Medicare Inoribhadhara Hospice Care Kwenguvai? Chinyorwa Chizere

Medicare inobhadhara hospice care kwenguvai? Hapana muganho wenguva wega webhenefiti yeMedicare hospice. Chero bedzi uchiramba uchisangana nezvinodiwa zvechirwere chekupedzisira, Medicare inobhadhara hospice zvisingaperi. Kubatsirwa kwakagadzirirwa mumwaka chaiwo (mitema miviri yemazuva 90, wobva wawedzera yemazuva 60) nekugoneseswa patsva kuchidiwa pakutanga kwemwaka wega wega. Varwere vazhinji vanogamuchira hospice kwemwedzi yakati wandei. Vamwe vanoigamuchira kwegore kupfuura apo mamiriro avo ezvinhu achiramba achikwanisa hospice. 'Mitemo yemwedzi mitanhatu' inowanzotaurwa inotsanangura chirongwa chinodiwa pakutanga kugoneseswa, kwete muganho pakuvhara.

Chinyorwa ichi chinotsanangura mashandiro anoita Medicare hospice benefit periods, kana kugoneseswa patsva kuchiitika, chii chinoitika kana mamiriro ako ezvinhu achivandudza, uye izvo mhuri dzinofanirwa kuziva nezve nguva. Ruzivo runobva ku CMS, Medicare.gov, uye National Hospice and Palliative Care Organization.

Chimiro chekugadzirirwa kwemazuva 90/90/60

Iyo Medicare hospice benefit yakakamurwa mumwaka chaiwo:

• Chikamu chekutanga chebhenefiti: mazuva 90

• Chikamu chechipiri chebhenefiti: mazuva 90

• Chikamu chechitatu chebhenefiti nezvimwe zvakadaro: Nguva dzisina muganho dzemazuva 60

Hapana huwandu hwakawanda hwemwaka yebhenefiti. Chero bedzi chiremba wechipatara che hospice achigonesesa patsva pakutanga kwemwaka mutsva kuti uri kurwara zvisingaporeswe, bhenefiti inoenderera pasina kumbomira.

Kunzwisisa kwakawanda: chirongwa che'mwedzi mitanhatu kana pasi' chinodiwa pakutanga kugoneseswa hazvireve kuti Medicare inorega kubhadhara mushure memwedzi mitanhatu. Chirevo ichocho chinotsanangura chiyero chekurapa che kugoneseswa, kwete nguva yekuvharwa. Vamwe varwere vanorarama kwenguva yakareba kupfuura zvakafanotaurwa, uye chengoti chiremba we hospice achiramba achigonesesa mamiriro avo ekupedzisira, hospice inoramba ichienda.

Zvinoenderana nedata reMedicare, pakati pehurefu hwekugara mu hospice ndeye mazuva 18. Vanenge 30% vevarwere ve hospice vanogamuchira kuchengetwa kwemazuva 7 kana pasi. Vanenge 10% vanogamuchira hospice kwemwedzi mitanhatu kana kupfuura. Musiyano unomirira kusatarisirwa kwemakosi ezvirwere zvekupedzisira pane kusununguka kweMedicare kubhadhara hospice kwenguva refu.

Kugoneseswa patsva: kuti Medicare inosimbisa sei kukwanisa kuenderera mberi

Pakutanga kwemwaka wega wega webhenefiti, chiremba wechipatara che hospice kana chiremba we hospice anofanirwa kugonesesa patsva kuti uri kurwara zvisingaporeswe (hupenyu hweupenyu hwe mwedzi mitanhatu kana pasi kana chirwere chichitevera nzira yacho yakajairika).

Kune chikamu chechitatu chebhenefiti nezvikamu zvese zvinotevera, kusangana nechiso nechiso nachiremba wechipatara che hospice kana mushandi wehupfumi kunodiwa kwete kupfuura mazuva 30 isati yatanga mwaka wega wega webhenefiti. Zvinodiwa izvi zvechiso nechiso zvakawedzerwa neAffordable Care Act muna 2011 kuti ive nechokwadi chekuti kukwanisa kuenderera mberi kwe hospice kwakasimbiswa nekurapa, kwete kungova pepa.

Maitiro ekugoneseswa patsva maitiro emuchengetedzi pa hospice. Varwere nemhuri havawanzoona kugoneseswa patsva sechinhu chakajeka. Mushandi wehupfumi we hospice kana mushandi wezvemagariro anoshanyira nguva dzose zvisinei, uye kugoneseswa patsva kwemagwaro kunoitika kumashure kwezviratidziro.

Izvo varwere nemhuri vanoona:

• Kuenderera mberi kwekutarisirwa pasina kumbomira

• Chikwata che hospice chinoramba chichiita mabasa ese

• Kunyaradza uye kururamiswa zvichiramba zvichitariswa

• Chirongwa chekutarisirwa chinogadziriswa sezvo mamiriro ezvinhu achichinja

Kuti uwane ruzivo nezve izvo Medicare hospice inovhara (bhenefiti yakazara), ona chinyorwa chedu does Medicare cover hospice.

Zvakadini kana mamiriro ako achivandudza?

Vazhinji vevarwere ve hospice vanovandudza zvakakwana kuti vatisisangane nezvinodiwa zvekusarudza hospice. Izvi zvinowanzoitika nekuda kwekuvandudza kwakanaka kwekutonga kwezviratidzo uye kuderera kwekunetseka kunobvumira muviri kugadzikana, kunyanya nezvirwere zvakakomba senge kusashanda kwemoyo kwakakomba kana end-stage COPD.

Kana chiremba wechipatara che hospice achiita sarudzo kuti hausisangane nezvinodiwa zvechirwere chekupedzisira, chikwata che hospice chichakuperekedza nechirongwa che 'live discharge' chekutarisirwa. Ichi hachisi chinhu chekudzokera shure. Ichi chiratidzo chekuti chirongwa chekurapa chazvino chiri kutaridzika zvakasiyana sezvaitarisirwa.

Maitiro ekuburitsa achirarama:

• Hospice inopa chiziviso chakanyorwa chinotsanangura kuti nei kukwanisa kusisashande

• Unodzokera kune yakajairika Medicare kuvharwa kwezvirwere zvekupedzisira nezvisina hukama

• Unogona kurega hospice zvakare gare gare kana mamiriro ako achidonha.

• Haurasikirwi nechero bhenefiti ye hospice yeramangwana nekuburitswa.

Vanenge 17% vevarwere veMedicare hospice vanoburitswa achirarama gore negore, zvinoenderana nedata reCMS. Zvikonzero zvakajairika zvinosanganisira kugadzikana kwemamiriro ezvinhu (zvinowanzova), sarudzo yemurwere yekutsvaga kurapa kunogadzirisa, kuchinjira kunzvimbo isiri ye hospice, kana kusafarirwa panguva yekugoneseswa patsva.

Kurega kusarudzwa kwekusarudza: kumisa hospice pane zvaunoda

Varwere vanogona kurega kusarudza hospice chero nguva, chero chikonzero. Kurega hospice kunokudzosera pakarepo kune yakajairika Medicare kuvharwa, kusanganisira kugona kwekutsvaga kurapa kunogadzirisa kwechirwere chekupedzisira.

Zvikonzero zvakajairika zvekusarudza kurega:

• Murwere anoda kuyedza nzira itsva yekurapa yakava iripo

• Mhuri kana murwere inochinja pfungwa nezve nzira ye hospice

• Murwere anoda kuyedza kurapwa kunotarisa pakugadzirisa

• Kuchinjira kunzvimbo isingabatane ne hospice (hapachawanzoitika)

Kurega, saina chirevo chekurega nehofisi yako ye hospice. Kuchinjana kwekuvhara kwakareba. Zuva raunorega ndiro zuva rekupedzisira remwaka wako webhenefiti. Mazuva akashandiswa anoonekwa panguva yako yepasi rose yebhenefiti (saka kana ukarega pazuva rechi30 remwaka wekutanga webhenefiti, washandisa 30 kubva pa90 mazuva kubva mumwaka iwoyo).

Unogona kurega zvakare hospice gare gare. Kutanga patsva kunotanga mwaka mutsva webhenefiti wakakodzera mamiriro ako panguva iyoyo.

Kuchinja vagadziri ve hospice

Une kodzero yekuchinja vagadziri ve hospice kamwe chete panguva yemwaka wega wega webhenefiti. Izvi dzimwe nguva zvinonzi "kuchinjisa" pane kurega. Kusiyana nekurega, kuchinjisa hakudzorere nguva yako yemwaka webhenefiti.

Zvikonzero zvinoita kuti mhuri dziite sevagadziri ve hospice:

• Kusaagutsikana nekukwiridzika kwekutarisirwa kana kukurukurirana

• Kuchinja kunzvimbo nyowani inoshandiswa neimwe hofisi

• Zvinodiwa zvekurapa zvakakosha zvisingakwanise kugadziriswa nehofisi iripo

• Zvisarudzo zvechitendero kana zvepamagariro zve hospice ine hwaro hwekutenda

Kuti uchinje, saina chirevo chekuchinjisa ne hospice nyowani. Hospice yazvino inoziviswa uye hospice nyowani inoonekwa. Hapana kumbomira mukuvharwa.

Hospice aggregate cap (uye nei isingakubati)

Unogona kunzwa mareferensi kune "hospice cap." Izwi iri rinoshanda kune vagadziri ve hospice, kwete kune varwere vemwe chete. Medicare inoshandisa muganho wekubhadhara wepagore kune imwe neimwe hospice agency zvichienderana nemhando inoita kuti Medicare ibhadhare imwe neimwe agency zvinosanganiswa nenhamba yevanoishandisa.

Iyi cap inokanganisa mashandiro anoenderana ne hospice agencies asi haimisi kuvharwa kweumwe murwere anoisana nezvinodiwa zve hospice. Kukwanisa kwako kunobva pane mamiriro ako ekurapa, kwete pane mari yepasi rose yeMedicare yemugadziri wako we hospice.

Kune 2026, hospice payment rates yakawedzera 2.6%, ichipa mari ye $750 miriyoni yekuwedzera mu hospice funding munyika. Kuverenga kwe cap yepasi rose kunogadziriswa zvakakodzera.

Nguva yeMedicare hospice: zvinotarisirwa panguva yekufambira

Kune mhuri dziri kusvika pakusarudza hospice, heino nguva chaiyo:

Chikamu cheisina kusarudza chisati chaitika: Kukurukurirana nachiremba wekutanga nemhuri nezve referral ye hospice. Hofisi ye hospice kazhinji inopa konsultesheni yemahara yemagwaro pasina chisungo. Chikamu ichi hachina muganho wenguva.

Kusarudza: Murwere kana mumiririri anosaina Hospice Election Statement. Kuvharwa kunotanga pakarepo. Hospice inopa Chiziviso cheKusarudza kuMedicare mukati memazuva 5 ekarenda.

Mazuva 90 Okutanga: Mabasa akajairika e hospice. Chikwata che hospice chinogadzira tsika ne hukama hwemhuri. Murwere anowanzowana kuvandudza mukunyaradza nekutonga kwemarwadzo.

Zuva rechi90: Kugoneseswa patsva kune chikamu chechipiri chebhenefiti. Chiremba we hospice anogonesesa patsva. Mhuri kazhinji haizvioni sechinhu chakajeka.

Zuva rechi180: Kusangana nechiso nechiso kunodiwa kune chikamu chechitatu chebhenefiti. Chiremba we hospice kana NP anoshanyira murwere mukati memazuva 30 isati yasvika zuva rechi180. Kugoneseswa patsva kunopedzwa.

Mazuva 240, 300, 360, nezvimwewo: Kusangana nechiso nechiso mazuva ese 60. Kuenderera mberi kwekutarisirwa kwakajairika.

Kupera kwehupenyu: Kutarisirwa kunowedzera mumazuva ekupedzisira (Service Intensity Add-On inopa mubhadharo wekuwedzera weMedicare kwemazuva 7 ekupedzisira). Tsigiro yekusuwa inoramba ichienderera nemhuri kwemwedzi 13 mushure mekufa.

Kuti uwane zvimwe zvakawanda nezve Medicare hospice kuvharwa, ona does Medicare cover hospice uye does Medicare cover home health care magwaro edu.

Mibvunzo Inowanzobvunzwa

Pane muganho wemwedzi 6 pa Medicare hospice here?

Kwete. "Mwedzi 6 kana pasi" inoreva chirongwa chinodiwa pakutanga kugoneseswa kwe hospice, kwete nguva yekugara yakawanda. Chero bedzi chiremba wechipatara che hospice achigonesesa patsva kuti uri kurwara zvisingaporeswe panguva yemwaka wega wega webhenefiti, kuvharwa kunoenderera zvisingaperi. Vamwe varwere vanowana hospice kwegore kupfuura.

Zvinobva zvaitika sei kana ndiri mu hospice kwemwedzi inodarika 6?

Kuvharwa kunoenderera pasina kumbomira chero bedzi kugoneseswa patsva kunosimbisa kukwanisa kuenderera mberi. Mushure memazuva 180 (kutanga kwechikamu chechitatu chebhenefiti), chiremba we hospice kana mushandi wehupfumi anofanirwa kuita kusangana nechiso nechiso mukati memazuva 30 isati yasvika mwaka wega wega webhenefiti unotevera kuti asimbise kukwanisa kuenderera mberi. Hospice care pachayo inoramba ichienderera.

Ungarega Medicare kubhadhara hospice pakati pekugara?

Medicare hairegi hospice nekuzvionera. Kuvharwa kunogona kupera kana: (1) chiremba wechipatara che hospice achiita sarudzo kuti hausisangane nezvinodiwa zvechirwere chekupedzisira panguva yekugoneseswa patsva (live discharge), (2) unorega zvakasarudza kusarudza hospice, kana (3) unochinjira kune mugadziri asiri we hospice wechirwere chekupedzisira. Muzviitiko zvese, yako yakajairika Medicare kuvharwa inodzoreredzwa pakarepo. Unogona kurega hospice zvakare gare gare kana mamiriro ako achidonha.

Kukwiridzira hospice kunofanirwa kugoneseswa patsva kangani?

Kugoneseswa patsva kunoitika pakutanga kwemwaka wega wega webhenefiti: pazuva rechi90 (kutanga kwechikamu chechipiri chemazuva 90), pazuva rechi180 (kutanga kwechikamu chekutanga chemazuva 60), uye mazuva ese 60 anotevera. Mushure memazuva 180, kugoneseswa patsva kunodawo kusangana nechiso nechiso nachiremba we hospice kana NP mukati memazuva 30 isati yasvika mwaka mutsva webhenefiti.

Ndinogona kuchinja vagadziri ve hospice kana ndisingagutsikane?

Ehe, kamwe chete pamwaka webhenefiti. Unosaina chirevo chekuchinjisa nemugadziri mutsva we hospice, uye ivo vanotora kutarisirwa kwako. Izvi zvakasiyana nekurega hospice zvachose. Kuchinjisa hakudzorere nguva yako yemwaka webhenefiti kana kukonzeresa kumbomira mukuvharwa.

Chii chinonzi live discharge kubva ku hospice?

Live discharge inoitika apo chiremba wechipatara che hospice anoita sarudzo kuti hausisangane nezvinodiwa zvechirwere chekupedzisira. Izvi zvinowanzoitika nekuda kwekutarisirwa kwakanaka kwe hospice kunogadzirisa mamiriro emurwere zvakakwana zvekuti chirongwa chemwedzi 6 hachisisashande. Unodzokera kune yakajairika Medicare kuvharwa pakarepo. Unogona kurega hospice zvakare gare gare kana mamiriro ako achidonha. Vanenge 17% vevarwere ve hospice vanoburitswa achirarama gore negore.

Chinhu chinokosha

Medicare inobhadhara hospice care zvisingaperi chengoti uchiramba uchisangana nezvinodiwa zvechirwere chekupedzisira. Bhenefiti inoshanda mumwaka miviri yemazuva 90 ichiteverwa nemwaka miviri yemazuva 60 isina muganho, nekugoneseswa patsva kuchidiwa pakutanga kwemwaka wega wega. Mushure memazuva 180, kusangana nechiso nechiso nachiremba we hospice kana NP kunodiwa isati yasvika mwaka mutsva webhenefiti. I "mwedzi 6" mukukwanisa kwe hospice inoreva chirongwa panguva yekugoneseswa, kwete nguva yekugara yakawanda. Varwere vanogona kurega zvakasarudza hospice chero nguva uye kurega zvakare gare gare. Live discharge inoitika kune vanenge 17% vevarwere ve hospice apo mamiriro avo anovandudza kupfuura zvinodiwa zve hospice. Kuti uwane ruzivo nezve izvo hospice inovhara uye mashandiro ayo, ona does Medicare cover hospice uye Medicare magwaro edu.