Khuphukisa iiNzuzo zakho ngaphandle kokudiliza
Ukuba ubhalise kwi-Florida Medicaid Inkqubo yeZindleko zeeNkcitho , kufuneka ukwazi indlela yokusebenzisa le inshorensi yempilo enzima ngokufanelekileyo. Ukuba uyisebenzisela ngokungalunganga, uya kuhlawula ngaphezu koko kuyimfuneko, okanye uya kulahleka kwi-coverage ye-Medicaid.
EFlorida, iNkqubo yeSabelo seNkcitho yeMali yeNkcazo yindlela yonyhorensi yezempilo kwiimfuno zonyango .
Aba bantu benza imali eninzi ukuze bakwazi ukufumana iMedicaid rhoqo, kodwa abanakho imali eyaneleyo yokuhlawula iimfuno zabo zonyango.
Zidibana nazo zonke iimfuno ezifanelekileyo zokufaneleka eziMedicaid ngaphandle kwemfuno yengeniso, kodwa zifumana neendleko zonyango ezibalulekileyo inyanga nganye. Ngoko inkqubo ivumela abantu ukuba bathabathe iindleko zabo zonyango kwimali yabo engenayo baze bafanele ukufumana iMedicaid ukuba kunye neendleko zabo zonyango zifike njani. Inkqubo iphinda ivuselele inyanga nganye.
Ingakanani Inani-yeendleko zenani?
Xa ufumana isaziso sokuthi uyamkelwa kwiNkqubo yoLuntu oluMilingo, iya kukuxelela isabelo sakho senyanga seendleko. Le mali inxulumene nokuba ingakanani imali yakho engenayo idlula imingcele yengeniso yeMedicaid. Ingakumbi imali oyenzayo, isabelo sakho seendleko siza kuba. Ukuba ingeniso yakho yentsapho iyatshintsha, okanye ukuba inani labantu abashintshayo ekhaya, isabelo sakho seendleko siya kutshintsha.
Yiyiphi Ukubaluleka kweSabelo seNdleko?
Isabelo sakho seendleko yimalini yeendleko zonyango omele uyenze phambi kokukhawulwa kwe-Medicaid ukukhaba kwinyanga leyo.
Uqala inyanga nganye ngaphandle kwe-Assurance yempilo yomshuwalense. Njalo xa unenkcitho yezempilo, uyazisa i-Florida Medicaid yeendleko (ngefeksi, i-imeyile, okanye ngomntu-mntu) kwaye ugcine umkhondo wenani elipheleleyo le nyanga.
Imini yakho iindleko zonyango lwenyanga zidlulile isabelo sakho seendleko, uqala ukuhlawula i-Medicaid. Ukususela ngaloo mini kude kube sekupheleni kwenyanga, ufumane i-Medicaid. Ngosuku lokuqala lwenyanga ezayo, uphinde ungabikho ngqalelo ukuze iindleko zonyango zakho zigqithise isabelo sakho seendleko.
Ngaba Ndifanele Ndihlawule Isabelo Sami Ngeendleko Ngenyanga nganye Ngaphambi kokuba i-Medicaid Kicks In?
Hayi!
Akunakwenzeka ukuba uhlawule iindleko zonyango ezisetyenziselwa ukufikelela kwisabelo sakho seendleko. Kufuneka uhlawulwe loo nto.
Xa i-Medicaid iqala ukukhutshwa, kungekhona nje ukuba i-Medicaid ihlawule iindleko zonyango lwakho kwinyanga leyo, ihlawula iindleko ezisetyenziselwa ukuhlangabezana nesabelo sakho seendleko ngaloo nyanga, ukuba zenzeke okanye emva komhla wokuba u-Medicaid iqala . Ukuba ukhetha ukuhlawula ezo ndleko, ziza kuba zibala ngokubhekiselele kwingxenye yakho yeendleko, kodwa awuyi kubuyiselwa yi-Medicaid malunga noko uhlawule.
Nasi umzekelo usebenzisa uCindy kunye nengxenye yakhe yeendleko ze-$ 1000:
UCindy unomsebenzi wokugqirha ugqirha ngoMeyi 1 ophumela kwisibhengezo se-$ 200. Ubeka i-faxes ibhajethi kwi-Medicaid yaseFlorida ukuze iMedicaid iqaphele ukuba iqokelele i-$ 200 ukuya kwi-$ 1000 yeendleko zayo ngoMeyi. I-Medicaid ayiyihlawula ibhilikhwe ukususela ngo-Cindy engazange ahlangane nesabelo sakhe seendleko zenyanga.
UCindy uvavanyo lwegazi ngo-Meyi 4, ufumana ibhajethi evela kwibhile ye-$ 900, kunye neefeksi eziyilwayo kwi-Medicaid. Phakathi koogqirha wakhe ukutyelela kunye nokuhlolwa kwegazi lakhe, ngoku uqokele i-1100 zama-indleko kwiinkcitho zonyango lwenyanga leyo, okungaphezulu kwexabiso lakhe lemali ye-1000.
Ekubeni iindleko zenyanga zenyanga zeCindy zidlulile isabelo sakhe seendleko ngomhla we-Meyi 4, ukufihla kweMediicaid yakhe eqala ngoMeyi 4 kwaye iyaqhubeka ekupheleni kukaMeyi. Nangona kungathatha iintsuku ezimbalwa kwiMedicaid ukujongana neendleko zeCindy kunye nokunika inkxaso ye-Medicaid, i-coverage iya kubuyiselwa kuMeyi 4.
I-Medicaid ihlawula iindleko zonyango kaCindy ukususela ngoMeyi 4 ukuya ekupheleni kwenyanga.
Oko kuthetha ukuba baya kuhlawula i-bill ye-900 yebhanki (ebona i-lab iyamkela iMedicaid, oku kuthetha ukuba kuya kufuneka bafumane ngaphantsi kwe-$ 900 njengentlawulo epheleleyo, ekubeni iMedicaid inexabiso elincinci lokubuyisela). I-Medicaid iya kuhlawula iindleko zokunyamekela ukuba uCindy ufumane ngexesha leenyanga. Kodwa i-Medicaid ayiyi kuhlawula isigqibo sokuba ugqirha u-Cindy abe nawo ngo-Meyi 1, ekubeni ukuxhaswa kwakhe kweMedicaid akuzange kwenzeke ngo-Meyi 4.
Ngaliphi na ixesha kwinyanga, kubalulekile ukuqinisekisa ukuba ababoneleli bezonyango ozisebenzisayo bazimisele ukuwamkela iMedicaid. Oku kuyinyani emva kokuqala koxilongo lweMedicaid, kodwa liyinyaniso ngelixa uqala kwisigaba senyanga apho iindleko zakho zonyango zixhomekeke kwisabelo sakho sexabiso lemali.
Njengoko ubona kumzekelo ongasentla, uCindy wenza i-billing enkulu kwibhule ngo-Meyi 4. Ukuba ibhodi ayifumanga iMedicaid, wayenamathela kwi-bhili yebhanki, nangona i-Medicaid yaqala ukusebenza ngomhla (xa wadibana nesabelo sakhe seendleko). Isabelo sakho semali yindleko sinokuvela kubaboneleli abakwenzayo okanye abamkeli iMedicaid. Kodwa iindleko ngomhla wokuba isabelo sakho seendleko sihamba phezu kwexabiso elifunekayo ukuze kulungele iMedicaid kuya kugqitywa nguMedicaid ukuba ngaba banikezeli abasebenzisa ngaloo mini bazimisele ukuwamkela iMedicaid.
Ziziphi iindleko ezingayisebenzisela ukuhlangabezana neSabelo sam seNdleko?
Unokusebenzisa iindleko zonyango eziqhelekileyo ukuba zifakwe kwi-Medicaid ukuba unesiqinisekiso seMedicaid. Ungasebenzisa iindleko ukusuka kwiintsuku ezili-90 ezedlulileyo. Imali oyihlawulayo kwiimali-mali ze-inshorensi yezempilo (ingabalwa kwizicwangciso zenkxaso-mali engaguqukiyo) ingabalelwa kwisabelo sakho seendleko, kwaye ngokunjalo nezindleko zokuhamba (nge-ambulensi, ibhasi okanye itekisi) zenzeke ukuba ufike kwiziko lonyango.
Iindleko zonyango akudingeki ukuba zibe ngawe. Unokusebenzisa iindleko zonyango kunoma ubani ongenayo imali engenayo ekumiseni ukufaneleka kwakho kweMedicaid. Kulo mzekelo ukhankanywe ngasentla, ukuba ingeniso yomyeni kaCindy yayifakwe kwiCindy's Medicaid ukuzimisela ukufaneleka, uCindy angasebenzisa iindleko zonyango lomyeni wakhe kwizabelo zakhe.
Nangona kunjalo, awukwazi ukusebenzisa iindleko ezingaphezu kweentsuku eziyi-90 ubudala. Kwaye, awukwazi ukusebenzisa iindleko ezisetyenziselwa ukuhlangabezana nesabelo seendleko kwinyanga edlulileyo. I-Florida Medicaid iphinda icacise ukuba awukwazi ukubala iindleko zee-anti-counter-counter counter.
[Ukubhekisela, ukulungelelaniswa kweMedicaid kusekelwe kwingeniso yekhaya (njengepesenti yezinga lehlwempu), ngokumalunga nobungakanani bendlu, kodwa izikhokelo zokufaneleka kubantu abahlukahlukeneyo ziyahluka ngokubanzi ukusuka kwelinye ilizwe ukuya kwelinye.]
Ndingayinceda njani iMahia?
Uya kufuneka ulungelelanise ukwenzela ukuba ukwandisa i-Medicaid coverage yakho.
- Yazisa i-Medicaid yeendleko zakho zonyango, ngeposi, ngefekisi, okanye kumntu.
- Ukutyunjwa kwexesha kunye neendleko ekuqaleni kwenyanga ukwenzela ukuba uhlangabezane nesabelo sakho seendleko ngokukhawuleza kunokuba emva koko ngenyanga. Oku kuya kukunceda ufumane iintsuku ezongezelelweyo ze-Medicaid benefit coverage.
- Gcina umkhondo weendleko zonyango zonyango osebenzayo de uze udlulise isabelo sakho seendleko nganye ngenyanga.
- Qaphela ukuba zeziphi iindleko zonyango sele zisetyenzisiweyo ukuhlangabezana nesabelo senyanga esingaphambi kwindleko, ezithe iindleko zingasetyenziswanga okwangoku, kunye neendleko ezingaphezulu kweentsuku eziyi-90 ubudala kangangokuba akunakusetyenziswa ukuhlangabezana nesabelo sakho samanje indleko.
- Uya kufuneka uhlawule nayiphi na indleko zonyango ezingaphezulu kweentsuku ezingama-90 ubudala, azizange zisetyenziselwe ukuhlangabezana nesabelo senyanga, kwaye azizange zifunyenwe ngelixa unemibuzo ye-Medicaid.
Ngaba kukho nawuphi na le Nkqubo enzima Kwenene Imisebenzi Efanelekileyo?
Ulwabiwo lweMalikayidi lweendleko lusebenza ngokukodwa kubantu abanemali ephezulu yokunakekelwa kwempilo eqhubekayo ngenyanga. Ngokomzekelo, ukuba unamayeza abiza i-$ 3,000 ngenyanga, kwaye isabelo sakho seendleko ngu-1,900 zamaRandi, uya kufumana isabelo sakho seendleko nganye ngenyanga xa ugcwalisa umyalelo wakho. Ixesha lakho lokuhlaziywa ngosuku lokuqala lwenyanga nganye, kwaye uya kugutyungelwa nge-Medicaid epheleleyo inyanga zonke inyanga nyanga zonke.
Ziziphi iingxaki ezinkulu kunazo zonke ngeFlorida Medicaid?
Kukho iingxaki ezintathu ezinkulu:
- Uninzi lweMedicaid I-Medicaid Yabelana ngeendleko abaxhamli abayiqondi le nkqubo. Bakholelwa ngokuphosakeleyo ukuba kufuneka bahlawule isabelo sabo ngokupheleleyo seendleko eziphuma ngaphandle kweenyanga. Banobunzima ukuhlawula isabelo sabo seendleko ngokwabo, okubangele ukuhlawula ngaphezu kokulindeleke kubo. Okanye, bayadangala ngenxa yokuba abanakho ukuhlawula isabelo seendleko nyanga zonke, kwaye bayakholelwa ngephutha ukuba abayi kuba negalelo kuze bahlawule. Ababoni ixabiso lentlawulo, bahlawule kakhulu ngaphandle kwe-pocket, baze baphelise iintsuku ezimbalwa ze-Medicaid.
- Kunzima ukufumana ababoneleli ngeenkonzo zempilo abaza kwamkela i-Medicaid Yabelana ngeNkcitho yeeNkcitho. Kwabanye ababoneleli abamkela iMedicaid ngokuthe rhoqo abayi kwamkela i-Medicaid Yabelana ngeNdleko. Ukuba umboneleli uhlola ukufaneleka kwakho kweMedicaid phambi kokuba uqeshwe kwaye ufumanisa ukuba awunabhaliswa ngenxa yokuba awuzange uhlangabezane nesabelo sakho seendleko zenyanga, banokucela ukuhlawulwa ngokugcwele ngexesha leenkonzo. Ukuba uyazihlawula, awuyi kubuyiselwa yi-Medicaid. Kodwa, ukuba awubahlawuli, banokungafuni ukubonelela ngenkonzo.
- Le nkqubo yenkxaso-mali ehlawulwa ngumhlawuli werhafu ayinakuxanduva. Uyilo lweprojekthi yaseFlorida Medicaid Yabelana ngeNdleko ikukhuthaza ukuba usebenzise iinkonzo ezininzi zonyango ngokunokwenzeka. Iimali ezongezelelekileyo ozenzayo, mhlawumbi uya kuba ne-inshorensi yempilo kwinyanga leyo. Akukho sikhuthazo sokugcina indleko zezempilo . Nangona kunjalo, utshintsho lunokuza njengoko iFlorida ifuna iindlela zokuhambisa abaxhamli beMedicaid kwiinkathalo ezilawulwayo .
Olu lwazi luchanekile xa lupapashwe. Nangona kunjalo, uRhulumente waseFlorida unokutshintsha i- Medicaid Yabelana ngeNkqubo yeNdleko ngaliphi na ixesha.
Imithombo:
> Imindeni yaseU.SA. Izikhokelo zeNtlupheko.
> Isebe laseFlorida leSebe lezingane kunye neentsapho. Uxilongo. Abaxhamli beMveli (Abelana ngeendleko) - Incwadana efumanekayo.
> Florida Law Usizo. Ulwabiwo oluthile lweeMpilo.
> Medicaid.gov. Amanqanaba okufaneleka afanelekileyo kwi-Medicaid kunye ne-CHIP.