Ungaphi na apho u-Medicare engayi kuhlawula?
I-Medicare ayikho ivenkile yokuyeka enye. Nangona iquka ubuninzi beenkonzo, kunokukushiya ukuba uzizibonele xa ufika kwiinkcukacha ezithile zokunakekelwa kwezempilo njengoko ukhula. Umzekelo, awufihla iilensi zokulungisa (umzekelo, ii-lens zoqhagamshelwano okanye iziglasi zelanga), amazinyo omzimba, izixhobo zokuvalelwa, okanye izitya ezimhlophe eziyimfama. Amanye amachiza aphezu kwetafile, kwakhona, nokuba unayo isicwangciso sezonyango sesigqibo seCandelo D.
Oku kungenxa yokuba i-Medicare ayicingi ukuba ezi zinto ziyimfuneko yempilo. Ngelishwa, oko bangaboniyo njengemfuneko yonyango kukunyamekela nokugcinwa kwekhaya lokugcina abantwana .
Unjani Ukunyamekela?
Ngamehlo amaziko e-Medicare kunye neeNkonzo zeMedicaid (CMS), ukunakekelwa kokunyamekela kungakhathaliseki ukuba kuqhutywe ngabaqeqeshi abanezakhono okanye abanezonyango ezifana negqirha, umongikazi okanye umphathiswa (umz. , i-therapists yomsebenzi, kunye neengcali zeengcali). Ukunyamekela ngokunyamekela kubandakanya ukuncedwa ngokuhlamba, ukucoca, ukupheka, ukugqoka, ukucoceka, kunye nokuhamba okanye ukuququzelela.
Ngelishwa, abaninzi abakhulileyo emakhaya asebekhulile banakho ngenxa yezizathu zokukhusela. Abakwazi ukuhlala ngokuzimela ngenxa yengxaki yokugula komzimba okanye ezinye iimeko zonyango, kwaye abanokuba nabantwana okanye abathandekayo abanokubanika inkxaso.
Ingxelo ka-2016 ye-Vital Health Statistics ingxelo yeSebe lezeMpilo leSebe lezeMpilo yase-United States (HHS), uninzi lwabantu abasemakhaya asebekhulile lifuna ukunakekelwa.
Iipesenti zabantu abafuna uncedo zininzi:
- Ukuhlamba - iiphesenti ezingama-96.4
- Ukugqoka - iipesenti ezingama-91.8
- Ukutya - iipesenti ezingama-58.0
- Ukukhupha - iipesenti ezingama-87.9
- Ukutshintshwa okanye kwi-bedin - i-85.2 yeepesenti
- Ukuhamba - iipesenti ezingama-90.7
Isidingo esandayo soKhathalelo lweKhaya laseKhaya
Ngokwemibiko efanayo yeHHS, kwakukho izibhedlele zasekhaya zokunakekelwa kwabanikazi abanemvume ezi-1.7 ezifumanekayo ngo-2014 kunye nezigidi ezili-1.4 ezihlala kwixesha elide kwiimibhede.
Ukujonga ngokusondeleyo, iipesenti ezingama-16.1 zalaba bantu babephakathi kweminyaka engama-65 ukuya kwe-74 ubudala, i-27.2 ekhulwini phakathi kweminyaka engama-75 no-84 ubudala, kwaye i-41.6 iphesenti iminyaka engama-85 ubudala.
Kulinganiselwa ukuba ama-baby boomers angama-10 000 aya kufikelela kuma-65 imihla ngemihla ukuya ku-2030, kwaye inenhlanhla kubo, ukuhlala kwexesha lokuphila kuya kwanda. Ngo-2014, ukulindeleka kobomi e-US iminyaka engama-78.8, ukwanda kweminyaka engama-9.1 ukususela ngowe-1960. Ingxaki kuphela kukuba ukuhlala ixesha elide kunandisa ukwanda kweemeko ezingapheliyo zezokwelapha kwaye oko kungena mngcipheko wokwenyuka.
Ukususela ngo-2016, izigidi ezingama-54 zaseMerika zifumene isifo sesifo se-Alzheimer kwaye inani lixelwe ukunyuka ukuya kwizigidi ezingama-5.8 ngo-2020 kunye ne-8.4 yezigidi ngo-2030. Enyanisweni, isifo se-Alzheimer kunye nomqondo we-dementia sele sele i-akhawunti engaphezu kwama-50 ekhulwini lwabantu bonke abahlengikazi.
Xa uqwalasela le miba, abaninzi abantu abadala nabasweleko kufuneka badinga ukunakekelwa kwikhaya lexesha elizayo.
Ixabiso eliyinyani loKhathalelo lweKhaya laseKhaya
Ukunakekelwa kwekhaya lononophelo ongekho mncinci. Iindleko zenyanga zenyanga kwiUnited States kwendawo ekwabelwana ngayo yi $ 6,692 ngenyanga. Igumbi labucala, li-$ 7,604 ngenyanga.
Ikhaya elilinganayo labahlengikazi libiza i-$ 80,304 ehlala kwindawo yokuhlala kunye ne-91,248 yezikolo kwigumbi labucala.
Lezo manani ziyahlukahluka ngokusekelwe kwindawo ohlala kuyo. Amahlanu amaxabiso axabisa kakhulu yiAlaska, Connecticut, eMassachusetts, eNew York, naseHawaii, ngaloo ndlela, kunye namakhaya anamahlengikazi e-Alaska axabisa i-$ 23,451 ngenyanga!
Amaxabiso ancinci kwiinkonzo zokunakekelwa kwabangamahlengikazi i-Oklahoma, eMissouri, eLouisana, eKansas, nase-Arkansas, ngokulinganiselwa kwamaxabiso ngama-5,000.
Ukubeka oku ngolu hlobo, uhlawulelo oluqhelekileyo lweeNtlalontle zokuncedisa umhlala-phantsi ngo-Disemba 2016 lwaluyimali eyi-1,360.13 ngeenyanga kwi-$ 16,321.56 epheleleyo ngonyaka.
Ngokusekelwe kula manani, akumangalisi ukuba bambalwa abantu abanokuhlawula ukunyamekela ekhaya.
Abantu bangaphi ukufumana indawo yokunakekelwa kwonyango ekhaya? Ziziphi iindlela ozikhethayo?
Umgangatho wezeMpilo woKhathalelo lwaseKhaya loNyango
Akunjalo ukuba i-Medicare ayihlawuli naliphi na ukunakekelwa kwekhaya lononophelo. Ihlawula ezinye, kodwa kuphela xa usandul 'uva esibhedlele kwaye kuphela ukuba ufuna unonophelo lwezakhono ubuncinane iintsuku ezintlanu ngeveki.
Akukuphela nje ukuba kufuneka ube esibhedlele ukuze ufanele ukufumana le ngxelo ye- Medicare Part A , kodwa kufuneka uvumeleke ukuba unikwe isigulane esibhedlele ubuncinane iintsuku ezintathu. Ngenhlanhla, usuku othunyelwa kuyo kwiziko loongikazi onokwazi alubala, kwaye lukhohlakele ngakumbi indlela i-CMS ichaza ngayo ukunakekelwa kwabagulayo.
Le mihla unako ukulala ubusuku esibhedlele, kodwa oko akuthethi ukuba unesifo sengqondo. Ngombulelo kumthetho ovezwe ngo-Oktobha 2013, owaziwa ngokuba yi- Two-Midnight Rule , unokuqwalaselwa kuphela ngononophelo lwangaphantsi (ukunyamekelwa yi-Medicare Part A) ukuba ukuhlala kwakho kulindeleke ukuba kudlule ixesha elide kuneemigangatho ezimbini kunye nokuba izinga lakho lokunyamekela kuthathwa njengemfuneko yempilo. Oko kuthetha ukuba awukwazi ukuba kwisibhedlele ufumana unonophelo olunokulawulwa lula lula kwenye indawo.
Ngaphandle koko, uya kufakwa phantsi kombono, unyameko ogqitywe yi- Medicare Part B.
Kwimeko apho ufumana imvume yokunonyamekela ngononophelo, uncedo lwe-Medicare Part A luhlanganisa iintsuku ezingama-20 zokuqala. Ngeentsuku ezingama-21 ukuya kwi-100, uya kuhlawula i-$ 164.50 ngemini ngo-2017. Emva kweentsuku ezili-100, uwedwa.
Ukuxhaswa kweMpilo yoLondolozo lweKhaya
I-Medicare inikezela ngononophelo lwangaphantsi kwexesha elifutshane. Yingakho abaninzi abantu bebuyela eMedicaid . Ingxelo ye-Vital Health Statistics ka-2016, ama-62.9 ekhulwini abahlali kumakhaya asebekhulile basebenzisa iMedicaid njengomthombo wabo wokuhlawula.
Akuyena wonke umntu ofanelekileyo weMedicaid. Ukufaneleka kuyahluka kubantwana, abafazi abakhulelweyo kunye nabanye abadala. Amazwe awandise iMedicaid phantsi koMthetho woNonophelo ongenakunqwenela uvule ukufaneleka kubantu abangabodwa ngaphandle kwabantwana, kanti amanye amazwe angabandakanyeka abo bantu ukuba bafumane ingxelo.
Kwakhona, le nkqubo ijoliswe kubantu abanomvuzo ophantsi. Nangona xa ucinga ngako, abambalwa abadala baya kuba nemali emininzi emva kokuba baqale ukuhlawula ukunyamekela kwikhaya lokunonyamekela.
Ngokwezidingo zayo zemali, iMedicaid inquma ukufaneleka ngokusekelwe kwingeniso yakho yenyanga kunye nezinto zakho. Ezi zixhobo zibandakanya i-annuities, iibhanki zebhanki, iimoto (ngaphandle kweyithuthi yakho ephambili), iibhanki, ixabiso lemali elingaphezu kwe-$ 2,000, imali yokunikezelwa kwemali yomshuwalense we-inshorensi (isebenza "kwimpilo yonke" kunye nemigaqo "yobomi bendawo yonke," kungekhona imigaqo-nkqubo yobomi) , Izicwangciso ze-Keogh, i-IRAs, iimali zeemarike zemali, iimali ezihlangeneyo, iimali zempesheni, i-real estate (ngaphandle kweendawo zokuhlala eziphambili ukuya kwixabiso elithile kuxhomekeke kwimeko), amasheya kunye nokukhethwa kwempahla.
Isizwe ngasinye ekugqibeleni sibeka umyinge wemali yokufaneleka, kodwa urhulumente wezepolisi ubeka imfuno emncinci kwilizwe ngalinye. Uya kufuneka ukhangele iimfuno zelizwe lakho ukuze ubone ukuba ufanelekile.
Abaninzi abakhulileyo bachitha phantsi impahla yabo ukuze bakwazi ukufumana iMedicaid. Abanye bazama ukukhusela impahla yabo ngokuyithumela kwiintsapho kunye nabathandekayo.
Nangona kunjalo, qaphela! Nakuphi na ukutshintshwa kweempahla kwiinyanga ezingama-60 zesicelo sakho seMedicaid kuya kuthathwa ingqalelo. Ukutshintshwa okwenzeka ngexesha lexesha lokubukeka kunokubangela izigwebo ezivela kwiMedicaid, ezinokubambezela ukunikwa kwengqalelo kwenkathalo yakho kwiinyanga ukuya kwiminyaka. Kuya kuxhomekeka kwimali enokuyidlulisela kunye nokuba yeyiphi imeko ohlala kuyo. Kukulungele ukuthetha nommeli wenkundla yomdala ukuxoxa ngezinto ozikhethayo ngaphambi kokuba ulungiselele nayiphi na imali.
Umgangatho Wemfihlo woKhathalelo lweKhaya laseKhaya
Kunokwenzeka ukuthenga i-inshorensi yexesha elide (LTC) ukuze uncede ukuhlawula ukunakekelwa kwonyango lwabahlengikazi. Ezi zicwangciso ze-inshorensi zihlawula iipesenti ezi-5 zoobuhlengikazi basekhaya eMelika.
I-inshurensi ye-LTC ingaba luncedo ukuba unayo ukuba ufuna unonophelo, kodwa ii-premiums zihlala zibiza kwaye zingaphandle kwebala kubantu abaninzi. Ezi ntlawulo ze-premiums zivame ukuphakama kumntu omdala owufumanayo, ngakumbi ukuba impilo yakho iyancipha. Abantu abangaphezu kweminyaka engama-65 ubudala kwaye abaneengxaki zonyango ezingapheliyo bangabona iiprayimari zenyanga ngenyanga kumawaka eedola.
Inkampani ye-inshurensi inokukhanyela ukuxhaswa ngokusekelwe kwiimeko ezikhoyo ngaphambili .
Inkcazo yonyango yexesha elide ngokubanzi isebenza ngale ndlela: Uhlawula i-premium yenyanga, kwaye ukuba unesiganeko esichukumisayo, oko kukuthi, into efuna ikhaya lasebekhulile okanye ukunakekelwa kwezempilo kwangexesha elide, uqala ukufumana i-inshorensi. Ezi zihlawulelo zingafakwa kwiinkonzo ezithile, kodwa inani lazo zihlawulwe liza kusekelwe kwisicwangciso sakho se-inshurensi ye-LTC. Bangakwazi okanye bangafihla iindleko ezipheleleyo zokunyamekela, kwaye ukuhlawula kunokugcina kuphela ixesha elide.
ILizwi
Namhlanje siphila ixesha elide, kwaye ukuhlala ixesha elide kuthetha ukucwangcisa ikusasa. Izilwanyana uza kufuna unonophelo lwangexesha elide kwiminyaka yakho ephakamileyo, nokuba ingaba kwindawo yokuhlala ekhuselayo, kwikhaya lononophelo, okanye njengonyango lwempilo yasekhaya. Ukuqonda zakho iinketho zokujonga kunye nokuba zininzi kangakanani eziya kukunceda ziza kwenza izigqibo ezinolwazi ezinganciphisa umthwalo kubathandekayo bakho.
> Imithombo:
> Izifo ze-Alzheimer's. Izifo ezingapheliyo Ukukhusela kunye nokuKhuthazwa kwezeMpilo, amaZiko okuLawulwa kweZifo kunye noThintelo. https://www.cdc.gov/chronicdisease/resources/publications/aag/alzheimers.htm. Ipapashwe ngo-Oktobha 17, 2016.
> Ukufa nokufa. IZiko leSizwe leeNkcukacha zezeMpilo, amaZiko okuLawulwa kweNtsholongwane kunye noThintelo. https://www.cdc.gov/nchs/fastats/deaths.htm. Ishicilelwe ngoMatshi 17, 2017.
> Harris-Kojetin L, uSengupta M, Park-Lee E, et al. Ababoneleli bexesha elide kunye nabasebenzisi benkonzo eMelika: Iinkcukacha ezivela kwiSizwe soPhando lwaBanini bexesha elide, Abakwa-2013-2014. IZiko leSizwe leeMpilo zoLwazi. INtital Health Statute. 2016; 3 (38): 1-118. https://www.cdc.gov/nchs/data/series/sr_03/sr03_038.pdf.
> Iindleko zaseKhaya zoLondolozo nguRhulumente. SkilledNursingFacilities.org iwebhusayithi. https://www.skillednursingfacilities.org/resources/nursing-home-costs/.
> Uncedo lweZiko loLondolozo lweNesi. KwiWebhare.gov website. https://www.medicare.gov/coverage/skilled-nerving-facility-care.html.