Oko kufuneka ukwazi xa ushiya esibhedlela ekuqaleni
Uninzi lwexesha, oogqirha kunye nezigulane ziyavuma xa ixesha likhutshwa esibhedlele. Nangona kunjalo, kukho iimeko apho kungekho ukungavumelani.
Ngamanye amaxesha, inkampani yomshuwalense okanye omnye umhlawuli angavumelani nokuhlala esibhedlele ixesha elide. Basenokubona ukuba ixesha lesigulane liphezulu kwaye abayi kuphinda bahlawule. Kwimeko apho, isigulane okanye umnikezeli unokufaka isibheno kwisigqibo sokukhutshwa esibhedlele .
Ngamanye amaxesha, le meko ibhekene noko. Isigulana sinokuvakalelwa kukuba sele silungele ukuhamba, kodwa oogqirha abakholelwa ukuba isigulane silungele ukuya. Ukuba isigulane siphumelele emnyango, siya kuthiwa "ukukhutshwa kwinqanaba lonyango" (iDAMA).
Kutheni Izibhedlele Zifuna Iziguli Zihlale
Sinqwenela ukucinga ukuba oogqirha kunye nabanye abasebenzi basezibhedlele baneemfuno zethu zempilo kunye nezonyango entliziyweni xa befuna ukuba sihlale esibhedlele, kwaye baninzi. Nangona kunjalo, kukho kwakhona amaxesha apho "imfuneko" yokuhlala ingakumbi ngemali kunempilo yesigulane.
Esinye isizathu esingaba kukuba uhlala ixesha elide, imali eyongezelelweyo esibhedlele yenza. Okokuthi, ngokukhawuleza ukuba banokubuyiselwa yintlawulo yomshuwalense wakho, omnye umhlawuli, okanye wena.
Esinye isenzo esingathandabuzekiyo kukuba ukuba uhlala ixesha esibhedlele esibhedlele, izinto ezingaphezulu. Ngokomzekelo, banokuyilungisa iinkqubo ezongezelelweyo, iimvavanyo ezongezelelweyo, njalo njalo.
Akuzona zonke ezi zinto zibalulekile, kodwa ziza kubakho iindleko ezongezelelweyo.
Kanti esinye isizathu saqala ukusebenza kuMthetho woNonophelo onoxanduva , oquka inkqubo ebizwa ngokuba yiNkqubo yokuNcitshiswa kweZibhedlele ze-Hospital (HRRP). Ihlawulisa izibhedlele ukuba izigulane ze-Medicare zivunyiwe zingadlulanga iintsuku ezingama-30 zokukhutshwa kwazo.
Le nto yenzelwe ukuqinisekisa ukuba izigulane azikhululwa ngaphambi kokuba ziphile ngokwaneleyo ukuya ekhaya ukuze zikhusele ukuba zingabuyi.
Kutheni Unokufuna Ukushiya i-AMA
Ukushiya isibhedlele malunga neengcebiso zonyango (AMA) akusisigqibo sokuthatha ngokulula. Nangona kukho isibalo sezizathu ungaqala ukucinga ngazo.
Esinye isizathu esivakalayo kukuba ungazivakalelwa kukuba awukwazi ukuhlala. Umzekelo, ukuba unomshuwalense wezempilo ophezulu okanye uhlawula imali, unokufuna ukunciphisa iindleko zokulaliswa kwakho esibhedlele. Ngaphambi kokuba ucinge ukuba awukwazi ukuyithengisa, cela ummeli wesigulane esibhedlele, ummeli wesigulane okanye u-ombudsman malunga neendleko zangempela. Kwezinye iimeko, akunakwenzeka ukuba ucinga kakhulu.
Usenokuba nokwesaba ukuba ukuhlala ixesha elide kuya kuba nefuthe elibi kwimpilo yakho. Izibhedlele zingaba ziindawo ezinobungozi kunye neziphene zezilwanyana kunye nezifo ziyakwenzeka. Kakade ke, kukho iinjongo ezinkulu zokuhlala esibhedlele ngenani lexesha elifunekayo. Iingxaki zityalo xa wena kunye noogqirha bakho ningavumelani nento "efunekayo."
Abanye abantu baye bafumana isipiliyoni esibi esibhedlele kwaye banokukhetha ukuhamba ukuba imeko ibonakala ingenakulungile. Ngokomzekelo, unokuba uzive ngathi ukuphulwa kweempazamo ezingenakukhathazeka ezinokubeka ingozi kwimpilo yakho okanye nakubomi bakho.
Izibhedlele kunye noogqirha baxanduva kwiimeko ezibizwa ngokuba "ziganeko ezibi" (SREs) . Kwiimeko ezininzi, unokhetho apho unokufumana unonophelo xa uvakalelwa ukhuseleko kwisibhedlele sakho sangoku.
Ngaphambi kokuba unqume ukushiya i-AMA ukuya kwingozi yempilo yakho, usenokufuna ukucela umntu ukuba akukhuthaze kude kube lixesha lokukhutshwa. Ilungu lentsapho, umhlobo, okanye nokuba ngummeli-bucala, ummeli wezempilo ungayilumkisa kuwe ngelixa uphilisa.
Oko Kufuneka Ukwazi NgeDAMA
Ukuba ufuna ukuhamba, unako. Njengoko uninzi lwezigulane lunokunyanga unyango lwezonyango , ezininzi izigulana ziyakushiya esibhedlele xa zifuna, nazo.
Akukho mthethweni kwaye kukhetha kwakho. Ngaphandle kweemeko ezininzi, izigulane zempilo yengqondo apho imithetho nemithetho ehlukileyo.
Zama ukwenza iingxaki. Ngokuxhomekeke kwizinto ezenzekile ukwenzela ukuba ufune ukushiya kwangethuba, kunokubakho abantu abanokukunceda. Oogqirha, abameli bezonyango zesibhedlele kunye nabanye banokukwazi ukusombulula ingxaki xa uvakalisa ukukhathazeka kwakho.
Musa ukwenza isigqibo sodwa. Ngokukodwa, ukuba ugulane lwakho luquka unyango kunye naluphi na uhlobo lwezonyango zomzimba okanye izilwanyana ezinokulala, okanye ukuba uziva ugule kakhulu okanye ungabi "ngokwakho," ke le sigqibo sibaluleke kakhulu ukuba wenze ngokwakho. ummeli wabucala ukuba akukhokele ekwenzeni isigqibo. Akuyiyo enye yokwenza xa ubuchule bakho beengqondo kunye neengqondo bengekho kwindawo yazo.
Uya kucelwa ukuba usayine idokhumenti. Oku kuya kuthetha ukuba uyaqonda ukuba uyashiya malunga neengcebiso zonyango. Isibhedlele ngasinye sinesimo sayo kwaye sinokuyikrakra, kungoko kukulungele ukuyihlolisisa nomntu othembela naye.
Kukho zonke iindidi zokuchazwa ezifakwe kwiphepha, ngoko qi niseka ukuba ulifunde ngokucophelela kwaye uyiqonde kakuhle. Kuya kubandakanya ukuba uthini uxanduva kunye nokuba yisibhedlele ayinembopheleleko malunga nempilo yakho, ukuhlawula, kunye nayiphi na imbopheleleko yomthetho.
I-inshurensi yakho iya kuqhubeka ihlawule ukunyamekela kwakho. Abasebenzi bezibhedlele banokuxelela ukuba uya kufuneka uhlawule ixesha lokuhlala. Nangona kunjalo, uphando lufumene ukuba ukushiya i-AMA kwakungekho mpembelelo kwiintlawulo ze-inshorensi yokunyamekela kwakho. Ukuze ube kwicala elikhuselekileyo, khangela i-insurer yakho ngaphambi kokuba ushiye esibhedlele.
Ngaphambi kokuba Uhambe AMA
Kungenxa yokuba ukhetha ukushiya kusenjenjalo akuthethi ukuba inkqubo yokukhutshwa kufuneka ifumaneke. Kusabalulekile ukuba ubuze imibuzo efanelekileyo kwaye ufumane ulwazi oluyidingayo ngaphambi kokuba uphume emnyango.
Yenza okusemandleni akho ukugcina inkqubo inentlonelo kwaye uzame ukulahlekelwa ngumsindo okanye udideke. Abasebenzi bezibhedlele bangazama ngamandla ukukugcina apho kwaye baqhuba imisebenzi yabo nje. Kanye njengoko uya kubahlonela, kufuneka ucele inhlonipho kubo.
ILizwi
Ngaphambi kokuba unqume ukushiya esibhedlele, yenza okusemandleni akho ukuvavanya ingozi nemiphumo yokukhetha ukushiya i-AMA. Thetha kwintsapho yakho okanye ummeli malunga nesizathu sokuba ucinga ukuba kuyona nto ibhetele kwaye ufumene imbono yabo kwimeko. Ngaphezu kwakho konke, khumbula ukuba impilo yakho ibaluleke kakhulu, nangona unelungelo lokukhetha ukushiya ukuba unomuvo ongcono.
> Umthombo:
> U-Alfandre D. Ukuqwalasela ngokukhawuleza malunga neengcebiso zokuxhatshazwa kwezonyango: Ukwamkela ubuGulane-oPhezulu ukuKhuthaza uLondolozo oluPhezulu oluPhakamileyo kunye ne-Agenda Research Agene. I-Journal yeGrimeli yangaphakathi . 2013; 28 (12): 1657-1662.
> IiNkonzo zeeMpilo neeMediicaid IiNkonzo. Inkqubo Yokunciphisa Ukufunda (HRRP). 2017.