Uhambisane nokuhlupheka kokubhalisela umshuwalense wezempilo . Ukhokhelwe ama- premium akho. Manje qiniseka ukuthi ungenzi enye yalezi zephutha zomshuwalense wezempilo uma usebenzisa umshwalense wakho wezempilo.
1) Awuyikuhlelwa kweDeductible and Coinsurance yakho
Umshuwalense wezempilo awusebenzi kahle uma ungenakuwusebenzisa ngoba awunakho ukukhokhela imali yakho yokubambisana , imali yokukhokha noma i-copays.
Ake sibhekane nakho, akuwona wonke umuntu onamadola angama-dollar ambalwa nje alele nje. Kodwa, ama-deductibles yiqiniso lokuphila ngezinhlobo ezithile zeminshuwalense yezempilo.
Kumele wenze uhlelo lokubhekana ne-deductible yakho, u-coinsurance, kanye ne-copays noma ungathola u-insured ngokugcwele kodwa awukwazi ukuthola ukunakekelwa kwezempilo okudingayo ngoba awukwazi ukukhokhela isabelo sakho sezindleko.
2) Ngokungahlosile Ukuphuma Ngaphandle Kwenethiwekhi
Izinhlelo eziningi zezempilo e-United States zinomnethiwekhi wezinhlinzeko zokunakekelwa kwempilo ezikhethwayo. Uma usebenzisa umhlinzeki kwinethiwekhi yakho yezinhlelo zempilo, ama-copays, u-coinsurance, kanye ne-deductible akho aphansi kunalokho uma usebenzisa umhlinzeki wangaphandle. Ama-HMO nama-EPO ngeke akhokhe noma yini ngokunakekelwa okuvela kumhlinzeki wangaphandle, kuyilapho ama-PPO kanye nama-POS akhokhela kancane, kodwa hhayi okuningi njengokungathi uzosebenzisa umnikezeli we-in-network.
Uma wazi ukuthi ungubani-inethiwekhi futhi akekho, ungabambelela kubanikezeli be-inthanethi futhi ugweme ukunakekelwa okungaphandle kwe-inthanethi okubiza kakhulu.
Nokho, lokhu akulula njengokuzwakalayo. Izinhlelo zezeMpilo zihlukumeza amanethiwekhi abo. Izivumelwano phakathi kwezinhlelo zezempilo kanye nabahlinzeki bazo zenethiwekhi ziphela futhi zingase zingabuyiselwa.
Udokotela wakho wokunakekelwa oyinhloko angase abe nomusa okwanele ukukwazisa uma eyeka ukubamba iqhaza kwinethiwekhi yakho yezinhlelo zempilo (noma angase angabikho), kodwa indawo yakho ye-mammogram, ilabhu yokuhlolwa kwegazi, kanye nekhemisi ayinakukunika amathuba okukunika.
Ngaphambi kokuba uthole noma yikuphi ukunakekelwa okungeyona eyiphuthumayo, hlola ukuthi umhlinzeki usese-inethiwekhi ngecebo lakho lempilo.
3) Ukungahambisani Nenani leNsiza yokuThuthukiswa kweNethiwekhi
Unelungelo lokunakekelwa ngaphandle kwenethiwekhi uma ukhetha, kodwa cishe uzokhokha ngaphezulu. Kodwa-ke, kwezinye izimo, ungase ukhethe ukukhokha ngaphezulu ngoba uzizwa ukuthi imali eyengeziwe iyakufanelekela ukunakekela kwakho kumhlinzeki othile.
Uma ukhetha ukuthola ukunakekelwa kwe-out-of-network, xozanani ngentengo yalokhu kunakekelwa kusengaphambili ngenkathi usenamandla okuxoxisana. Umhlinzeki wakho wokuphuma ngaphandle wenethiwekhi uyaqonda ukuthi uma engeke axoxe, angase alahlekelwe ibhizinisi lakho. Futhi, nakuba engaphandle kwenethiwekhi kuwe, mhlawumbe use-inethiwekhi yelinye uhlelo lwezempilo, ngakho unikeza umuntu isaphulelo. Kungenzeka futhi asondise leso saphulelo kuwe.
Ngokuxoxisana nezindleko zokunakekelwa kusengaphambili, ungakwazi ukunciphisa ingozi yakho yezezimali futhi ugweme ukukhokhiswa kwezimali kanye nezinye izimangalo zezimali ezimbi.
4) Ukungatholi Ukugunyazwa Uma Kudingeka
Ingabe uhlelo lwakho lwezempilo ludinga ukuba uthole ukugunyazwa kwangaphambi kokuba ube nokuhlolwa kwamanani, izinqubo, noma ukwelashwa? Ama-PPO amaningi nama-EPO enza. Uma uhlelo lwakho lwezempilo ludinga lokhu futhi ungatholi ukugunyazwa kwangaphambili, ungase uthuthuke ngokumangala okungokwemali.
Isibonelo, uma uhlelo lwakho lwezempilo lunesidingo sokugunyazwa kwangaphambi kokugunyazwa kwezingcingo ezingekho eziphuthumayo ze-MRI futhi uthola ukuskena kwe-MRI ngaphandle kokuthola kuqala ukugunyazwa, uhlelo lwakho lwezempilo lungenqaba ukukhokha ukuskena. Lokhu kuyiqiniso ngisho noma ungafakazela ukuthi udinga ngempela ukuskena. Cabanga ngakho njengenhlamba yobuchwepheshe. Awuzange ulandele imithetho futhi ugxume kuwo wonke ama-hoops ngendlela elungile, ngakho-ke uthola ukuhlawuliswa ngokukhokha imali yakho.
Ukuze ugweme lokhu, uma uhlelo lwakho lwezempilo ludinga ukugunyazwa kwangaphambili, ungacabangi nje ukuthi udokotela wakho uzothola ukugunyazwa kwangaphambi kwakho. Angase; kodwa, uma engakwenzi, le buck ihamba nawe, hhayi naye.
Uzoba nguyena onamathela ekukhokheleni umthethosivivinywa. Uma ungaqiniseki uma ukuhlolwa, inqubo, noma ukwelashwa kudinga ukugunyazwa kwangaphambili, shayela uhlelo lwakho lwezempilo bese ucela.
5) Ukungalandeli Ngokuhlelwa Kwezinhlelo Zokwelapha
Uma unayo i- HMO, i-PPO, i-EPO, noma i-POS plan, enye yezobuchwepheshe uhlelo lwakho lwezempilo olungasetshenziswa ukuze lukwazi ukuphatha izindleko zalo luhlelo lwezokwelapha. Izinhlelo zokwelashwa zase-Tiered zisebenza kanje: uma kunezindlela ezintathu zokwelapha inkinga yakho yezokwelapha, lolu hlelo luzofuna ukuthi usebenzise ukhetho oluncane lokuphatha ukwelashwa kuqala. Uma uzama ukwelashwa okungabizi okungabizi kakhulu futhi akusebenzi, khona-ke uhlelo luzovuma ukukhokha ukhetho lwezokwelapha olubizayo lwesibili. Lolu hlelo luzovuma kuphela ukukhokha izinkokhelo eziyingozi kakhulu kulezi zindlela ezintathu zokwelashwa ngemuva kokuthi uzame futhi wehlulekile izinketho ezimbili ezibizayo.
Ungase usho ukuthi izinketho eyodwa nobili ngeke zisebenzele wena, futhi ufuna ukweqa ngakwesokudla kunketho ezintathu. Kodwa-ke, ngaphandle uma kukhona isizathu sezokwelapha ukuthi kungani okukhethwa kukho kokubili kokubili kungaba yingozi endaweni yakho ethile (isibonelo, unelungelo lokuzivocavoca kumuthi owodwa ongakhetha kukho), uhlelo lwakho lwezempilo luzokwehla ukukhokha inketho ezintathu uze uzame futhi ukuhluleka kokubili izinketho zokwelapha ezishibhile.
Kungani izinkampani zomshuwalense wezempilo zenza lokhu? Ngenxa yokuthi iningi labantu lizoyeka futhi libeke inketho eyodwa noma okukhethwa kukho kabili nakuba kungasebenzi kanye nokuthi babethemba. Bagula futhi bekhathele ukubuyela kudokotela besalokhu bekhononda ngale nkinga efanayo, ngakho bahlala emiphumeleni engaphansi ngoba bangenele. Ekugcineni, lokhu kugcina izinkampani zomshuwalense wezempilo imali eningi.
Uma lokhu kwenzeka kuwe, umsebenzi wakho uwukubuyela emuva futhi usebenze ngendlela yakho kuze kube yilapho uthola ukhetho lwezokwelapha olusebenza ngempela kokubili umzimba wakho nendlela yakho yokuphila.
6) Akuyona Ukuthengiswa Ngaphandle Kwezinhlinzeko Ze-In-Network Uma Uzothola I-Coinsurance
Ingabe kufanele ukhokhe amaphesenti angu-20, amaphesenti angu-30, noma ngisho no-40% wezinkampani zokunakekelwa kwempilo? Ingabe udinga isevisi ebiza kakhulu? Khona-ke udinga ukuthenga nxazonke, ngisho naphakathi kwabahlinzeki be-in-network .
Izinkampani zomshuwalense wezempilo zixoxisana ngamazinga atholakalayo nabanikezeli babo be-in-network, kodwa isaphulelo akuyona into efanayo kubo bonke abahlinzeki. Ngezinye izikhathi uhlelo lwakho lwezempilo luxoxisana ngesaphulelo esikhulu; ngezinye izikhathi kuxoxisana nesaphulelo esibi.
Njengoba u-coinsurance yakho iphesenti lentengo ehlisiwe, qinisekisa ukuthi uyayikhokha ngesilinganiso esiphezulu esiphenduliwe, hhayi ngesilinganiso esiphezulu ngoba awuzange uthenge phakathi kwabahlinzeki be-in-network.
Nakhu ukuthi kusebenza kanjani. Ake sithi uhlelo lwakho lwezempilo luxoxisane nesilinganiso esilinganiselwe samaRandi ayi-10 000 ekuhlinzekeni kwezinyawo zakho noDkt. Jones. Ukubambisana kwakho kungamaphesenti angama-30, ngakho-ke uzokhokha u-$ 3,000 ephaketheni lakho uma uDkt Jones enza ukuhlinzwa.
Ngakwesokudla edolobheni, uDkt. Brown naye u-inethiwekhi ngecebo lakho lempilo kodwa akuyona into engumxhumanisi. Uhlelo lwakho lwezempilo lukwazi ukumenza avumelane nesilinganiso esaphulelo samaRandi ayi-8,000 ukuze kwenziwe ukuhlinzwa okufanayo kwe-ankle. Uzokhokha imali engu-30% uma usebenzisa uDkt Brown, kodwa uzogcina imali ngoba ukhokha kuphela amaphesenti angu-30 etafuleni lakhe elingamaRandi ayizigidi ezingu-8, kunama-30% wezinga likaDkt Jones '$ 10,000. Ungalondoloza imali engu- $ 600 ngokusebenzisa uDkt Brown kunokuba uDkt. Jones noma ngabe bobabili odokotela abahlinzayo babese-inethiwekhi necebo lakho lempilo.
7) Akunakudluliswa Ukulahlwa Kwemangalo
Kunezikhathi lapho wenze khona konke okulungile kodwa uhlelo lwakho lwezempilo lunyakazela isimangalo somshuwalense wezempilo. Uma lokhu kwenzeka kuwe, thatha umoya ojulile futhi ubuke ngokucophelela okwenzekile. Uke walandela yonke imithetho yakho yezempilo? Ingabe ukukhathalela kunenzuzo ehlanganisiwe yecebo lakho lempilo? Ingabe udinga ngempela ukunakekelwa? Uma uphendula u-yebo kuwo wonke wale mibuzo, kufanele ususe isikhala sakho sokuphika isimangalo sezempilo.
Nakuba kungase kube nomuzwa wokuthi uDavid ulwa nenkampani yomshuwalense weGoliath ene-slingshot kuphela, khumbula ukuthi uDavide wayinqoba leyo mpi. Amaphesenti amakhulu okuphika amacala aphikisana nesibheno. Bhalisa usizo ludokotela wakho, thola amadada akho ngokulandelana, bese uhamba nge-slingshot yakho.