Iindlela ezili-10 zeSmart zokuTyala iiBhili zoKhathalelo lwezeMpilo

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I-CO-PAYS. UKUQINISEKISA. IINDLEKO ZANGAPHANDLE KWEPOKETHI. Ingaziva ngathi ufuna ukukhuphela iakhawunti yakho yokonga ukuze uhlale usempilweni. Awuwedwa: Umntu omnye kwabathandathu baseMerika uchitha ubuncinane i-10 ekhulwini lomvuzo wakhe wonyaka ekuthengeni amayeza, iipremiyamu kunye nonyango. Abasetyhini abaninzi bacinga ukuba ezi ndleko azinakuthengiswa, utshilo uMichelle Katz, umbhali Iingcebiso ze-Inshurensi yeMpilo eyi-101. "Kodwa kulula ukugcina amakhulu eedola kumatyala akho minyaka le ngokuthetha nogqirha wakho okanye ukhethe elinye icebo leinshurensi." Apha, funda ukuba kutheni uhlawula kakhulu-kwaye ungayibuyisela njani loo mali epokothweni yakho.

• Khetha isicwangciso ngononophelo Xa kufika ixesha lokuba uphinde ubhalise kulo nyaka, sukujonga ngokungakhathali ibhokisi ecaleni komgaqo-nkqubo wakho wangoku. Vavanya kwakhona isicwangciso sakho qho ngonyaka ukuqinisekisa ukuba siyazifezekisa iimfuno zakho, utshilo uKimberly Lankford, umbhali I-inshurensi yemaze. Umbuzo wokuqala omawuwubuze ngowokuba ngaba unaye ugqirha omthandayo okanye imeko yezonyango efuna ukhathalelo lwengcali. Ukuba uphendule ngo-ewe nakweyiphi na indlela, ukubheja kwakho okungcono kunokuba yenye yeepriceer Provider Provider Organisation (PPO) okanye i-pointof- service plans (POS), ezikunika inkululeko yokutyelela nawaphi na ugqirha, utshilo uLankford. Ngokubanzi, ugqirha okwi-network uza kubiza i-10 ukuya kwi-25 yeedola kutyelelo ngalunye; Ibhili ye-MD engaphandle kwenethiwekhi ikwenzela iipesenti ezingama-30 zemirhumo yazo. Kodwa ukuba ubona ugqirha wakho amaxesha ambalwa kuphela ngonyaka, umbutho wolondolozo lwempilo (HMO) unokuba ufanelekile. Oku kunika ukhetho olunqunyelwe loogqirha ngeeprimiyamu ezingabizi kakhulu kunye nentlawulo yokubambisana.

  Ukuba uqeshwe ngokwakho okanye umqeshi wakho akanikeli nge-inshurensi yezonyango, jonga iiWebhusayithi ezinje nge-ehealthinsurance.com, enikezela ngexabiso kunye nokuthelekiswa kukarhulumente. "Thatha ingqalelo imigqaliselo yakho, iimfuno zolondolozo rhoqo, kunye nempilo yengqondo kunye neendleko zombono," utshilo uLankford. "Kwakhona qwalasela ukuba uceba ukukhulelwa enyakeni, kuba ayizizo zonke izicwangciso ezigubungela ezo ndleko." Nje ukuba uchaze zonke iinkonzo oza kuzifuna, crunch the numbers with a online calculator such as money-zine.com. "Musa ukoyikiswa yimigaqo-nkqubo enezitsali eziphezulu, imali ekufuneka uyihlawule epokothweni ngaphambi kokuba i-inshurensi iqale," utshilo uLankford. "Ezo zicwangciso zineentlawulo zenyanga ezinexabiso eliphantsi, ngoko ke zinokufaneleka ukuba iimfuno zakho zonyango zincinci."

  
  
• Buza iimvavanyo zakho "Oogqirha abaqondi ukuba zeziphi izikrini kunye neemviwo ezifakwe kwi-inshurensi yakho," kusho uKatz. Ukuthintela ukumangaliswa ngamaxabiso, yiza noluhlu lweelebhu ezivunyiweyo kwindawo yakho yokuqala nogqirha omtsha. Jonga kwakhona umboneleli wakho weinshurensi ngaphambi kokuba ucwangcise naluphi na unyango okanye iimvavanyo, ezinje ngee-X-reyi, ii-MRIs, kunye nee-ultrasound zebele; kunokufuneka ufumane imvume ebhaliweyo okanye yomlomo kwangaphambili. Bhala phantsi wonke umntu othetha naye kunye nexesha kunye nomhla othethe ngawo," utshilo uLankford. "Umkhondo wephepha ubalulekile ukuba kukho imibuzo okanye iingxabano kamva."

• Thethana nogqirha wakho Ukuba uhlawula amatyala akho epokothweni, ungabi nazintloni okanye ube neentloni zokucela ugqirha wakho ngesaphulelo. "Chaza imeko yakho," utsho uKatz. "Yithi," Awukho kwinethiwekhi yam, kodwa andizukuthemba omnye umntu ukuba ayiphathe le nto. Ngaba ikhona enye indlela onokuthi uhlengahlengise ngayo umrhumo wam? ' " Eli qhinga lasebenzela uKatz: Njengomfundi ophumeleleyo ongafundiswanga, wacela ugqirha wezonyango owaziwayo ukuba anyange umonzakalo wakhe. "Ekuqeshweni kwam okokuqala, ndiye ndaxoxa naye ngezam iingxaki zemali," utshilo. Akazange amdlulisele kwisibhedlele esinexabiso eliphantsi kuqhaqho lwakhe, wavuma nokwenza utyando ngesiqingatha semali yakhe yesiqhelo. Ngaphezu koko, wamvumela ukuba ahlawule iindleko kwishedyuli yenyanga, emgcinela i-14,000 yeedola. “Eyona nto ibalulekileyo kukuseka ulwalamano lobuqu nogqirha wakho nabasebenzi,” utsho uKatz, ocebisa ukuba ufike kwangethuba ukuze ufumane amadinga kwaye usoloko uvakalisa uxabiso lwakho.
• Yazi into omawuyenze ngexesha likaxakeka Xa kuvela ingxaki, isibhedlele kunye nemirhumo yoogqirha yeyona nto yokugqibela ucinga ngayo. Kungenxa yoko le nto kubalulekile ukuba uphonononge umgaqo-nkqubo wakho kwangaphambili. Lankford (ungalufumana olu lwazi kwincwadana yomgaqo-nkqubo weinshurensi okanye kwiWebhusayithi yenkampani. ). Uya kuzikhusela kwityala elingalindelekanga: Iinkampani zeinshurensi yezempilo ziyakhanyela iipesenti ezingama-20 zazo zonke izicelo zokuhlawula ngononophelo ezifuna ukugunyaziswa kwangaphambili, ngokophando lwakutsha nje olupapashwe kwi-Annals of Emergency Medicine.

  "Ukuba kuyangxamiseka, ungathandabuzi ukubiza inqwelo yezigulana," utshilo uLankford. Kodwa kwiimeko ezingezizo ezoyikisayo, ezifana nethambo elaphukileyo okanye umkhuhlane ongaphantsi kwe-103 ° F (ngaphandle kokuba unesisu esibuhlungu, esinokubonisa i-appendicitis), cela umhlobo okanye ilungu losapho ukuba likukhwelise ukuya esibhedlele.

  
  

• Hlola ityala lakho lasesibhedlele Uninzi lwabasetyhini luzihlolisisa iingxelo zekhadi labo lokuthenga ngetyala nyanga zonke, kodwa bambalwa kakhulu abade bajonge kwii-invoyisi zabo zasesibhedlele. Kodwa bafanele: Iingcali ziqikelela ukuba ukuya kutsho kuma-90 ekhulwini amatyala esibhedlele aneempazamo. Ngaphambi kokuba uphume, cela ityala eliyilwayo. Unyango ngalunye olufumanayo lunikwa ikhowudi yamanani, ucacisa uKatz. "Ke xa umntu echwetheze ngempazamo kwikhowudi enokuthetha umahluko kumakhulu okanye amawaka eedola." Phambi kokuba uhambe, jonga ityala lakho ukuze ufumane naziphi na iindleko ezingaqhelekanga. Emva koko, kwidinga lakho elilandelayo, cela ugqirha wakho okanye umntu osebenza naye ukuba ahambe phezu kwayo nantoni na ongayaziyo.
• Hlawula ngeedola zangaphambili Ngaphantsi kweepesenti ezili-15 zabantu baseMelika basebenzise iakhawunti yokonga impilo (HSA) okanye ulungelelwaniso lwenkcitho eguquguqukayo (FSA), omabini anikezelwa ngabaqeshi. Oko kuthetha ukuba uninzi lwethu luphulukana nemali yasimahla: Ezi akhawunti zikuvumela ukuba uhlawule iindleko zonyango ngemali oyibekele bucala kwi-paycheck yakho phambi kokuba kukhutshwe irhafu. Isiphumo: ukonga ukuya kuthi ga kwi-30 yepesenti kwiindleko zakho zokhathalelo lwempilo. Unokusebenzisa iiakhawunti ukubhatalela iindleko ezingagutyungelwanga yi-inshurensi yezempilo, enje ngokuhlawulwa ngugqirha kunye nokuyalelwa esibhedlele kunye nokuhlala esibhedlele. Izicwangciso ezininzi zikwakuvumela ukuba uthenge isisombululo seelensi zonxibelelwano, iiglasi, i-Band-Aids kunye neasprini. Uninzi lwabaqeshi banikela uhlobo olunye lweakhawunti, nokuba yi-HSA okanye i-FSA. Ukwahlukana okukhulu phakathi kwezi zibini kukuba unokugqithisa imirhumo yakho ye-HSA unyaka nonyaka kunye nomsebenzi ukuya emsebenzini. Kodwa nge-FSA, uphulukana nayo nayiphi na imali eseleyo kwiakhawunti yakho ukuba awuyichithi ngo-Matshi 15 wonyaka olandelayo okanye ukuba utshintsha iinkampani.

  Uqikelelo oluchanekileyo lweendleko zonyango, jonga inkcitho yakho enxulumene nempilo kwezi nyanga zili-12 zidlulileyo, emva koko wongeze kuzo naziphi na iindleko ezongezelelweyo (umzekelo, umzekelo) olindele ukuwenza kwixesha elizayo. "Kodwa khumbula ukuba kufuneka ufake iifom zebango ukuze ubuyiselwe, ngoko ke ukuba uyoyikeka kumaphepha okanye ubambelele kwiirisithi, ezi ntlobo zeeakhawunti zingabikho kuwe," kusho uKatz.

  
  

• Yiba sisixhobo esithengisa iziyobisi “Ungonga ukuya kutsho kuma-30 epesenti kwiindleko zakho zomyalelo kagqirha ngokwenza igeneric,” utshilo uSteve Miller, M.D., igosa eliyintloko lezonyango le-Express Scripts, inkampani yolawulo lwezibonelelo zekhemesti ese-St. Buza ugqirha wakho ukuba ngaba kukho uhlobo oluqinisekisiweyo lonyango amiselweyo. “Banomgangatho ofanayo kunye neerekhodi zokhuseleko njengamayeza egama lebrand,” utshilo. Ukuba akukabikho emarikeni, buza iM.D. ukuba kukho enye indlela engabizi kakhulu kodwa esebenza ngokulinganayo kwichiza alimiselayo. Nokuba ugqirha wakho ukunika iisampulu zasimahla zechiza, cela amayeza enziwe afana nalawo aveliswe ngumenzi: Nje ukuba iipakethi ezincedisayo ziphele, kusenokwenzeka ukuba kuya kufuneka wenze ifolokhwe ngaphezulu kwemali, utshilo uMiller. Ngapha koko, uphononongo olusuka kwiYunivesithi yaseChicago lufumanise ukuba abaguli abafumene isampulu enye yasimahla yeyeza eligama lebrand bachitha iipesenti ezingama-40 ngaphezulu kumayeza kwiinyanga ezintandathu kunabo bangawafumananga, mhlawumbi ngenxa yokuba bebeqhubeka nokuthenga. iipilisi zomthengi.

• Yiba ngumsasazi wepilisi "Amanye amachiza axabisa ngokufanayo kwiidosi eziphezulu nezisezantsi," utshilo u-Hae Mi Choe, Pharm.D., unjingalwazi oncedisayo weklinikhi kwiYunivesithi yaseMichigan, uAnn Arbor, kwiSikolo seKhemesti. Ukuba unamayeza, anjengeyelesterol ephezulu, buza ugqirha wakho ukuba angakubhalela na ipilisi yepilisi ephezulu onokuyinqumla kwisiqingatha ekhaya, utshilo u-Choe. Kutshanje uqhube isifundo esafumanisa ukuba izigulane zingonga ukuya kutsho kuma-50 epesenti kwiindleko zamachiza ngokwazo ngokwahlulahlula iipilisi zazo. Kodwa oku akusebenzi kuwo onke amayeza. "Ezinye, ezinjengama-capsules, iipilisi ezigqunyiweyo, kunye neefomyula zokukhupha ixesha, akufanele zinqunywe," kusho uChoe. "Ngoko ke qhagamshelana nogqirha wakho okanye usokhemesti kuqala." Ukuqinisekisa ukuba uhlala uthatha idosi echanekileyo, sebenzisa isixhobo sokuqhekeza iipilisi, ezifumaneka kwiivenkile ezithengisa iziyobisi.

• Fumana isaphulelo kwikhemesti Amaketanga amakhulu anje ngeThagethi kunye noWal-Mart bathengisa amachiza enziwe afana nalawo okulwa nonyango, kunye neepilisi ezinciphisa i-cholesterol, kangangeedola ezi-4 kunikezelo lweentsuku ezingama-30. ICostco nayo igcwalisa imimiselo ngesaphulelo (awunyanzelekanga ukuba ube lilungu lokusebenzisa ikhemesti). Unokuphinda ubuze i-MD yakho ukuba ikubhalele isigunyaziso seenyanga ezintathu, emva koko uyi-odole kwikhemesti ekwi-intanethi enxulunyaniswa nesicwangciso sakho seinshurensi okanye esizimeleyo, njenge walgreens.com, drugstore.com, okanye cvs.com. Kodwa qiniseka ukuba uthelekisa ivenkile: Abaphandi abavela kwiCreighton University School of Pharmacy bafumana I-brand-name Rx's zitshiphu xa zithengwa ngeposi, kodwa amayeza enziwe afana nalawo enziwa ngumenzi anokuxabisa ngaphezulu.
• Thatha ithuba lokufumana izinto ezifihliweyo kwisicwangciso sakho U-Lankford (ugqirha kwinethiwekhi uhlala efuna ukukunika imvume kwangaphambili). Jonga ukuba ngaba ukubonelela ngezaphulelo okanye ukuhlawula iinkqubo zokuyeka ukutshaya, ukunciphisa umzimba okanye ukucebisa ngesondlo, okanye ubulungu bokuzivocavoca. Iinkampani ezimbalwa zeinshurensi, kubandakanya iAetna kunye neKaiser Permanente, nazo ziqala ukugubungela ezinye iindlela zonyango, ezinje ngokuthambisa, unyango lokuthambisa, kunye nokunyamekela i-chiropractic.

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