Isiqulatho seMilicaid Elifanelekile kunye neNzuzo
Ukumboza ngaphezu kwezigidi ezingama-72 zaseMerika, iMedicaid yinkampani enkulu ye-inshorense yempilo e-United States. Inkqubo, eyadalwa phantsi kohlengahlengiso lwezeNtlalo ka-1965, ifumaneka kubantu abanomvuzo ophantsi e-United States, iSithili sase-Columbia kunye ne-US. Kuyinto intsebenziswano phakathi koomasipala kunye noorhulumente karhulumente ukubonelela ngoncedo lwezempilo olusisiseko. Ukuqonda indlela okusebenza ngayo kuya kukunceda wenze uncedo lwezona zinzuzo.
Ngubani Ongayifumana Ingqondo?
Abantu abaninzi abaneemali eziphantsi baya kukwazi ukufumana i-inshurensi yezempilo ngaphandle koncediso lukaRhulumente. Le yilapho i-Medicaid iya kudlala khona. ISebe lezeMpilo laseMelika kunye neeNkonzo zoLuntu liqikelela izinga lokuhlwempuzeka (federally level) (FPL) rhoqo ngonyaka, kwaye ezi zithethe zisetyenziselwa ukubeka imilinganiselo yokufaneleka yeM Medicaid.
Akunjalo wonke umntu ufanelekile kwiMedicaid, nangona kunjalo, nokuba ngaba baneengeniso eziphantsi.
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Umlingani wakho uhamba kwi-Medicaid kwaye uhambela kwiKhaya loLondolozi. Ngoku kuthweni?
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Ulungelelwaniso lweMilicaid kunye neMpahla Yakho: Yintoni exabisayo kwaye akunjalo?
Kwakhona kufuneka awele kwiindidi ezithile ezidibana neemfuno zentlangano kunye nekarhulumente. Amaziko e-Medicare kunye neeNkonzo zeMedicaid zigunyazisa ukuba la maqela alandelayo afakwe kwi-Medicaid kuwo onke amazwe:
- Abantwana abatsha baneminyaka emihlanu ubudala kunye neengeniso zentsapho ukuya kuma-133 ekhulwini kwi-FPL
- Abantwana abaneminyaka emithandathu ukuya kwengu-18 ubudala kunye neengeniso zentsapho ukuya kuma-100 ekhulwini kwi-FPL
- Abantu abakhulileyo abanemali engenayo ukuya kuma-75 ekhulwini kwi-FPL
- Imindeni enezingane ezixhomekeke kwimali engenayo ukuya kwi-11 ukuya kuma-68 ekhulwini kwi-FPL (ngokusekelwe kwiNcediso kaRhulumente kwiintsapho kunye neNgxowa-mali yokufumana abantwana abaxhomekeke kwiSebe)
- Abantu abakhubazekileyo kwiNkxaso- ntle ye-Social Security (SSI) ngenzuzo engenayo ukuya kuma-75 ekhulwini kwi-FPL
- Abafazi abakhulelwe abaneemali ukuya kuma-133 ekhulwini kwiFPL
Urhulumente wephondo ubeka i-standard kodwa i-individual states ingakhetha ukwandisa ukukhutshwa ngaphaya kwemida. Ngokomzekelo, banokwandisa umyinge wemali yokubandakanya abantu abaninzi.
Indlela uMninimzi ojongene noNonophelo ochaphazelekayo uthinta njani ukufaneleka kweMilisiid
UMthetho woKhathalelo ongenakunceda, okanye u- Obamacare , waba nomthelela omkhulu kwi-Medicare ukufaneleka xa wenziwa ngo-2010. Ukwandisa ukunakekelwa kwempilo kwizigidi zabantu baseMerika, i-Obamacare inikezela ukunyuka kwamaMedicaid .
Ukutshintshiselwa ngemali yenkxaso-mali, amazwe avumile ukukhulisa i-Medicaid coverage kumntu onemali engenayo ukuya kuma-133 ekhulwini we-FPL, kungakhathaliseki naziphi na izinto. (Abantwana abangenamntwana babengeke basabandakanywa kwi-coverage.)
Ngeli xesha, i-32 ithi kunye neSithili sase-Columbia baye baqhuba ukunyuka kwe-Medicare. Lawa mazwe aya kufumana inkxaso-mali yoncedo kwiminyaka emithathu yokuqala yokwanda kwawo kwaye ke i-90 ekhulwini yeendleko zokunyuka nge-2022. Amazwe asele aqhubeka nokulandela imigaqo-migaqo yokufaneleka yeMedicaid.
Ukufuduka kwamanye amazwe kuthintela njani ukufaneleka kweMilisiid
Ukuba ngummi waseMelika uqinisekisa ukuba unokufumana ukuxilwa kweMedicaid ngexesha elide nezinye iimfuno zidibene nazo. Okufanayo akunakutsholwa kulabo abanesimo semfudumalo.
Amazwe anquma ukuba ngaba baya kuthi banikezele ngokubhengezwa kubantu abangengabemi base-US, kwimeko apho urhulumente wesigqeba ubeka ezi zikhokelo ukuba zilandele. Abafuduki bezomthetho abahlala kweli lizwe phambi ko-1996 banokufumana izibonelelo ezipheleleyo. Ngaphandle kwabo be-SSI, abafuduki bezomthetho abangena kwilizwe emva kowe-1996 banokufumana izibonelelo ezipheleleyo emva kweminyaka emihlanu yokuhlala. Abafuduki abaye bangena kwelizwe ngokungekho mthethweni banokufumana iinkonzo eziphuthumayo kuphela, kungekhona ukufumana i-Medicaid ngokupheleleyo.
Yintoni Ukugubungela Ngendlela Yokucamngca?
I-Medicaid ayigqubuthele yonke into kodwa iquka kakhulu. Urhulumente wesigqeba ufuna ukuba iinkonzo ezithile zinikezelwe kubo bonke abaxhamli beMedicaid. Ezi nkonzo ezinyanzelekileyo ziquka ezi zilandelayo:
- Unonophelo olunikezelwa kumaziko empilo oluntu kunye neekliniki zempilo zasemaphandleni
- Unonophelo olunikezelwa kwiindawo zokunceda abantu abaneminyaka engama-21 ubudala nangaphezulu
- Unonophelo olunikezwa ngamagqirha, umongikazikazi, kunye nabahlengikazi
- Inkqubo yokuhlola i-Early and periodic screening, i-diagnostic, kunye neyeza (EPSDT) kubantu abangaphantsi kweminyaka engama-21 ubudala
- Iinkonzo zocwangciso lweentsapho kunye nempahla
- Unonophelo lwezempilo lwasekhaya kubantu abafanelekileyo kwiinkonzo zoncedo lwabongikazi
- ILebhu neenkonzo ze-x-ray
- Ukuthutha izizathu zonyango
Nangona kunjalo, urhulumente ngamnye unokukhetha ukwandisa kwezo nkonzo. Kwaye ba soloko bekwenza. Ezi zinkonzo ezikhethiweyo zingabandakanya kodwa azithethi:
- Ulawulo lwemeko
- Ukunakekelwa kwamazinyo (kuquka amazinyo )
- Izixhobo zonyango ezizinzileyo
- Ukunyamekela kwabantwana
- Iinkonzo zempilo yengqondo
- Iyezayeza imithi
- Izixhobo zeprosthetic
- Iinkonzo zokubuyisela (kubandakanywa unyango lwezonyango kunye neyeza lokusebenza )
- Telemedicine
- Ukunyamekela (kubandakanywa neeklasi)
Ukuba ufanelekile okanye okwangokunjalo kwiMedicaid, ungafunda ulwazi oluninzi malunga neprogram yakho yesimo kwilizwe le-Medicaid.gov.
Umehluko phakathi kweMedicalid and Medicare
Ukuxilongwa kunye neMedareyori inokuvakala kwaye ikhangeleke ngokufanayo, kodwa ungadukiswa.
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Iyintoni i-Medicaid eyenza Ngetyhefu yeNkokeli?
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I-Medicare Izwe I-More ngakumbi ngezidakamizwa kunokuba i-Medicaid okanye i-VA
Zoncedo iinkqubo zonyango zingablawulwa yiZiko zeMedare neeNkonzo zeMedicaid, kodwa kukho ukungafani kakhulu phakathi kweenkqubo ezimbini .
Nangona i-Medicare yiprogram eqhubayo, i-Medicaid iqhutywa ngamazwe. Zombini iinkqubo zinika ukunakekelwa kwabalupheleyo kunye nabakhubazekileyo, kodwa kuphela iMedicaid inika abantu abanomvuzo ophantsi kwabo bonke ubudala kungakhathaliseki ukuba yintoni impilo yabo. I-Medicare igxininisa ukunakekelwa kwabantwana abasesikweni emva kokuhlala kwisibhedlele, kodwa kuphela iMedicaid inikezela ngononophelo lwabahlengikazi kwixesha elide.
Abantu abangaphezu kwezigidi ezisibhozo bafanelekile kwiMedicalid and Medicare. Aba bantu bathunyelwa kuthiwa bavumelekile . Bafumana ezilungileyo zezo zombini, ngoko kuthetha. I-Medicaid ibancedisa ukuba bahlawule iinkonzo ezithi i-Medicare ayifihla .
Indlela yokuBhalisa kwi-Medicaid
Ukubhalisa kwi-Medicaid kunokwenziwa ngokulula kwi-Intanethi kwi-Medicare.gov. Ngapha koko, ungaqhagamshelana neofisi yakho ye-Medicare yangaphakathi ukuba ufake isicelo ngefowuni okanye ulungiselele ukuqeshwa komntu. Ukuba ufanelekile, uya kufuna ukubhalisa ngokukhawuleza ukuba wenze inzuzo enkulu.
> Imithombo:
> Uxilongo - I-Primer: Ulwazi oluKhulu kwiNkqubo yeSizwe soPhulo lwezeMpilo kubantu abaNcinci-ngeniso. IKhomishoni yeKaiser kwiMedicaid kunye ne-Uninsured. https://kaiserfamilyfoundation.files.wordpress.com/2010/06/7334-05.pdf. Kushicilelwe ngoMatshi 2013.
> Isicelo seMedicaid kunye ne-CHIP, ukuQinisekisa ukuVunywa, kunye noLwazi lokuBhalisa. Website Medicaid.gov. https://www.medicaid.gov/medicaid-chip-program-information/program-information/medicaid-and-chip-enrollment-data/medicaid-and-chip-application-eligibility-stermination-and-enrollment-data. html.
> Ukuxhaswa kwemali. Umbutho weSizwe we-Medicaid Directors website. http://medicaiddirectors.org/key-issues/medicaid-financing/.
> Ukwandiswa kwe-Obamacare Medicaid. Obamacare Facts website. http://obamacarefacts.com/obamacares-medicaid-expansion/.
> Izikhokelo zobumpofu. ISebe lezeMpilo leSebe lezeMpilo yaseMzantsi Afrika. https://aspe.hhs.gov/poverty-guidelines. Ishicilelwe ngoJanuwari 15, 2016.