Medicaid ndi pulogalamu ya chithandizo cha chitukuko cha anthu omwe amapereka inshuwalansi kwa anthu osauka ku United States. Kaya ndinu wolandira mankhwala kapena mukufuna kukhala amodzi, kumvetsetsa momwe Medicaid ikugwirira ntchito zingathandize kuti mupeze chithandizo chamankhwala chomwe mukusowa. Ngati simukuthandizidwa ndi Medicaid, komabe muyenera kusamalira odwala Medicaid, kumvetsetsa momwe Medicaid imagwirira ntchito kungakuthandizireni odwala anu zomwe akufunikira.
Mmene Medicaid Imagwirira Ntchito Malingaliro A Wolandira
Medicaid Eligibility
Kuvomereza kwa Medicaid kumakhala kopanda pang'onopang'ono kuchokera pa ndalama. M'madera ena, okhala ndi malipiro 138 peresenti ya umphawi wadziko lonse kapena ochepa adzayenerera ku Medicaid. Kuti mulandire Medicaid m'mayiko ena, muyenera kumakumana ndi zofunikira zochepa komanso kukhala membala wa gulu losatetezeka monga mwana, amayi oyembekezera, munthu wachikulire, munthu wolumala, munthu wakhungu, kapena kholo la wamng'ono mwana.
Kuonjezera apo, mayiko ena amafuna kuti mukhale ndi malangizo othandizira kuti mupeze Medicaid. Mwachitsanzo, ngakhale kuti ndinu munthu wokalamba wopeza ndalama, simungakwanitse kupita ku Medicaid ngati muli ndi $ 100,000 omwe mumakhala pa akaunti yopuma pantchito chifukwa katundu wanu ndi wamkulu kwambiri.
Ndizofala kuti zimakhala ndi njira zingapo zomwe munthu angayenere ku Medicaid. Mwachitsanzo, mukhoza kukhala ndi ndalama zosakwana 138% za FPL, pokhala ndi ndalama zochepa zopitirira 200% za FPL ndi kukhala ndi pakati, kapena kulandira Phindu la Supplemental Security.
Pali njira zingati zomwe zingayeneretse Medicaid ndi zofunikira zenizeni zoyenera zimasiyana kuchokera ku boma kupita kudziko.
Madalitso a Medicaid
Madalitso omwe mumalandira mukalandira Medicaid amasiyanasiyana kuchokera ku boma kupita kudziko komanso amasiyanasiyana kuchokera kwa munthu aliyense m'boma. Malamulo a boma amafuna kuti phindu linalake liperekedwe kwa anthu ena omwe ali pangozi m'mayiko onse.
Komabe, kupyola apo, akunena kuti amatha kusinthasintha pa zosankha zomwe amapereka kwa magulu a anthu.
Mwachitsanzo, boma lingapereke opindula onse omwe ali oyenerera ku Medicaid pansi pa njira imodzi yokha ndi madokotala ambiri a inshuwalansi. Ikhoza kupereka anthu omwe ali oyenerera pansi pa zifukwa zosiyana ndi zochepa chabe zomwe gulu loyamba linapeza.
Momwe mungapezere madalitso anu a Medicaid ngati ndinu wolandira Medicaid amasiyanasiyana kuchokera ku boma kupita ku boma komanso kudziko lililonse. Komabe, njira zingapo ndizofala.
- Ndalama-Kwa-Utumiki. Ngati madalitso anu a Medicaid akuperekedwa kudzera mu njira yowonjezera, mumasuka kukaonana ndi dokotala aliyense, chipatala, kapena wina aliyense amene angalandire ndalama za Medicaid. Wopereka aliyense adzalipidwa ndi Medicaid chifukwa cha ntchito yomwe iye amawamasulira nthawi iliyonse yomwe mukufunafuna chisamaliro.
- Kusamalira Kusamalidwa. Ngati madalitso anu a Medicaid akuperekedwa kudzera mu chisamaliro chowongolera monga HMO , mungathe kupeza chisamaliro kuchokera kwa opereka chithandizo mu malo ogwiritsira ntchito osamalira odwala . Kuonjezera apo, mungafunikire kupeza chithandizo cham'mbuyomu musanalandire mtundu wina wa chisamaliro, kapena mutumizidwe kuchokera kuchipatala chanu choyamba . Kaŵirikaŵiri, mapulogalamu a Medicaid amalandira mgwirizano ndi makampani a inshuwalansi apadera kuti athe kupereka chithandizo choyang'anira bwino. Mu mkhalidwe uno, mautumiki anu a Medicaid angaperekedwe kupyolera kapena kuperekedwa ndi kampani ya inshuwalansi yaumwini monga Blue Cross, UnitedHealthcare, Humana, kapena othandizira ena a zaumoyo.
Nthaŵi zina, simungakhale ndi mwayi wosankha ngati mungapeze ndondomeko yosamalidwa yosamaliridwa kapena ndondomeko yamagulu a ntchito yanu mukalembetsa ku Medicaid. Nthawi zina, mumatha kusankha pakati pawo pamene mwalembetsa. Kapena, mungaperekedwe ndi mtundu wosakanizidwa umene boma lanu limagwirizana ndi bungwe losamalira chisamaliro chotheka kuti lipereke madalitso ambiri a Medicaid, koma madalitso angapo a Medicaid amaperekedwa pamalipiro a ntchito. Mwachitsanzo, mwinamwake chithandizo chachipatala, chipatala, kuchipatala , ma laboratory, ndi ma x-rays amaperekedwa kudzera mu mgwirizano wodalirika, koma thandizo la zamalonda likhoza kuperekedwa pamalipiro a ntchito.
Njira iliyonse Medicaid ikugwiritsa ntchito kuti ikupindulitseni inu, pafupifupi onse omwe amapereka chithandizo chanu chaumoyo ndi madokotala, anamwino, zipatala, ndi zipatala m'dera lanu. N'zosakayikitsa kuti mukusamalira kuchipatala chomwecho kapena ku gulu limodzi la madokotala kuti ena omwe simukukhala nawo pafupi ndi Medicaid akugwiritsa ntchito, ngakhale kuti mwinamwake mumalipira zochepa pazinthu zomwe anzanu akulipira.
M'madera ena, mungafunikire kugula mozungulira kuti mupeze dokotala yemwe amalandira odwala atsopano a Medicaid kuti achite zomwe akuchita. M'madera ena, palibe vuto kupeza wopereka.
Mosiyana ndi inshuwalansi yaumwini yaumwini, ambiri opindula ndi Medicaid amalandira Medicaid popanda kulipiritsa malipiro pamwezi uliwonse. Momwemonso, chithandizo chamankhwala ambiri chimaperekedwa kwa opatsidwa mankhwala a Medicare popanda kulipira deductible , copay, kapena coinsurance kwa ntchito. Komabe, zigawo zina zikufufuza njira zowonetsera ndalama zothandizira ndalama zazinthu zina. Mwachitsanzo, boma lingapereke maofesi opanda chithandizo mwadzidzidzi pokhapokha ngati mwadzidzidzi, koma mukhoza kulipira ndalama zokwana madola 25 $ ngati kuyendera ER kunali chinachake chomwe chingawasamalire ku ofesi ya dokotala wanu m'malo mwake.
Kugwiritsa ntchito Medicaid
Mukhoza kugwiritsa ntchito Medicaid mwa njira ziwiri zosiyana.
- Lembani mwa kulankhulana ndi ofesi ya pulogalamu yanu ya Medicaid mwachindunji. Pezani mauthenga a adiresi ya pulogalamu yanu ya Medicaid kuchokera pa tsamba la Ma State Profiles la Medicaid.gov.
- Ikani mwa kudzaza pempho la inshuwalansi pamtundu wanu Wodalirika Care Act wathanzi inshuwalansi kuwombola . Ngati zikuwoneka ngati mutha kuyenera Medicaid, kusinthana kungagwiritse ntchito ntchito yanu ya Medicaid kapena kutumiza ntchito yanu ku pulogalamu ya Medicaid. Pankhaniyi, mudzapatsidwa malangizo owonjezera pa zomwe muyenera kuchita kuti mutsirize ntchito yanu ya Medicaid. Pezani inshuwalansi ya umoyo wanu wa boma kudzera mupeza pa Marketplace ku Healthcare.gov.
Mmene Medicaid Imagwirira Ntchito Chifukwa cha Utsogoleri
Medicaid ndi pulogalamu yowunikira boma ndi boma. Boma la federal limapanga malamulo omwe amapereka chilengedwe chonse chomwe mapulogalamu onse a Medicaid ayenera kutsatira. Dziko lililonse limapanga dongosolo la Medicaid pulogalamu ya federal.
Popeza malamulo a federal amalola pang'ono kupanga mapangidwe osinthika, mapulogalamu a Medicaid amasiyana kuchokera ku boma kupita kudziko. Mwachitsanzo, ngati munthu alandira Medicaid mu chikhalidwe chimodzi ndiye kuti asamuke, sangathe kukwaniritsa zovomerezeka mudziko lake latsopano. Ngati atakumana ndi vuto la Medicaid m'zochitika zake zatsopano, Medicaid imapindulapo komweko ingakhale yosiyana ndi zomwe analandira kale.
Ndalama za Medicaid
Medicaid imalipidwa ndi ndalama kuchokera ku boma la federal ndi boma la boma lililonse. Boma la federal limapereka ndalama zokwana 50-83 peresenti ya ndalama zomwe anthu oyenera kulandira. Izi zimapereka ndalama zotsala.
Anthu olemera omwe amakhala m'madera a dzikoli, pogwiritsa ntchito ndalama zowonjezera ndalama, amachepetsa kuchuluka kwa ndalama zoperekedwa ndi boma. Ndalama zina zonse zimachokera ku dziko lanu. Mukhoza kuona ndondomeko ya ndalama za pulogalamu ya Medicaid yanu kuchokera ku boma kuno.
Chodziwika kwambiri kwa 50-83% ulamuliro wa federal ndalama za Medicaid ndi kukula kwa Medicaid kotengedwa ndi Wopindulitsa Care Act. Boma la federal liyenera kupereka ndalama zokwana 90-100 peresenti ya kupereka Medicaid kwa iwo omwe akulandira Medicaid chifukwa cha kukula kwa ACA's Medicaid.
Medicaid ndi Affordable Care Act
Olemba a ACA pachiyambi ankafuna kuti mayiko onse apereke chithandizo cha Medicaid kwa anthu omwe ali ndi 138% ya FPL kapena zochepa. Komabe, chigamulo cha Supreme Court chinapanga mwayi wa Medicaid. Madera ena asankha kupititsa Medicaid monga poyamba analembedwera ndi olemba a ACA; mayiko ena asankha kusawonjezera Medicaid. M'mayiko omwe sanawonjezere Medicaid, zimakhala zovuta kuti apeze Medicaid ndipo chiwerengero chachikulu cha anthu opeza ndalama zochepa sichikulimbikitsidwa kuposa momwe adasinthira Medicaid.
Phunzirani zambiri zokhudza Medicaid
Medicaid ndi labyrinth yovuta, yosasintha yomwe maboma a boma ndi maboma amatsutsana ndi maboma am'deralo, malonda ogulitsa phindu, zopanda phindu, ndi anthu apadera. Medicare ndi Medicaid pamodzi amapereka madalitso kwa anthu oposa 100 miliyoni.