Yini Okukhululekile Futhi Okungekho
Ngenxa yoMthetho Wokunakekelwa Onganakekelwayo , abaqinisekisi bezempilo e-US kufanele bahlinzekele ukunakekelwa kwezempilo okuvimbela kokubili abadala nabantwana ngaphandle kokukhokha imali ekhokhwayo, ikhophi yokukhokhela noma imali yokukhokhela imali .
Kodwa-ke, okubaluleka njengokunakekelwa kokuvikela kungadideka. Nasi uhlu olusekelwe eminyakeni yobudala lwezinsizakalo zokunakekelwa ezinganeni zokuthi, uma kunconywa udokotela wengane yakho, kufanele ikhokhwe ngumshuwalense wezempilo wengane yakho ngaphandle kokukwabelana ngezindleko .
Abantu abadala banalo uhlu oluhlukile .
Ukunakekelwa Kwezingane Ukuvimbela Kuhlanganiswe Ngaphandle Kwezindleko-Ukwabelana
Izinsana
- Ukuzwa ukuhlolwa
- Imithi yokuvimbela i-Gonorrhea emehlweni
- Ukuhlolwa kwesilonda noma i-hemoglobinopathy
- Ukuhlolwa kwe-Hypothyroidism
- Ukuhlolwa kwe-Phenylketonuria (PKU)
Iminyaka engu-0-11 yobudala
- Ukuhlola kokuziphatha
- Ukuhlolwa kwengcindezi yegazi
- Ukuphakama kwesisindo, isisindo, nesilinganiso somzimba womzimba
- Umlando Wezokwelapha
- Ukuhlolwa komngcipheko wezempilo ngomlomo
- Ukuhlolwa kwe-Tuberculin uma ingane yakho isengozini enkulu yesifo sofuba
- Ukuhlolwa kokuthuthukiswa
- Izithako ze-Iron ezinganeni ezineminyaka engu-6 kuya ezinyangeni ezingu-12 uma zisengozini yokuthola i-anemia
Iminyaka engu-1-4
- Ukuhlolwa kokuziphatha
- Ukuhlolwa kwegazi
- Ukuphakama, isisindo, nokulinganisa kwenani lomzimba
- Umlando wezokwelapha
- Ukuhlolwa kwengozi yempilo yomlomo
- Ukuhlolwa kwe-tuberculin uma ingane yakho isengozini enkulu yesifo sofuba
- Ukuhlolwa kwesifo se-dyslipidemia uma ingane yakho isengozini enkulu ye-lipid disorder
- Ukuhlolwa kwe-Autism ezinyangeni ezingu-18 nezinyanga ezingu-24
- Ukuhlolwa okuthuthukayo kwabantwana abangaphansi kweminyaka emithathu ubudala
Iminyaka engu-5-10
- Ukuhlolwa kokuziphatha
- Ukuhlolwa kwegazi
- Ukuhlolwa kwesifo se-dyslipidemia uma ingane yakho isengozini enkulu ye-lipid disorder
- Ukuphakama, isisindo, nokulinganisa kwenani lomzimba
- Umlando wezokwelapha
- Ukuhlolwa kwengozi yempilo yomlomo
- Ukuhlolwa kwe-tuberculin uma ingane yakho isengozini enkulu yesifo sofuba
Iminyaka engu-11-14 yobudala
- Ukuhlolwa kokuziphatha
- Ukuhlolwa kwegazi
- Ukuhlolwa kwesifo se-dyslipidemia uma ingane yakho isengozini enkulu ye-lipid disorder
- Ukuphakama, isisindo, nokulinganisa kwenani lomzimba
- Umlando wezokwelapha
- Ukuhlolwa kwe-tuberculin uma ingane yakho isengozini enkulu yesifo sofuba
Iminyaka engu-15-17 yobudala
- Ukuhlolwa kokuziphatha
- Ukuhlolwa kwegazi
- Ukuhlolwa kwesifo se-dyslipidemia uma ingane yakho isengozini enkulu ye-lipid disorder
- Ukuphakama, isisindo, nokulinganisa kwenani lomzimba
- Umlando wezokwelapha
- Ukuhlolwa kwe-tuberculin uma ingane yakho isengozini enkulu yesifo sofuba
Izinsana
- Ukuhlolwa kokusetshenziswa kotshwala nokusetshenziswa kwezidakamizwa
- Ukuhlolwa kwe-dysplasia yomlomo wesibeletho kwabesifazane abenza ucansi
- Ukuhlola ukucindezeleka
- Ukuhlola i-HIV uma kunengozi eyengeziwe
- Ukuhlolwa kwegciwane lesandulela ngculazi nokululekwa ngokuvimbela ukuvimbela isifo uma kunengozi eyengeziwe
Yonke iminyaka kusukela ekuzalweni kuya eminyakeni engu-18, noma hhayi eqondene nonyaka
- I-fluoride supplements yezingane ngaphandle kwe-fluoride emthonjeni wamanzi
- Ukuhlolwa kwe-Hematocrit noma i-hemoglobin
- Ukuhlola ukuhola izingane ezisengozini yokuchayeka
- Ukuhlolwa kokukhuluphala nokululekwa
- Ukuhlola ukubuka
- Ukugonywa njengoba kunconywa ngokusekelwe eminyakeni yobudala kanye nenani labantu
- I-diptheriya, i-tetanus, i-pertussis
- Haemophilus influenzae uhlobo b
- I-hepatitis A
- I-hepatitis B
- I-Papillomavirus yabantu
- I-Poliovirus engasebenzi
- Umkhuhlane
- Izisulu
- I-Meningococcal
- I-pneumococcal
- I-Rotavirus
- I-Varicella
Ukunakekelwa Okuvimbelayo Okungeyona Ekhululekile
Uma ingane yakho inomsebenzi wezempilo wokunakekelwa ophethwe osebenzisa inethiwekhi yomnikezeli , kuvunyelwe ukukhokhisa ukwabelana ngezindleko zokunakekelwa kokuvikela okuhlinzekwa ngabanikezeli be-out-of-network. Uma ungafuni ukukhokha ukunakekelwa kwengane yakho, sebenzisa umhlinzeki we-in-network.
Uma insizakalo yokuvimbela ingavunyelwe ngudokotela wengane yakho futhi
- kulinganiswe "A" noma "B" kulezincomo zamanje ze-United States Zokuvimbela Amasevisi Okuvikela, noma
- okuhlinzekwe kuzo iziqondiso eziphelele ezixhaswe yiMpilo yezokuPhathwa kanye nokuPhathwa kweziNsiza, noma
- Kunconywe yiKomidi Elulekayo Emisebenzini Yokugoma I-Centers for Disease Control and Prevention
ngakho-ke ngokuvamile ngeke inikezwe ngaphandle kokwabelana ngezindleko.
Uma umshuwalense wezempilo yengane yakho isuhlelo lwezempilo oluhle, luvunyelwe ukukhokhisa ukwabelana ngezindleko zokunakekelwa kokuvikela. Izincwadi zokuhlela ezempilo zizokutshela ukuthi uhlelo lwezempilo lube lukhulu kangakanani. Ngaphandle kwalokho, ungabiza inombolo yesevisi yamakhasimende kumakhadi we-ID yomshuwalense wezempilo yengane yakho noma hlola nomnyango wezinzuzo zabasebenzi uma ukuhlinzekwa kwempilo yengane yakho kusebenza ngomsebenzi wakho.
Ukunakekelwa Okuvimbelayo Akukakhululekile Ngempela
Nakuba umshuwalense wempilo yengane yakho kufanele ukhokhele izinsizakalo zezempilo zokuvimbela ngaphandle kokushaja i-deductible, i-copay, noma i-coinsurance, lokhu akusho ukuthi lezo zinsizakalo zikhululekile. Umshuwalense uthatha izindleko zokunakekelwa kwezinsizakalo zokuzivikela lapho ebeka amanani okuqala ngonyaka.
Nakuba ungakhokhi izindleko zokwabelana ngezindleko uma ingane yakho ithola ukunakekelwa kokuvikela, izindleko zalawo masevisi zihlanganiswe izindleko zemshuwalense wezempilo. Lokhu kusho ukuthi, noma ngabe ingane yakho ithola ukunakekelwa okuvikelwe okunconywe noma cha, uyayikhokha noma kunjalo ngezindleko zemishanguzo yomshuwalense wezempilo.
> Imithombo:
> Ukukhathazeka kwe-Care Act okuyizintambo - Setha i-12, Isikhungo Sokwaziswa Komthengi & Ukwaziswa Kwomshuwalense, Amasevisi Wezokwelapha Nezokwelapha.
> Umthetho Wokunakekelwa Okunakekelwayo Okunakekelwayo Ongathintekayo - Setha 18, Isikhungo Sokwaziswa Kwabathengi & Ukwaziswa Kwomshuwalense, Amasevisi Wezokwelapha Nezokwelapha.
> Imibuzo mayelana ne-Care Affordable Act Implementation (Ingxenye XXVI), UkuPhathwa KwezokuSekela UkuSebenza kwabasebenzi, uMnyango Wezabasebenzi wase-United States.
> Imisebenzi yezempilo evikela izingane, HealthCare.gov.