Iwe unogona kuzvibatsira iwe pachako kuchengetedza mari pamutengo wemishonga yemishonga
Kana iwe une chirongwa chekuvhara mishonga yemishonga chiremba wako anorayira, iwe unoda kuziva iwe inshuwarisi yekambani, Medicare kana mubhadhari wezvinodhaka zvinoshandiswa muropa zvinonzi formulary .
Chiremera chemishonga mu formulary's tier pricing system ichaita musiyano mukuru mune yako yose zvinodhaka zvinodhaka.
Chii chinonzi Formulary?
Mubhadharo wako, pasinei nekambani yehushuwarisi yega yega, Medicare, Tricare, Medicaid kana imwe purogiramu ine runyorwa rwemishonga inobhadhara iyo inonzi iyo formulary.
Zvinyorwa zvaro zvinoumbwa nemishonga inogadzirwa nemishonga, mishonga yemishonga uye dzimwe nguva pamusoro pezvinodhaka zvinokonzerwa nemishonga (OTC) iyo yakambogadzirwa mishonga-chete madhiragi. Semuenzaniso, Prilosec naNaproxen vaishandiswa kuva mishonga chete, asi vose vari ikozvino OTC zvinodhaka. Zvimwe zvirongwa zvekubhadhara zvinosanganisira Prilosec naNaproxen mumashandi avo.
Chii Chinonzi Formulary Tiers?
Nhengo idzi mapoka ezvinodhaka izvo zvinowira mukati motsanangudzo uye mapoka emagetsi:
- Nhamba 1 kana Tier I: Chikamu 1 zvinodhaka zvinowanzosara kune zvinodhaka , zvinodhura zvinodhaka zvinodhaka. Dzimwe nguva dzimwe nguva, zvigadziriswa zviduku zvinodhaka zvinodhaka zvinowira mune izvi, zvakare. Nzira I madhiragi inotitorera isu yakaderera-co-pays, kazhinji $ 10 kusvika $ 25.
- Chidzidzo 2 kana Chipiri II: Chipiri II chinowanzomirirwa nemishonga yemidziyo kana zvinodhura zvakawanda. Kana iwe uchifanira kutora zita remishonga , mushandi wako ane runyora rwemishonga inonzi branded iyo inofarira (nokuti mari yavo yakaderera, inotsanangurwa pasi apa.) Aya mararamiro anosarudzwa anowanikwa muTanho 2. Chipiri II mishonga inotitorera isu pakati -pay, kazhinji $ 15 kusvika $ 50.
- Nhamba yechitatu: kana Zita III: Zvinodhura zita remishonga yemishonga, uye kazhinji iyo iyo inshuwarisi yako yekambani haifariri iwe kuwana mishonga (nokuti iyo inodhura yakakwirira, inotsanangurwa pasi apa) inonziwo isingadi. Vanowanikwa muTanho 3. Muenzaniso wechitatu mishonga inotitorera isu kupfuura zviduku zvakaderera, kazhinji $ 25 kusvika $ 75 co-pay.
- Nzira 4 kana Tier IV, inonziwo inyanzvi yemishonga: Izvi zvinowanzotenderwa nemishonga yemishonga, uye inodhura zvokuti mubhadha wako anoda kuderedza mirairo yezvinodhaka. Nzira IV inyoyo itsva, yakashandiswa muna 2009.
Nzira yeChipiri IV inoratidzika seyokubata-yose yemishonga inodhura. Panzvimbo pekupa imwe nzvimbo yebhadharo yekubhadhara, vateresi vachapa chikamu, se 60%. Somuenzaniso, mari inodhura zvikuru chemo, inodhura pa $ 1 000 inogona kukwereta murwere $ 600.
Nei Zvinodhaka Zvichitevedzwa Muzvikamu?
Iri ndiro mhinduro imwechete yemubvunzo iwoyo: mari.
Kushandiswa kwechirwere chechirwere chinhu chezvinhu zviviri: mari yaro chaiyo uye mari yebhadhari inotaurirana. Kunyanya zvinodhaka zvinodhura mubhadharo, zvakasimudzirwa, uye zvinowedzera kukwereta.
Zvimwe zvinodhaka mumishonga yega yega yezvinodhaka zvinongororwa muzvikamu zvakasiyana. Somuenzaniso, kirasi yemishonga inobatsira vanhu vane GERD (gastroesophageal reflux disease) inonzi proton pump inhibitors, kana PPIs. Iyo PPI inonyanya kudhura ndiyo inowanzoita, inonzi omeprazole, uye iyo inowanikwa inowanikwa muTier I. Zvimwe zvepakati pezvigadzirwa zvePPI zvinonzi PPIs , zvakadai sa Prilosec kana Prevacid, zvinowanzonyorwa muTeer II. MaPIs anodhura zvikuru, akafanana neAaciphex kana Nexium , akanyorwa pane Tier III.
Kushandisa mufananidzo wePPI kumusoro: Mubhadhari anogona kutaurirana nemutengo wayo nemuiti kana muparidzi weimwe yemishonga inodhura, yakafanana neAaciphex kana Nexium kusvika pakaderera zvikuru. Kana vachiita izvi kubudirira, chirwere ichocho chakava "chinonzi chinonzi brand," icho chinowanzoreva kuti chinova chechipiri chinodhaka. Kana vasingakwanisi kuitaurirana zvakakwana, ichaiswa muTeer III uye ichadhura varwere zvakare, zvakare.
Ko Mishandisirwo Ose Anoshandisa Same Tiers Here?
Aiwa, vose vanobhadhara havakwanisi kunyora mishonga imwechete kune mumwechete. Sezvakangofananidzirwa, mubhadharo wemubhadharo unobva pane mari inotaurirana. Kana Mutero A anogona kutaurirana mutengo wakaderera weimwe chirwere chemishonga chinopfuura Payer B negotiates, ipapo Mutero A anganyorera marimi iwayo paTeer II apo Mutero B ungainyora paTi III.
Ndingawana sei Health My Insurer's Formulary?
Chero chero mubhadharo wehutano achaita kuti formulary yako iwanikwe kwauri - vanoda kuti iwe uitore uye uishandise. Ichava nyore kuwanika pa webhusaiti yayo, kana kuti iwe unogona kudana nhamba yebasa revanhu uye uvakumbire kuti vatumire iko kwauri.
Hazvisi zvisizvo kune mubhadhari kuti aite shanduko kumusana waro kana kuti kuendesa mishonga kubva kune mumwe mutsi kune mumwe. Kana iwe ukatora mishonga zuva nezuva kana nguva dzose, unogona kuziviswa kana kuchinja kuchiitika. Uyewo, iwe unoda kuwedzera kaviri-chengeta gore roga roga paunyoresa, kana iwe uine mukana wekuchinja kuurongwa hwako hwekugovera, kuona kana mushonga wako wakashandura nzvimbo yawo mubhadhare ye formulary.
Ungachengetedza Mari Sei uchishandisa Mubhadharo Wako Wokubhadhara?
Kana uine ruzivo rwekutanga rwemishonga yezvinodhaka uye mutengo wekutengesa, iwe unogona kushanda nachiremba wako kusarudza mishonga inokubhadhara iwe zvishoma. Dzokorora chikoro chechiremba, uye uwane nzvimbo yayo mubhadhare yako yebhadhari kuitira kuti uve nechokwadi chokuti uri kuwana mishonga yaunoda nokuda kwemari shoma yemari.