Uthini umahluko phakathi kwe- Medicare kunye neMedicaid ? I-Medicare yenzelwe abantu abadala kunye nabakhubazekile, ngelixa i-Medicaid ihluphekileyo (abanye abantu bayakufanelekela bobabini ), kodwa ulwahluko phakathi kwe-Medicare neMedicaid likhulu kunaloo. I-Medicare neMedicaid iyahluka
- ngubani ongabhalisa
- o baleka
- indlela asebenza ngayo
- indlela abaxhaswa ngemali ngayo
- zeziphi iingenelo ababonelela ngazo
Ngubani ofumana i-Medicare vs Medicaid?
Abantu abadala kunye nabakhubazekile bafumana unyango; Abantu abahluphekileyo bafumana iMedicaid. Ukuba uneminyaka emibini kwaye uhluphekile okanye ukhubazekile kwaye uhluphekile, unako ukufumana zombini.
LweMida
Uninzi lwabaxhamli be-Medicare baneminyaka engama-65 okanye ngaphezulu, kodwa ngo-2016, bekukho abantu abangaphezu kwezigidi ezili-9 (malunga neepesenti ezili-16 ze-Medicare epheleleyo) ngaphantsi kweminyaka engama-65 kunye ne-Medicare coverage. Laba bantu babefanelekile kwi-Medicare kuba bakhubazekile (kwiimeko ezininzi, kufuneka ufumane inzuzo yokukhubazeka kweNtlalontle iminyaka emibili ngaphambi kokuba uvumeleke kwi-Medicare, kodwa kukho ukungabikho kubantu abaneesifo sokuqhawula isifo sokugqibela kunye ne-amyotrophic lateral sclerosis ).
Ufanelekile kwi-Medicare ukuba ubuncinane ubuneminyaka engama-65 ubudala kwaye wena okanye wakho umlingane wakhokhela i-Medicare irhafu yentlawulo ubuncinane iminyaka eyi-10. Ingaba ucebile okanye uhlwempuze akunandaba; ukuba uhlawule irhafu yakho yokuhlawula kwaye udala ngokwaneleyo, uya kufumana iMedare.
Kwimeko apho, uya kufumana i- Medicare Part A mahhala. Kwaye uninzi lwabantu, ii-premium ze-Medicare Part B zijikeleze i-$ 130- $ 134 / ngenyanga ngo-2018 (uya kuhlawula iiprayimari eziphezulu kwi- Medicare Part B kunye neCandelo D ukuba ingeniso yakho iphezulu kune-85,000 / ngonyaka ngomntu oyedwa, okanye i-$ 170,000 / ngonyaka isibini esitshatileyo).
Ukuba uneminyaka engaphezulu kwama-65 kodwa awuzange uyihlawule irhafu yerhafu ye-Medicare xa usencinane, usenokuba ufanelekile kwi-Medicare.
Nangona kunjalo, uya kuhlawula iiprayimari eziphezulu, njengoko uza kufuneka uhlawule i-premium rhoqo kwiNgxenye B, ngaphezu kwe-premium yeCandelo A.
Uxilongo
Ngaphantsi koMthetho woNonophelo ongenakunceda, ufanelekile kwiMedicaid ukuba umvuzo wakho wekhaya ungaphantsi kwama-138 ekhulwini kwinqanaba lehlwempu. Nangona kunjalo, ezinye iindawo ziye zalahla eli lungiselelo , kwaye zigcine ukufaneleka kwazo kwiMedicaid njengoko kwakungaphambi kwe-ACA, oko ngokuqhelekileyo kuthetha ukuba ngaphezu kokufumana imali engenamvuzo, kufuneka ube ngumntwana, umfazi okhulelweyo, okhulile, oyimfama , abakhubazekileyo, okanye umzali ongenamvuzo omncinci wabantwana abancinci.
Kukho iziganeko ezingama-19 apho i-Medicaid ayinakwandiswa khona ukufihla abantu ukuya kuma-138 ekhulwini kwinqanaba lobuhlwempu, kwaye ngo-18 kubo, kukho ikhefu lokungena (oko kukuthi, akukho zikhokelo zokubambisana) kubantu abadala abangenabantwana abanomvuzo ongaphantsi kwinqanaba lehlwempu.
Le tstshana ibonisa amanqanaba okufaneleka okuxhaswa yiMedicaid (ngepesenteji yezinga lokuhlupheka).
Ngubani oqhuba i-Medicare vs Medicaid?
Urhulumente wephondo usebenza kwiProgram ye-Medicare . Urhulumente ngamnye uqhuba uhlelo lwakhe lweMedicaid. Yingakho i-Medicare yinto efanayo kwilizwe lonke, kodwa iinkqubo zeMedicaid zihluke kwilizwe ukuya kutsho.
Nangona uluntu ngamnye luyila kwaye luqhuba inkqubo yalo yeMedicaid, zonke iinkqubo zeMedicaid kufuneka zihlangabezane nemigangatho ebekwe nguRhulumente wephondo ukuze athole imali ye-federal.
Amaziko e-Medicare kunye neeNkonzo zeMedicaid, inxalenye yombuso karhulumente, uqhuba inkqubo ye-Medicare. Ikwajongana neprogram nganye yelizwe iMedicaid ukuqinisekisa ukuba ihlangabezana nemigangatho emancinane yomgaqo-nkqubo. Ukuze benze utshintsho olukhulu kwiiprogram zabo zeMedicaid, ama-state kufuneka afune imvume kwi-federal government ngokusebenzisa inkqubo yokuyeka.
Inkqubo Yenzelwe njani i-Medicare vs Medicaid?
I-Medicare yinkqubo yomshuwalense ngoxa i-Medicaid yinkqubo yenhlalakahle yentlalo .
Abamkeli beMedare bafumana i-Medicare kuba bahlawula irhafu ngeentlawulo zerhafu ngelixa bebesebenzayo, kunye neeprimishina zenyanga emva kokuba babhalise.
Abamkeli beMedicaid akufuneki bahlawule iirhafu kwaye abaninzi abahlawuli iiprayimesi kwi-Medicaid coverage (ezinye iifisi zifuna i-Medicaid zibhalise ekupheleni kwezinga elifanelekileyo lokufumana imali yokuhlawula imali). Endaweni yoko, inkxaso-mali yabakhokhi berhafu inikezela abantu abahluphekayo ngendlela efana neyezinye iinkqubo zentlalontle ezifana noNcedo lwexeshana lweeNtsapho ezihluphekileyo, iintsana zeNtombi kunye nabantwana, kunye neNkqubo yoNcedo lweZondlo.
Ziziphi iindlela zeMedare neeMedicaid ezahlukeneyo?
Iprogram ye-Medicare yenzelwe ukunika abaviwa abaneMicroare ithuba lokukhethwa kwezinto ezininzi. I-Medicare yenziwe ngamacandelo amaninzi ahlukeneyo, ngalinye libonelela ngomshuwalense uhlobo oluthile lwenkonzo yokhathalelo lwempilo. Ngokomzekelo, i- Medicare Part A yi-inshurensi ye-hospitali, i- Medicare Part B yinshurensi yokuphulukana nokugula kunye neenkonzo zoogqirha, kunye ne- Medicare Part D yi-inshurensi yobisi yonyango.
Abamkeli beMedaretha banokukhetha iindidi ezahlukeneyo ze-inshurensi ye-Medicare ngexesha elinye , okanye olunye uhlobo. Bangakhetha i-Medicare Advantage okanye i-Medicare yasekuqaleni . Kuqhelekile ukuba ube neengxenye ze-Medicare A, B, ne-D ngexesha elinye. Nangona kunjalo, abanye abantu bakhetha kuphela ukuba babe negalelo le-Medicare Part A ukuze bahlawule iiprayimari zenyanga zenyanga ze-Medicare Parts B kunye noD (akunakungenangqondo ukwenza oku ngaphandle kokuba unezinye iindawo zokuthenga ngetyala-ngaphandle koko, Ndiza kufumana isigwebo sokugqibela sokubhalisa xa ekugqibeleni ubhalisele iNgxenye B no-D, kwaye isohlwayo siya kuhlala kwindawo yonke ebomini bakho).
Kwixesha elidlulileyo, iinkqubo zeMedicaid azizange zinikeze ukhetho oluninzi ngokwecebo loyilo. Kodwa namhlanje, amaninzi asetyenziswayo kwimibutho yonakekelo yeMedicaid (iMCOs). Ukuba kukho inketho engaphezulu kweyodwa kwi-MCO kwingingqi yombuso, ababhalisile bangavunyelwa ukuba bakhethe owakhethayo.
Uphi i-Medicare neMedicaid Imali Yabo?
I-Medicare ixhaswa ngemali kwinxalenye yerhafu yerhafu ye-Medicare, inxalenye yee-premium zabameli be-Medicare, kwaye inxalenye yerhafu yombutho jikelele. Iirhafu zokuhlawula i-Medicare kunye neeprisimesi ziya kwi-Medicare Trust Funds. Iingxowa-mali zokunakekelwa kweenkonzo zezempilo kwiimviwo ze-Medicare zihlawulwa kwii-Medicare Trust Funds.
I-Medicaid ixhaswa ngemali ngumbuso karhulumente kwaye ixhaswa ngemali ngurhulumente ngamnye. Ingakanani urhulumente wephondo owenza inxaxheba kwimali nganye kwinkqubo ye-Medicaid kwinkqubo kuxhomekeke kumvuzo oqhelekileyo wabemi bahlali. Urhulumente wephondo uhlawula umyinge malunga neepesenti ezingama-63 zeendleko zeMedicaid, kodwa ipesenteji zisuka kuma-50 eepesenti ukuya kuma-75 ekhulwini, kuxhomekeke kwimeko (amazwe amaninzi ahlawula iindleko zeMedicaid, kanti amahlwempu afumana uncedo olungakumbi rhu lumente).
Kodwa phantsi kwe-ACA yokwandiswa kweMedicaid, urhulumente wephondo uhlawula isabelo esikhulu. Kubantu abasanda kulungele ukufumana iMedicaid ngenxa ye-ACA (oko kukuthi, abantu abadala abanemali engenayo ukuya kuma-138 ekhulwini kwinqanaba lehlwempu), urhulumente wephondo uhlawule iipesenti ezili-100 zeendleko ukususela ngo-2014 ukuya ku-2016. Amazwe aqala ukuhlawula ama-5 ekhulwini iindleko ngo-2017, kwaye ezo zonyuka ukuya kuma-6 ekhulwini ngowama-2018, kwaye ziya kunyuka ukuya kuma-7 ekhulwini ngo-2019. Emva koko, ukususela ngo-2020 ukuya phambili, iza kubhatala iipesenti ezili-10 zeendleko kwaye urhulumente wephondo uza kuhlawula ipesenti ezingama-90.
Uncedo lweMithi kunye neMicroidity Benefits njani?
I-Medicare ne-Medicaid ayifuni ukuba ikhusele iinkonzo ezifanayo zonyango. Ngokomzekelo, i-Medicare ayihlawuleli ukunakekelwa kwexesha elide lokunyamekela ukuhlala ngonaphakade kwikhaya labahlengikazi, kodwa iMedicaid ihlawula ukunyamekelwa kwexesha elide. Iintlawulo zeMedicaid ziyahluka ukusuka kummandla ukuya kwilizwe, kodwa inkqubo nganye yelizwe iMedicaid kufuneka inikezele ngeenzuzo ezincinci ezithile. Iintlawulo zeMedare ziyafana kulo lonke ilizwe.
Unokufunda okungakumbi malunga neentlobo zeenzuzo zeMedare, kunye noko ungalindela kwiindleko zangaphandle kwele ncwadana .
Funda kabanzi malunga neenzuzo zokubhengezwa ngokubanzi zeMedicaid apha, okanye uye kwiwebhusayithi ye-Medicaid yelizwe ukuze ufunde ngeenzuzo zeMedicaid kwimeko yakho.
Ukutyelela iCandelo le-Medicare ne-Medicaid ngokubanzi, ulwazi olunzulu malunga ne-Medicare kunye neMedicaid.
> Imithombo:
> ECubanski, uJuliette; Neuman, Tricia; Damico, Anthony. Kaiser Family Foundation. Indima ye-Medicare kubantu abangaphantsi kweminyaka yobudala 65 abakhubazekileyo. Agasti 2016.
> Kaiser Family Foundation. Isabelo sikaRhulumente kunye neSizwe seMedicaid Spending. 2016.
> Medicaid.gov. IiNqanaba zokuLungiswa kweeMvavanyo kunye neCIP.
> Medicare.gov. Icandelo A Iindleko.
> Ulawulo loKhuselo loLuntu, iiNyanga zeMagare: iMithetho yabaNcedisi abaPhezulu , i-2018.