Iyini Inkokhelo Elinganiselwe?
Akuwona wonke udokotela owamukela i- Medicare . Ngisho nalabo abenzayo, akuzona zonke ukudlala ngemithetho efanayo. Lokho kufaka phakathi ukuthi bazokukhokhela kangakanani izinsizakalo zabo. Ukwazi ukuthi ungabheka nini uma ukhetha udokotela wakho angakugcina imali.
Odokotela Abakhetha Ukuphuma KweMithi
Izinto zokuqala kuqala, ingabe udokotela wakho uthatha i-Medicare? Ukuze wenze kanjalo, udokotela wakho udinga ukungena ngemvume ku-Medicare.
Lokhu kusho ukuthi uyavuma ukwamukela i-Medicare njengomshuwalense wakho futhi uyavumelana nemigomo yesevisi ebekwe uhulumeni wesifundazwe.
Ngenxa yokwenyuka kwama-bureaucracy kanye nezidingo zokuphatha, odokotela abengeziwe bayaphuma e-Medicare . Ngonyaka ka-2010, odokotela abangu-130 kuphela abakhetha ukuphuma eMedare kodwa isibalo sanyuka kancane kancane ngonyaka, kwaze kwafika ukuphakama kuka-7 400 ngo-2016. Nakuba le nombolo yehle yaba ngu-3,732 ngo-2017, lokhu kungase kungabi isilinganiso esilungile. Kwakukhona njalo ukuthi udokotela kwakudingeka aphume-ke njalo eminyakeni emibili. Kusukela ngo-2015, isicelo sokuphuma singapheli kuze kube phakade. Lokhu kungahle kuthinte inani lezincwadi ezifakiwe zokuphuma ezibalwe ngo-2017.
Uma udokotela wakho engamukeli i-Medicare ngenkokhelo, khona-ke ungase ube enkingeni. Endabeni yokuphuthumayo yezokwelapha yangempela, unesibopho sokukuphatha. Ngaphandle kwalokho, kulindeleke ukuthi ukhokhele izinsizakalo zakhe ephaketheni. Lokhu kungadla ngokushesha.
Kusobala ukuthi kunesithakazelo sakho ukukhetha udokotela ovula i-Medicare. Lokho kungase kungabi njalo uma kunesidingo sokudokotela endaweni yakho.
Odokotela Abakhetha Ukungena Futhi Bavumelane Nesikhathi Sokukhokhelwa Kwemithi Ye-Medicare
Ukusebenzisa udokotela owamukela umshuwalense wakho uzakusindisa imali kodwa ungakwandisa kanjani imali leyo?
Odokotela abamukela i-Medicare ngenkokhelo baba ngezigaba ezimbili. Labo 'abamukela isabelo' nalabo abangenalo.
Njalo ngonyaka, amaCenter for Medicare and Medicaid (CMS) ahlinzekela uhlelo lokukhokhelwa kwemithi odokotela. Odokotela abamukela le simiso lemali "bamukela isabelo" futhi babizwa ngokuthi abahlinzeki abahlanganyele. Bavuma ukuthi bangakhokhisi ngaphezu kwenani eliphakanyisiwe kunoma iyiphi insizakalo enikeziwe. Izivivinyo zokuzivivinya ezivimbelayo zikhululekile kuwe uma ziyalwe ngumhlinzeki obambe iqhaza.
Odokotela Abakhetha Ukungena Nokukukhokhela Okuningi
Odokotela abangamkeli isabelo, ngakolunye uhlangothi, bakholelwa ukuthi izinsizakalo zabo zibaluleke kakhulu kunalokho okushiwo isimiso semali yesidingo. Laba bahlinzeki abangabambi iqhaza bayokukhokhisa ngaphezu kwamanye odokotela.
I-Medicare ibeke umkhawulo wokuthi bangaki labo odokotela abangakhokhisa. Leli nani liyaziwa ngokuthi likhawulo elikhawulelwe. Ngesikhathi samanje, ukukhokha okukhawulelwe kusethwe ngamaphesenti angu-15. Odokotela abakhokhisa ngaphezu kwecala elikhawulayo bangase basuswe ohlelweni lwe-Medicare.
Isibonelo, uma isimiso semali sibhala insizakalo ye $ 100, udokotela angakukhokhela kuze kube ngu-US $ 115. I-Medicare izokhokhela ingxenye engu-$ 100 yalowo mthethosivivinywa futhi udokotela uzokukhokhela ngokwehlukana u-$ 15.
Ngokudabukisayo, ukukhokhiswa kwemali kuphela kunweba abahlinzeki bezempilo. Abahlinzeki abangabambi iqhaza bemishini yezokwelapha , okusho ukuthi 'abamukeli isabelo' noma bayavumelana nesimiso semali, bangakukhokhisa ngangokunokwenzeka. Yilokho okwenzekayo ngisho noma udokotela owathi leyo mishini yamukele isabelo. Kuyinto enhle kakhulu ukuthenga ezungeze izinkampani zokuhlinzeka ngezokwelapha ezinikeza izindleko ezingcono kanye namakhasimende.
Izikhuthazo zoDokotela
Yini okumisa bonke abahlinzeki bakwaMedare ukuba bangahlanganyeli? Ingabe ukukhokha okukhawulelwe kungabasize benze imali eyengeziwe? Impendulo ilula. Odokotela bakhuthazwa yi-Medicare ukuba bahlanganyele esimisweni semali.
I-Medicare izofaka amaphesenti angu-100 emali yokunconywa kwemali yokunconywa yabahlinzeki abathintekayo kodwa amaphesenti angu-95 kuphela kwabanikeli abangabambi iqhaza. Kulula, kuzo zonke izinsizakalo zezinkulungwane ezingu-100, umhlinzeki ongenzi iqhaza uzolahlekelwa yi- $ 5 evela ku-Medicare.
Nakuba udokotela angakwazi ukukhokhela imali engu-R15 ngaphezulu ngokukhokhiswa okukukhawulelwe, lokhu kungcono kube yinzuzo ye-$ 10. Udokotela kufanele ahlole ukuthi ngabe isiguli sakhe singakwazi yini ukukhokhela izindleko ezengeziwe noma cha uma imali eningi ingase ilahleke ezinkokheni ezimbi nakwezindleko zokuqoqa.
Ezinye izinzuzo zabahlinzeki abathintekayo zihlanganisa:
- Ukuhlolwa kokuvikela okumahhala. Ngenkathi udokotela eqhubeka ehola imali evela kuMedare ngenxa yokunakekelwa kwakhe, abahlomuli beMedare abakhokha izindleko zezimpahla.
- Ukucubungula okusheshayo kwezimangalo ze-Medicare. Uhulumeni uhlonishwa ngezikhathi zokuphendula kancane. Ukubuyisela ukubuyisela imali kuyisibonelelo esibalulekile kunoma yiliphi ihhovisi lezokwelapha.
- Imibhalo ye-Medicare. I-Medicare ikhuthaza abahlinzeki abahlanganyelayo ezinhlanganweni eziphezulu nakumuntu ocela isiqondisi sabo.
Ungakanani Okuyokhokha
Ezinye izivivinyo zokuhlola zokuvikela zikhululekile kuwe uma uthola ukunakekelwa ngokusebenzisa umhlinzeki obambe iqhaza. Esikhathini sonke isikhathi, i-Medicare ikhokhela amaphesenti angu-80 wezindleko eziphakanyisiwe futhi ukhokhela u- 20% wemali yokuqinisekisa .
Abahlinzeki abathintekayo | Abahlinzeki abangabandakanyeki | |
| Isamba Isamba Semali | $ 100 | $ 100 |
Ukukhokha okulinganiselwe | N / A | US $ 15 (amaphesenti angu-15 angaphezulu) |
| Yeka ukuthi udokotela angakwazi ukukhokha kangakanani | $ 100 | US $ 115 |
| Yeka ukuthi ukwelashwa okuningi kangakanani | U- $ 80 (Amaphesenti angama-80 okukhokhelwa kwemithi ejwayelekile) | $ 76 (Amaphesenti angama-95 emaphesenti angama-80 okukhokhelwa kwemithi ejwayelekile) |
| Ungakanani Okuyokhokha | $ 20 (Imali engama-20% | $ 34 ($ 19 [amaphesenti angu-95 we-standard yakho ye-20% ye-coinsurance] + $ 15 yokukhokha imali) |
Ukuqonda ukuthi uhlelo lusebenza kanjani kuzokusiza ukuthi usebenzise kakhulu amadola akho. Ithebula elingenhla liveza ukuphazamiseka kwezindleko uma uthola insizakalo efanayo ye-$ 100 evela kumhlinzeki ohlanganyela futhi ongabambe iqhaza.
Izwi kusuka
Ukunakekelwa kwezempilo kuyabiza ngokwanele ngaphandle kokukhathazeka ngodokotela wakho ekushaja okuningi. Izinsizakalo ozitholayo kunoma yimuphi udokotela ohlelweni lweMederalare ziyafana kodwa unenzuzo yokuthola ukunakekelwa kokuvikela okukhululekile futhi ungakhokhiswa kancane kwezinye izinsizakalo zakho uma ukhetha owodwa "owamukela isabelo". Thola umhlinzeki we-Medicare obambe iqhaza futhi uvune izinzuzo.
Umthombo:
UBoccuti, C. Ukukhokhela Ukuvakashela Udokotela: Ukuvikelwa Kwamanje Kwezezimali Zamagciwane We-Medicare Lapho Uthola Izinsizakalo Zikadokotela. I-Henry J. Kaiser Family Foundation. http://kff.org/medicare/issue-brief/paying-a-visit-to-the-doctor-current-financial-protections-for-medicare-patients-when-ceiceiving-physician-services/. Kushicilelwe ngo-Ephreli 7, 2014.
> UDickinson V. Abadokotela abambalwa abaphuma ku-Medicare. Ukunakekelwa kwempilo yanamuhla. http://www.modernhealthcare.com/article/20180130/NEWS/180139995. Ishicilelwe ngo-January 30, 2018.
Medicare.gov. Izindleko Eziphansi Ngezithunywa Zomsebenzi t. http://www.medicare.gov/your-medicare-costs/part-a-costs/assignment/costs-and-assignment.html.