Okudingayo ukwazi ngezinguquko zeMedicaid zalo nyaka

Izindaba

Njengoba uhlelo lweMedicaid luvuselelwa njalo (uma lungalungiswa ngaphezulu), kungaba nzima ukuhambisana nemininingwane yakho. Nakhu okushintshile ngo-2020.

I-Medicaid wuhlelo lombuso nolwezwe olusiza ngezindleko zokwelashwa zabantu abanemali elinganiselwe nezinsizakusebenza ezifanelekayo. Ixhaswa yizintela zikahulumeni ze-Federal, imali engenayo yentela ejwayelekile, kanye nama-premium wabazuzi ukunikeza izinzuzo ezingavamisile ukuhlanganiswa ezinye izinhlelo zosizo lukahulumeni, kufaka phakathi ukunakekelwa kwamakhaya asebekhulile nezinsizakalo zokunakekelwa komuntu siqu. I-Medicaid ivame ukudideka ne-Medicare (uhlelo lomshuwalense wezempilo olulawulwa nguhulumeni, oluxhaswe ngemali ngabantu abangama-65 nangaphezulu nabanye abantu abakhubazekile), kepha bahluke kakhulu. Kepha ngenxa yokuthembela kukaMedicaid kubo bobabili ohulumeni bamazwe kanye nohulumeni abaguqukayo kusuka ekuphathweni okukodwa kuye kokulandelayo, uhlelo futhi lunokuthambekela kokushintsha ngokuhamba kwesikhathi — okwenza kube nzima ukwazi nokuqonda imininingwane yokutholakala nezinzuzo.

Izinqubomgomo zeMedicaid sezenze izinguquko eziningi selokhu kwaphasiswa umthetho we-Affordable Care Act (ACA) ngonyaka ka-2010, futhi ngenxa yalokho, abantu abaningi baseMelika abathembele kwiMedicaid namanje abazi noma bathinteka kanjani, ngisho nangemva kweminyaka eyishumi. Yingakho sibheka ezinye zezinguquko zakamuva zeMedicaid namaqiniso asesikhathini ukuze ukwazi ukwenza okungcono kakhulu ngesimo sakho samanje sezokwelapha.

Yiziphi izidingo zokufanelekela iMedicaid?

Njengamanje, ukuze ufanelekele iMedicaid, kufanele uhlangabezane nemibandela (echazwe ngezansi) kanye nokulandelayo:

• Abahlomuli ngokuvamile kumele babe izakhamuzi zombuso lapho bethola khona iMedicaid.
• Kumelwe babe yizakhamizi zase-United States noma abathile abangewona izakhamizi, njengezakhamuzi ezihlala njalo ezisemthethweni.
• Amanye amaqembu okufaneleka anqunyelwe ngeminyaka, noma ngokukhulelwa noma isimo sokuba ngumzali.
• Imindeni engenayo imali ephansi, abesifazane abakhulelwe abaqeqeshiwe kanye nezingane, kanye nabantu abathola i-Supplemental Security Income (SSI) bayizibonelo ze amaqembu afanelekile wokufaneleka .

Ngokwengeziwe, amazwe ngamanye anakho ukukhetha ukusungula uhlelo oludinga ukwelashwa lwabantu abanezidingo ezibalulekile zezempilo imali yabo engenayo iphakeme kakhulu ukuthi bangafanelekela iMedicaid ngaphansi kwamanye amaqembu okufaneleka. Lokhu kudinga ukuthi lowo muntu asebenzise imali ephansi.

Yiziphi izinguquko zakamuva zeMedicaid?

Ngoba uhlelo lweMedicaid luxhaswe ngokuhlanganyela ngohulumeni bakahulumeni kanye nohulumeni, imvamisa kuba nokuhlukahluka okukhulu uma kukhulunywa ngokufaneleka kanye nezinzuzo ezivela kuhulumeni kuya kuhulumeni. Ngokusho kwesikhulu Amarekhodi eMedicaid , uhulumeni wesifundazwe ukhokhela amazwe amaphesenti athile wezindleko zohlelo, abizwa ngeFederal Medical Assistance Percentage (FMAP). Ngemuva kwalokho, umbuso ngamunye unesibopho sokusebenzisa uhlelo lwawo lweMedicaid ngaphakathi kwemihlahlandlela yenhlangano. Amazwe anokuguquguquka okukhulu ekwakhiweni nasekuphathweni kwezinhlelo zawo. Ngenxa yalokhu, ukufaneleka nezinzuzo zeMedicaid futhi kaningi kwehlukahluka kakhulu kuye ngezwe.

Isimo samanje sokufaneleka nokunwetshwa

Ngemuva kokuthi i-ACA idluliselwe ngo-2010, ukufaneleka kweMedicaid kwandiswa ukuze kufakwe iziqu eziningi zokuthola imali ephansi, kuze kufike ku-138% womugqa wobuphofu. Lokhu kusho ukuthi labo abanemali engenayo yonyaka engu- $ 16,753 noma ngaphansi kanye nomndeni wabane abanemali engenayo yonyaka yamakhaya engu- $ 34,638 noma ngaphansi bayakufanelekela ukutholakala kweMedicaid. Ngakho-ke ngokuvamile, umkhawulo wemali engenayo ngo-2020 ngu- $ 2,349 ngenyanga ezifundazweni eziningi futhi umkhawulo wefa ngu- $ 2,000 kumuntu ofaka isicelo oyedwa. Ukuqinisekisa le mali, i-ejensi yombuso iMedicaid ibeka umthwalo wobufakazi bengeniso yenyanga kumfakisicelo. Ukuhumusha: I-Medicaid idinga abafakizicelo abaningi ukuthi banikeze yonke imibhalo eceliwe futhi edingekayo ukuqinisekisa lokho okubhalwe kuhlelo lokusebenza.

Okwamanje izifundazwe zivunyelwe ukuthi zithathe ingxenye yokwandiswa noma zikhethe ukuphuma. Kusukela ngo-Ephreli 2020, Izifundazwe ezingama-35 kanye nesifunda saseColombia basebenzise ukunwetshwa kweMedicaid ukusiza abantu abadala abahlwempu nabahola kancane. Lezo zifaka phakathi:

1. I-Alaska
2. E-Arizona
3. I-Arkansas
4. California
5. IColorado
6. I-Connecticut
7. I-Delaware
8. IHawaii
9. Idaho
10. I-Illinois
11. I-Indiana
12. I-Iowa
13. EKentucky
14. ELouisiana
15. Maine
16. EMaryland
17. EMassachusetts
18. EMichigan
19. IMinnesota
20. IMontana
21. INevada
22. ENew Hampshire
23. Ijezi elisha
24. ENew Mexico
25. I-New York
26. ENyakatho Dakota
27. I-Ohio
28. Oregon
29. EPennsylvania
30. Rhode Island
31. Utah
32. I-Vermont
33. IVirginia
34. Washington
35. ENtshonalanga Virginia

Ukunwetshwa kubukeka kwehlukile kuzwe ngalinye, kanjalo nokwenza ukwandiswa. Kepha okusemqoka ukuthi uma izwe lakho lamukele futhi lasebenzisa ukunwetshwa, manje usungafaneleka ukuthola iMedicaid — noma ngabe ubungazange ukwenze esikhathini esedlule. Ukubuka okuningiliziwe ekusetshenzisweni kombuso wakho, hlola iKaiser Family Foundation's imephu exhumanayo . Kusukela manje, izifundazwe eziyi-14 azikakwamukeli ukwanda. Kulawo mazwe, uma uwe ngaphansi noma ngaphansi kwe- Umugqa we-Federal Poverty ngosayizi wendlu yakho ($ 12,760 ngemali engenayo yonyaka ngamunye), usengakufanelekela ukutholakala kweMedicaid.

Ezinye izifundazwe manje zinezidingo zomsebenzi

Ezinye izifundazwe manje zidinga ubufakazi bomsebenzi wokufaneleka nokugcinwa kwezinzuzo zeMedicaid. Ngokusho kweKaiser Family Foundation, iCenters for Medicare neMedicaid Services (CMS) yakhipha ukuholwa ngaphansi kokuphathwa kukaTrump ngeziphakamiso zokuyekelwa kukaMedicaid zombuso ezingabeka izidingo zomsebenzi eMedicaid njengesimo sokufaneleka. Lokhu kudilizwa kudinga abahlomuli ukuthi baqinisekise ukuqashwa kwabo, ukusesha kwabo okusebenzayo ngomsebenzi, kanye / noma nezinhlelo zokuqeqesha umsebenzi ngenani elithile lamahora ngesonto ukuthola noma ukugcina ukumbozwa kweMedicaid. Imininingwane emayelana nenombolo ethile yamahora, imisebenzi evunyelwe, ukukhululwa, kanye nenqubo yokubika iyahluka ngombuso ngamunye osebenzisa ukukhishwa.

Kuyaqapheleka ukuthi ukuyekelwa kwezidingo zomsebenzi kuholele kubantu abayi-17,000 e-Arkansas ukulahlekelwa ukumbozwa ngo-2018.

Ngabe iMedicaid iyashintsha ngo-2020?

NgoJanuwari, abaphathi bakaTrump bakumemezela lokho kuzovumela amazwe ukuthi akhululeke kakhudlwana ekushintsheni imali esetshenziswayo nokutholakala kwezidakamizwa ngaphansi kweMedicaid kubantu abaningi abampofu, ishift enkulu leyo - ngokusho kwe- New York Times —Nikeza inketho yokwehlisa izinzuzo zezempilo ezigidini ezitholile ukumbozwa ngohlelo ngaphansi koMthetho Wokunakekelwa Ongabizi. Lolu hlelo olusha lubizwa ngokuthi yi-Healthy Adult Opportunity, futhi — uma lusetshenziswa yizifundazwe — luzovumela amazwe ukuthi amboze imithi embalwa kulabo ababhalisile. Lokhu kungaba wushintsho oluphelele lwenqubomgomo kusuka kulokhu okukhona njengamanje, okusho ukuthi izifundazwe kufanele zihlanganise zonke izidakamizwa ezidingekayo kwezokwelapha. Futhi yize lokhu kuncishiswa kweMedicaid kungagcina izinga eliphansi lokutholwa kwabantu ngaphansi kweziqondiso zezigaba eziyi-10 ze-Affordable Care Act zezinzuzo zezempilo ezibalulekile, ukumbozwa kuzoba mncane kakhulu kunalokho manje. Amazwe azokwazi ukunquma ukuthi ngubani ngempela ozokwemboza futhi anciphise noma ashiye ngokuphelele izinzuzo zendabuko ze-Medicaid-kufaka phakathi ukunakekelwa kwesikhathi eside, ukuthuthwa lapho kubekwa khona abezokwelapha, nokufakwa kabusha kokuphinda kusebenze (aka, i-retro coverage) yabantu abathola ukunakekelwa esikhathini esiyizinsuku ezingama-90 ngaphambi kokuba balungele iMedicaid. Uma lezi zinguquko zenziwa ngonyaka we-2020, iMedicaid nokufinyelela okungabizi kwezempilo kuzobukeka kwehluke kakhulu.

Ngabe uMongameli uTrump wenze ushintsho kuMedicaid phakathi nokuqubuka kwe-coronavirus?

Ubhadane lwe-coronavirus lomhlaba seluthathe inani elikhulu kuzo zonke izici zempilo yethu, kufaka phakathi ukufinyelela kwezokunakekelwa kwezempilo. Futhi izinqubomgomo zeMedicaid zibona ushintsho. INebraska izoba yisifundazwe sama-37 ukwamukela ukunwetshwa kweMedicaid, kepha akukasetshenziswa okwamanje. Ngosizo lweCoronavirus Aid, Relief, and Economic Security ( UKUNAKEKELA ) UMthetho, uMongameli uTrump awusayine waba ngumthetho ngoMashi 27, imali eningi yohulumeni izokwabelwa amazwe okwandisa kunezindawo ezinganwetshiwe. Izizwe zokunwetshwa kweMedicaid zizothola u- $ 1,755 kwizimali zikahulumeni ngesakhamuzi ngasinye ngokuqhathaniswa ne- $ 1,198 ngomhlali ngamunye wezindawo ezinganwebeki, ngokusho kwezibalo ezenziwe Isikhwama seCommonwealth .

Ngokwengeziwe, ukuhlolwa kokuxilongwa kwe-COVID-19 kumbozwe yiMedicaid ngaphandle kwezindleko ezigulini — kepha okwamanje akukho myalelo kahulumeni wokuthi ukwelashwa kwe-COVID-19 kumbozwe ngaphandle kwezindleko ezigulini. Kuyadida okuncane, kepha ezinye izifundazwe zikhombisile ukuthi ziyekela ukwabiwa kwezindleko okuhambisana nokuhlolwa kanye / noma ukwelashwa kwe-COVID-19. Ezitatimendeni zomphakathi, izikhulu zikahulumeni zikhombisile ukuthi izinkampani zomshuwalense ezihlinzeka ngokutholakala ngeMedicaid zivumile ukumboza konke ukuhlolwa kwe-COVID-19 ngaphandle kokwabelana ngezindleko nokuqinisekisa ukuthi ukwelashwa kuhlanganiswe ngokuphelele, ngokusho I-KFF .

Izinkinga zamanje nge-Medicaid

Amarekhodi akhombisa ukuthi uhulumeni wesifundazwe uvame ukukhokha phakathi kuka-50% no-77% wezindleko zombuso ngamunye zeMedicaid. Kodwa ngezindleko zabantu abadala abafanelekela iMedicaid ngaphansi koMthetho Wokunakekelwa Ongabizi, lelo nani liphakeme kakhulu: 90%. Ukunciphisa ukufaneleka, ukumbozwa kwezidakamizwa, nokwandisa inkululeko kahulumeni wezwe yokuyalela amaphuzu amahle kakhulu wezinhlelo zeMedicaid kungumzamo wokwehlisa leyo mali. Kepha, lokho kungaholela ezinkulungwaneni — noma kungezona izigidi — zabantu baseMelika abalahlekelwa ukufinyelela kwezempilo okungabizi. Kukhona nokunye ukungalungi kwabazuzi beMedicaid, kufaka phakathi ukukhetha okulinganiselwe nokutholakala kokunakekelwa, odokotela, imishanguzo nezindawo zokunakekelwa zesikhathi eside.

Ungonga kanjani ngemiyalo ene-Medicaid

Ngenkathi ungakwazi ukusebenzisa izinzuzo ze-SingleCare neMedicaid ngesikhathi esifanayo , ungasebenzisa i-SingleCare uma izintengo zethu ziphansi kune-Medicaid noma uma incwadi kadokotela ingamboziwe izinzuzo zakho. Uma usebenzisa ikhadi lakho le-SingleCare, ikhemisi liyalicubungula esikhundleni salokho wekhadi lakho le-Medicaid, hhayi ngokuhlangana ngekhadi lakho le-Medicaid. I-SingleCare ingakusiza wonge kufika kuma-80% emithini kadokotela — ukunciphisa izindleko zezidakamizwa ukuze ube nemali eningi esele yezinye izindleko zakho ezibalulekile. Ukuphela kokufanele ukwenze ukuvakasha iwebhusayithi yethu , funa umuthi wakho, bese uthumela ikhadi le-Rx kuwe noma uliphrinte ngokushesha — zombili izinhlobo zisebenza ekhemisi. Ungafunda kabanzi ngokusebenzisa i-SingleCare kanye nezinzuzo zakho zeMedicaid lapha .