Medicare Inobhadhara Kuchengeta Kwemapenzi Kwemaawa 24 Mumba Here?

Panyaya dzekuva pakati pemhuri dzichisarudza nezvekupedzisira kweupenyu, chimwe chezvinonyanyokosha ndechekuti "kupi Medicare kuchabhadhara maawa 24 ekutarisirwa mumba panguva yatiri mudambudziko iri?" Hongu, asi panguva dzedambudziko rekurapa chete apo danho reMedicare hospice rinofanirwa kunzi "kuchengeta kwemba kunoramba kuchienderera mberi." Mari yekuchengeta kweHospice yeMedicare ine zvikamu zvina zvekutarisirwa zvinokwira sezvo mamiriro emurwere achiwedzera kuipa. Rudzi runowanzoitika rwekuchengetwa kwemumba ndirwo kuchengetwa kwemba kwakajairika, kuchikwira kusvika pa99% yezuva rose reHospice munyika yose. Vanenge 11% yevapiwe veHospice vanogamuchira kuchengetwa kwemba kunoramba kuchienderera mberi, kunova maawa 8-24 pakuvhenekera kwekurapa pazuva panguva pfupi. Kuchengetwa kwekurapa kwechimbichimbi kunogona kupihwa munzvimbo kwemazuva anosvika 5 achiteedzana kuti vapi venherera vapihwe zororo. Kuchengetwa kwekurapa kwevavhenekeri kwekunzvimbo ndiko danho repamusoro rekutarisirwa kwemapenzi kunopiwa muchipatara, kana kuchengetwa kwemba kusina kukwana. Masangano eMedicare & Medicaid Services (CMS) akagadzwa maitiro ekukodzera uye mashandisiro echikamu chega chega.

Bhuku iri rinovhara marudzi mana ekutarisirwa kweHospice kunopiwa pasi peMedicare kana mumba memunhu, kuwanikwa kwekutarisirwa kwemaawa 24 mumba, ruzivo rwekukodzera, uye izvo mhuri dzinogona kutarisira. Data yakapiwa ne Medicare.gov, CMS, uye The National Hospice and Palliative Care Organization. 

Zvikamu zvina zvekutarisirwa kweHospice kweMedicare

Mari yekutarisirwa kweHospice yeMedicare inoshanda kuburikidza nezvikamu zvina zvekutarisirwa zvakasiyana, vachipinda pakati pezvikamu sezvo zvinodiwa zvavo zvichichinja. Kunzwisisa chikamu chese kunobatsira mhuri kuziva kuti kutarisirwa kunowanikwa uye riini.

Kuchengetwa kwemba kwakajairika (RHC) ndiko kwesevhisi yeHospice yakanyanya kuwanda, kunopiwa kwese kwese kunogara murwere. Imba yemurwere inogona kuva imba yekugara yakazvitsaurira, nzvimbo yekugara yakabatsirwa, nzvimbo yekurapa yakakwirira, kana nzvimbo yekurarama kwenguva refu. Chikwata cheHospice chenyanzvi dzakawanda (chiremba, vanamukoti, vashandi vemunharaunda, vaparidzi, vabatsiri veHospice, nevamwe) vanoita kushanya kwakajairika zvichienderana nechirongwa chekuchengetwa, kazhinji kanoverengeka pavhiki. Chikwata ichi chinonzi chakagadzirira 24/7 panguva dzemhirizhonga, kunyange zvazvo vasiri kupa kuchengetwa kwemubhedha kunoramba kuchienderera panguva dzakajairika.

Kuchengetwa kwemba kunoramba kuchienderera (CHC) ndicho chikamu chinopa maawa anosvika 24 ekutarisirwa kwevanamukoti kumba. CHC inopiwa chete panguva pfupi dzedambudziko rekurapa apo kuchengetwa kwakadzama kwevanamukoti kunodiwa kuti murwere agare mumba uye adzivise kuiswa muchipatara. Chikamu ichi chinoda maawa anosvika 8 ekutarisirwa kwakananga kumurwere mumaawa 24, nehuwandu hwe (anopfuura 50%) huchiva kuchengetwa kwevanamukoti vane ruzivo kubva kuRNs, LPNs, kana LVNs. Vabatsiri veHospice nemashandiro emumba zvinogona kuwedzera kuchengetwa kwevanamukoti.

Kuchengetwa kwekurapa kwechimbichimbi kwakagadzirirwa kupa vapi venherera zororo, kwete kune manejimendi yedambudziko rekurapa. Vapiwe vanogamuchira kutarisirwa munzvimbo yakatenderwa neMedicare (chikamu cheHospice chekunzvimbo, chipatara, kana imba yekurapa) kwemazuva anosvika 5 achitevedzana panguva imwe chete. Kuchengetwa kwechimbichimbi kunosanganisira mukamuri nekudya. Vapi vanowanzo gadzirira chimbichimbi kuti vafambe, vatore zviitiko zvakakosha, kana kutarisira zvinodiwa zvavo zveutano.

Kuchengetwa kwekurapa kwevavhenekeri kwekunzvimbo (GIP) kunobata mapenzi asingagoni kutarisirwa mumba. Vapiwe vanogamuchira kutarisirwa muchipatara, chikamu cheHospice chekunzvimbo, kana imba yekurapa ine vanamukoti vane ruzivo vanowanikwa maawa 24. GIP inokodzera kurwadziwa kusingadzoreki, kuda kurutsa kana kurutsa kwakaipa, kunetseka kufema, maronda akaipa anoda kurapwa kwakadzama, kana mamwe mapenzi akasimba anoda kupindira kwakadzama.

Kune ruzivo rwakanyanya nezve kuvharwa kweHospice kweMedicare, ona gwara redu reHospice yeMedicare.

Nguva yekuti kuchengetwa kwemba kunoramba kuchienderera mberi (maawa 24) kuwanikwe

Kuchengetwa kwemba kunoramba kuchienderera mberi kunosiyana-siyana kwekuchengetwa kwemazuva ano kune nguva pfupi dzemhirizhonga yekurapa. Chinangwa ndechekupa kuchengetwa kwakadzama kwevanamukoti kudzora mapenzi akasimba uye kudzivirira kuiswa muchipatara uye kudzorera murwere kune kuchengetwa kwemba kwakajairika kana dambudziko rapfuura.

Zvimwe zvinhu zvine chekuita nezvinodiwa kuchengetwa kwemba kunoramba kuchienderera mberi zvinosanganisira kurwadziwa kusingadzoreki kusiri kupindura kune kupindira kweHospice, kunetseka kwakakomba kufema (kunge kudedzera kwemhepo kana kufema zvakaoma), kuda kurutsa kana kurutsa zvisingatarisirwe kana kunoramba kuchienderera kusina kugadziriswa nemishonga yakajairika, kurwadziwa kwakadzokorora (kutanga kutsva, kana izvo zvisiri kudzorwa nemishonga yakajairika) uye/kana kugadziriswa kwemishonga kunoda kutarisirwa kwakadzama kwevanamukoti.

Zvinodiwa nemurwere nemhuri kuti vagare mumba mavo pane kuenda kuchipatara kana kunzvimbo yeHospice yekunonzi. CHC inofanira kuva nekuchengetwa kwevanamukoti semurapi mukuru (anopfuura 50% yekuchengetwa kwevanamukoti vane ruzivo neRN, LPN kana LVN). Mabasa ekuchengeta anoitwa nevabatsiri veHospice asingadi hunyanzvi hwekurapa semasikiro, kufamba kana kubatsira nekudya zvinowanikwawo kuti zvawedzere kuchengetwa kwevanamukoti.

CHC haina chekuita nekuneta kwevapi venherera nezvinodiwa zvekurara zvisina hunyanzvi (ndizvo kuchengetwa kwechimbichimbi), nezvematambudziko ekugadzwa, kana kuti hachisi kuchengetwa kwemazuva ano kwekurara kwekurara kwemurwere ari kuderera pasina zviitiko zvechirwere. Kana dambudziko rapfuura, murwere anodzokera kune kuchengetwa kwemba kwakajairika.

Chikamu chepamusoro chesevhisi yeHospice iCHC, chikamu chevatapi vevashandi chakanyanya uye chinodhura. Masangano mazhinji eHospice ane vanamukoti vashoma vane ruzivo rweHospice uye vanooma kuwana munharaunda uye kugadzirisa nekukurumidza kwekutarisirwa kwemumba kwakadzama. Kwedzero yekukurumidza (apo CHC inodiwa) dzimwe nguva inopiwa kuburikidza nekondirakiti nesangano rekugadzirisa vashandi.

Kuchengetwa kwekurapa kwechimbichimbi: kubatsira vapi venherera

Kuchengetwa kwekurapa kwechimbichimbi kunogona kubatsira kudzorera muvapi mukuru apo vanoda zororo (kwete apo murwere ari mudambudziko) uye kunobatsira murwere kuburikidza nemazuva anosvika 5 ekurara pakugadzwa munzvimbo yakatenderwa neMedicare. Kunyange zvazvo pasina muganho wakasarudzika pane kugadzwa kwechimbichimbi pagore, kune kuongorora kweMedicare kune kushandiswa kwakakodzera.

Kuchengetwa kweHospice kwekunzvimbo kunopiwa munzvimbo yekuchengetwa kweHospice yekunonzi, chipatara kana imba yekurapa ine kondirakiti nesangano reHospice. Nzvimbo iyi inopa vanamukoti nekutsigira mabasa maawa ese. Vapi vechimbichimbi vanogara mukamuri ine mukamuri nekudya zvinobhadharwa neMedicare, ichi chinhu chikuru (kazhinji hachipiwi kune vapiwe vanogamuchira kutarisirwa mumba mavo).

Kuchengetwa kwechimbichimbi kune 5 muzana mari yekubhadhara pamwe chete kwezuva rekutarisirwa, kusvika kumubhadharo wechipatara wepagore ($1,736 muna 2026). Mari yekubhadhara kunze kwepakiti kune zvikamu zvakawanda zvechimbichimbi zvemazuva 5 kana isingapfuuri haisi yakakura.

Kune murwere anogara munzvimbo yekurapa, kuchengetwa kwechimbichimbi hakuna kuwanikwa (nekuti murwere atove kugamuchira kutarisirwa kwemaawa 24 muimba yekurapa). Chimbichimbi chinotarisana chaizvo nemurwere anogara kumba uye kutarisirwa kwezuva nezuva kunopiwa nemupi werimwe mhuri. 

Kuchengetwa kwekurapa kwevavhenekeri: apo mumba hazvina kukwana

Kuchengetwa kwekurapa kwevavhenekeri (GIP) kune vapiwe vane mapenzi avo asingagoni kutarisirwa mumba kunyangwe nekupindira kwakadzama. GIP inopiwa muchipatara, chikamu cheHospice chekunzvimbo, kana imba yekurapa ine vanamukoti vane ruzivo vanowanikwa maawa 24.

GIP yakasiyana neCHC, nekuti inoitika munzvimbo yakasiyana. CHC inoramba ichitarisira murwere kumba nekushanya kwakawanda, GIP inoendesa murwere kunzvimbo yekutarisirwa kwemishonga kwakadzama. Izvi zvinosarudzirwa ne mapenzi anodiwa, zvinodiwa nemurwere nemhuri, nezvinhu zvekunzvimbo.

Zvikonzero zveGIP zvinosanganisira kurwadziwa kusingadzoreki kunoda kugadziriswa kwemishonga kazhinji uchishandisa nzira dzeintravenasi kana manejimendi ye epidural, uye kunetseka kwakakomba kufema kunoda kugadziriswa kweokisijeni kana kupindira kwakakosha, kana kutarisirwa kwemaronda akaoma kunoda kupindira kwakawanda kwezuva nezuva, kana kuda kurutsa kana kurutsa kwakaipa kunoda mishonga yeintravenasi uye kuongorora kwakawanda, uye kutsamwa kwakakomba kana kusagadzikana kwekupedzisira kunoda kutarisa kwakadzama.

Murwere haabhadhari mari yekubhadhara pamwe chete pamazuva eGIP (Medicare inobhadhara mutengo wakazara weHospice). Kana mapenzi afadza, chikwata cheHospice chinodzosera murwere kunzvimbo yekuchengetwa kwemba kwakajairika kana imwe nzvimbo yakakodzera.

Ona gwara redu renguva re kuti Medicare inobhadhara Hospice kwenguvai. 

Zvinodiwa kuti Medicare Hospice ikwanise

Kugamuchira chero danho rekuchengetwa kweHospice kweMedicare, vapiwe vanofanirwa kuzadzisa zvinodiwa pakukodzera. Chiremba anopa rubatsiro (kana paine) uye chiremba weHospice vanofanira kuzvisimbisa kuti murwere une chirwere chekupedzisira chine chirongwa chekurapa che mwedzi mitanhatu kana kusvika kudaro kana chirwere chichiramba chichifamba zvakanaka. Murwere anofanira kusaina chirevo chekusarudza kuchengetwa kweHospice uye kuramba mari yeMedicare yekurapa kwechirwere chekupedzisira nezvinhu zvine chekuita nazvo.

Murwere anofanira kuva ne Medicare Part A. Chikamu B hachidiwe kune Hospice, kunyange vazhinji vanobatsirwa vane zvese. Nhengo dzepurogiramu yeMedicare Advantage dzinogona kusarudza kutarisirwa kweHospice pasi peOriginal Medicare uku dzichichengeta purogiramu yavo yeMedicare Advantage kune kutarisirwa kusiri kweHospice.

Chirongwa che mwedzi mitanhatu ndicho chiyeuchidzo chekurapa, kwete muganho wakasimba. Vapi vakawanda veHospice vanorarama kwenguva refu kupfuura zvavaiidzivirira. Kuchengetwa kweHospice kunogona kuenderera mberi chero bedzi chiremba achisimbisazve chirwere chekupedzisira panguva dzakakodzera (mazuva 90 ematanho maviri ekutanga emubatsiro, ozotevera mazuva 60 ega ega).

Kune zvizhinji nezve nguva yeHospice nekusimbisazve, ona gwara redu renguva yeHospice.

Mibvunzo Inowanzobvunzwa

Medicare Inobhadhara Kuchengeta Kwemapenzi Kwemaawa 24 Mumba Here? 

Hongu, asi panguva dzedambudziko rekurapa chete kuburikidza ne "kuchengetwa kwemba kunoramba kuchienderera mberi," chimwe chezvitanhatu zveHospice zveMedicare. Kuchengetwa kwemba kunoramba kuchienderera kunopa maawa 8-24 ekutarisirwa kwevanamukoti pazuva apo vapiwe vane mapenzi akasimba (kurwadziwa kusingadzoreki, kunetseka kwakakomba kufema, kuda kurutsa kwakaipa, kurwadziwa kutsva) kunoda kuchengetwa kwakadzama kwevanamukoti kuti vatungamirirwe mumba nekudzivisa kuiswa muchipatara. Kuchengetwa kunofanira kunge kunyanya kuchengetwa kwevanamukoti vane ruzivo (RN, LPN, kana LVN vanopa anopfuura 50% emaawa). Vanenge 11% yevapiwe veHospice vanogamuchira kuchengetwa kwemba kunoramba kuchienderera panguva imwe chete.

Ndezvipi zvikamu zvina zvekutarisirwa kweHospice kweMedicare? 

Zvikamu zvina zveHospice zveMedicare ndizvo: (1) Kuchengetwa kwemba kwakajairika, chikamu chakanyanya kuwanda chinopa kushanya kwakajairika kwechikwata cheHospice kwegara murwere; (2) Kuchengetwa kwemba kunoramba kuchienderera, kunopa maawa 8-24 ekuchengetwa kwakadzama kwevanamukoti panguva pfupi dzemhirizhonga yekurapa; (3) Kuchengetwa kwekurapa kwechimbichimbi, kunopa kusvika kumazuva 5 munzvimbo yekupa vapi venherera zororo; uye (4) Kuchengetwa kwekurapa kwevavhenekeri kwekunzvimbo, kunopa manejimendi yemapenzi ehuzhinji hwemuchipatara apo kuchengetwa kwemba kusina kukwana.

Mumwe munhu anogona kugamuchira kuchengetwa kwemba kunoramba kuchienderera mberi kwenguva yakareba sei? 

Kuchengetwa kwemba kunoramba kuchienderera kunorehwa kuti ngwarire nguva pfupi dzemhirizhonga yekurapa, kwete kuchengetwa kwenguva refu. Vapiwe vanowanzo gadzirira CHC kwemaawa kusvika kumazuva mashoma apo mapenzi akasimba anoiswa mudenga. Kana dambudziko rapfuura, murwere anochinjira kune kuchengetwa kwemba kwakajairika. Medicare haisati yagadzirira nguva yakatarwa, asi zvinodikanwa zvekurapa kwevanamukoti kunofanira kuenderera mberi. CHC haina kukodzera kune zvinodiwa zvemaawa 24 pasina zvikonzero zvechirwere zvakasarudzika.

Chii musiyano uripo pakati pekuchengetwa kwemba kunoramba kuchienderera uye kuchengetwa kwekurapa kwevavhenekeri kwekunzvimbo? 

Zvikamu zvese zvinobata mamiriro apo kuchengetwa kwakajairika kweHospice hakuna kukwana. Kuchengetwa kwemba kunoramba kuchienderera kunochengeta murwere mumba nekugara kwemaawa 8-24 kwevanamukoti vanochengeta. Kuchengetwa kwekurapa kwevavhenekeri kwekunzvimbo kunoendesa murwere kuchipatara, chikamu cheHospice chekunzvimbo, kana imba yekurapa yekutarisirwa kwemishonga kwakadzama. CHC inokodzera apo mapenzi anogona kutarisirwa mumba nekutsigirwa kwakadzama kwevanamukoti; GIP ndeyezvinhu zvinoda kupindira kwekurapa kwakadzama sekushandisa mishonga yeIV kana kutarisa kunoramba kuchienderera.

Medicare Inobhadhara Kuchengeta Kwemapenzi kweHospice Here? 

Hongu. Kuchengetwa kwekurapa kwechimbichimbi kunopa kusvika kumazuva 5 achitevedzana munzvimbo yakatenderwa neMedicare (chikamu cheHospice chekunzvimbo, chipatara, kana imba yekurapa) kuti upe muvapi werimwe mhuri zororo. Pasina muganho pane nhamba yekugadzwa kwechimbichimbi pagore. Mari yemurwere i5% mari yekubhadhara pamwe chete pazuva. Medicare inobhadhara mukamuri nekudya panguva yekurara, kusiyana nekuchengetwa kwemba kwakajairika munzvimbo dzekugara dzakazvitsaurira. Chimbichimbi hachina kuwanikwa kana murwere achigara munzvimbo yekurapa (nekuti kutarisirwa kwemaawa 24 kunotova kune uko).

Ndiani Anopa Kuchengetwa Kwemapenzi Kwemaawa 24 Mumba? 

Kuchengetwa kwemba kunoramba kuchienderera kunopiwa nechikwata cheHospice chemurwere, kunyanya vanamukoti vane marezenzi (RNs, LPNs, LVNs) nevabatsiri veHospice vanotsigira kuchengetwa kusingadi hunyanzvi. Sangano reHospice rinoronga vashandi, dzimwe nguva richiita kondirakiti nenzvimbo dzekugadzirisa vashandi kune kwedzedzero yekukurumidza apo vashandi vavo pachavo vasina kukwana. Hazvisi zvese zvinhu zveHospice zvine kugona kweCHC kwakakwirira nekuda kwekushomeka kwevanamukoti, saka mhuri dzinoda kubvunza zvakakosha nezve kuwanikwa kweCHC panguva yekusarudza mupi weHospice.

Chikuru

Medicare ichabhadhara kuchengetwa kwemapenzi kwemaawa 24 mumba pasi pe "kuchengetwa kwemba kunoramba kuchienderera mberi," chimwe chezvikamu zvina zvekuchengetwa kweHospice zvakagadzirirwa nguva pfupi "dambudziko" rekurapa. Zvikamu zvina zvekutarisirwa ndizvo kuchengetwa kwemba kwakajairika (chakanyanya kuwanda, ~99% yezuva reHospice), kuchengetwa kwemba kunoramba kuchienderera (maawa 8-24 ekutarisirwa kwevanamukoti panguva pfupi, dambudziko rakangoerekana raitika, ~11% yevapiwe), kuchengetwa kwekurapa kwechimbichimbi (kusvika kumazuva 5 ekubatsira vapi venherera) uye kuchengetwa kwekurapa kwevavhenekeri (manejimendi yemapenzi ehuzhinji hwemuchipatara). Kurwadziwa kwakasimba kunoda kuchengetwa kwakadzama kwevanamukoti kumba nemhuri ichida kugara mumba kunotora kuchengetwa kunoramba kuchienderera kumba. Chikwata cheHospice chinodzosera murwere kubva pachikamu chimwe chekutarisirwa kune chimwe sezvo zvinodikanwa zvavo zvichichinja. Kuti uwane ruzivo rwakakwana nezve kuchengetwa kweHospice, tarisa gwara redu nezve kuti Medicare inobhadhara Hospice uye kuti Medicare inobhadhara Hospice kwenguvai. Kana uri kutsvaga kuvharwa kwakakwana kweMedicare, ona magwara edu e Medicare uye zvikamu zveMedicare zvakatsanangurwa.

Sezvo izvi zvichigona kunge zvichinyanya kunzwa, uye sezvo chimwe chezvakaoma zvikuru zvinosangana nemhuri, tinoziva kuti idzi idanho rakaoma. Ungade rubatsiro rwakawanda uye unofanirwa kusvika kune mushandi wezvemagariro weHospice, chikwata chekurapa kwechipatara chenyu, kana muongorori wenyaya dzekužisirwa. Mhuri dzinogona kuwana zviwanikwa paThe National Hospice and Palliative Care Organization, nhpco.org/">nhpco.org.