Ukuqonda Izizathu Ezibangelwa Impilo Yomshuwalense Wokumangalelwa Kwezempilo
Uma udokotela wakho ekhuthaza ukuhlolwa, imithi, noma inqubo futhi umshuwalense wakho wezempilo ngeke akhokhele, kungasabisa. Uma kukhona ukuhlolwa okunye, imithi, noma inqubo ezosebenza futhi uhlelo lwakho lwezempilo luzofihla, khona-ke lesi simo nje kuyisisindo esicasulayo. Kodwa, uma ukuhlolwa, imithi, noma inqubo yinto kuphela ezosebenza, isimo singasongela ukuphila.
Uma lokhu kusho noma ukuphika kokugunyazwa kwangaphambi kokugunyazwa kwenzeka kuwe, kuvamile ukuba uthukuthele futhi ufuna ukulwa nokuphika. Nokho, ngaphambi kokuba usebenzise amandla akho kule mpi, qiniseka ukuthi wazi kahle ukuthi kwenzekani nokuthi kungani uhlelo lwakho lwezempilo lungakhokhelwa.
Ngenkathi ucwaninga imbangela yokuphika isimangalo noma ukwenqaba isicelo sakho sokugunyazwa kwangaphambi kokugunyazwa, uzothola ukuqonda okubalulekile ezindinganisweni zokwelapha inkinga yakho yezokwelapha, kanye nendlela inkampani yakho yomshuwalense wezempilo "ecabanga ngayo." Uzoba isosha elinamandla kakhulu uma ukulwa nenkampani yakho yomshuwalense wezempilo kuyadingeka.
Izizathu Umshwalense Wempilo Yakho Ngeke Ukhokhele Ukunakekela Udokotela Wakho Uthi Udinga
Okudingayo akuyona inzuzo ehlanganisiwe yecebo lakho lempilo.
Uma uhlelo lwakho lwezempilo luphika isimangalo sakho noma lwenqaba isicelo sakho sokugunyazwa kwangaphambi kwalesi sizathu, ngokuyisisekelo sithi inqubomgomo yakho ayihlanganisi lokho kuhlolwa, ukwelashwa, noma izidakamizwa kungakhathaliseki ukuthi izimo ziphi.
Umshwalense wakho kufanele azi kahle ukuthi izinzuzo zakho zinikeza izinzuzo nokuthi yini engavunyelwe, kepha ngezinye izikhathi umshwalense wakho akalungile . Hlola inqubomgomo yakho ngokucophelela. Uma umshuwalense wakho wezempilo usebenza ngomsebenzi wakho, hlola ngehhovisi lakho lezinzuzo zokusebenza ukuze ubone ukuthi empeleni unayo yini ukuhlinzeka ngensizakalo yomshuwalense wakho wezempilo uthi awuhlanganisiwe.
E-United States, amaqembu amancane kanye nezinhlelo zempilo zomuntu manje kufanele abhekane nezinzuzo zezempilo ezibalulekile, kodwa izinhlelo ezinkulu eziqashiwe nomqashi kanye namacebo amakhulu azidingeki ukuhlinzekela okufanayo.
Uma unomuzwa wokuthi unqatshelwe izinzuzo zokufaka inqubomgomo yakho ukuthi usuke unayo, landela inqubo yokudlulisela incwajana yakho yezinhlelo zempilo. Futhi, funa usizo lwehhovisi lakho lezinzuzo zomsebenzi uma ukufakwa kwakho kusekelwe emsebenzini, noma umshuwalense wombuso wakho wombuso uma umshuwalense wakho ungasebenzi.
2. Uthola ukunakekelwa kusuka kumhlinzeki wangaphandle wenethiwekhi uma ukuhlinzekwa kohlelo lwakho lwezempilo kunqunyelwe kubahlinzeki be-inthanethi.
Uma unayo i- HMO noma i- EPO , ngezinye izimbalwa ezimbalwa, ukuhlinzeka kwakho kunqunyelwe kubahlinzeki be-inthanethi ukuthi uhlelo lwakho lwezempilo lunesivumelwano. Umshwalense wakho wezempilo ngeke akhokhe uma usebenzisa umhlinzeki wangaphandle.
Uma ucela ukugunyazwa kwangaphambi kokuqala futhi isicelo sakho sokugunyazwa kwangaphambi kokugunyazwa sinqatshiwe ngenxa yomhlinzeki wakho okhethiwe, ungaphinda uhambise isicelo usebenzisa umnikezeli wenethiwekhi kunokuba umhlinzeki wangaphandle.
Kodwa-ke, uma usuvele unakekele futhi uhlelo lwakho lwezempilo ngeke ukhokhe isimangalo sakho ngoba uphume ngaphandle kwenethiwekhi, uzoba nokulwa okunzima kakhulu ezandleni zakho.
Ungaphumelela uma ungabonisa ukuthi akekho abahlinzeki be-in-inethiwekhi abakwazi ukuhlinzeka ngaleyo nsizakalo ngakho kufanele uhambe ngaphandle kwenethiwekhi. Ungaphumelela futhi uma ungabonisa ukuthi kwakuyisimo esiphuthumayo futhi waya kumhlinzeki oseduze ongakwazi ukunakekelwa okudingayo.
3. Uhlelo lwakho lwezempilo alucabangi ukuthi ukuhlolwa, ukwelashwa noma izidakamizwa kunesidingo sempilo.
Uma isicelo sakho noma isicelo sokugunyazwa kwangaphambi kokugunyazwa sithole isidingo sezokwelapha esiphikayo, kubonakala sengathi umshuwalense wakho wezempilo ngeke akhokhe ngoba ucabanga ukuthi awudingi ngempela ukunakekelwa udokotela wakho akuphakamisile. Lokhu kungaba yilokho uhlelo lwakho lwezempilo empeleni lisho, kodwa kungenzeka ukuthi alukho.
Kunezizathu ezithile zokuphika okudingekayo kwezokwelapha ukuthi akusho ngempela ukuthi uhlelo lwakho lwezempilo lucabanga ukuthi ukunakekelwa akudingekile. Ukuze uthole ukuthi yikuphi, ngokuqondile, ukuphika okudingekayo kwezokwelapha kusho, kuzodingeka ukhiphe. Izindaba ezinhle yilokhu ukumba kungakukhombisa indlela yokuthola isicelo sakho sokugunyazwa ngaphambi kokugunyazwa, noma isimangalo sakho sikhokhelwa, uma nje uvula kancane indlela yakho.
Funda kabanzi ku-"Kungani I-Health Plan Yami Ithi Ukunakekela Ngidinga Akudingekile?"
4. Uhlelo lwakho lwezempilo aluboni ukuthi unelungu elizuzayo, nokunye ukuxuba.
Lolu hlobo lwesimo luvame kakhulu kunabantu abaningi abangacabanga. Esikhathini sesimiso sokunakekelwa kwempilo esiyinkimbinkimbi yanamuhla, ulwazi mayelana nokuthunyelwa kwakho kufanele lugele kahle kusuka kumqashi wakho, umthengisi womshuwalense, noma ukushintshaniswa komshuwalense wezempilo ohlelweni lwakho lwezempilo. Uma kune-glitch noma ukubambezeleka noma ikuphi endleleni, kungabonakala sengathi awunayo umshuwalense wezempilo noma ngabe wenza ngempela.
Kule migqa efanayo, kuvamile ukuba abahlinzeki benkampani bezempilo baphumelele ekhamphani yokuphathwa kwezokwelapha isinqumo sokwenza ukuthi ngabe ukuhlola kwakho, ukwelashwa noma izidakamizwa zakho kuzotholakala noma cha. Kulesi simo, ulwazi mayelana nokuthunyelwa kwakho kufanele lugele ngokufanele kusuka ohlelweni lwakho lwezempilo ku-kontrakta yokuphathwa kwezokwelapha. Ngokufanayo, ulwazi mayelana nesimo sakho sezokwelapha kufanele lugele kahle kusuka ehhovisi ledokotela yakho kuya ohlelweni lwezempilo noma ukwelashwa kwezokwelapha. Noma yikuphi ukugqama kokugeleza kwalolu lwazi kungaholela ekuphikeleni isimangalo noma ukwenqaba kwesicelo sakho sokugunyazwa kwangaphambili.
Izindaba ezinhle ukuthi ukuphika kokumangalelwa noma ukulahlwa kokugunyazwa kwangaphambi kokugunyazwa kungaba lula ukuguqulwa uma uqonda kahle ukuthi iyiphi inkinga. Ukuze uthole ulwazi oluthe xaxa, bheka " Indlela Ye-Silly Mix-Ups Yenza Ukuthi Ukumangalelwa Kwempilo Yomshuwalense Wezempilo ."
5. Ukuhlala kwakho esibhedlela kwakuthathwa ngokungalungile njengesifo sengqondo esibhedlela.
Uma i-Medicare noma uhlelo lwakho lwezempilo lenqaba ukukhokhela ukuhlala esibhedlela, isizathu singase sibe nokungavumelani ngesimo esifanele sokuhlala esibhedlele kunokuba kungavumelani ngokuthi ngabe empeleni udinga ukunakekelwa. Uma iziguli zifakwa esibhedlela, zinikezwe isimo sokubuka noma isimo sesineke esibhedlela ngokwemigomo nemigomo eyinkimbinkimbi.
Kuvamile esibhedlela kanye nodokotela wakho wokuvuma ukukholelwa ukuthi kufanele uvunyelwe isimo sesineke, kanti uMedare noma uhlelo lwakho lwezempilo ucabanga ukuthi kufanele ube esibhedlela ngesimo sokubheka. Nakhu okubanjwayo: uma ungeniswe esimweni esingalungile, uhlelo lwakho lwezempilo noma uMedare unganqaba ukukhokha konke ukungena ngisho noma umshwalense wakho evuma ukuthi udinga ukunakekelwa esibhedlela esinikeziwe. Kuyinto enjengokungcolisa ubuchwepheshe.
Funda kabanzi mayelana nale nkinga ngokubhekene nesimo sengqondo sesifo sengqondo esibhedlela "Esikhathini Sokubheka Isibhedlela? Uzokhokha Okunye . "
Kufanele Usebenzise Nini Ummeli Wokukhokhelwa Kwezokwelapha?
Yebo, kunesilinganiso sokunakekelwa kwempilo e-United States