Dzidza nezvemhando dzakasiyana dzekupa mitambo
Kana iwe uri wekushanda iwe pachako kana kuti uzviwanire mumamiriro ezvinhu apo iwe unoda kuwana yako yehutano inshuwarheni yekugovera, zvisarudzo zvinowanikwa kwauri zvinogona kuvhiringidza. Hungu, rubatsiro rwakapetwa runokonzerwa, nokuda kweAne Affordable Care Act, asi zvimwe zvikamu zvehuwandu hunopesana zvakanyanya kubva pamutemo kusvika kumutemo.
Paunenge uchitenga, iwe uchange uchitsemura nemashoko akaita seHMO, PPO, kubhadhara pamwe, uye kubviswa, izvo zvose zvingave zvinotyisidzira kana iwe usingazivi zvavanoreva.
Nzvimbo yakanakisisa yokutanga, kunyange zvakadaro, ndeyokutarisa rudzi rwechiremba wekunakirwa kunopiwa mumitemo yakasiyana-siyana: HMO, PPO, uye mari-yekushumira.
HMO (Health Maintenance Organization) Mutemo
Zvizhinji zvezvirongwa zvaunowana zvichapa zvose uye kubva pane humwe humwe huri hutano hutano inshuwarheni huchava HMO zvirongwa. Izvo zvirongwa zvinowanzova zvishoma kudhura zvingasarudzwa.
HMO dzinoda kuti iwe urege kushanduka pakugadzirisa chiremba wako kana nzvimbo yezvokurapa uye kunamatira kune urongwa hwevashandi vanobatanidzwa muHMO. Mune zvimwe zviitiko, urongwa uhwu hunogona kunge hwakanyanyisa. Iwe unogona kutora kutumirwa kubva kuchiremba wako wekutanga kuitira kuti uone nyanzvi.
Zvirongwa zvinogadziriswa seHMO zvinogona kunge zvinonzi "yakavharwa mitambo," izvo zvinoreva kuti insurer haichabhadhari chinhu chekutarisira kwako kana iwe ukaona chiremba kana mumwe mutapi wehutano asati ari mumutambo. Emergency care inowanzovharwa, zvisinei, kunyange kana ikaitika kunze kwe-network.
Iwewo uchange uine ma-co-payments, ayo ari chikamu chako chekubhadhara kune chiremba kana vamwe vanopa, uye deductible, iyo inenge yakatarwa yaunofanirwa kuribhadharira kurapwa usati wesa bhizimisi uchatanga kuripa.
PPO (Mutengi Anofanirwa Sangano) Mutemo
PPO zvirongwa zvinokupa iwe kushanduka kunoenderana neHMO, uye kazhinji inodhura zvakare ...
dzimwe nguva, zvakawanda kwazvo, zvichienderana neurongwa chaihwo.
Sezvo neHMO, PPO ichava nerwendo rwe "vakagadziriswa vanopa" - vanachiremba uye zvipatara avo vakabvumirana kuti vabatane muurongwa. Vaya vanopa iyo vakadanwa mu-network network providers, uye zvichange zvisingadhuri kuti iwe uone avo vanopa.
Iwe unayowo sarudzo yekushanyira mumwe mupi weunosarudza kunyange kana asiri mumutambo. Munyaya iyi, inshuwarisi yako inogona kuvhara chikamu chebasa, asi kazhinji iwe unoda kubhadhara chikamu chikuru kubva muhomwe yako.
Kufanana nemitemo yeHMO, mapurogiramu ePPO anonyanya kutakura zvinodhura uye anoda kubhadhara mari.
Nheyo-ye-Service Policy
Mitemo-ye-kushanda (FFS) mazano (dzimwe nguva anonziwo zvirongwa zvekuregererwa) zviri kuve zvishoma nezvishoma - chaizvoizvo, iwe haungatongowani zvachose munharaunda yako. Iko inowanzo inonyanya kukosha yehutano inshuwarisi.
Muzvikwereti-zve-mapurogiramu, unogona kusarudza chero chiremba uye chero chipatara chaunoda. Iwe unobhadhara zvikwereti zvakananga, uye ipapo iwe unyorera mapepa nemubhizimisi wako kuti udzoserwe pamhosva.
Kufanana nemishonga yemishurenzi yehutano, mari yekubhadhara-ye-purogiramu inoda kuti iwe ubhadhara zvinokonzerwa nekubhadhara mari yako yekubhadhara.
HMO vs. Vhesi yeBasa nePPO Purogiramu dzeInishuwarenzi
Kana uchifananidza zvirongwa zvehutano zvakasiyana, unofanira kutanga nezvinhu zvakakosha kwauri iwe nemhuri yako.
Kana ukasarudza chiremba wako kune zvakakosha zvikuru kwauri, ipapo iwe uchada kusarudza HMO kana PPO iyo inosanganisira chiremba wako, kana kusarudza mari-ye--basa hurongwa (kutora imwe inowanikwa munzvimbo yako).
Kana kune rumwe rutivi, kuchengeta mari yako pasi kunokosha, iwe unogona kutarisisa zvakanyanya paHMO. Zvisinei, chenjerera kuti urege kunyengedzwa nepasimenti yakaderera - iva nechokwadi kuti iwe unofananidzawo zvakatarirwa kunze kwepodhesi yemari. Kana ukangosarudza kuti urongwa hupi huchakufananidza iwe, iwe unogona kutanga kutarisa zvirongwa zvakafanana kune rumwe rutivi.