HMO, PPO, EPO, POS - Muyenera Kusankha Ndondomeko Yanji?

Kumvetsetsa chisamaliro chosamalidwa ndi gawo lofunikira pa kusankha ndondomeko yaumoyo

Kuti musankhe inshuwalansi yabwino ya moyo wanu ndi banja lanu, muyenera kumvetsa kusiyana pakati pa dongosolo la thanzi la HMO, PPO, EPO, ndi POS. Izi ndi zizindikiro za mitundu yosiyanasiyana yothandizira yosamaliridwa yomwe ikupezeka m'madera ambiri.

Mwachidule

• HMO = Ntchito Yothandizira Zaumoyo: Ma HMO amakhala ndi malipiro ochepa a mwezi uliwonse komanso kugawidwa kwa ndalama zochepa kusiyana ndi mapulani omwe ali ndi zochepetsera zochepetsera pa intaneti, koma amafuna kutumiza othandizira apamtima (PCP) ndipo sadzalipiritsa chisamaliro kunja kwazidzidzidzi kupatula pazidzidzidzi. .

• PPO = Ogwirizira Othandizira Ofunidwa : PPOs ali ndi dzina limeneli chifukwa ali ndi intaneti ya opatsa omwe amawakonda kuti mugwiritse ntchito, koma iwo adzalandirabe chisamaliro chapadera. Popeza kuti sali oletsera kusiyana ndi mitundu yambiri ya mapulani, iwo amakhala ndi malipiro apamwamba pamwezi uliwonse ndipo amafuna kugawidwa mtengo wapamwamba. Ngakhale kuti mapulani a PPO anali otchuka m'zaka zapitazi, akhala akudziwika kwambiri m'zaka zaposachedwa pamene mapulani a zaumoyo amachepetsa kukula kwa ogwira ntchito awo ndipo amapita patsogolo ku EPO ndi HMO pofuna kuyendetsa ndalama. PPOs adakali ofala pakati pa malonda omwe amagwiritsidwa ntchito ndi abwana, koma asokonezeka ponseponse pa malonda a inshuwalansi m'mayiko ena (inshuwalansi ndi mtundu womwe mumagula nokha - kuphatikizapo kupititsa patsogolo kwanu - kusiyana ndi kupeza kuchokera kwa abwana )
• EPO = bungwe lapadera loperekera bungwe: EPO ali nalo dzina chifukwa ali ndi makina omwe amapereka okha . Muyenera kumamatira kwa ogulitsa pazandandanda kapena EPO simulipira. Komabe, EPO zambiri sizingakupangitseni kuti mutumizidwe kuchokera kuchipatala choyamba kuti muzitha kukaonana ndi katswiri. Ganizirani za EPO monga yofanana ndi PPO koma popanda kutsegula kwa-intaneti.

• POS = Pulogalamu ya Utumiki: Mapulani a POS amafanana ndi ma HMO koma amalepheretsa kuti muloledwe, mwakuchitika zina, kuti musamalumikize monga momwe mungakhalire ndi PPO. Monga ma HMO, mapulani ambiri a POS amafuna kuti mukhale ndi chilolezo cha PCP kwa chisamaliro chonse kaya chiri mkati kapena kunja.

Pofuna kulongosola, mapulani osamaliridwa omwe sali woyendetsedwa amatchedwa ndondomeko zothandizira.

Izi ndi ndondomeko zaumoyo zomwe sizikhala ndi malo ogwiritsira ntchito, ndipo zimangobwezeretsanso gawo lina lazifukwa zanu zachipatala. Ndondomeko zopanda malire zakhala zosakondwera zaka makumi angapo zapitazo ndipo ndizosowa kwambiri masiku ano. Ndondomeko zothandizira mano ndizofala, koma pafupifupi zonse zogulitsa zamankhwala amagwiritsa ntchito chisamaliro chosamaliridwa

[Mapulani ochiritsira okhazikika omwe amawagwiritsira ntchito zachipatala amalingaliridwa kupatulapo zopindula pansi pa Affordable Care Act, ndipo satsatira malamulo ake; Kuwunikira pansi pa ndondomeko yodalirika yopanda malire sikutengedwa kuti ndikofunikira kwenikweni kufotokozera, zomwe zikutanthauza kuti anthu omwe ali ndi ndondomekoyi saganiziridwa kuti ali ndi inshuwalansi, ndipo akugonjetsedwa ndi chilango cha ACA payekha .].

Onani kuti mawu ena omwe amagwiritsidwa ntchito kawirikawiri, HSA , samatanthauza mtundu wa chisamaliro choyang'anira. HSA imayimira akaunti yopezera ndalama, ndipo mapulani oyenerera a HSA angakhale HMO, PPOs, EPOs, kapena mapulani a POS. Mapulani oyenerera a HSA ayenera kukwaniritsa zolinga zofunikira zogwiritsidwa ntchito ndi IRS, koma sizongowonjezeredwa ndi chisamaliro chomwe amachigwiritsa ntchito.

Kuti musankhe njira yabwino kwambiri ya ndondomeko ya thanzi lanu, muyenera kumvetsetsa njira zisanu ndi ziwiri zofunika kwambiri zokhudzana ndi thanzi labwino komanso momwe zidzakhudzidwire.

Kenaka, muyenera kudziwa momwe HMOs, PPOs, EPOs, ndi POS zikukonzekera ntchito iliyonse, malinga ndi mfundo zisanu ndi ziwirizo.

Mfundo Zosiyana

Njira zisanu ndi ziwiri zofunika kwambiri za HMO, PPOs, EPOs ndi POS zikusiyana ndi:

• Kaya mukufunikira kukhala ndi dokotala wamkulu (PCP) kapena ayi.
• Kaya mukufunikira kuti mutumize kukaonana ndi katswiri kapena kupeza zina
• Kaya mukuyenera kukhala ndi chithandizo chamankhwala chisanayambe kugwira ntchito
• Kaya kapena ayi ndondomeko ya thanzi lidzalipire chisamaliro chomwe mumalandira kunja kwa eni ake ogwiritsira ntchito
• Kulipira ndalama zochuluka bwanji -kugawana ndiwe yemwe ali ndi udindo wolipira pamene iwe ukugwiritsa ntchito inshuwalansi yaumoyo

• Kaya muli ndi fomu ya inshuwalansi kapena ayi

Momwe Zimayendera Mapulani

Mitengo ya inshuwalansi ya umoyo imasiyanasiyana kuchokera ku boma kupita ku boma ndipo nthawi zina dongosolo silidzamamatira mwachidwi ku dongosolo lokonzekera. Gwiritsani ntchito tebuloyi monga chitsogozo chachikulu, koma werengani bwino pa Chidule cha Mapindu ndi Mapindu pa ndondomeko iliyonse yomwe mukulingalira musanayambe kulemba. Mwanjira imeneyo mudzadziwira zedi zomwe dongosolo lililonse lidzayembekezera kuchokera kwa inu, ndi zomwe mungathe kuziyembekezera.

	Amafuna PCP	Akufuna kutumiza	Amafuna chisanayambe chilolezo	Akuyang'anira zosamalidwa zosatetezedwa	Kugawana mtengo	Kodi muyenera kulemba mapepala?
HMO	Inde	Inde	Sizinkafunikira nthawi zambiri. Ngati chofunika, PCP imachita.	Ayi	Kawirikawiri amatsika	Ayi
POS	Inde	Inde	Osati kawirikawiri. Ngati pakufunika, PCP imachita. Kutulutsidwa kwapakati pa-network kungakhale ndi malamulo osiyana.	Inde, koma kumafuna kutumiza kwa PCP.	Kawirikawiri amachepetsa mu-intaneti, apamwamba kwa kunja kwa intaneti.	Zomwe zimangotchulidwa kunja.
EPO	Ayi	Ayi	Inde	Ayi	Kawirikawiri amatsika	Ayi
PPO	Ayi	Ayi	Inde	Inde	Ambiri apamwamba, makamaka pa chithandizo cha kunja kwa intaneti.	Zomwe zimangotchulidwa kunja.

Zofunikira za Chipatala

Mitundu ina ya inshuwalansi ya umoyo imakufunsani kuti mukhale ndi dokotala wamkulu. Muzinthu zathanzizi, udindo wa PCP ndi wofunika kwambiri kuti pulogalamuyi ikhale ndi PCP ngati simusankha mwamsanga mndandanda wa mapulani. Mapulani a HMO ndi POS amafuna PCP.

Muzinthu izi, PCP ndi dokotala wanu wamkulu yemwe akugwirizanitsa ntchito zina zonse zaumoyo. Mwachitsanzo, makonzedwe anu a PCP omwe mumawafuna monga mankhwala kapena ma oxygen. Iye amawongolanso chisamaliro chomwe mumalandira kuchokera kwa akatswiri.

Chifukwa chakuti PCP yanu ikuganiza ngati mukufunikira kuona katswiri kapena ayi kuti mupeze chithandizo chamankhwala kapena mayeso, mu mapulani awa PCP yanu imakhala ngati mlonda wam'chipatala akuyang'anira mwayi wanu wopita kuchipatala chapadera.

Mu zolinga zopanda pulogalamu ya PCP, kupeza maluso apadera kungakhale kovuta, koma muli ndi udindo wambiri wosamalira chisamaliro chanu. EPO ndi PPO mapulani sakufuna PCP.

Chilolezo Cholowa

Kawirikawiri, mapulani azaumoyo omwe akufuna kuti mukhale ndi PCP amakhalanso ndi inu kuti mutumizidwe kuchokera ku PCP musanayambe katswiri kapena kupeza mtundu wina uliwonse wa chithandizo chamankhwala chosakhala mwadzidzidzi. Kufuna kutumizidwa ndi kampani ya inshuwalansi ya njira ya kusunga ndalama poonetsetsa kuti mukufunikira kuona katswiri kapena kupeza ntchito yamtengo wapatali kapena mayeso.

Zotsutsana ndi zofunikira izi zikuphatikizapo kuchedwa pakuwona katswiri komanso kuthekera kusagwirizana ndi PCP yanu ngati mukufunikira kuona katswiri kapena ayi. Kuonjezera apo, wodwalayo akhoza kukhala ndi zina zowonjezera chifukwa cha mapepala oyenerera pa ulendo wa PCP komanso woyendera katswiri.

Ubwino wa zofunikirazo ndizitsimikiziranso kuti mukupita ku dokotala wabwino komanso katswiri wothandizira. Ngati muli ndi akatswiri ambiri, PCP yanu imadziwa zomwe mwapadera aliyense akuchita kwa inu ndikuonetsetsa kuti mankhwala opaderawa sakutsutsana.

Ngakhale zili zofanana ndi HMO ndi POS zikukonzekera kuti zikhale zofunikira, mapulani ena osamalidwa omwe akhala akufuna kuti ma PCP ayambe kusandulika "chitsanzo chotseguka" chomwe chimalola anthu kuti aone akatswiri omwe ali mkati mwa mapulani awo popanda kutumiza. Choncho ngakhale kuti pali zambiri zokhudza mapulani ochezera osamalira, palibe choloweza mmalo mwa kuwerenga zolembedwa bwino pamaganizo anu kapena ndondomeko zomwe mukuziganizira.

Pre-Authorization

Chilolezo chisanayambe kapena chilolezo chisanayambe chimakhala kampani ya inshuwalansi ya umoyo imakufunsani kuti mulandire chilolezo kwa mitundu ina ya chithandizo chamankhwala musanavomerezedwe kusamalira. Ngati simulandira izi, ndondomeko yaumoyo ikhoza kukana kulipira.

Mapulani a zaumoyo amaonetsetsa kuti mukufunikira ndalama zomwe mumazipeza. Mu zolinga zomwe mukufuna kuti mukhale ndi PCP, dokotalayo ndi amene ali ndi udindo woonetsetsa kuti mukufunikiradi mautumiki omwe mukupeza. Mapulani omwe samafuna PCP (monga EPO ndi mapulani a PPO) agwiritseni ntchito chitsogozo choyambirira monga njira yokwaniritsira cholinga chomwecho: ndondomeko ya thanzi imalipilira chisamaliro chomwe chiri chofunikira kuchipatala.

Mapulani amasiyana ndi mtundu wanji wa mautumiki omwe ayenera kukhala ovomerezedwa kale koma pafupifupi padziko lonse amafuna kuti chipatala chisamangidwe ndi madokotala apitirize kuvomerezedwa. Ambiri amafunanso kuti adzilamulire kale zinthu monga MRI kapena CT scans, mankhwala okwera mtengo, ndi zipangizo zamankhwala monga oxygen kunyumba ndi mabedi a chipatala.

Kuloledwa kwina nthawi zina kumachitika mofulumira ndipo udzakhala ndi chilolezo musanachoke ku ofesi ya dokotala. Nthawi zambiri, zimatenga masiku angapo. Nthawi zina, zingatenge masabata.

Kutuluka kwa Network Care

HMOs, PPOs, EPOs, ndi POS amapanga zonse zomwe zimapereka ma intaneti. Izi zikuphatikizapo madokotala, zipatala, mabala ndi othandizira ena omwe ali ndi mgwirizano ndi dongosolo la thanzi kapena, nthawi zina, amagwiritsidwa ntchito ndi ndondomeko yaumoyo. Ndondomeko zimasiyanasiyana ngati mungakhale ndi chithandizo cha chithandizo cha zaumoyo kuchokera kwa ogwira ntchito amene sali pa intaneti.

Ngati muwona dokotala wodalirika kapena atayesa kuyembekezera mwazi pa labata yopezeka, ntchito zina zathanzi sizilipira. Mudzakhala kulipira ngongole yonse ya chisamaliro chomwe muli nacho. Kupatula izi ndi chisamaliro chapadera. Ndondomeko za chisamaliro zidzasamalira chithandizo chodzidzimutsa chomwe chinaperekedwa mu chipinda chodzidzimutsa chachinsinsi pokhapokha polojekiti yaumoyo ikuvomereza kuti chisamalirocho chinali chofunikiradi ndipo chinapangika mwadzidzidzi (onetsetsani kuti wothandizira pa Intaneti sangathe kukulipirani kusiyana pakati pa zomwe amalipira ndi zomwe inshuwalansi akulipira).

Muzinthu zina, inshuwalansi idzaperekera chisamaliro chatsopano. Komabe, iwe uyenera kulipira kuchuluka kwa mtengo wa mtengo kuposa momwe iwe ukanalipira ngati utalandira chisamaliro chomwecho mu-intaneti.

Mosasamala kanthu kamangidwe ka ndondomeko, ogulitsa otuluka kunja kwa intaneti sali omangidwa ndi malonda aliwonse ndi kampani yanu ya inshuwalansi ya thanzi. Ngakhalenso inshuwalansi yanu ya POS kapena PPO ikulipira gawo limodzi la ndalamazo, wothandizira zachipatala akhoza kukupatsani kusiyana pakati pa milandu yawo yeniyeni ndi zomwe inshuwalansi yanu ikulipira. Ngati atero, ndiwe amene ali ndi udindo wolipira. Izi zimatchedwa kulipira ngongole , ndipo ndizovomerezeka muzinthu zambiri za chisamaliro cha kunja kwa intaneti, ngakhale pazidzidzidzi.

Kugawana Ndalama

Kugawana mtengo kwa ndalama kumaphatikizapo kulipirira gawo limodzi la ndalama zomwe mumagula-mumagawana mtengo wa chisamaliro chanu ndi kampani yanu ya inshuwalansi. Zopindulitsa , zolipidwa , ndi ndalama zothandizira ndalama ndizogawidwa kwa mitundu yonse.

Mapulani a zaumoyo amasiyana ndi mtundu wanji komanso momwe amafunira ndalama zambiri. Kawirikawiri, zolinga zowonjezera zowonjezereka za umoyo zimakupatsani mphotho yokhala ndi zofunikira zogawidwa mtengo, pamene zofuna zambiri zaumoyo zimalola kuti mutenge gawo lalikulu la ndalamazo pogwiritsa ntchito ndalama zowonjezera, ndalama zothandizira ndalama kapena ndalama.

Koma izi zasintha pamene nthawi ikupita. M'zaka za m'ma 80 ndi 90, zinali zachilendo kuona ma HMO opanda deductible konse. Masiku ano, HMO ikukonzekera ndi madola 1,000,000 omwe amawomboledwa amodzi (pamsika pawokha, ma HMO akhala akukonzekera kwambiri m'madera ambiri, ndipo nthawi zambiri amaperekedwa ndi deductibles $ 5,000 kapena kuposa).

Mu malingaliro omwe amapereka gawo la ndalama zanu, pamene inu muwona ogulitsa a kunja, a mthumba anu adzakhala ochuluka kwambiri (kawiri kawiri) kuposa momwe akanakhalira ngati inu muwona madokotala osonkhana. Mwachitsanzo, ngati ndondomeko yanu ili ndi $ 1,000, mukhoza kukhala ndi ndalama zokwana madola 2,000 chifukwa cha kusamalidwa.

Malire apamwamba pa zomwe mudzayenera kulipira mu ndalama zapakati (kuphatikizapo coinsurance) zingakhale zapamwamba kwambiri mukapita kunja kwa mapulogalamu anu. N'kofunikanso kuzindikira kuti mapulani ena a PPO ndi mapulani a POS adasinthira ndalama zopanda malire pamene anthu akufuna kupeza chithandizo chamagulu. Izi zikhoza kukhala zodula kwambiri kwa ogula omwe sakudziwa kuti kapu ya ndondomeko ya ndalama zomwe zili kunja kwa ndalama (monga momwe ACA imafunira) zimangogwiritsidwa ntchito m'ntchito yopereka mapulogalamu.

Zolemba Zotsatsa

Ngati mutasamala, mumakonda kufotokozera mapepala omwe mumanena nawo ndi kampani yanu ya inshuwalansi. Ngati mutakhala mu-network, dokotala wanu, chipatala, lab, kapena wina aliyense amapereka zofunikira zonse.

Muzinthu zomwe sizikutseketsa chisamaliro chatsopano, nthawi zambiri palibe chifukwa chokhalirapo pokhapokha ngati mutalandira chisamaliro chadzidzidzi kunja kwa intaneti kuyambira pamene inshuwalansi yanu sichidzakubwezerani ndalamazo.

Ndikofunika kuti muzindikire zomwe mwalandira, komabe, ngati mutha kupereka ndalama zanu pafupipafupi (ngati iwo ali oposa 7.5 peresenti ya ndalama zanu, izi zidzakula mpaka 10 peresenti kuyambira 2019 ). Kapena, ngati muli ndi HSA , mukhoza kudzibwezera nokha (pa nthawi kapena utumiki, kapena nthawi ina iliyonse mtsogolo) ndi ndalama zisanapereke msonkho kuchokera ku HSA yanu, mukuganiza kuti simudapereke ndalama zanu pazobwezera msonkho (mungathe Zili zonsezi;

Momwe Dokotala Wanu Amaperekera

Kumvetsetsa momwe dokotala wanu amaperekera kungakulimbikitseni kuti mukambirane momwe zinthu zilili zofunika kuposa momwe mukufunikira, kapena zinthu zomwe mungafunikire kukakamiza kuti musamalire.

Mu HMO, adokotala kawirikawiri amagwira ntchito ya HMO kapena amaperekedwa ndi njira yotchedwa capitation . Kuponderezedwa kumatanthauza kuti dokotala amapatsidwa ndalama zina mwezi uliwonse kwa mamembala onse a HMO omwe akuyenera kuti asamalire. Dokotala amapeza ndalama zofanana kwa membala aliyense ngati membalayo akusowa misonkhano mwezi kapena ayi.

Ngakhale kuti njira zowonetsera zowonongeka zimalepheretsa kuitanitsa mayeso ndi mankhwala omwe sali oyenera, vuto ndikutchulidwa ndikuti palibe cholimbikitsana chothandizira kulamulira zofunika , mwina. Kwenikweni, chizoloŵezi chopindulitsa kwambiri chikanakhala ndi odwala ambiri koma osapereka chithandizo kwa aliyense wa iwo.

Mapeto ake, zomwe zimalimbikitsa anthu kuti azisamalidwa bwino mu HMO ndizokhumba zowonetsera chisamaliro choyenera, kuchepa kwa ndalama za nthawi yaitali poonetsetsa kuti mamembala a HMO ali ndi thanzi labwino, kukhala ndi anthu onse komanso kukhala ndi mwayi wokhutiritsa makasitomala.

Mu EPOs ndi PPOs, madokotala amadzipidwa nthawi zonse akamapereka chithandizo. Odwala ambiri omwe amawona tsiku, amapeza ndalama zambiri. Komanso, zinthu zambiri zomwe dokotala amachita pakapita maulendo onse, kapena kupita kukadandaula kwachipatala kumafuna, makamaka dokotala amaperekedwa pa ulendo umenewo. Kukonzekera kotereku kumadziwika kuti kulipira-kwa-ntchito.

Zomwe zimapangitsa kuti apeze ndalama zothandizira ndalama ndizopangitsa kuti dokotala azipereka chisamaliro chokwanira kuposa momwe zingakhalire zofunika. Powonjezera maulendo obwereza omwe mukufuna, ndalama zomwe dokotala amapanga. Komanso, popeza dokotala amapereka ndalama zambiri kuti azitha kuyendera, sizidabwitsa kuti odwala ali ndi mayeso ambiri a magazi, X-rays, ndi mndandanda wa mavuto aakulu.

Chifukwa chakuti anthu angakhale ndi chisamaliro chochuluka kuposa chofunikira, kukonzekera malipiro kwa-ntchito kumapangitsa kuti ndalama zowonjezera zowonjezera ziwonjezeke komanso ndalama zapamwamba zothandizira inshuwalansi .

Medicare ndi Medicaid

Anthu pafupifupi 36.7 peresenti ya anthu a ku United States amalembedwa mu Medicaid kapena Medicare. Awa ndiwo mapulani a umoyo omwe amayendetsa boma. Mwachikhalidwe, boma (federal for Medicare; federal ndi boma la Medicaid) linangopereka osowa chithandizo mwachindunji pamene olembetsa adalandira chisamaliro.

Koma m'zaka zaposachedwa, pakhala paliwombo loyang'aniridwa ku chisamaliro choyendetsedwa ku Medicaid ndi Medicare. Kuyambira m'chaka cha 2014, madera oposa atatu pa Medicaid omwe anali olembetsa anali mu dongosolo la chisamaliro la Medicaid (boma limagwirizana ndi dongosolo limodzi kapena zambiri zaumoyo; olembetsa angalandire khadi la ID ya Blue Cross Blue Shield, mosiyana ndi khadi la chidziwitso kuchokera ku boma Pulogalamu ya Medicaid). Mu 2017, gawo limodzi mwa magawo atatu a anthu odwala matenda a Medicare anali muzinthu zothandizira (Medicare Advantage).

Ndi Yabwino Kwambiri?

Zimadalira m'mene mumakhalira ndi zoletsa komanso kuchuluka kwa momwe mukulipira. Pomwe dongosolo la thanzi likulepheretsani ufulu wanu wosankha, mwachitsanzo, musamalipire chithandizo cha kunja kwa intaneti kapena mukufuna kuti mutumizidwe kuchokera kwa dokotala musanayambe kuonana ndi katswiri, sizingagwiritse ntchito ndalama zambiri pamalopo kugawana mtengo. Ufulu wochuluka wosankha dongosololo liloleza, ndipamene mungathe kulipira ufulu umenewo.

Ntchito yanu ndi kupeza ndalama zomwe mumakhala nazo bwino. Ngati mukufuna kusungitsa ndalama zanu mozama ndikusamala zoletsedwa kuti mupitirize kukhala pa intaneti ndikukhala ndi chilolezo kuchokera kwa PCP kuti muwone katswiri, ndiye kuti HMO ndi yanu. Ngati mukufuna kusunga ndalama zochepa, koma zikukulimbikitsani kuti mutumizidwe kwa katswiri, ganizirani EPO.

Ngati simukumbukira kupereka malipiro ena, patsiku la mwezi uliwonse ndi kugawana mtengo, PPO idzakupatsani inu kusinthasintha kuti mupite kunja kwa intaneti ndi kukawona akatswiri popanda kutumizidwa. Koma, PPOs imabwera ndi ntchito yowonjezereka yoti ikhale ndi chitsogozo chokwanira kuchokera kwa inshuwalansi kwa ntchito zamtengo wapatali, ndipo amayamba kukhala njira yoyenera kwambiri.

Ngati mukugula zolemba zanu (mosiyana ndi kuzilandira kwa abwana anu), simungakhale ndi mwayi uliwonse wa PPO, monga momwe malonda amodzi akugwiritsira ntchito pa HMO. Ndipo ngati mukulengeza kuchokera kwa abwana anu, momwe mungagwiritsire ntchito ndondomeko yanu idzadalira kukula kwa abwana anu. Olemba akuluakulu amakonda kupereka njira zambiri, koma wogwira ntchito zing'onozing'ono angakhale ndi dongosolo limodzi loti antchito avomereze kapena atenge.

Mawu Ochokera

Pafupifupi masiku onse inshuwalansi ya inshuwalansi imayang'anira ndondomeko yosamalira, komabe pali kusiyana kwakukulu mu kukula kwa womangamanga ndi zofunikira zomwe zimagwiritsidwa ntchito kwa wogwiritsa ntchito.

Mfundo yofunika: palibe njira yodalirika yothetsera thanzi. Chilichonse chimangokhala malire osiyana pakati pa zopindulitsa ndi zoletsedwa ndi pakati pa ndalama zambiri poyerekeza ndi ndalama zochepa. Kumvetsetsa kusiyana pakati pa PPO, EPO, HMO, ndi POS ndi sitepe yoyamba pa kusankha momwe mungasankhire ndondomeko ya inshuwalansi ya umoyo yomwe idzagwira ntchito bwino kwa inu ndi banja lanu.

> Zotsatira:

> Congress.gov. HR1 - Lamulo loperekera mgwirizano mogwirizana ndi maudindo a II ndi V a ndondomeko ya mgwirizano pa bajeti ya chaka cha 2018 >. Inakhazikitsidwa 12/22/2017.

> Gaba, Charles. Chizindikiro cha ACA, Health Care Coverage Kusweka kwa anthu onse a US ku Chithunzi chimodzi. March 2016.

> HealthCare.gov, Dipatimenti ya Inshuwalansi ya Zaumoyo ndi Mitundu Yogwirizanitsa: HMOs, PPOs, ndi zina.

> Kaiser Family Foundation, Medicare Advantage Spotlight 2017: Kulembetsa Ma Market Market. June 2017.

> Kaiser Family Foundation, Total Medicaid Inayang'anira Kulembetsa Kusamalira, 2014.