Kodi Malipiro Otani?
Osati dokotala aliyense amalandira Medicare . Ngakhale kwa iwo omwe amachita, iwo samasewera ndi malamulo omwewo. Izi zimaphatikizapo kuchuluka kwa zomwe angakulipire ntchito zawo. Kudziwa zomwe muyenera kuyang'ana pamene mukusankha dokotala kungakupulumutseni ndalama.
Madokotala Amene Amachokera ku Medicare
Choyamba choyamba, kodi dokotala wanu amatenga Medicare? Kuti muchite zimenezi, dokotala wanu amafunika kuti alowe mu Medicare.
Izi zikutanthauza kuti amavomereza kuvomereza Medicare monga inshuwalansi ndikuvomerezana ndi malamulo ogwiritsidwa ntchito ndi boma la federal.
Chifukwa cha kuchuluka kwa maofesi a boma ndi malamulo, madokotala ambiri akuchoka ku Medicare . Mu 2010, madokotala 130 okha adasankha kuchoka ku Medicare koma chiwerengerocho chinawonjezeka pang'onopang'ono chaka chilichonse, mpaka chinakwera kufika pa 7,400 mu 2016. Ngakhale kuti chiwerengero chinachepa kufika 3,732 mu 2017, izi sizingakhale zowerengera zolondola. Pomwepo adakhalapo dokotala woti atuluke zaka ziwiri zonse. Kuyambira mu 2015, pempho lakutuluka likhoza kukhala kwamuyaya. Izi zikanakhudza chiwerengero cha mauthenga otuluka mu 2017.
Ngati dokotala sakhoza kulandira Medicare kuti akulipire, ndiye kuti mungakhale ndi vuto. Ngati vuto lachidziwitso lachidziwitso, akuyenera kukuchitirani. Kunja kwa izo, mudzayembekezere kulipira ntchito zake kunja kwa thumba. Izi zingatenge mtengo mwamsanga.
N'zachiwonekere kuti mukufuna kusankha dokotala yemwe amapita ku Medicare. Izi sizingatheke nthawi zonse ngati pali dokotala m'dera lanu.
Madokotala Amene Amalowetsamo ndipo Amavomereza Pulogalamu ya Malipiro a Medicare
Kugwiritsa ntchito dokotala yemwe amavomereza inshuwalansi kukupulumutsani ndalama koma mungatani kuti muwonjezere ndalamazo?
Madokotala omwe amalandira Medicare kulipira amalowa m'magulu awiri. Amene "amavomereza ntchito" ndi iwo omwe sachita.
Chaka chilichonse, Centers for Medicare ndi Medicaid (CMS) amapereka ndondomeko ya madokotala. Madokotala omwe amavomereza ndondomeko imeneyi "avomereze ntchito" ndipo akutchedwa opereka gawo. Amavomereza kuti asakulipire ndalama zambiri kuposa ndalama zomwe analangizidwa pa utumiki uliwonse. Mayesero olimbitsa thupi ali omasuka kwa inu pamene akulamulidwa ndi wopereka gawo.
Madokotala Amene Amalowa-Ndiponso Akukulemberani Zambiri
Madokotala omwe salandira ntchito, komano, amakhulupirira kuti ntchito zawo ndi zofunika kwambiri kuposa zomwe madokotala amalephera kuchita. Omwe osapereka nawo gawoli adzakulipirani kuposa madokotala ena.
Medicare yaika malire pa madokotala omwe angakhoze kulipira. Ndalamayi imadziwika ngati kuchepetsa malipiro. Pakali pano, malipiro amalembedwa pa 15 peresenti. Madokotala omwe amapereka malipiro oposa malipiro angathe kuchotsedwa pulogalamu ya Medicare.
Mwachitsanzo, ngati ndondomeko ya msonkho ikulemba ndalama zokwana madola 100, dokotala akhoza kukulipirani ndalama zokwana $ 115 madola. Medicare amapereka ndalama zokwana $ 100 gawo la ndalamazo ndipo dokotala adzakulipiritsani nokha $ 15.
N'zomvetsa chisoni kuti kuchepetsa malipiro okhawo kumapereka kwa othandizira zaumoyo. Osagwira nawo ntchito zothandizira zamankhwala , kutanthauza kuti "savomereza ntchito" kapena kuvomereza ndondomeko ya malipiro, akhoza kukulipirani monga momwe akufunira. Izi ndizo ngakhale adokotala amene atumizira kuti zipangizozo zinalandira ntchito. Ndibwino kuti mugulitse makampani opereka mankhwala omwe amapereka ndalama zabwino komanso ntchito yamakasitomala.
Zothandizira Madokotala
Ndi chiyani chomwe chimaletsa onse a Medicare providers kuti asatenge nawo mbali? Kodi malipiro ochepawo sangayambe kuwathandiza kupeza ndalama zambiri? Yankho ndi lophweka. Madokotala amalimbikitsidwa ndi Medicare kuti athe kutenga nawo gawo pa ndandanda ya malipiro.
Medicare idzapereka maperesenti 100 peresenti ya msonkho wokonzedweratu kuchuluka kwa opereka nawo gawo koma 95 okha peresenti kwa osapereka nawo mbali. Mwachidule, pa ndalama zonse za madola 100, wopereka osagwira ntchito adzataya $ 5 kuchokera ku Medicare.
Ngakhale adokotala akanakhoza kulipira $ 15 powonjezera ndalama, izi zingakhale ndalama zokwana madola 10. Dokotala ayenera kuyembekezera ngati odwala ake kapena odwala ake angathe kulipira mtengo wowonjezera kapena ngati ndalama zambiri zikhoza kutayika muzokwanira ngongole ndi ndalama zosonkhanitsira.
Zopindulitsa zina kwa opereka nawo mbali ndi awa:
- Kuwonetsetsa kwapadera kwaulere. Ngakhale dokotala akulipira malipiro kuchokera kwa Medicare kuti asamalire, odwala a Medicare samalipiritsa ndalama zonse.
- Kuthamanga msanga kwa madandaulo a Medicare. Boma limatchuka ndi nthawi yowonongeka. Kulipira kubwezera kulipindulitsa kwambiri ku ofesi iliyonse ya zamankhwala.
- Mankhwala a Medicare. Medicare imalimbikitsa anthu omwe amapereka nawo mbali ku mabungwe akuluakulu ndi aliyense amene akufunsira.
Mudzalipiritsa Zambirimbiri
Mayesero ena owonetsetsa ndiwopanda kwa inu mukalandira chisamaliro kupyolera mwa wopereka gawo. Nthawi yonseyi, Medicare amalipira 80 peresenti ya mtengo wotsimikiziridwa ndipo mumalipira ndalama zokwana 20 peresenti .
Ogwira nawo mbali | Omwe Osapereka Ogwirapo | |
| Ndondomeko ya Malipiro a Madokotala | $ 100 | $ 100 |
Kulepheretsa Kulipira | N / A | $ 15 (pafupifupi 15 peresenti) |
| Momwe Dokotala Angalimbikitsire | $ 100 | $ 115 |
| Kodi Mankhwala Ambiri Amatha Bwanji? | $ 80 (80 peresenti yolipirira malipiro a Medicare) | $ 76 (95 peresenti ya 80 peresenti yolipira malipiro a Medicare) |
| Mudzalipiritsa Zambirimbiri | $ 20 (20 peresenti coinsurance) | $ 34 ($ 19 peresenti yanu ya 20 peresenti coinsurance] + $ 15 kuchepetsa malipiro) |
Kumvetsa momwe dongosololi likugwirira ntchito kudzakuthandizani kuti muzigwiritsa ntchito bwino ndalama zanu. Gome pamwambapa likuwonetsa kuwonongeka kwa ndalama ngati mutalandira ndalama zokwana $ 100 kuchokera kwa wopereka nawo gawo komanso osalandira nawo mbali.
Mawu ochokera
Thandizo la zaumoyo ndi lamtengo wapatali popanda kukhala ndi nkhawa ndi dokotala wanu akukugulitsani kwambiri. Mapulogalamu omwe mumalandira kuchokera kwa dokotala aliyense mu pulogalamu ya Medicare ndi ofanana koma muli ndi ubwino wopezera chisamaliro chaulere ndipo mukhoza kulipira zochepa pazinthu zina zanu ngati mutasankha munthu yemwe "amavomereza ntchito". Pezani wothandizira odwala Medicare ndipo muwathandize.
Chitsime:
Boccuti, C. Kukaona Ulendo kwa Dokotala: Kutetezedwa Kwambiri kwa Ndalama kwa Odwala Odwala Pamene Akulandira Mapatala. Henry J. Kaiser Family Foundation. http://kff.org/medicare/issue-brief/paying-a-visit-to-the-doctor-current-financial-protections-for-medicare-patients-when-receiving-physician-services/. Lofalitsidwa pa April 7, 2014.
> Dickinson V. Zochepa Madokotala Akuchoka ku Medicare. Zaumoyo Zamakono. http://www.modernhealthcare.com/article/20180130/NEWS/180139995. Idasindikizidwa pa January 30, 2018.
Medicare.gov. Ndalama zotsika mtengo ndi Ogawa t. http://www.medicare.gov/your-medicare-costs/part-a-costs/assignment/costs-and-assignment.html.