Nhamba inowedzera yemakambisi einishuwarenzi nemasangano ekuchengetedza anotarisira kuisa mishonga inobatanidza uye inoshandiswa, inoshandiswa nekutengeswa kwevatengi uye humwe huri kukura huchapupu hwezvesayenzi huchiratidza kubatsirwa uye mari inobudirira.
Kuongororwa kwechangopfuura kwema18 maHMO makuru uye vashandi vehushuwarisi, kusanganisira Aetna, Medicare, Prudential, naKaiser Permanente, vakawana kuti 14 yavo yakafukidza 11 kubva kune 34 mamwe maitiro ekurapa.
Chiropractic, massage therapy, uye acupuncture ndiwo maitirwo matatu akafukidzwa kwazvo akatevedzerwa nemishonga inonzi naturopathic. Mimwe mishonga inowedzera kubatanidzwa ndeyemishonga yemishonga, kugadzirisa misha, kugadzikana kwepfungwa-kugadzirisa kushanda, nekufungisisa.
Asi huwandu hwekuparidzira huchiri kuderera; vanhu vanowanzobhadhara mazano pamutengo usingabhadharwi-kubasa kana kuti vanobvumirwa nhamba dzisinganzwisisiki dzezvikamu.
Mhedzisiro yekuguma ndeyokuti kurapwa hakusi kutongwa sekusakundikana apo dambudziko rechokwadi nderokuti kuvharidzirwa kwakakwana hakuna kubvumira munhu kuti apedze chirongwa chinorayirwa kurapwa.
Heano mhinduro dzemibvunzo 12 inowanzojairika pamusoro pehushandi hwekuchengetedzwa kwemishonga inobatsira uye yakasiyana.
1. Vanhu vanobhadhara sei kubatsiridza uye kushandiswa kwemishonga?
Vanhu vazhinji vanobhadhara kubatsiridza uye kushandiswa kwemishonga pamwe nemishonga ivo pachavo.
Nhamba inowedzera yehutano hwehutano inopa kugoverwa kwemishonga inobatanidza uye yakasiyana, zvisinei, iyo inowanzova isina kukwana uye inosiyana kubva kune imwe nyika kuenda kune imwe nyika.
2. Ndingawana sei kana pane mitemo mune zvandinenge ndiri pamusoro peinishuwarenzi yekurapwa kwandinofarira?
Iwe unogona kuedza kutaura nesangano rehurumende renyika yehutachiona hwechirongwa ichocho, somuenzaniso, masangano evanhu vanogadzirisa maitiro.
Vakawanda vezvikwata izvi vanocherechedza inishuwarenzi yekudzivirirwa uye kubhadhara zvekuda kwavo.
3. Ndine inshuwarhu yehutano. Kana ini ndine chido chokuwana kurapwa kubva kumushandi, ndeapi mibvunzo yemari yandinofanira kukumbira?
Kutanga, unoda kuziviswa nezvehutano hwehutano hwehutano. Inopa chero hupi hupi hwehuwandu hwemishonga inobatanidza uye inoshandiswa mishonga? Kana zvakadaro, chii chinodiwa nemiganhu? Semuenzaniso, chirongwa ichi chinopedza mamiriro acho ezvinhu here, zvinoda rubatsiro rwemishonga inobatsira uye yakasiyana-siyana inogona kuendeswa nevanoita (zvakadai sechiremba ane chiremba kana vashandi vari mumakambani ekambani), kana kuvhara mapepa chete kana chirongwa ichocho chichisarudza kuva mishonga zvinodiwa? Verenga sarudzo yako zvakanaka, kusanganisira mirefu uye zvisarudzo. Iyo pfungwa yakanaka kutarisa nekambani ye inshuwarisi usati wawana kurapwa.
Heano mimwe mibvunzo inokubvunza iwe insurer:
- Izvi zvinotarisirwa kunge zvakagara zvichigadzwa here kana kuti zvisati zvabvumidzwa?
- Ndinoda here kutumirwa kubva kune mukuru wangu anotarisira?
- Ndezvipi masangano, miedzo, kana zvimwe zvinodiwa zvichafukidzwa?
- Inguva ipi yekushanyira yakavharwa uye pamusoro penguva ipi yemazuva (somuenzaniso, 6-10 kushanyira gore rokugadzirisa)?
- Pane mari yekubhadhara?
- Kurapa kuchave kwakavharwa chero mamiriro ezvinhu here kana kuti kune mamwe mamiriro ezvinhu?
- Pane imwe nguva mari inogona kuvharwa, yakadai seongororo yekuongorora, zvokudya zvekudya, zvekushandisa, kana zvinhu?
- Ndingada here kuona chiremba munhare yako? Kana zvakadaro, iwe unogona kundipa runyora rwevanyori munharaunda yangu here?
- Kana ndikashandisa chiremba asiri chikamu cheterevhizheni yako, unopa chero chekugovera here? Pane imwezve yekunze-ye-muhomwe inodhura here?
- Pane imwe dhora kana kemumiganhu miganhu yangu here?
Ichakubatsira iwe kuchengeta zvinyorwa zvakarongeka pamusoro pekubatana kwega nekambani yako ye inshuwarisi. Chengeta makopi matsamba, mabhiriro, uye zvirevo.
Ita zvinyorwa pamusoro pefonero, kusanganisira zuva, nguva, zita remumiririri wevashandi, uye izvo zvawakataurirwa. Kana iwe usingagutsikane netsanangudzo yemumiririri, bvunza kutaura kune mumwe munhu.
Kana kambani ye inshuwarisi ichikumbira kuti uve nekutumira, iva nechokwadi chokuti uiwane uye itora nayo iwe kumushandi. Iyo pfungwa yakanaka kuchengetedza kopi yemabhuku ako pachako.
4. Ndeipi mibvunzo yezvemari ndinofanira kumubvunza?
Heano mimwe mibvunzo yekubvunza mubhii kana vashandi vake vehofisi:
- Unobvuma inshuwarisi yehutano here?
- Ndinotora mafomu ekutsvaga here, kana iwe (mupiriri) unotarisira izvozvo?
- Chii chinokonzerwa nekugadzwa kwekutanga?
- Ndezvipi zvirwere zvandinoda?
- Ndinogona here kugamuchira kurapwa kwenguva yekuedza kuti ndione kana chirwere ichi chichishanda kwandiri ndisati ndazvipira kune imwe nzira?
- Ko pachava nehumwe mari inowedzera here?
Inogonawo kubatsira kubvunza kuti inishuwarenzi inoronga mushandi anogamuchira, kana iwe uchida kuchinja zvirongwa pane imwe nguva (somuenzaniso, kuburikidza nokuchinja kwebasa).
Kana iwe usina inshuwarisi yekupa kurapwa uye kubhadhara mari yakazara nguva imwe neimwe ingave yakaoma kwauri, ungabvunza kuti:
- Ko ofisi yako inogona kuronga hurongwa hwokubhadhara kuitira kuti mari dzangu dzipararire kwenguva yakareba here?
- Iwe unopa mubhadharo wemadhora? Mari inoshandiswa yakawanda inogadzirisa zvikwereti zvinoenderana nemari yemuwani uye kukwanisa kubhadhara.
5. Zvakadini nehuwandu hwemishonga inshuwarisi inoshandiswa inogona kupiwa kuburikidza nevashandi?
Kana kuwedzera kwemishonga uye kushandiswa kwemishonga kugoverwa kunopiwa, kazhinji pane imwe yemhando dzinotevera:
Zvikwereti zvakakwirira. A deductible iyo inodha mari yakawanda iyo mutengi anofanira kuripa mushure mekunge inshurensi atanga kubhadhara mari yekurapa. Pasi pemhando iyi yemitemo, kubhadhara mishonga inobatsira uye yakasiyana-siyana inopiwa, asi mutengi anopa chikwereti chakakwirira.
Mutambi wevatambi. Mutasvi wiri kuchinjwa kune inishuwarenzi inogona kuchinja kupararira mune imwe nzira (zvakadai sokuwedzera kana kuderera kunobatsira). Iwe unogona kukwanisa mutasviki anowedzera kana kuwedzera kuparidzirwa munharaunda yemishonga inobatsira uye yakasiyana.
Mvumo yakagadzirwa nevatengi. Vamwe vashandi vanoita basa neboka revatsigiri vezvemishonga pamwe chete nevamwe vanobvumirana kupa zvigaro kumapoka eboka pamutengo wakaderera pane wakapa kune vasiri nhengo. Iwe unobhadhara kunze-kwe-muhomwe kurapwa, asi pamutengo wakaderedzwa.
Vashandi vanotaurirana nemakambani einishuwarenzi kuti varonga zvirongwa nemabasa. Izvi zvinoitwa pane dzimwe nguva (kazhinji gore negore). Iwe unogona kuda kubvumira mutungamiri wekambani yako kuti azive nezvehupi hupi hunofanirwa kugoverana iwe unahwo. Kana kambani yako inopa zvirongwa zvinopfuura rimwe, nyatsoongorora izvo mumwe nomumwe anopa, saka unogona kusarudza chirongwa chinonyatsoenderana nezvido zvako.
Sangano reWealthcare Research uye Quality (AHRQ), sangano reGurumende, rine mabhuku anobatsira pamusoro pokusarudza nekushandisa hurongwa hwehutano hwehutano.
6. Mubhadhari wangu akandikumbira kuti ndiwane uchapupu, kubva mune zvesayenzi uye zvezvokurapa, pamusoro pekushandiswa kwemishonga inobatanidza / mamwe mishonga. Ndekupi kwandinowana?
I National Center for Complementary and Alternative Medicine (NCCAM) Clearinghouse inogona kukubatsira kuwana ruzivo kubva mune zvesayenzi uye zvezvokurapa nezvekurapa kwakasiyana. Vanoshandisa zvinyorwa zvemashoko ezvepamusoro-shanduro yesayenzi uye ezvehutano, zvakadai seCAM paPublicMed.
7. Inishuwarenzi yangu kambani yakaramba kuda kwangu kubatsiri / mamwe maitiro ekurapa. Pane chimwe chinhu chandingaita here?
Hapana chimwe chinokanganisa kunze kwekutsvaga kudai kwakarambwa. Izvo zvakatoitika kune vanhu mushure mokunge vatsigira pamusoro pefoni vachishandisa kambani ye inshuwarisi pamusoro pekurapa kwakasiyana.
Sezvakakurukurwa pekutanga, iva nechokwadi kuti unoziva hurongwa hwako hunosanganisira kuti chii, uye hausi, unofanirwa kuvhara. Cherechedza kana pane kuve nekukanganisa mune coding kana kubhadhara kwebasa rako (rainzi iko kukanganisa kwekodhi), kana nehofisi yevashandi kana nekambani ye inshuwarisi; enzanisa nheyo dzemutemo wevashandi nematare ehurukuro yawakagamuchira kubva kune kambani yveshuwarenzi.
Kana iwe uchifunga kuti inshuwarisi yako yakaita kukanganisa kushandura kuda kwako, unogona kukumbira kuongorora kubva kune kambani.
Uyezve, kambani yeInishuwarenzi inofanira kuva nekuteterera uye kugovera kopi yacho nemitemo yako. Zvinogona kubatsira kubvunzana nemuranda wako kana achigona kuita chero chinhu panzvimbo yako, sekunyora tsamba. Kana iwe wakatora matanho aya uye dambudziko racho risati ragadziriswa, taura nehofisi yako yehurumende inshuwarisi yemuhofisi, iyo ine mukana wekunyunyuta kwevatengi.
8. Pane mitemo inondibatsira kuti ndichengetedze inshuwarano yehutano here kana ndikarasikirwa kana kuchinja mabasa? Idzi mitemo iyi inoshandiswa kune dzimwe nzira dzokurapa uye dzakasiyana-siyana here?
Kana iwe iye zvino une chirongwa chehushuwarisi chinosanganisira chero mishonga inobatsira uye inoshandiswa kune dzimwe nzira, mitemo inotevera inogona kufarira iwe.
Mutemo Wehutano Inoshandiswa Kwekuchengetedza uye Kuita Mutemo (HIPAA) we1996 inopa kudzivirirwa kwakakwana kune vakawanda vanoshanda veAmerica. HIPAA inodzivirira hutano hwehutano hwevashandi uye mhuri dzavo kana mushandi achichinja kana kurasikirwa nebasa rake. Mutemo:
- Kunogadzirisa kukwanisa kwekambani dzemishuwarenzi kuramba kuparidzirwa zvichienderana nemamiriro ezvinhu epreexisting.
- Zvinodzivisa zvirongwa zvehutano zveboka kubva pakuramba kana kubhadhara zvimwe zvekugoverwa nekuda kwekare kana kuti ikozvino hutano husina kunaka.
- Kutsigirwa kuvandudzwa kwehupfumi, pasinei noutano hwehupi hwevanhu vakavharwa pasi pemutemo.
- Vimbiso kune vamwe vashandi vaduku-bhizimisi, uye vamwe vanhu vanorasikirwa nehuwandu hwebasa, kodzero yekutenga inshuwarisi yehutano.
ICentral for Medicare neMedicaid Services inogona kukupa ruzivo rwezvemitemo pamusoro peHeralp HIPAA program. Cherechedza kuti humwe hurumende inogona kuva nemitemo yakananga yakabatana neHIPAA zvinodiwa; kana uchida mamwe mashoko pamusoro peHIPA muhurumende yako, taura nehofisi yako yehurumende inshuwarisi commission.
Imwe mitemo yeDhipatimendi inogona kukubatsira iConsolidated Omnibus Budget Reconciliation Act (COBRA) ya1985.
COBRA kuenderera mberi kugoverwa kunokupa mukana wekutenga nekuchengetedza boka rako remazuva ano hutano hwehutano kwenguva yakatsanangurwa kana iwe wakarambidzwa kana kuti maawa ako emabasa akaderedzwa pasi pezinga rekuwana rubatsiro.
Kureba kwekuenderera mberi kwekugovera kunoenderana nechikonzero chekurasikirwa kweboka rako.
COBRA inowanzovhara zvirongwa zvehutano zvemabhizinesi nevashandi makumi maviri kana kupfuura, masangano emashandi, uye hurumende dzehurumende kana dzomunharaunda.
Iwe unosangana nemamwe mapepa ekurasikirwa uye mamwe mamiriro ezvinhu, zvakadai semheteti yekubhadhara, kuchengetedza kuparidzirwa pasi peCOBRA. COBRA inogonawo kukubatsira kuti usapedzisira uripo kana uchichinja mabasa uye hausi pakarepo kukodzera kugoverwa mukambani yako itsva.
Kuti uwane mamwe mashoko pamusoro peCOBRA, taura nehofisi yako iri pedyo yePension uye Welfare Benefits Administration yeDhipatimendi reBasa.
Nyika yako inogonawo kuva nemutemo unoda vatsigiri vekuchengetedza hurumende kuti varambe vachironga mapoka ekugadzira mapoka kune avo vanorasikirwa nehutano hwavo hwezvikonzero nezvikonzero zvakasiyana-siyana. Tarisa nehofisi yako yehurumende inshuwarisi commission.
9. Ndeapi mitero-kubhadharwa mari yekubhadhara mari? Vangandibatsira sei?
Kushandisa mari yakashandurwa (FSA; dzimwe nguva inonzi Flexible Spending Account) inyaya inopiwa nevamwe vashandi vanopa nzira yekubatsira kubhadhara mari yezvemari, kunze kwekuderedza mari yaanoshandira mari.
Ne FSAs nezvehutano hwehutano hwakasarudzwa, unosarudza mari yakawanda yekusati yateresa mari kuti uise pamabhadharo yako nguva imwe neimwe yekubhadhara. Mari iyi inowanikwa panguva iyo yekudzikinura zvimwe zvikwereti zvine chokuita nehutano izvo zvisina kubhadharwa chero imwe nzira, zvakadai neinishuwarenzi.
Iwe unogona kudikanwa kupa zvinyorwa zvinobva kunachiremba kana mumwe mupi wehutano hwehutano kuti kurapwa kunorapwa.
Cherechedza kuti IRS haina kubvumira mari imwe chete (s) kuti idzose mbiri kuburikidza neFSA uye inonzi semutengo wokubvisa mutero.
Imwe mhando yemutero-kusabhadharwa kubhadhara kwehutano-yakabhadharwa mari yenyaya yekuchengetedza yehutano (HAS). Yakagadzwa neCongress munaDecember 2003, HSAs inobvumira vamwe vanotora muurongwa hwehutano hwakakosha hwekuchengetedza mari munhoroondo isina mvumo. Kana iwe uchikodzera, iwe unogona kushandisa idzi kuchengetedza kubhadhara mari yako yeramangwana rekurapa kana yeawakaroorana naye kana vanovimba navo. IRS ine mabhuku ane ruzivo rwakanyanya pamusoro peFSAs neHSAs. Dhipatimendi reMariki yezveMari inobatanidza zvakananga kune ruzivo pamusoro peHSA pane webhusaiti yayo.
10. IHurumende yeHurumende ine zvigaro zvingandibatsira mune zvehupfumi nemari yangu yehutano?
Pari zvino, hurongwa hweHurumende hwehutano hwehutano hahugadzirwi kuti hubatsire nemimwe nzira yekurapa mari
Zvinotarisirwa kupa rubatsiro rwakananga (kubhadhara zvakakwana) kana kutsigira kwakasiyana (zvakadai seimba kana kuti mari yekuchengetwa kwevana, kurapwa pamakiriniki ehurumende, kana mamwe masangano ehuruzhinji) kuvanhu avo Hurumende inofunga kuti inoda. Mienzaniso inosanganisira vanhu avo:
- Iva nemari shoma uye mari shoma
- Usina imwe inshurensi yezvehutano
- Iva nehurema
- Vari chikamu chehuwandu hwevanhu vanoomerwa nekuwana kurapwa kwechiremba
- Anenge makore makumi matanhatu nemashanu
- Wakashanda muchiuto
Pano pane Federal databases paInternet iyo inogona kukuzivisai kumapurogiramu aya. GovBenefits (www.govbenefits.gov) inopa muongorori uye kuzviongorora kuti ikubatsire kuziva kana zvipi nezvipi zvakakosha pane zvaunoda. FirstGov (www.firstgov.gov) ine ruzivo pamusoro pezvirongwa zvakasiyana-siyana zvehutano zvakadai seMedare and Medicaid.
Sechikamu chekutsvakurudza kwayo, National Center for Complementary and Alternative Medicine (NCCAM) inotungamirira kuongororwa kwekliniki kune dzimwe nzira dzokurapa dzakasiyana.
11. Inobatsira uye inoshandiswa pakushandisa mishonga inobviswa pamutero wangu wemari here?
Kubva muna 2002, IRS inobvumira nhamba shomanana yezvikwereti zvekubatsiridza uye mamwe mabasa nemishonga.
12. Unogona here kuratidza chero humwe hupfumi?
Kana kurapwa (ingava mushonga unobatanidza / unogona kuitika) kune chirwere kana chiitiko chinokonzera dambudziko rezvemari iwe nemhuri yako, ungada kuedza zvinotevera kuti uwane mamwe mashoko:
- Kana iwe uchigamuchira kutarisirwa kuchipatara kana kliniki, chivako ichocho chinogona kuva nevanoshuwaridzana vehupfumi kana murwere anotarisa anogona kukupa zano.
- Iwe unogonawo kuwana zvichibatsira kutaurirana nehurumende dzisingabatsiri dzinoshanda pane chirwere chako kana chirwere chekurapa (edza kutsvaga paIndaneti kana chengetedza zvinyorwa muraibhurari yako yega).
Mhedziso: Matambudziko Emari Yevatengi muKutevedza uye Mamwe Mushonga Mushonga, National Centre yeKutevedza uye Mamwe Mushonga Mushonga (NCCAM). http://nccam.nih.gov/health/financial/
Zvinonzwisisika: Mashoko anowanika pane ino yepaiti anogadzirirwa zvinangwa zvekudzidzisa chete uye haasi kutsiva mazano, kuongororwa kana kurapwa.