Lapho I-Medicare Ihamba Ngesikhathi, Ayinakekeli
Ungathemba ukuthi ukugula ngokwanele ukuhlala esibhedlela ubusuku bonke bekuyokwanela ukuthola iMedricare ikhokhele ingxenye yabo enhle. Okuhle emehlweni akho futhi emehlweni kaMediare, noma kunjalo, kungaba okuhluke kakhulu.
Njengoba i- Medicare ilindeleke ukuthi ilahlekelwe yimali ngo-2030 , ekuqaleni uma i-GOP ilawula ukudlulisa umthetho wabo wokukhokha intela, uhlelo luhlose ukunciphisa izindleko noma ngabe kunini.
Kwenza lokhu ngokuqeda izindleko ezithile kuwe. Imithetho elandelayo ibalulekile ukuthi uyiqonde, ikakhulukazi njengoba isekelwe kakhulu uma izinto zenzeka kunezempilo yakho.
Imithetho emibili-phakathi kwamabili
Ngaphambi kokubusa kukaMbili-Midnight , ukuhlala esibhedlela kwakusekelwe esibhedlela. Mane nje, uma unesifo esingathí sina, wamukelwa njengesiguli ngoba isibhedlela sasiyindawo efanelekile yokuthola lokho kunakekelwa; okungukuthi ukuhlolwa nezinqubo azikwazanga ukusebenza kahle ehhovisi likadokotela, umnyango wesibhedlela ongapheli, ekhaya lakho, noma ngisho nasesikhungweni sobuhlengikazi abanekhono.
Konke kwashintsha ngo-2013 lapho kuvela uMthetho Wezimbili-Midnight. Manje, akudingeki nje kuphela ukuthi unesizathu esivumelekile sezokwelapha sokungeniswa njengesiguli, kodwa ukuhlala esibhedlela kufanele kulindeleke ukuthi usebenzise izigaba ezimbili:
Ukuhlala esibhedlela kusukela ngo-11: 9 ekuseni ngoJanuwari 23 kuya ku-12: 00 ekuseni ngoJanuwari 25 (amahora angu-24, 1 iminithi) kubalwa okufana neyodwa kusukela ngo-12: 00 ekuseni ngoJanuwari 23 kuya ku-12: 00 AM NgoJanuwari 25 (amahora angu-48). Zombili zihlala isikhathi eside.
I-Medicare isekelwe ngokusemthethweni ukubaluleka kokuphakathi kunokuba ngesikhathi sangempela umuntu ahlala esibhedlela. Lokhu akukwenzi kube kuhle kwabazuzi, futhi ngenxa yalesi sizathu, abantu abaningi ngisho nezibhedlela baye bathatha isinyathelo ngokumelene nohulumeni ezinkantolo.
Okukukhathazayo: Uma ungavunyelwanga njengesiguli, ufakwa ngaphansi kokubheka.
Isikhathi sokuhlala esibhedlela singakhokhiswa ku- Medicare Part A , kanti ukuhlala kokubuka kubhalwa ku- Medicare Part B. Ingxenye A amacala akhokhelwa owodwa ukuhlala kwakho konke, $ 1,316 ngo-2017, ngaphezu kwamaphesenti angu-20 azo zonke izimali zodokotela. Ingxenye B, noma kunjalo, ukukhokhisa amaphesenti angu-20 enkonzweni ngayinye etholakele, kuhlanganise nemali yokudokotela . Nakuba isibhedlela singavunyelwe ukukukhokhisa ngaphezu kwenani le-Part A elingenayo imali ekhokhelwa yimuphi umsebenzi owodwa, izindleko zengeza ngokushesha. Ngokuvamile, ukuhlala okubonwayo kuvame ukubiza okungaphezu kokungenwa kwesiguli isikhathi esifanayo, noma ngabe uthola izinsizakalo ezifanayo.
Isikhungo Sokuhlengikaza Esikwazi Ukuhlinzeka Ngosizo Lwezinsuku ezintathu
Abantu bangadinga ukunakekelwa abanolwazi emva kokubhedlela esibhedlela . Kungase kungadingeki ukuthi izinga eliphezulu lokunakekelwa esibhedlela linikeza, kodwa kungase kube ngokomzimba ukubuyela ekhaya. Bangase badinge ukunakekelwa okungeziwe, ukuqapha okusheshayo, nezinsizakalo ezivamile, njengokwelashwa ngokomzimba nokusebenza . Ukuhlala esikhungweni sokuhlengikaza abanekhono (SNF) noma isikhungo sokuvuselela isimo singaba kufanele kulezi zimo.
Ukufaneleka kokungenwa kweziguli, kodwa, akusho ukuthi ufanelekile ukuthola ukunakekelwa kokuvuselelwa ngemuva kokuhlala esibhedlela.
Konke kuya kweSNF yezinsuku ezintathu.
Umthetho uthi udinga ukuvunyelwa ukuthi unesifo sengqondo esibhedlela izinsuku ezintathu ezilandelanayo ukuze ufanele ukuhlala endaweni yokuhlengikaza enekhono. Ngeshwa, usuku oluthunyelwa ngalo kusikhungo alubala. Empeleni, udinga ukuhlukaniswa njengesifo sofuba izinsuku ezine:
Uma ngabe ubeke ngaphansi kokubukwa ngosuku lwakho lokuqala, lolo suku ngeke lubale ngokuqondene nesidingo sakho sezinsuku ezintathu.
Khumbula ukuthi i-Medicare ayivumeli udokotela wakho noma isibhedlela ukuba sishintshe ngokuzenzakalelayo ama-oda. Ngisho noma ukuhlala esibhedlela sekude kunama-midnights amabili, lezo zinsuku azikwazi ukuguqula isimo sesiguli ngemuva kweqiniso.
Lokhu kusho ukuthi uzodinga ukuhlala esibhedlela isikhathi eside ukuze ufanelekele ukunakekelwa kwezingane ekhaya.
Okukukhathazayo: Uma uhlangabezana noMthetho Wezinsuku ezintathu we-SNF, i-Medicare Part A izofaka zonke izindleko zesikhungo sakho sokunakekela abanekhono zihlale izinsuku ezingu-20. Uzokhokha ikhodi ye-$ 164.50 ngosuku ngosuku lwango-2017 izinsuku ezingu-21 kuya ku-100. Ngemva kwalokho, uwedwa. Uma ungavunyelwanga njengesiguli izinsuku ezintathu ezilandelanayo, noma kunjalo, zonke izindleko zokuvuselela zizokhokhwa kuwe ngqo. Uma kunjalo, noma i-Medicare Part A noma ingxenye B ngeke ihlanganise lezi zinsizakalo.
Ukungahambisani nemithethonqubo yeMedare
Imithetho ishintsha kancane uma uhlinzwa. Izinqubo ezithile zisohlwini olulodwa lwezokwelapha, okusho ukuthi amaCenter for Medicare and Medicaid Services (CMS) aqaphela ukubunzima kwezihlinzeko ezithile futhi avumele ngokuzenzakalelayo ukuba bangenwe iziguli. Imithetho emibili-phakathi kwamabili ayisasebenza kulokhu:
Uma ufakwe kwi-Medicare Shared Savings Program, ungase ufanelekele ukukhishwa kwi-SNF-Day Rule.
Ukunciphisa lokhu okungekho, iMederal Medicare (Ingxenye A neNgxenye B) inamathela eMbusweni wama-Two-Midnight kanye noMthetho Wezinsuku Ezintathu Wokugula. Ngakolunye uhlangothi, ama- Medicare Advantage (Ingxenye C) , anganikeza ukuguquguquka okukhulu. Lokho kungaba yinto enhle neyimbi.
Okuhle: Uhlelo lwe-Medicare Benevantage lungakhetha ukubeka umthetho we-SNF wezinsuku ezintathu. Kungakhathaliseki ubude bokuhlala esibhedlela, ungakwazi ukuthola ukunakekelwa kokuvuselelwa okudingayo.
Okubi: Imishanguzo ye-Medicare Advantage ingakwazi ukuphuma ekuhlinzekeni ohlwini lwabagulayo kuphela, okusho ukuthi akudingeki ukuba bavume ukuhlinzekwa kweziguli. Babekwazi ukuyikhokhela njengendlela yokuphulukisa iziguli. Lokhu kungaholela ekuhlinzekeni okunye okukukhokhela kakhulu ekukhokheni kwezindleko.
I-Ugly: Ngokuvamile, izinhlelo ze-Medicare Advantage zilandela uMthetho Wezimbili-Midnight.
Izwi elivela
Isikhathi yisikhathi. I-Medicare inquma ukuthi ingakanani Ingxenye A ezokhokha ngokubeka imingcele yesikhathi ekunakekeleni kwakho. Imithetho emibili-phakathi kwamabili kanye ne-SNF-Day Rule Rule ithambekele ekunakekelweni kwe-Medicare Part B, lapho uvame ukukhokhela okuningi ngaphandle kwephaketheni lezinsizakalo ezifanayo. Ngeshwa, ungathola kunzima ukuthola ukunakekelwa okudingayo ngentengo oyifanele.
> Imithombo:
> Christina Alexander, et al., Abaphikisi, vs. Thomas E. Inani, uNobhala WezeMpilo Nezinsizakalo Zabantu, uMshushisi . Inkantolo yesifunda sase-United States, District of Connecticut. http://www.medicareadvocacy.org/wp-content/uploads/2017/08/Order-on-Class-Certification.pdf. Ishicilelwe ngoJulayi 31, 2017.
> Inqubomgomo Yempilo Ngokufushane: Imithetho Ebili-Midnight. Ezempilo , ngoJanuwari 22, 2015. http://www.healthaffairs.org/do/10.1377/hpb20150122.963736/full/.
> Ukwelashwa Kwemithi Yokunakekelwa Kwabahlengikazi Abaqeqeshiwe . Amasevisi we-Medicare neMediicaid Services. https://www.medicare.gov/Pubs/pdf/10153.pdf. Ibuyekezwe ngoJanuwari 2015.
> Ubuhlengikazi Abaqeqeshiwe Ukukhishwa Kwemigomo Emalanga amathathu. Amasevisi we-Medicare neMediicaid Services. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/Downloads/SNF-Waiver-Guidance.pdf. Kushicilelwe ngo-Agasti 2017.