Kodi chitsimikizo ndi chiyani?

Kampani Healthcare Yafotokozedwa

Nthawi zina mawu azaumoyo amatha kumveka ngati chilankhulo china. Ndi mawu onga copay , kuchotsedwa , ndi Kutuluka mthumba kuponyedwa mozungulira, kodi mukuyenera kudziwa chiyani? Ndipamene mndandanda wathu wa Healthcare Defined umabwera. Timawononga mawu kuti mumvetsetse-ndipo kumvetsetsa kumabwera ndalama zabwino.

Apa, tikumana ndi chitsimikizo cha ndalama. Coinsurance ndiye kuchuluka kwa ndalama zolipirira chithandizo chamankhwala chomwe mumayenera kulipira mthumba mukafika kuchotseredwa pachaka. Chiwerengerochi chimatsimikiziridwa ndi peresenti yomwe imagwiritsidwa ntchito pamtengo wathunthu wazithandizo zamankhwala. Kampani yanu ya inshuwaransi imalipira zochulukirapo, ndipo mukuyembekezeka kubweza zochepa. Mwachitsanzo, inshuwaransi wanu amalipira 80% ndipo mumalipira 20%. Lingaliro ili, lomwe nthawi zambiri limatchulidwa kuti kutenga nawo gawo, limachepetsa chiopsezo ku kampani ya inshuwaransi pofunsa kuti munthuyo agawane gawo lazomwe amachotsera pambuyo pake.

Coinsurance vs copay

Kumvetsetsa chitsimikizo kumafuna kumvetsetsa gawo lake munjira yogawana ndalama. Njira zina zogawana mtengo zikuphatikiza deductibles ndi copays , ndipo mawu onse atatuwa amagwiritsidwa ntchito mosinthana. Kukopera ndi ndalama zolipiritsa zomwe munthu amafunika kulipira panthawi yomwe dokotala akuyendera kapena akamupatsa mankhwala. Ndalama zolipirira ndalama, mosiyanitsa, ndi gawo la ndalama zonse za dokotala kapena zamankhwala, kutanthauza kuti ndalama zotulutsira mthumba zimatha kusiyanasiyana.

Ogwiritsa ntchito ena amaganiza kuti akakwaniritsa chaka chilichonse kutuluka m'thumba deductible, kampani yawo ya inshuwaransi yazaumoyo idzalowererapo ndikulipira ndalama zina zowonjezera chaka chonse. Tsoka ilo, dongosololi sikuti limakhala losavuta nthawi zonse.

Chotsalira ndichokhazikika chomwe munthu ayenera kulipira m'thumba kampani ya inshuwaransi isanalowemo kuti athe kulipira ndalama zambiri. Coinsurance imayamba kugwira ntchito pambuyo poti deductible ikwaniritsidwa.

Lingaliro lalikulu la chitsimikizo ndi losavuta. Mukachotsa deductible, kampani yanu ya inshuwaransi imalipira gawo linalake la mtengo waulendo uliwonse, ndikukusiyirani otsalira. Mwachitsanzo, tinene kuti muli ndi njira ya $ 1,000 ndipo inshuwaransi yanu imakhudza 90% ya mtengo wonse. Kusungitsa ndalama kwanu ndi 10%, komwe pakadakhala $ 100.

Kodi chitsimikizo chachuma ndi chabwino kapena choipa?

Coinsurance siyabwino kwenikweni kapena yoyipa, koma zenizeni zamapulogalamu ambiri a inshuwaransi. Nkhani yabwino ndiyakuti nthawi zambiri pamakhala malire pazomwe mungagwiritse ntchito muthumba. Kampani yanu ya inshuwaransi pamapeto pake imalipira ngongole yonse kuti ikuthandizireni mukangofika pachilichonse, chomwe chimaphatikizapo ndalama zanu zapachaka zopezera ndalama. Nkhani yoyipa ndiyakuti anthu ambiri samakumana ndi ndalama zawo zotulutsira mthumba chaka ndi chaka.

Kodi kutalika kwa mthumba ndi chiyani?

Kutalikirana kwa thumba ndi ndalama zambiri zomwe munthu amalipira kuchipatala chothandizidwa ndi inshuwaransi mchaka chimodzi. Pambuyo pokumana ndi deductible, mukuyenera kulipira peresenti kudzera mu chitsimikizo cha ndalama. Komabe, ndalama zochulukirapo mthumba zikakwaniritsidwa mukamalipira ndalama zochotseredwa, zolipiritsa, komanso ndalama za inshuwaransi, kampani ya inshuwaransi imalipira ntchito 100% zomwe zimakonzedwa ndi inshuwaransi yazaumoyo wanu.

Kotero mu chitsanzo chomwecho kuchokera pamwambapa, tinene kuti mapulani anu ali ndi $ 5,000 kutuluka mthumba. Mukamaliza kugwiritsa ntchito ndalamazo mumadulira, ma copay, komanso ndalama zandalama, inshuwaransi imalipira 100% mpaka mapulani anu abwezeretsanso (makamaka kumapeto kwa chaka cha kalendala).

Kodi kutsimikizika kumatanthauza chiyani kwa inu?

Kuchuluka kwa ndalama zanu kumasiyana malinga ndi inshuwaransi yaumoyo kapena Ndondomeko ya Medicare mumasankha. Pambuyo pomenya deductible, magawo ambiri a inshuwaransi anu motsutsana ndi zomwe mumalemba ndi 80/20, 90/10, kapena 70/30.

Chifukwa chake mwangogunda kuchotsera kwanu - tiyeni titchule kuti $ 2,000 - zomwe zikutanthauza kuti mwawononga ndalama zochuluka chonchi pazinthu zosiyanasiyana zolipira kuchipatala mchaka chimodzi. Tsopano, chitsimikizo chanu cha ndalama chimalowererapo. Ngati ngongole yanu ndi 20%, mumalipira 20% ya ndalama zonse zachipatala, ndipo inshuwaransi yanu imalipira 80% yotsalayo.

Mwachitsanzo, mumapita kukaonana ndi adokotala kukhosi, ndipo ndalama zake zimakwana $ 100. Ngati chitsimikiziro chanu ndi 20%, mudzakulipirani $ 20 paulendowu ndipo inshuwaransi yanu ilipira $ 80.

Koma zinthu zimatha kukhala zovuta kuchokera pamenepo. Makampani a inshuwaransi nthawi zambiri amakhala ndi mitengo yolipirira ndalama zothandizira omwe sagwirizana ndi netiweki zawo-ndiye kuti, ntchito zomwe akatswiri azachipatala omwe alibe mgwirizano ndi kampani yanu ya inshuwaransi.

Chiwongoladzanja cha intaneti cha 10% nthawi zambiri chimadumphira ku 30% kapena 40% kwa dokotala wapaintaneti kapena mankhwala. Zolinga zina mwina sizingakupatseni mwayi wopezeka kunja kwa netiweki.

Kuphatikiza apo, ngati chindapusa cha ntchito yomwe waperekayo inali yokwera kuposa yomwe omwe amapereka pa intaneti angalipire, munthuyo nthawi zambiri amayenera kupanga kusiyana pamtengo.

Momwe mungasankhire dongosolo loyenera

Ngati mupeza kuti mumawononga ndalama zambiri chaka chilichonse, mungafune kuganizira mapulani apamwamba kulipira pamwezi , popeza izi zitha kukhala ndi ndalama zochepa zochotsera komanso inshuwaransi, ndipo inshuwaransi yanu idzakwaniritsa zolipira zanu zachipatala posachedwa.

Ngati simumakonda kukaonana ndi dokotala, mungafune kuganizira mapulani omwe mumalandira ndalama zochepa pamwezi ngakhale mutakhala ndi deductible yayikulu komanso chitsimikizo chazachuma. Ndipo kumbukirani, zochotseredwa zimakhazikitsidwanso kumapeto kwa chaka chomwe mukufuna.

Kuganizira za ndalama zandalama komanso ndalama zochotseredwa ndi zina mwazinthu zomwe muyenera kuganizira posankha dongosolo. Muyeneranso kuganizira ngati madotolo anu akutenga nawo gawo muukonde wa mapulani komanso ngati chithandizo chamankhwala chomwe mukufuna chimakwaniritsidwa.

Ziribe kanthu dongosolo lanu la inshuwaransi, Osakwatira itha kuthandizira ndi mankhwala akuchipatala omwe sangakhale okwera mtengo ngakhale atakhala ndi inshuwaransi. Ingofufuzani mankhwala anu kuti mupeze mtengo wabwino kwambiri - palibe zolipiritsa zobisika kuti mulowe nawo kapena kugwiritsa ntchito.