleni kwakhe. Oko kuthetha ukuba kukho izigulane ezithunyelwa ekhaya ngokukhawuleza. Ukuba baqala ukugula kwakhona okanye bafumane kwiintlungu ezingenakulibala, baya kuzama ukubuyela esibhedlele. Kodwa ukuba isibhedlele sinqwenela ukuwamkela, abo basigulane abanako ukunyamekela abayidingayo. Isikhundla sokuba "isimo sengqalelo" sichaphazela ukunyamekela kwabo ngenxa yokuba abazange bavunyelwe ngokugcwele esibhedlele kwaye ngenxa yoko ayiyiyo inxaxheba ngokupheleleyo kwinkqubo yesibhedlele yokunyamekela izigulane.
- Izigulane zeMedare kufuneka zivunyelwe ukuba zivunyelwe ukuba zifikelele esibhedlele ngokupheleleyo phambi kokungeniswa kwekhaya labahlengikazi ukuba zilindele ukuba i-Medicare ihlawule ikhaya labo labahlengikazi. Ukuba isigulane sasibekwe kwisimo sokujonga endaweni yokubakholiswa ngokupheleleyo, ngoko ayiyi kuba nekhaya lokuhlawula ikhaya elingabahlengikazi - elinokuba likhulu kumakhulu amawaka okanye ngaphezulu. Ukuba i-Medicare igubungela nayiphi na iindleko zekhaya labahlengikazi, isigulane kufuneka sivunywe ngokusemthethweni esibhedlele ubuncinane ubuncinane emithathu (engekho umgaqo ofanayo nolawulo oluphakathi kwamabini amabini okukhankanywe ngasentla.)
Kodwa eli nqaku lithetha kuphela izigulane ze-Medicare, nangona kunjalo, ukuba unyango lwakho lugqitywa ngumhlawuli wangasese, okanye omnye umhlawuli karhulumente (iTricare, Medicaid), ubuya kuba bubulumko ukuba uhlole nabo ukuba bafumane ukuba ngaba isimo sakho sokuqwalaselwa sijongwa.
Kufuneka kwakhona kuqaphele ukuba izibhedlele zinganquma kwaye zitshintshe isimo sesigulane ngaphandle kokuvumela umntu ukuba azikwenzile. Basenokuxelela isigulane ukuba uyangeniswa esibhedlele, kodwa endaweni yoko kuya kubonisa isimo sokujonga. Nangona isigulane singeniswe, isibhedlele sinokutshintsha loo ndawo ngasiphi na ixesha.
Yintoni Ongayenza Ukuze Uzikhusele okanye Uthandeke Ukuba Ubekwa Kwimeko Yokongamela Isibhedlele?
Lo mbuzo awunakho iimpendulo ezilula. Umfutshane wokuphepha igumbi lexakeka ngokukhawuleza, akukho nto ongayenza ukuze uzikhusele okanye umthandayo ukuba abekwe kwisimo sokujonga.
Nangona kunjalo, unokukwazi ukufumana okanye umntu wakho othandekayo uyamkelwa esibhedlele endaweni yoko.
- Qaphela ngokucacileyo ukuba awufuni ukubanjelwa esibhedlele kwindawo yokujonga. Nangona kunokuba kukhange kuvelelwe ngokukodwa ngenxa yokuba ityhola okwethutyana (kwaye ucinga ukuba ubuya ekhaya ngokukhawuleza), yazi ukuba akukho zikhundla ezikhoyo kwiimeko zokujonga.
- Xhumana nogqirha wakho wokunakekela ugqirha ngaphambi kokuya ekamelweni eliphezulu. Uya kucebisa malunga nokuba unamanye ama- ER . Ngaphezu koko, ukuba kufuneka uhambe kwi-ER kwaye uhlale esibhedlele, kufuneka ukwazi ukubhalisa ugqirha wakho ukukunceda ukuba uqiniseke ukuba uyavuma ngokupheleleyo.
- Cela ukuba ubone iphepha elibonisa ukuba uvumelekile. Ukuba ubona igama elithi "ukubonwa" kufuneka ucele ukuthetha nomntu oza kukuvuma ngokupheleleyo - kwaye uqiniseke ukuba ufuna. Unokufuna ukufumana umlawuli wesibhedlele - kwaye ungesabi ukuphikisana ngawo.
- Ukuba ukwesaba ukuthetha, okanye ukuba ufuna inkxaso kuyo nayiphi na indlela yokutshintsha imeko, qhagamshelana nommeli wesigulane ukukunceda .
Iyakuthanda ukuphindaphinda - nokuba wena okanye wakho othandekayo akayiyo isigulane seMedare, hlola kabini umhlawuli wakho ukuze uqiniseke ukuba ukuhlala esibhedlele kuhlanganiswe, isimo sokujonga okanye cha.