Ukukhetha i-inshurensi yezempilo akulula njengokukhetha isicwangciso esineprimiyamu ephantsi yenyanga. Kubemi abaninzi baseMaryland, umceli mngeni wokwenene kukufumana ukhuseleko oluhambelana nendlela abaphila ngayo ngokwenene. Ingcali esencinci eBaltimore inokufuna ukhuseleko olufikelelekayo olunokufikelela kunyango olungxamisekileyo. Usapho eFrederick lunokufuna ukhuseleko oluxhasa utyelelo oluqhelekileyo loogqirha, amayeza, unyango lwamazinyo, kunye neemfuno zokubona. Umcebisi ozisebenzelayo e-Annapolis unokufuna iindlela eziguquguqukayo ezingaxhomekekanga kumqeshi.
Yiyo loo nto izigqibo zomshuwalense wezempilo zifuna okungaphezulu nje kokuthelekiswa ngokukhawuleza kwamaxabiso. Isicwangciso esifanelekileyo kufuneka sihambelane nohlahlo-lwabiwo mali lomntu, iimfuno zempilo, oogqirha abakhethwayo, ukunyamezela umngcipheko, kunye neenjongo zexesha elide. Kufuneka kwakhona kunike uxolo lwengqondo xa kuvela iingxaki zonyango ezingalindelekanga.
Abemi baseMaryland banokufikelela kwiintlobo ezahlukeneyo zomshuwalense wezempilo, kubandakanya izicwangciso ezixhaswa ngumqeshi, izicwangciso zemarike, iMedicaid, iindlela zexesha elifutshane, umshuwalense owongezelelweyo, izicwangciso zamazinyo, izibonelelo zokubona, kunye nezisombululo zomshuwalense wezempilo wabucala. Ukhetho olufanelekileyo luxhomekeke kwiimeko zomntu ngamnye. Akukho sicwangciso sinye esisebenza ngokugqibeleleyo kuye wonke umntu.
Kubantu abathelekisa izicwangciso zeinshorensi yezempilo eMaryland , kunceda ukujonga ngaphaya komphezulu kwaye bagxile kwindlela ukhuseleko oluza kusebenza ngayo kubomi bemihla ngemihla. Isicwangciso sinokubonakala singabizi kakhulu xa usijonga okokuqala, kodwa iinkcukacha ezimalunga needeductibles, iinethiwekhi zababoneleli, amayeza, kunye neendleko eziphuma epokothweni zinokwenza umahluko omkhulu.
Nazi izinto ezibalulekileyo abemi baseMaryland abafanele baziqwalasele ngaphambi kokukhetha umshuwalense wezempilo.
Qala Ngeemfuno Zakho Zokhathalelo Lwempilo
Ngaphambi kokuba uthelekise izicwangciso, kubalulekile ukuqonda ukuba loluphi uhlobo lonyango olindele ukulusebenzisa. Abanye abantu baya kugqirha kube kanye okanye kabini ngonyaka. Abanye bafuna amayeza rhoqo, utyelelo lweengcali, idinga lonyango, umsebenzi webhu, okanye unyango lwesigulo esinganyangekiyo.
Umntu omdala osempilweni ongenazo iimfuno zonyango ezininzi unokubeka phambili iiprimiyamu zenyanga eziphantsi kunye nokhuseleko olusisiseko kwiindleko ezinkulu ezingalindelekanga. Usapho olunabantwana lunokufuna ukhuseleko oluqinileyo lokutyelelwa kwabantwana, unyango olukhawulezileyo, amayeza, kunye neenkonzo zokuthintela. Umntu ophethe isifo seswekile, i-asthma, isifo sentliziyo, okanye esinye isifo esiqhubekayo unokufuna ukufikelela koogqirha namayeza ngendlela eqikelelweyo.
Eli nyathelo lokuqala linceda ukunciphisa uphendlo. Endaweni yokubuza, “Sesiphi isicwangciso esingabizi kakhulu?” kungcono ukubuza, “Sesiphi isicwangciso esihambelana nendlela endisebenzisa ngayo ukhathalelo lwempilo?”
Umzekelo, isicwangciso seprimiyamu esiphantsi sinokuba nomtsalane, kodwa ukuba siza notyelelo lweengcali olubiza kakhulu nolunexabiso eliphantsi, sisenokungabi yeyona ifanelekileyo kumntu ofuna unyango rhoqo. Kwelinye icala, isicwangciso seprimiyamu esiphezulu sinokuba luncedo kumntu olindele iindleko zonyango rhoqo unyaka wonke.
Abemi baseMaryland bafanele benze uluhlu olulula ngaphambi kokuba bathelekise ukhuseleko. Bandakanya oogqirha abakhoyo, amayeza aqhelekileyo, amadinga alindelekileyo, iinkqubo ezizayo, kunye nazo naziphi na iimfuno zempilo yosapho. Oku kwenza kube lula ukugweba ukuba isicwangciso sibonelela ngexabiso lokwenyani na.
Thelekisa Okungaphezulu Kweprimiyamu Yenyanga
Iiprimiyamu zenyanga zihlala ziyinombolo yokuqala abantu abayiqaphelayo. Oko kuyavakala kuba iiprimiyamu zichaphazela uhlahlo lwabiwo-mali lwentsapho inyanga nenyanga. Nangona kunjalo, iprimiyamu yinxalenye enye kuphela yeendleko zizonke zomshuwalense wezempilo.
Isicwangciso esineprimiyamu ephantsi sinokuba nemali eninzi etsalwayo. Oku kuthetha ukuba ilungu linokufuna ukuhlawula ngaphezulu ngaphambi kokuba isicwangciso siqale ukugubungela iinkonzo ezithile. Ezinye iindleko zingabandakanya ii-copays, i-coinsurance, iindleko zikagqirha, kunye ne-out-of-pocket maximum.
Ixabiso eliphezulu eliphuma epokothweni libaluleke kakhulu. Libonisa uninzi lweendleko umntu afanele azihlawulele iinkonzo ezigutyungelweyo kunyaka ocwangcisiweyo. Kubantu abaxhalabileyo ngeziganeko ezinkulu zonyango, eli nani linokuba libaluleke njengeprimiyamu yenyanga.
Uthelekiso olukrelekrele lujonga umfanekiso opheleleyo wezemali. Abemi baseMaryland kufuneka baqwalasele ukuba bangahlawula malini kunyaka oqhelekileyo kunye nokuba bangahlawula malini kunyaka onzima. Isicwangciso esibonakala singabizi kakhulu kwiinyanga ezisempilweni sinokubiza kakhulu emva kokutyelela igumbi likaxakeka, utyando, okanye unyango olukhethekileyo.
Kukwanceda nokucinga ngokuhamba kwemali. Abanye abantu bakhetha iprimiyamu ephantsi kwaye bakhululekile ukwamkela umngcipheko ongakumbi wokuphuma epokothweni. Abanye bakhetha iintlawulo eziphezulu zenyanga ngokutshintshiselana neendleko eziqikelelweyo xa befumana unyango. Akukho ndlela ichanekileyo okanye ingalunganga ngokuzenzekelayo. Ukhetho olungcono luxhomekeke kwimali yomntu kunye nenqanaba lokuthuthuzela.
Jonga iiNethiwekhi zabaNiki ngononophelo
Ukufikelela kwababoneleli kunokwenza okanye kuphule isicwangciso se-inshurensi yezempilo. Isicwangciso sinokubonelela ngeenzuzo ezinamandla ephepheni, kodwa ukuba ugqirha, ikliniki, isibhedlele, okanye ingcali ekhethwayo ayisebenzi kwinethiwekhi, iindleko zinokunyuka ngokukhawuleza.
Abemi baseMaryland kufuneka bajonge ukuba ngaba ababoneleli babo bangoku bayabandakanyeka na kuthungelwano lwesicwangciso. Oku kubaluleke kakhulu kubantu abasele benoogqirha abathembekileyo okanye ubudlelwane bokhathalelo oluqhubekayo. Iintsapho kufuneka zihlole noogqirha babantwana, amaziko okhathalelo olungxamisekileyo, izibhedlele, iikhemesti, kunye neengcali.
Ubungakanani benethiwekhi kunye nokuguquguquka kubalulekile. Ezinye izicwangciso zibonelela ngokufikelela okubanzi kubaboneleli abaninzi, ngelixa ezinye zilinganiselwe. Inethiwekhi encinci inokuba neendleko eziphantsi, kodwa inokunciphisa nokukhetha. Kubantu abahamba rhoqo okanye abachitha ixesha phakathi kweendawo ezahlukeneyo, ukufikelela okubanzi kunokuba luncedo ngakumbi.
Abemi basemaphandleni eMaryland banokufuna ukuqaphela ngokusondeleyo ukufumaneka kwababoneleli. Isicwangciso esisebenza kakuhle kwelinye isithili sisenokungabi lula kwelinye. Ukufikelela kunyango olukufutshane kunokuchaphazela indlela umntu akhawuleza ngayo ukulufuna unyango kunye nendlela okulula ngayo ukuqhubeka nemihlangano yesiqhelo.
Ngaphambi kokuba ubhalise, yingcinga entle ukuqinisekisa ukuba uthatha inxaxheba kwinethiwekhi ngokuthe ngqo ngesixhobo sokukhangela somboneleli wenkampani yomshwalense okanye ngokufowunela iofisi yomboneleli. Iinethiwekhi zinokutshintsha, kwaye ulwazi oluphelelwe lixesha lunokubangela izimanga kamva.
Cinga Ngokhuseleko Lwamayeza Angonyango Oluvela Kugqirha
Ukugutyungelwa ngugqirha yenye into ebalulekileyo ekukhetheni isicwangciso sezempilo. Kwanonyango olunye oluqhelekileyo lunokuchaphazela iindleko zonyango lwenyanga. Kubantu abathatha amayeza amaninzi, umahluko phakathi kwezicwangciso unokuba mkhulu.
Isicwangciso ngasinye sinefomyula, oluluhlu lwamayeza agutyungelweyo. Amayeza adla ngokubekwa kumanqanaba asezantsi. Amayeza akumgangatho ophantsi asenokubiza kancinci, ngelixa amayeza aphezulu okanye awodwa anokubiza ngaphezulu. Amanye amayeza anokufuna imvume yangaphambili okanye unyango olunyathelo ngaphambi kokuba kufakwe ukhuseleko.
Abemi baseMaryland kufuneka bahlole ukuba amayeza abo ayahlawulelwa na kunye nokuba aza kubiza malini na. Kukwaluncedo ukujonga ukuba iikhemesti ezikhethwayo zifakiwe na kwinethiwekhi yesicwangciso. Ezinye izicwangciso zibonelela ngamaxabiso aphantsi ngeekhemesti ezithile okanye iindlela zoku-odola ngeposi.
Eli nyathelo kulula ukulityeshela, kodwa libalulekile. Isicwangciso esineprimiyamu ephantsi sisenokungabi lixabiso lihle ukuba asigubungeli kakuhle amayeza afunekayo. Kubantu abaphatha izifo ezingapheliyo, ukugutyungelwa ngugqirha kufanele kube yeyona nto iphambili.
Musa Ukungazihoyi Iimfuno Zamazinyo Nokubona
Iincoko zomshuwalense wezempilo zihlala zigxila kunyango, kodwa iimfuno zamazinyo kunye nombono nazo zinokuchaphazela uhlahlo lwabiwo-mali lwentsapho. Ukucoca amazinyo rhoqo, ukugcwalisa, izithsaba, iibraces, ukuvavanywa kwamehlo, iiglasi, kunye neelensi zoqhagamshelwano kunokubiza kakhulu ngaphandle komshuwalense.
Ezinye izicwangciso zempilo zinokubandakanya izibonelelo zamazinyo okanye zokubona ezilinganiselweyo, kodwa abantu abaninzi bafuna ukhuseleko olwahlukileyo. Iintsapho ezinabantwana zinokungenelwa ngakumbi kukuphonononga iindlela zamazinyo kunye nezokubona zabantwana. Abantu abadala kufuneka baqwalasele nokuba bazisebenzisa kangaphi ezi nkonzo.
Ukugubungela amazinyo kunokunceda ngononophelo lokuthintela kwaye kunokunciphisa iindleko zeenkqubo ezibandakanyekayo. Ukugubungela amehlo kunokwenza uhlolo lwamehlo, iilensi, oonxibelelwano, kunye neefreyimu zifikeleleke ngakumbi. Kubantu abasele besazi ukuba bafuna ezi nkonzo minyaka le, izicwangciso zamazinyo kunye nezokubona ezahlukeneyo zinokuba nexabiso elinamandla.
Iindlela zokugubungela i-USHEALTH Group eMaryland ziquka izisombululo zempilo, zamazinyo, nezokubona, ezinokuba luncedo kubemi abafuna ukujonga ukugubungela ngokupheleleyo kunokugxila kuphela kwiingenelo zonyango.
Cinga nge-Inshorensi eyongezelelweyo yoKhuseleko olongezelelweyo
Nokuba kukho i-inshorensi yezempilo, iindleko zonyango ezingalindelekanga zisenokubangela uxinzelelo lwezemali. Iimali ezitsalwayo, i-coinsurance, iindleko zokuhamba, ixesha lokungabikho emsebenzini, kunye neendleko ezingagutyungelwanga zinokwanda ngokukhawuleza. Ukhuseleko olongezelelweyo lunokunceda ekuboneleleni ngokhuseleko olongezelelekileyo kwiimeko ezithile.
Izicwangciso ezongezelelweyo zingabandakanya ukhuseleko lwengozi, ukhuseleko lwesifo esithile, ukhuseleko lwesifo esibalulekileyo, izibonelelo zembuyekezo yesibhedlele, okanye ezinye iindlela zokuhlawula isixa-mali. Ezi zibonelelo azithathi indawo yokhuseleko olukhulu lwezonyango, kodwa zinokunceda ukuvala izikhewu.
Umzekelo, umntu onesicwangciso sezempilo esihlawulelwayo kakhulu unokufuna ukhuseleko olongezelelweyo lwengozi ukunceda ngeendleko emva kokwenzakala. Usapho olunembali yeemeko ezithile zonyango lunokufuna ukhuseleko olongezelelweyo lwezemali xa ugula kakhulu. Umntu ozisebenzelayo unokufuna ukhuseleko olunceda ekunciphiseni impembelelo yemali yeziganeko zempilo ezingalindelekanga.
Ixabiso le-inshorensi eyongezelelweyo lixhomekeke kwinqanaba lomngcipheko womntu, uhlahlo-lwabiwo mali, kunye neenzuzo ezikhoyo. Akunyanzelekanga ukuba wonke umntu ayisebenzise, kodwa inokuba luncedo kubantu abafuna olunye udidi lokhuseleko lwezemali.
Unxulumaniso lweNgxaki nemeko yakho yomsebenzi
Imeko yengqesho idlala indima enkulu kwizigqibo zomshuwalense wezempilo. Abemi abaninzi baseMaryland bafumana i-inshurensi ngumqeshi. Abanye basebenza ngokuzimeleyo, abasebenzi bexeshana, abakhi abazimeleyo, abanini bamashishini amancinci, okanye phakathi kwemisebenzi.
Abantu abane-inshorensi exhaswa ngumqeshi kufuneka baphinde bahlole iindlela zabo ngononophelo ngexesha lokubhalisa okuvulelekileyo. Izicwangciso zabaqeshi zinokutshintsha unyaka nonyaka, kuquka iiprimiyamu, ii-deductibles, iinethiwekhi zababoneleli, kunye ne-inshorensi kagqirha.
Abasebenzi abazisebenzelayo kunye nabakhontraki abazimeleyo banokufuna iindlela eziguquguqukayo ngakumbi. Ngaphandle kwenkxaso-mali yomqeshi, banokuthelekisa izicwangciso zabucala, izicwangciso zemarike, iindlela zexesha elifutshane, okanye iimveliso ezongezelelweyo. Iimfuno zabo zinokutshintsha ngokuxhomekeke kwingeniso, ubungakanani bosapho, kunye nokuzinza kweshishini.
Abanini bamashishini amancinci banezinye izinto ekufuneka baziqwalasele. Ukubonelela nge-inshorensi yezempilo kunokunceda ekutsaleni nasekugcineni abasebenzi, kodwa ulawulo lweendleko lubalulekile. Abaqeshi banokufuna ukuthelekisa izicwangciso zeqela, amaqhinga okufaka igalelo, kunye neendlela zokuxhasa ezixhasa ishishini kunye namalungu eqela lalo.
Eyona nto ibalulekileyo kukukhetha ukhuseleko olubonisa umsebenzi wokwenyani kunye neendlela zokufumana umvuzo. Isicwangciso esisebenza kumsebenzi wexesha elizeleyo sisenokungamlungeli umntu ofumana umvuzo oguquguqukayo okanye otshintsha umsebenzi.
Nika ingqalelo kwiiWindows zoBhaliso
Ixesha libalulekile xa ukhetha i-inshurensi yezempilo. Izicwangciso ezininzi zifumaneka kuphela ngamaxesha athile okubhalisa ngaphandle kokuba umntu uyafaneleka kwixesha lokubhalisa elikhethekileyo. Ukungafikeleli kwixesha elibekiweyo kunokudala izikhewu zokugubungela okanye kuthintele iindlela ezikhoyo.
Abemi baseMaryland kufuneka balandele imihla yokubhalisa evulekileyo kunye nemithetho yokubhalisa ekhethekileyo. Iziganeko ezibalulekileyo zobomi ezifana nomtshato, uqhawulo-mtshato, ukuzalwa komntwana, ukufuduka, ukulahlekelwa ngumsebenzi, okanye ukulahlekelwa lolunye ukhuseleko kunokuvumela umntu ukuba abhalise ngaphandle kwefestile eqhelekileyo.
Kungcono ukuqala ukuthelekisa ukugubungela ngaphambi kokuba umhla wokugqibela ufike. Izigqibo ezikhawulezileyo zinokubangela iimpazamo. Abantu banokulibala ukujonga iinethiwekhi, ukungawahoyi amaxabiso kagqirha, okanye bakhethe isicwangciso esisekelwe kwixabiso leprimiyamu kuphela.
Ukulungiselela kwangethuba kwenza inkqubo ibe lula. Qokelela ulwazi lwengeniso, iinkcukacha zangoku zeinshorensi, amagama ababoneleli ngeenkonzo, uluhlu lwamayeza, kunye neemfuno zonyango ezilindelekileyo ngaphambi kokuba uphonononge izicwangciso.
Khangela Isikhokelo Xa Iinketho Zivakala Zinzima
I-inshurensi yezempilo inokuba yinto edidayo, kwaye abantu abaninzi abaqinisekanga ngento abayithengayo. Yinto eqhelekileyo leyo. Amagama asetyenziswa kuphela anokucaphukisa: iiprimiyamu, iideductibles, i-coinsurance, ii-copays, iinethiwekhi zababoneleli, iiformularies, ii-exclusions, kunye ne-out-of-pocket maximums.
Ukusebenza nomcebisi weinshorensi onelayisenisi kunokunceda abahlali baqonde ngokucacileyo ukhetho lwabo. Umcebisi unokuchaza umahluko kwisicwangciso, axoxe ngeengxaki zohlahlo-lwabiwo mali, ahlole iimfuno zosapho, aze ancede ekuchongeni ukhuseleko oluhambelana nemeko.
Olu hlobo lwenkxaso lunokuba luncedo ngakumbi kubantu abazithengela ukhuseleko ngokwabo, iintsapho ezineemfuno ezahlukeneyo zempilo, abasebenzi abazisebenzelayo, okanye nabani na ocinga ngezibonelelo ezongezelelweyo.
Isikhokelo esilungileyo asifanele sivakalelwe kukuba umntu ucinezelwe. Sifanele simncede umntu enze isigqibo esinolwazi. Injongo kukukhetha ukhuseleko ngokuzithemba, kungekhona ukudideka.
Kutheni i-Inshorensi yezeMpilo yaseMaryland ibalulekile
I-inshurensi yezempilo ayipheleli nje ekuhlangabezaneni neemfuno okanye ukuphatha ikhadi lesazisi. Imalunga nokukhusela impilo, imali, kunye noxolo lwengqondo. Ukhuseleko olufanelekileyo lunokwenza kube lula ukufumana unyango lokuthintela, ukulawula iimeko eziqhubekayo, ukuphendula kwiimeko ezingxamisekileyo, kunye nokuphepha iindleko zonyango ezinzima.
Kubemi baseMaryland, isicwangciso esilungileyo sixhomekeke kwiimfuno zomntu ngamnye. Abanye abantu bafuna ukufikelela kumboneleli ngokubanzi. Abanye bafuna iindleko zenyanga ezifikelelekayo. Abanye babeka phambili amayeza kagqirha, ngelixa abanye befuna ukhuseleko lwamazinyo, lombono, okanye olongezelelweyo. Iintsapho zinokufuna ukhuseleko olwahlukileyo kunabantu ngabanye. Abasebenzi abazisebenzelayo banokufuna iindlela ezahlukeneyo kunabasebenzi.
Yiyo loo nto ukuthelekisa kubalulekile. Isigqibo esiqinileyo somshuwalense wezempilo sijonga yonke into: iindleko, ukufikelela, iingenelo, ukuguquguquka, kunye nokhuseleko lwexesha elide.
Abemi baseMaryland banokukhetha okuninzi, kodwa okulungileyo kufanele kubonakale kuluncedo kubomi bemihla ngemihla. Nokuba umntu uzikhusela, iqabane lakhe, abantwana, okanye abasebenzi, injongo iyafana: ukhuseleko oluthembekileyo oluhambelana neemfuno zempilo kunye nohlahlo lwabiwo-mali.
Ukukhetha ukhuseleko kungathatha ixesha, kodwa kufanelekile umgudu. Isicwangciso esicingisisiweyo singabonelela ngenkxaso ngexesha lokhathalelo oluqhelekileyo kunye nokuqinisekiswa ngamaxesha angalindelekanga angakhange acwangciswe mntu.