Nurse-navigator amathandiza odwala kupeza chisamaliro chomwe akufunikira

SAN ANTONIO – Maria Lee, wodziyimira pawokha wa inshuwaransi komanso mlangizi wa Medicare, amagwiritsidwa ntchito kupulumutsa makasitomala ake ndalama mwezi uliwonse, koma tsiku lina muofesi amasunga mwendo wa mayi.

Ndinakumbukira kuona kasitomala watsopano m’nyumba yaing’ono ya maofesi imene ndinachita lendi kum’mwera kwa San Antonio.

zokanidwa: Momwe COVID yawonongera mbali yakumwera kwa San Antonio

Mayiyo adamuuza kuti amavutika kuti azilipira $ 45 kawiri pa sabata chifukwa chodulidwa pang’onopang’ono, zomwe zinakula kwambiri ndi matenda a khansa ya siteji-4 ya mwamuna wake. Ndalama zomwe amapeza pamwezi zinali zosakwana $2,000.

thanzi labwino: Madera olemera a San Antonio ali ndi zipatala zambiri

Kenako mayiyo anakweza mwendo wake n’kuonetsa chilonda chotuluka. Lee, wazaka 47, yemwe anali namwino wamabanja asanakhale woyendetsa zachipatala, adadziwa kuti mayiyo ali pachiwopsezo choduka mwendo.

“Ndinkafuna kuyenda kudutsa msewu kupita ku chipatala, chifukwa ngati izo zifika m’magazi, zikhoza kukhala zodulidwa,” adatero Lee, ponena za San Antonio Vascular and Endovascular Clinic.

za nkhaniyi

Laura Garcia wanena za kusiyana kwaumoyo ku Express-News ngati 2021 Annenberg National Fellow ku University of Southern California’s Annenberg Center for Health Journalism komanso wopindula ndi Dennis A. Hunt Health Press. Werengani zambiri Expressnews.com/access-denied.


Lee adayimbira chipatala, chotchedwa SAVE, kuti awone ngati dokotala wa opaleshoni ya mitsempha Dr. Mwamwayi kwa mayiyu, ndinali ndi mgwirizano ndi Ochoa-CEO komanso woyambitsa wa SAVE Clinic komanso m’modzi mwa akatswiri ochepa amankhwala a mitsempha ku South Side yomwe ilibe mphamvu mumzindawu.

Pamene Lee ankagwira ntchito kuti mayiyo apite ku ndondomeko yaumoyo yotsika mtengo, a SAVE Clinic adatha kupulumutsa mwendo wake.

Zogwirizana: Momwe tidasanthulira zambiri zakusalinganika kwaumoyo ku San Antonio

Lee ndi Ochoa ndi m’gulu la anthu oyenda panyanja ku San Antonio omwe amalankhula Chisipanishi ndipo amamvetsetsa zovuta zachikhalidwe komanso zopinga za chikhalidwe cha anthu zomwe zimalepheretsa anthu ambiri kupeza chisamaliro chomwe akufunikira.

Lingaliro, akuti, ndikuletsa odwala kuti asagwe m’ming’alu yachitetezo chaumoyo chomwe chimayendetsedwa ndi phindu mdziko muno – ming’alu yomwe ingakhale yotakata komanso yowopsa kwa ambiri ku South Side, makamaka Latinos.

Opaque system

Kwa zaka zingapo zapitazi, Lee wakhala waluso kwambiri pofufuza njira zothandizira anthu.

Kudziwa ma nuances azachipatala sikophweka, ngakhale kwa iwo omwe ali m’makampani. Zochita pakati pa makampani a inshuwaransi payekha, makampani opanga mankhwala ndi othandizira azachipatala akusintha nthawi zonse.

Njira iliyonse yazaumoyo Lily amauza makasitomala ake kuti ili ndi zofunikira zake komanso zoletsa, chifukwa chake yambani kuwadziwa.

Ngati makasitomala ake ali ndi zaka 65 kapena kupitilira apo kapena ali ndi chilema, amawathandiza kufunsira Medicare ndikuwonetsetsa kuti madotolo awo ndi zipatala zapafupi zili pa intaneti.

Kwa makasitomala ang’onoang’ono omwe sangathe kupeza mapulani omwe amathandizidwa ndi abwana, amafufuza kuti awone ngati akuyenerera ndondomeko yaumoyo yothandizidwa ndi Affordable Care Act. Ngati ndondomeko yavomerezedwa pa health.gov, imawathandiza kupeza dokotala wodziimira yekha yemwe angavomereze inshuwalansi ya ACA.

Koma ngati mapulaniwo sangatheke, amapeza ngati ali oyenerera pulogalamu yachitetezo yakumaloko kudzera ku CommuniCare kapena CentroMed, chipatala chovomerezeka ndi federal chomwe chimapereka chithandizo chamankhwala chotsika mtengo, zamakhalidwe, zamano, komanso zachipatala.

Lee amatsogoleranso anthu okhala ku South Side ku Wesley Health and Wellness Center yapafupi kapena Dixon Health and Wellness Center, yomwe imayendetsedwa ndi bungwe lopanda phindu la Methodist Health Care Ministries la South Texas Inc.

Koma ngati akukhala ku Bexar County ndipo angafunikire kugonekedwa m’chipatala, amawatsogolera ku CareLink, pulogalamu yothandizira ndalama yomwe imalola anthu kuti apeze University Health kudzera mu Chipatala cha Bexar County Hospital District. Pulogalamuyi imafunikira umboni wokhala ndi ndalama zabanja.

Lee atasiya udokotala, ndidakhala mlangizi wovomerezeka ndi CentroMed munthawi yanga yoyamba yolembetsa ku Obamacare ndipo pamapeto pake ndidapeza digiri ya masters pazaumoyo.

Pambuyo pake adakhala bizinesi ya inshuwaransi yovomerezeka kuti athe kuthandiza anthu kuyesa zomwe angasankhe ndikuphunzira momwe angayendetsere chithandizo chamankhwala.

Lee wakhala akudikirira makasitomala kwa milungu ingapo kuti abwererenso ndi miyezi kuti apite kuchipatala, ndipo ena adamuuza kuti akuganiza zopeza ndalama mu 401 (k) mapulani awo asanafike kuti asasunthike.

Awonapo anthu akudyetsedwa ndi scammers: omwe akugulitsa inshuwaransi zomwe zimatchedwa “zochepa” zomwe sizimalipira Medicare nthawi zonse kapena ma broker omwe akugulitsa mapulani okwera mtengo ndi inshuwaransi ya moyo ndi chithandizo cha mano ndi masomphenya.

Chifukwa ndi yodziyimira pawokha, ilibe udindo wotsogolera makasitomala ku mapulani ena ndipo salipira magawo ake.

Anatinso makasitomala ena amabweretsa achinyamata kuti awathandize kumvetsetsa tsatanetsatane wa chithandizo chawo chaumoyo monga ndalama zolipirirana, ndalama zochotsera komanso zipatala zapaintaneti. Auzeni za kuchotsera ndi njira zosungira ndalama zomwe mwapatsidwa.

Nthawi zina, mukudziwa kuti achinyamata anu akufuna kupita ku koleji, kotero mumawathandiza kuti apemphe thandizo la ndalama.

Makasitomala ake okhazikika kaŵirikaŵiri amasonyeza kuyamikira kwawo patchuthi, iye anati, ndi zinthu zowotcha, chilili chatsopano, ndi tamales zopangira tokha.

“zoyipa m’mitima mwanu”

Kwa anthu ambiri, makamaka omwe amakhala ku South Side, kupeza chithandizo chamankhwala kungakhale vuto lachuma, adatero Dr. Carlos Roberto Jaean, mkulu wa mankhwala a banja ndi ammudzi ku Long School of Medicine ku UT Health San Antonio.

Kutengera ndi mitengo yomwe opereka inshuwaransi amakambilana ndi azachipatala, ogula amatha kugwa m’ngongole mosavuta. Njirayi ndi yosamveka: Mtengo woyezetsa magazi nthawi zonse ku San Antonio umachokera ku $ 57 mpaka $ 443, malinga ndi lipoti la Health Care Cost Institute pogwiritsa ntchito deta kuchokera ku 2017.

Jian, sing’anga wamabanja, amathandizira odwala ena omwe ali osauka kwambiri komanso odwala kwambiri mumzindawu ku Family Health Center yothandizidwa ndi boma, yomwe ili kumunsi kwa sukulu ya Robert B.

Kafukufuku wopangidwa ndi Jian ndi ofufuza ena anayi adapeza kuti kupereka mayendedwe aulere opita kuchipatala kwa odwala omwe ali pamavuto azachuma kudapangitsa kuti ziwonetserozo zichepe komanso kuletsedwa, kupulumutsa chipatala cha m’chigawocho kuposa $15,000 pamwezi.

Kupereka maulendo ozungulira kunathandizanso odwala kupewa kuyendera zipinda zadzidzidzi kapena kugona m’chipatala, zomwe kafukufukuyu adati zitha kuwononga nthawi 141 kuposa kulandira chithandizo chadzidzidzi.

Komabe, kusiyana kwaumoyo sikungathetsedwe pongolipira zokwera za Uber kapena kumanga zipatala zambiri.

Kafukufuku akuwonetsa kuti kupirira zovuta kumatha kukhala ndi zotsatirapo zoyipa pamaganizidwe ndi thupi, ndikuwonjezera mwayi wokhala ndi matenda osachiritsika monga mtundu wa 2 shuga ndi matenda amtima.

“Tikudziwa kuti kupanikizika kosalekeza kumapweteka mkati mwanu,” adatero. “Zimakweza mahomoni onse opsinjika maganizo omwe amakweza kuthamanga kwa magazi, omwe amakweza shuga wanu m’magazi ndipo amachititsa kuti thupi lanu likhale lofanana ndi maapulo chifukwa cha momwe thupi lanu limasungira mafuta.

Zosapiririka basi.

Pamene Lee anali namwino, nthawi zambiri ankawona odwala matenda a shuga omwewo akupita ku chipatala popanda kuoneka kuti akuchira. Amawafunsa ngati akumwa mankhwala ndipo adamva kuti ambiri aiwo sanapite ku pharmacy kukalemba mankhwala awo. Ndi okwera mtengo kwambiri.

“Amabweranso kwa ife m’milungu iŵiri kapena itatu ndendende, ngati sichoipa kwambiri, chifukwa chakuti timayiwala kuti kunja kwa ulendowu umene mwina umawatengera $25 kapena $40 powalipira nawo limodzi, sangaupeze,” iye anatero. amayenera kuchiritsidwa mwezi umodzi nthawi zina amatenga miyezi itatu.”

Lee ankawona zochitika zopweteka mtima ngati zimenezi tsiku lililonse kuntchito, koma sanazimvetse mpaka pamene amayi ake anapezeka ndi matenda a shuga a mtundu wachiwiri ali ndi zaka 40.

Mayi ake a Lee, a María Jimenez, ankagwira ntchito maola 12 tsiku lililonse m’lesitilanti, pamene bambo ake ankagwira ntchito yomanga dziwe losambira. Nthawi zambiri ankagwira ntchito usiku mu lesitilanti yomweyo. Analibe inshuwaransi yazaumoyo kudzera mwa owalemba ntchito. Izi zinali patsogolo pa Affordable Care Act, yomwe imapereka ndalama zothandizira kulipira ndalama za inshuwaransi pamwezi.

Amayi ake adapatsidwa mankhwala amkamwa otchedwa Actos kuti achepetse shuga wake m’magazi. Popanda kuchitapo kanthu, iye anali pachiopsezo cha mavuto aakulu, kuphatikizapo sitiroko ndi kuwonongeka kwa maso.

Amakumbukira kuti ankapita kunyumba ya amayi ake n’kumeta zidutswa za mtengo wa aloe, n’kuziika pachilonda pa mwendo wa mayi ake, n’kupemphera kuti chira chichiritse. Iwo ankamumanga bandeji chifukwa mayi ake ankayenera kupita kuntchito, ndipo nthawi zonse ankaopa kuti akhoza kudwala matenda n’kuduka chiwalo.

Kwa kanthawi, Lee adatha kupeza mankhwala amtunduwo kudzera m’mapulogalamu othandizira azachipatala kapena kupeza zitsanzo polumikizana ndi anthu omwe amawadziwa, koma zidazo zitatha, banjali lidayang’anizana ndi kulipira mpaka $250 pamwezi.

Anandiuza kuti: “Zinali zosaneneka.

Lee anali atangobereka kumene mwana wake woyamba, ndipo makolo ake ankatumiza ndalama kwa makolo awo ku Mexico. Chifukwa chake, popeza mapiritsi alibe ndalama komanso mayi ake a Lee akufunika kutsitsa shuga m’magazi awo, adokotala adapereka insulin.

Maso a Lee adagwetsa misozi pomwe amawopa mayi ake kuti adzibaya jakisoni wa insulin.

Anandiuza kuti: “Ndinayenera kumuthandiza jekeseni madzulo ndikumuwonetsa mobwerezabwereza.” “Osachepera ndinali ndi galimoto ndipo ndinaphunzitsidwa zachipatala, koma ndinkawauza kuti, ‘Amayi, muyenera kutenga izi. Ndikudziwa kuti simukufuna zimenezo.’

Mayi ake a Lee anafunsa mobwereza bwereza chifukwa chimene analephera kupitiriza kumwa mapiritsi.

Ndinkati, Amayi, sitingakwanitse kugula mapiritsi. … Chifukwa chake insulin idakhala moyo wabwinobwino kwa iye. “Kubaya zala kawiri kapena katatu patsiku kwakhala njira yachibadwa kwa iye,” adatero. “Panalibe kuchitira mwina.”


laura.garcia@express-news.net

Leave a Comment

Your email address will not be published. Required fields are marked *