Izimangalo ze-Medicare-For-Service (FFS) ngezinsuku zokusebenza noma izinsuku zokukhishwa ngomhla ka-Ephreli 1, 2013, zizoqhubeka nokunciphisa amaphesenti angu-2 emalini yokukhokha kuze kufike esinye isaziso. Lokhu kuqhubeka ukusebenza ngo-2017. Ngaphandle kokuthi kushintshwe, ukusikeka ngeke kuphele kuze kube ngu-2021.
Ukwehla kwesabelomali kwesimiso sezimali esithinta ama- Medicare izicelo kwaqala ukusebenza ngoMsombuluko Wama-Fools, kodwa kwakungeyona into ehlekayo.
Zithinta uhlelo lwe-Medicare Fee For Service (FFS), eyaziwa nangokuthi yiM Medicare HMO (Part C) izimangalo kanye Nezidakamizwa Zezokwelapha Ezihlala Phakade, Prosthetics, Orthotics, ne-Supplies (DMEPOS).
Ukubala Izinkokhelo ZeMithi Ngokunciphisa Ukulinganisa
Ukunciphisa amaphesenti amabili okukhokhwa kubalwa emva kokudonswa kwesiguli, ukuqinisekiswa kwemali, kanye ne-copay kuye kwachithwa inani elivunyelwe.
Ngaphambi kuka-Ephreli 1 2013, izinkokhelo zeMedricare zibalwe ngale ndlela
ISIKHATHI ESIKHULULEKILEYO - UKUPHATHWA KWEZEMPAKATHI (kubandakanya ukukhishwa kwezimali, ukukhokhelwa kwezimali kanye ne-copay) = UKUHLAWULWA KWAMEDICARE
Ngemuva kwe-Ephreli 1, 2013, izinkokhelo zeMedricare sezibalwe ngale ndlela
ISIKHATHI ESIKHULULEKILEYO - UKUPHATHWA KWEZEMPAKATHI (kufaka phakathi i-deductible, i-coinsurance, ne-copay) = UKUHLAWULWA KWAMEDICARE X 98% = UKUHLAWULWA KWEZINDABA
Isimangalo Sokulungiswa Kwemibono
Iseluleko se-electronic remittance (ERA) sichaza izizathu zokulungiswa kokumangalelwa amakhodi asetshenziselwa ukucubungula isimangalo. Ezinye zazo zihlanganisa okulandelayo:
Isimangalo Sokulungiswa Kwemibono
- CO 45
- PR 1
- I-PR 2
- I-PR 3
- I-PR 96
Chaza Izincazelo Zokulungiswa
- CO Ukulungiswa kokusebenza
- Umthwalo wemfanelo we-PR
- Inani elinguDeductible
- 2 Inani lokuQinisekisa
- 3 I-Copay Inani
- Ukukhokhwa kwedlula imali yesimiso / isamba esiphezulu sokuvunyelwa noma sokwenziwa kwemithetho
- Amacala angekho embozwe ama-96
Ukuze kuchazwe ukunciphisa amaphesenti amabili kwi-ERA, ikhodi entsha yokulungisa isetshenziswa.
I-CO 253: Ukukhishwa kwezimali - ukunciphisa ukukhokha okusemthethweni.
Ngenxa yokuthi i-253 ihambisana ne-CO, isiguli asikwazi ukukhokhiswa lesi simali. Kuyinto yokubhalwa komhlinzeki. Lokhu ukunciphisa kuthinta kuphela umhlinzeki, yingakho ukunciphisa kubalwa emva kokuba umthwalo wesiguli uzimisele.
Isibonelo, esimangalisweni esikukhokhwa ngu-$ 50.00 kusuka ku-Medicare esikhathini esidlule manje sasizokhokha imali engu-$ 49.00 nge $ 1.00 eyabelwe i-CO 253 ukumele ukunciphisa amaphesenti amabili.
Ukuthinteka kwe-Medicare Ukunciphisa Ukunciphisa Ukwelashwa kwi-Medical Office
Ukuze uphathe kahle izici zezezimali zehhovisi lezokwelapha, kubalulekile ukubuyekeza imibiko yakho ukuze ubonise izinguquko ekubuyiselweni kwakho. Lokhu futhi kuphakamisa izinkinga zemikhuba eminingi engathinteka kabi yizicucu. Abanye odokotela banquma ukunciphisa inani labaguli abagulayo abaphatha noma abayeke ukwelapha iziguli ze-Medicare ngokuphelele. Ngeshwa, lokhu kudala inkinga yeziguli, ezinokuzikhethela ezimbalwa zokubhekana nezidingo zabo zokwelashwa zanamuhla nezesikhathi esizayo.
Ukufinyelela okuncane kweziguli ze-Medicare kusho ukuvakashelwa kwamagumbi okuphuthumayo, izibhedlela eziningi, nezindleko ezengeziwe ezikhiqizwa embonini efuna izindlela zokunciphisa izindleko.
Kunenye indlela yokuguqula iziguli zeMedare, eziningi zazo ezingaphezu kweminyaka engama-65 ubudala kanye / noma ezikhubazekile ngokomzimba noma ngokwengqondo. Abahlinzeki bezokwelapha bangakwazi ukuguqula lokho okulahlekelwa yi-Medicare futhi basebenzise amasu okuthuthukisa ukusebenza kwezezimali kwezinye izindawo.
Ukwenza amaphesenti amabili e-Medicare akweqiwe, indawo eyodwa ihhovisi lakho lezokwelapha lingagxila kulokhu ngokunikeza izaphulelo zokukhokha ngokushesha ukukhohlisa izinkampanini zomshuwalense wemoto, izinkampani zokukhokhela izinkampani kanye nokuzikhokhela iziguli ukuze ukhokhe ngokushesha. Ukunikeza izaphulelo zokukhokha okusheshayo kwenza ihhovisi lakho lezokwelapha lihlangabezane nezibopho zezezimali, ukwandise futhi ukhule futhi uthuthukise imisebenzi yakho yonke yokuthola imali.
> Umthombo:
> C MS.gov MLN ixhuma umhlinzeki eNews, 3 Mashi 2016.