Ingaba Intshuwalense Yempilo Iyakuhlawula Ukuhlinzwa Okhethiweyo?

Cinga i- inshorensi yempilo ayiyi kuhlawula ukuhlinzwa okhethwayo? Ngalunganga. Intshuwalense yezempilo iya kuhlawula ukuhlinzwa okhethwayo. Enyanisweni, uninzi lweenkqubo zokugqirha ezenziwa eMelika zikhethiweyo; Uninzi luhlawulwa, ubuncinane inxalenye, yinshuwalense yezempilo. Kwaye i- Medicare neMedicaid ihlawula ukuhlinzwa okhethwayo.

Ukubambisa kukuba ezininzi izicwangciso zempilo ziya kuhlawula kuphela ukuhlinzwa okukhethiweyo okuyimfuneko yonyango , kwaye imbono yakho yomshuwalense wezempilo yinto efunekayo emzimbeni inokungafani noluvo lwakho logqirha.

Kutheni iCandelo loKhuseleko lokuKhethwa koBulala lidibanisa abantu

Abantu bacinga ukuba i-inshorensi yempilo ayiyi kuhlawula ukuhlinzwa okhethwayo kuba idibanisa igama elithi "ukukhethwa" ngegama elithi "ayimfuneko imithi." Akunjalo into efanayo.

Utyando olukhethiweyo luyinkqubo yokutyanda onokukhetha ukuba nayo, okanye ukhethe ( ukhethwa ) ukuba ungabi nako. Olunye uphando olukhethiweyo luyimfuneko yonyango; ezinye azikho.

Isicwangciso ngasinye sempilo siya kuba nencazelo ecacileyo yonyango oluyimfuneko. Nangona kunjalo, ngokubanzi, inkqubo yokucwangcisa imfuno enyanisekileyo:

Imizekelo yokuKhenketho okhethwayo kunye noBuqirha obuyimfuneko

Uninzi lwezicwangciso zempilo luya kuhlinzekwa ngonyango olukhethiweyo oluyimfuneko yonyango ngexesha nje ulandela imithetho yezolawulo lwezocwangciso zezempilo. Ukuba isicwangciso sakho sezempilo sidinga phambi kokugunyazwa , yifumane. Ukuba isicwangciso sakho sezempilo sidinga ukuba usebenzise umnikezeli we- in-network , yenza njalo. Ukuba isicwangciso sakho sezempilo asivumelani ukuba utyando lwakho luyimfuneko yonyango, akunakwenzeka ukuba uyihlawule.

Nangona isicwangciso sezempilo sibandakanya ukutyunjwa okukhethiweyo, akunakufaneka ukuhlawula i-100% yeendleko. Inkqubo yokucoca ngokukhethayo iya kuthotyelwa kwenkqubo yokwabelana ngeendleko zezempilo, ngoko ke kufuneka uhlawule i- deductible okanye i- coinsurance .

Grey Areas

Ngamanye amaxesha isicwangciso sezempilo singabhekisela ekutyunjweni okhethwayo nangona kungengeyomsebenzi wempilo. Umzekelo, ininzi yomshuwalense ibandakanya ukuvuselelwa kwebele okanye ukuhlinzwa kwebele ngokulandela isifo somhlaza wesifuba. Izicwangciso ezininzi zezempilo zibandakanya uphando lwe-sterization ezifana ne-tubal ligation kunye ne-vasectomy.

Ngamanye amaxesha unokucinga ukuba inqubo imele impilo, kodwa inkampani yakho ye-inshorensi yempilo yonyango ayivumelani. Kule meko, unelungelo lokubhena eso sinqumo.

Ngoku ukuba uyazi i-inshorensi yempilo ehlawula ukuhlinzwa okhethwayo, jonga ukuba yintoni enye imfundiso engafanelekileyo enomshuwalense wezempilo.