Ukuba mdala nge-MS: Iingcebiso ezi-7 zokuHamba kwiHlabathi ye-Inshurensi yezeMpilo

Umxholo

• 1. Fumana ukuba ingaba ukulungele na ukufumana i-inshurensi yezempilo yasimahla
• Jonga ukuba ungalufumana na uncedo lukarhulumente
• 3. Chaza ukuba ufuna ingxelo engakanani
• 4. Jonga ukuba ugqirha wakho ukwisicwangciso na
• 5. Jonga ukuba iinkonzo zakho ziyagutyungelwa na
• 6. Ukuphonononga kwakhona ifomula yesicwangciso
• 7. Dibanisa zonke iindleko eziphuma epokothweni
• Yise kude

Kunokuba nzima ukuhamba kwisifo esitsha njengomntu osele ekhulile, ngakumbi xa kufikwa ekufumaneni i-inshurensi yezempilo. Ngeendleko eziphezulu zononophelo, ukufumana ingxelo efanelekileyo kubalulekile.

Ukuba awukagutyungelwanga phantsi kwesicwangciso sabazali bakho okanye isicwangciso sabaqeshi, kuya kufuneka ujonge ukhuselo kwiNdawo yeNtengiso ye-Inshurensi yezeMpilo, okanye kumthengisi weinshurensi. Ngaphantsi koMthetho woKhathalelo ongenakunceda (ACA), izicwangciso zeemarike azikwazi ukukukhanyela okanye ukuhlawulisa ngaphezulu ukukhutshwa xa unesifo esinjenge-MS.

Ezinye izicwangciso zinokuba neepremiyamu zamaxabiso okanye ezitsalwayo.Ukuba awulumkanga, ungaphela uhlawula kakhulu ngakumbi kugqirha kunye namayeza kunokuba ubulindele.

Nazi iingcebiso ezisixhenxe malunga nendlela yokuhamba kwelinye ilizwe elinamaqhinga leinshurensi yezempilo.

1. Fumana ukuba ingaba ukulungele na ukufumana i-inshurensi yezempilo yasimahla

I-inshurensi inokubiza, ngakumbi kumvuzo okwinqanaba lokungena. Kufanelekile ukujonga ukuba uyakufanelekela na iMedicaid. Le nkqubo yomanyano kunye nelizwe inikezela nge-inshurensi yezempilo ngexabiso elincinci okanye ngaphandle kweendleko kuwe.

Ngaphantsi kwe-ACA, ama-35 athi, kubandakanya iWashington, DC, bandise ukufaneleka kwabo ukubandakanya uluhlu olubanzi lwengeniso. Nokuba ufanelekile na kuxhomekeke kwimeko ohlala kuyo.

Ukufumanisa ukuba ufanelekile, tyelela iMedicaid.gov.

Jonga ukuba ungalufumana na uncedo lukarhulumente

Ukuba awuyifanelanga iMedicaid, unokwenza ukusikwa kwenkqubo encedisa kwiindleko zeinshurensi yezempilo. Urhulumente ubonelela ngoncedo ngohlobo lwenkxaso, iikhredithi zerhafu, kunye nokwehliswa ekwabelaneni ngeendleko xa uthenga isicwangciso kwindawo yentengiso yelizwe lakho. Olu ncedo lwezezimali lunokuzinciphisa kakhulu iipremiyamu kunye neendleko zokuphuma epokothweni.

Ukulungela iipremiyamu ezincitshisiweyo, kuya kufuneka uzuze phakathi kwe- $ 12,490 kunye ne- $ 49,960 (ngo-2020). Kwaye ukufumana uncedo malunga nokutsalwa, ukukopishwa kunye nokuqinisekiswa kwemali, kufuneka wenze phakathi kwe- $ 12,490 kunye ne- $ 31,225.

3. Chaza ukuba ufuna ingxelo engakanani

I-ACA inamanqanaba okugubungela: ibhedu, isilivere, igolide kunye neplatinum. Ukuphakama kwenqanaba, kokukhona isicwangciso siya kugubungela-kwaye kokuya kukuxabisa inyanga nenyanga. (Khumbula, ungagcina imali kwiipremiyamu kuwo onke amanqanaba ukuba ukulungele ukuncediswa ngurhulumente.)

Izicwangciso zeBronze zineepremiyamu zenyanga eziphantsi. Banazo ezona zitsaliweyo ziphezulu- yimalini oyakuhlawula ngayo ukhathalelo lonyango kunye neziyobisi ngaphambi kokuba isicwangciso sakho siqale. Izicwangciso zePlatinam zineepremiyamu eziphezulu zenyanga, kodwa zigubungela malunga nayo yonke into.

Izicwangciso zethusi ezisisiseko ziyilelwe abantu abasempilweni abafuna kuphela i-inshurensi yezempilo kwimeko kaxakeka. Ukuba ukwirejimeni yamachiza e-MS, unokufuna isicwangciso esikwinqanaba eliphezulu. Cinga ukuba uhlawula malini amayeza kunye nonyango xa ukhetha inqanaba.

4. Jonga ukuba ugqirha wakho ukwisicwangciso na

Ukuba kukho ugqirha obukhe wambona iminyaka, qiniseka ukuba bayagutyungelwa sisicwangciso seinshurensi yezempilo. Zonke izicwangciso zibandakanya oogqirha nezibhedlele ezithile. Abanye oogqirha bathathwa njengabangaphandle kwenethiwekhi, kwaye baya kukubiza ngaphezulu kutyelelo ngalunye.

Khangela bonke oogqirha kunye neengcali ozibonayo ngoku usebenzisa isicwangciso sokukhangela kwi-intanethi. Kwakhona jonga isibhedlele osithandayo. Ukuba oogqirha nesibhedlele sakho abekho kwinethiwekhi, unokufuna ukuqhubeka ukhangela elinye icebo.

5. Jonga ukuba iinkonzo zakho ziyagutyungelwa na

Ngokomthetho, isicwangciso ngasinye kwiNdawo yeNtengiso ye-Inshurensi yezeMpilo kufuneka sigubungele iinkonzo ezili-10 ezibalulekileyo. Oku kubandakanya izinto ezinje ngamayeza amiselweyo, iimvavanyo zelebhu, ukutyelelwa kwegumbi likaxakeka, kunye nokunakekelwa kwabalaliswayo.

Zeziphi ezinye iinkonzo ezigutyungelweyo zahlukile kwisicwangciso sokucwangcisa. Ngelixa utyelelo lonyaka nogqirha wakho wokhathalelo oluphambili kufanele ukuba lubekhona kwisicwangciso ngasinye, izinto ezinje ngonyango okanye ukubuyiselwa kwimeko yesiqhelo akunakho ukubandakanywa

Uza kuhlawula malini ngeenkonzo ezinokwahluka ngokuxhomekeke kwinkampani oyikhethayo. Kwaye izicwangciso ezithile zinokunciphisa umda kwinani lotyelelo olufumana neengcali ezinje ngengcali yezomzimba okanye iingcali zengqondo.

Jonga kwiwebhusayithi yesicwangciso okanye ubuze ummeli weinshurensi ukuze abone isishwankathelo seZibonelelo kunye nokuNgqinisisa (SBC). I-SBC idwelisa zonke iinkonzo ezigutyungelwe sisicwangciso, kwaye ihlawula malini kwinkonzo nganye.

6. Ukuphonononga kwakhona ifomula yesicwangciso

Isicwangciso seinshurensi nganye yezempilo ine-formulary yeziyobisi-uluhlu lwamachiza alugubungelayo. Iziyobisi zihlelwe ngokwamanqanaba abizwa ngokuba zii-tiers.

Inqanaba 1 ihlala ibandakanya amayeza enziwe afana nalawo enziwa ngumenzi. Inqanaba lesi-4 linamachiza awodwa, kubandakanya nexabiso elichasene ne-monoclonal antibodies kunye nee-interferon ezisetyenziselwa ukunyanga i-MS. Ukuphakama kwenqanaba leziyobisi olifunayo, kokukhona unokuchitha epokothweni.

Jonga ichiza ngalinye olithathayo ngoku ukunyanga i-MS kunye nezinye iimeko. Ngaba bakwisicwangciso sefomula? Bakweliphi inqanaba?

Kwakhona, fumanisa ukuba ingakanani imali ekufuneka uyihlawule ukuba ugqirha wakho ukumisela iyeza elitsha elingekho kwifomula yesicwangciso.

7. Dibanisa zonke iindleko eziphuma epokothweni

Xa kuziwa kwiindleko zakho zonyango lwexesha elizayo, iipremiyamu ziyinxalenye yepuzzle. Phuma kwi-calculator yakho xa uthelekisa izicwangciso, ukuze ungothuswa ngamatyala amakhulu kamva.

Yidibanise:

• ipremiyamu yakho - imali oyakuyihlawulela i-inshurensi yezempilo inyanga nenyanga
• Ukutsalwa kwakho - uza kuhlawula malini ngeenkonzo okanye amayeza ngaphambi kokuba isicwangciso sakho siqale
• ukuhlawulwa kwakho kwemali-isixa oza kuhlawula ngaso ugqirha ngamnye kunye notyelelo lweengcali, ii-MRIs kunye nolunye uvavanyo, kunye namayeza

Thelekisa izicwangciso ukuze ubone ukuba yeyiphi eya kukunika eyona nzuzo yempunzi yakho. Xa ubhalisa kwakhona kwisicwangciso sentengiso unyaka nonyaka, yiya kule nkqubo kwakhona ukuze uqiniseke ukuba usafumana eyona nto intle.

Yise kude

Ukukhetha inkampani yeinshurensi yezempilo sisigqibo esikhulu, ngakumbi xa unemeko ebandakanya iimvavanyo ezibiza kakhulu kunye nonyango, njengeMS. Thatha ixesha lokujonga ngononophelo ukhetho lwakho. Ukuba udidekile, tsalela umnxeba inkampani nganye yeinshurensi kwaye ubuze omnye kubaphengululi ukuba bathethe ngezibonelelo zesicwangciso nawe.

Ukuba awuphelelanga ekuthandeni isicwangciso seinshurensi yezempilo ekugqibeleni ukhetha, ungoyiki. Awunamathelanga nayo ngonaphakade. Ungasitshintsha isicwangciso sakho ngexesha lokubhaliswa okuvulekileyo ngonyaka, okuhlala kwenzeka ekwindla emva kwexesha.