Nthawi Itatha
Anthu ambiri amalipira chisamaliro chawo. Zomwe amapereka zimadalira dongosolo la thanzi limene amagwiritsa ntchito.
Kaya wina ali pa Medicare , ndondomeko ya Health Insurance Marketplace, inshuwalansi yogulitsidwa ndi abwana, kapena ndondomeko ina ya inshuwaransi yapadera idzayenera kulipira malipiro pamwezi kuti agwiritse ntchito ndondomekoyi. Iwo adzaperekanso ndalama zopereka ndalama komanso ndalama zothandizira ntchito zomwe amalandira.
Medicaid , komabe, amagwira ntchito mosiyana. Malingana ndi boma, misonkhano ya Medicaid ikhoza kukhala yaufulu kwa anthu ena. Zina koma sizinthu zonse zidzafuna malipiro; zina zidzafuna mapepala. Madera ena atha kuyambitsa zofunikira za ntchito kuti adziwe zoyenera. Cholinga cha Medicaid chatsopano ndicho kuwonjezera malire a pulogalamuyo.
Mosasamala kanthu ka dongosolo la thanzi la ntchito, zingakhale zochititsa mantha kuti aphunzire kuti, ngakhale wina atapereka gawo lawo, phindu lawo likhoza kuchotsedwa patapita nthawi, mosasamala kanthu za thanzi kapena zosowa. Ngati malingaliro a Medicaid akudutsamo, zikhoza kutsatira mzere wautali wamasiku onse a moyo omwe adaikidwa ndi a inshuwalansi akale.
Zolekezera za Moyo pa Inshuwalansi Yokha
Asanayambe kuchitapo kanthu ku ACA , 2010, makampani a inshuwalansi okhaokha anali ndi mwayi wowonjezera malire awo.
Osati kokha a inshuwalansi adaonjezera mtengo wa malipiro kwa anthu omwe analipo kale , iwo anasiya kulipira chisamaliro atatha ndalama zina.
Kaya panali malire pachaka kapena nthawi ya moyo (kuchuluka kwa munthu amene analembera ndondomeko) yongoganizira momwe inshuwalansi idzalipirire, opindula adzagwiritsidwa ntchito ndi ndalama zonse zotsalira mutatha malirewo.
Mwamwayi, ACA inachotsa osati pokhapokha pokhazikisting zochitika koma pachaka komanso moyo nthawi, makamaka pankhani zothandiza zaumoyo opindulitsa .
Anthu odwala kwambiri sakanakhalanso opanda chithandizo chamankhwala pamene amafunikira kwambiri.
Zolekezera za moyo pa Medicare
Medicare ndi pulogalamu ya federal yomwe imasamalira okalamba komanso / kapena omwe ali ndi zolemala. Gawo A , limodzi mwa magawo anayi a Medicare, limapereka chithandizo cha matenda opatsirana kuchipatala , kukhala kwa kanthawi kochepa kumamwino osungirako ana , ndi hospice .
Ngakhale kuti anthu ambiri salipira malipiro a gawo la A , izi sizikutanthauza kuti ndiufulu. Zowonongeka ndi ndalama zothandizira ndalama ziyenera kulipidwa pa mautumiki omwe amaperekedwa nthawi iliyonse yopindula. Palinso masiku osungirako moyo kuti aganizire.
Gawo A limaphatikizapo masiku 90 kuchipatala nthawi iliyonse yopindula. Pambuyo polipira deductible, masiku 60 oyambirira ndi ufulu kwa wopindula. Mu 2018, masiku 61 mpaka 90 adzafuna ndalama zokwana madola 335 pa tsiku. Pambuyo pa masiku 90, wopindulayo adzalipiritsa ndalama zonse kuchokera m'thumba kapena ayi kulowa mu masiku awo osungirako moyo. Ine ndikutero, iwo adzalipira madola 670 pa tsiku pa tsiku lirilonse la kusungirako moyo. Munthu aliyense ali ndi masiku 60 omwe angagwiritse ntchito pa moyo wawo wonse.
Malo osungira moyo nthawi zonse angagwiritsidwe ntchito mu chipatala chimodzi chokhalapo kapena kudutsa maulendo ambiri. Zimadalira zosowa za munthu aliyense.
Mipingo ya moyo wa Medicaid
Medicaid imathandizidwa pamodzi ndi mabungwe a federal ndi boma koma akuthamangitsidwa ndi mayiko.
Ngakhale boma la federal likuika miyezo yochepa ya kulumikizidwa kwa Medicaid, boma lirilonse lingathe kusinthana kusintha kwa miyezo imeneyi kupyolera mu 1115 kuchoka kwa Medicaid .
Mpaka pano, Indiana ndi Kentucky akhala akugonjetsedwa ndi boma la federal kuti likhale ndi ntchito zofunikira kuti Medicaid ikhale yoyenera. Lingaliro ndilokuti "anthu amphamvu" ayenera kulimbikitsidwa kugwira ntchito. Kuchita zimenezi kungapangitse zovuta kuti athe kupeza malingaliro ogwiritsidwa ntchito ndi abwana, mmalo mwa kudalira Medicaid. Ena asanu ndi atatu akunena, kuphatikizapo Arizona ndi Maine, ali ndi ntchito zofunikira zomwe zikuyembekezeredwa.
Tsopano, zisanu zikufotokozera zomwe zimafunikira moyo phindu.
Ana, amayi apakati ndi anthu olemala sangakhale ndi malire a malire. Ndipotu, zikuwoneka kuti "anthu onse" a ku America akukakamizidwa ndi zomwe zimachitika pa nthawi ya moyo.
Arizona ndi Maine adalumikiza malire awo a moyo wawo kuntchito zofunikira. Nthawi imangoyamba kugwedeza pamene anthu sakukwaniritsa zofunikira za ntchito pa chikhalidwe chimenecho. Kansas, Utah, ndi Wisconsin akutsata miyeso ya moyo kwa ana opanda akulu omwe alibe kapena sakukwaniritsa ntchito. Mwachidziwitso, ambiri achikulire opanda ana adangokhalira kulandira pulogalamuyi atatha kuwonjezereka kwa Medicaid.
| State | Zofuna za Ntchito | Nthawi |
| Arizona | Inde | Zaka zisanu |
| Kansas | Ayi | Miyezi 36 |
| Maine | Inde | Miyezi 36 * |
| Utah | Ayi | Zaka zisanu |
| Wisconsin | Ayi | Miyezi 48 |
* Maine akufuna kuchepetsa kufalitsa kwa miyezi itatu yokha pa nthawi ya miyezi 36.
Zomwe zadandaula zakhala zikukhudzidwa pazinthu izi.
Poyamba, sikuti onse olemba malipiro ochepa amapereka chithandizo chamankhwala. Ngakhale munthu atakwaniritsa zofunikira za ntchito, sangakhale ndi mwayi wodalirika. Miyeso ya moyo idzawombera anthu pogwiritsa ntchito ndondomeko za abwana awo, zomwe sizingatheke.
Ena amanena kuti Medicaid cholinga chake ndi kukhala otetezeka, osati pulogalamu ya chithandizo. Anthu omwe ali odwala ndi ovuta akhoza kutenga chithandizo cha inshuwalansi ngati akufunikira kwambiri. Zimakhala vuto labwino.
Mawu Ochokera
Mu 2010, ACA inasiya makampani oyimilira okhaokha kuti asawononge malire awo pa moyo wawo, ngakhale kuti angapereke malire pazinthu zina. Medicare amaletsa zaka zingati zachipatala zomwe zidzakumbidwa. Tsopano Medicaid ikhoza kuyitanitsa malire a moyo, nayonso. Amuna asanu adapereka maofesi 1115 kuti apemphe kusintha kwa mapulogalamu awo a Medicaid. Kaya zikugwirizana ndi zofuna za ntchito kapena kukulitsa kwa Medicaid, anthu posachedwa adzayang'aniridwa ndi kuchepa kwa chithandizo chamankhwala.
> Zotsatira:
> Ponena za ACA: Pindulani malire. Dipatimenti ya Zaumoyo ya Ukhondo ku United States. https://www.hhs.gov/healthcare/about-the-aca/benefit-limits/index.html. Idasinthidwa pa January 31, 2017.
> Malamulo omalizira a Plane Plathered Plans, Preexisting Condition Exclusions, Lifetime ndi Zomwe Zachaka Zomwe Zimaperekedwa, Zosankha, Zomwe Zimagwirizanitsa, Zomwe Akupempha, Ndiponso Odwala Pakati pa Chithandizo Chachidwi Chake. Malamulo omaliza. Utumiki Wopezeka M'zinthu Zamkatimo, Dipatimenti ya Chuma Chambiri; Ubwino Wogwira Ntchito Ntchito Yopezera Ukhondo, Dipatimenti ya Ntchito; Maofesi a Medicare & Medicaid Services, Dipatimenti ya Zaumoyo ndi Zipatala za Anthu. 2015 Nov 18; 80 (222): 72191-294. https://www.gpo.gov/fdsys/pkg/FR-2015-11-18/pdf/2015-29294.pdf.
> Haefner M. 5 Mayiko Akufunafuna Wopereka Mphoto kwa Moyo Wanu Nthawi Zonse Zomwe Mungathe Kudziwa: 6 Zinthu Zodziwa. Becker Hospital Review. Chiwongola dzanja Idasinthidwa pa February 7, 2018.
> Inpatient Hospital Care. Medicare.gov. https://www.medicare.gov/kukhudzana/hospital-care-inpatient.html.
> Musumeci M, Rudowitz R, Hinton E, Antonisse L, Hall C. Gawo 1115 Medicaid Zisonyezero Zowonetsera: The Current Landscape of Approved and Wending Waivers. Henry J. Kaiser Family Foundation. Chiwongoladzanja Lofalitsidwa pa February 1, 2018.