Izinkampani zomshuwalense zisebenzisa ukugunyazwa kwangaphambi kokugcina izindleko zezempilo ezibheke
Ukugunyazwa kwangaphambili kuyimfuneko yokuthi udokotela wakho uthola imvume evela kumhlinzeki wakho wezempilo ngaphambi kokumisela imithi ethize noma ukwenza umsebenzi othile. Ngaphandle kwalokhu kuvunyelwe kuqala, umhlinzeki wakho womshuwalense wezempilo angeke ahlinzekele ukukhokhelwa, noma akhokhe, imithi yakho noma ukusebenza, akushiye ukumboza ezinye, noma zonke, izindleko eziphuma ephaketheni.
Kungani Abahlinzeki Bempilo Abadinga Ukugunyazwa Ngaphambi Kokuqala?
Kunezizathu eziningana ukuthi umhlinzeki womshuwalense wezempilo udinga ukugunyazwa ngaphambi. Ikhamphani yakho yomshuwalense wezempilo isebenzisa isidingo sokugunyazwa kwangaphambili njengendlela yokugcina izindleko zokunakekelwa kwezempilo ngokuhlola. Ifuna ukuqinisekisa ukuthi:
- Isevisi noma izidakamizwa ozicelayo kuyadingeka ngempela imithi .
- Insizakalo noma izidakamizwa zilandela izincomo zakamuva kuze kube yinkinga yezokwelapha osebenzelana nayo.
- Isidakamizwa yilona ukhetho olunomthelela kakhulu lwezokwelapha olutholakalayo ngesimo sakho. Isibonelo, iDrug C (ezishibhile) kanye neDrug E (ezibizayo) kokubili ziphatha isimo sakho. Uma udokotela wakho ebeka iDrug E, uhlelo lwakho lwezempilo lungase lufune ukwazi ukuthi kungani iDrug C ingasebenzi kahle. Uma ungabonisa ukuthi i-Drug E iyindlela engcono, ingase iqinisekiswe ngaphambili. Uma kungekho isizathu sezokwelapha ukuthi kungani i-Drug E ikhethwe phezu kweDrug C eshibhile, uhlelo lwakho lwezempilo lungenqaba ukugunyaza izidakamizwa E.
- Le nsizakalo ayibhaliwe. Lokhu kukukhathazeka lapho ochwepheshe abaningi behilelekile ekunakekeleni kwakho. Isibonelo, udokotela wakho wephaphu angalawula isifuba se- CT scan , engaqapheli ukuthi, amasonto amabili nje edlule, ube nesifuba CT oyalelwe udokotela wakho womdlavuza. Kulesi simo, umshwalense wakho ngeke avumele ukuhlola okwesibili kuze kube yilapho eqinisekisa ukuthi udokotela wakho wamaphaphu ubonile ukuskena kwakho okungamaviki amabili edlule futhi ukholelwa ukuthi kuyadingeka ukuthi kuthathwe ukuskena okwengeziwe.
- Isevisi eqhubekayo noma ephindaphindiwe empeleni ikusiza. Isibonelo, uma uthola ukwelashwa ngokomzimba izinyanga ezintathu futhi ucela ukugunyazwa ezinye izinyanga ezintathu, ingabe ukwelashwa ngokomzimba ngempela kusiza? Uma wenza kancane, intuthuko elinganiswayo, izinyanga ezintathu ezengeziwe zingase zigunyazwe ngaphambilini. Uma ungenzi nantuthuko nhlobo, noma uma i-PT empeleni yenza uzizwe unzima nakakhulu, uhlelo lwakho lwezempilo lungase lungagunyazi ezinye izikhathi zeP PT kuze kube yilapho ukhuluma nodokotela wakho ukuqonda kangcono ukuthi kungani ecabanga ezinye izinyanga ezintathu I-PT izokusiza.
Empeleni, isidingo sokugunyazwa kwangaphambi kokugunyazwa kuyindlela yokulinganisa ukunakekelwa kwezempilo . Uhlelo lwakho lwezempilo lukwazisa ukutholakala okukhokhelwayo kumithi ebiza kanye nezinsizakalo, ukuqinisekisa ukuthi abantu kuphela abathola lezi zidakamizwa noma izinsizakalo yizizwe ezifanele izidakamizwa noma isevisi.
I-ACA (Obamacare) nokugunyazwa kwangaphambili
Umthetho Wokunakekelwa Okungenakusiza, owasayinwa ngumthetho ngo-2010 (futhi ubhekene nokuchithwa nokushintshwa ngaphansi koMnyango wezokuThutha ) uvumela abaqashi ukuba baqhubeke nokusebenzisa ukugunyazwa kwangaphambili njengendlela yokulawula izindleko nokuqinisekisa ukuthi iziguli zithola ukwelashwa okuphumelelayo.
Kodwa lwenqabela izinhlelo zezempilo ezingenakulinganiswa nokudinga ukugunyazwa ngaphambi kokubona i-OB-GYN futhi ivumela iziguli ukuba zikhethe udokotela wabo wokunakekela oyinhloko (kuhlanganise nodokotela wezingane noma i-OB-GYN).
Iyakwenqabela izinhlelo zezempilo ukuthi zidinga ukugunyazwa kwangaphambi kokunakekelwa okuphuthumayo esibhedlela esingaphandle kwe-network.
Kubuyekezwe nguLouise Norris.
> Umthombo:
> Amasevisi e-Medicare naseMedicaid Services. Isikhungo Sokwaziswa Komthengi kanye Nokuqapha Umshuwalense. Umthethosivivinywa wamaLungelo omNyango wezeNhlalakahle ongenakuthembekile.