Kunzwisisa kutarisirwa kwakachengetedzwa chikamu chikuru chekusarudza chirongwa chehutano
Kuti usarudze hutano huri nani hwehutano iwe nemhuri yako, unofanira kunzwisisa mutsauko pakati peHMO, PPO, EPO, uye POS hurongwa hwehutano. Izvo zviyeuchidzo zvemarudzi akasiyana-siyana ehutano hwekutarisira hunoonekwa munzvimbo dzakawanda.
Overview
- HMO = Hurongwa hwehutano hwehutano: HMO inowanzova nemari miviri yepamwedzi yepamwedzi uye kugovana-kudhura kwepamusoro pane zvirongwa zvine zvishoma mitambo mitambo, asi dzinoda kutarisira wekutanga (PCP) kutumira uye hazvizobhadhari kutarisira kunze kwe-network kunze kwekukurumidza .
- PPO = Mutapi Anoda Kuda Sangano: PPOs ine zita iroro nokuti rine network yevashandi yavanosarudza kuti iwe uishandise, asi ivo vacharamba vachibhadhara zvekunze kwe-network. Sezvo vaine zvishoma kudzvinyirira kupfuura mamwe akawanda emhando dzemagadziro, vanowanzova nezvikwereti zvepamwedzi zvepamwedzi uye vanoda kudhura-kugoverana mari. Kunyange zvazvo zvirongwa zvePPO zvaiwanzoshandiswa munguva yakapfuura, dzave dzisina kunyanya kuzivikanwa mumakore achangopfuura sezvo zvirongwa zvehutano zvinoderedza huwandu hwavanopa mishandura uye kuwedzera kushanduka kune EPOs uye HMOs mukuedza kudzora mari. PPOs zvichiri kuwanzana pakati pemashandiro ehutano akashandiswa nevashandirwi, asi zvakanyangarika zvachose mumushuwarisi wemushuwarisi mune dzimwe nyika (munhu wese inshuwarheni ndiyo mutengo waunotenga iwe pachako-kusanganisira kuburikidza nekushandura muhurumende yako-kusiyana nekuwana kubva kumushandi )
- EPO = Exclusive Provider Organisation: EPO yakagamuchira zita iroro nokuti ine network yevashandi vanoshandisa chete . Unofanirwa kunamatira kune vanotengesa pane iyo urongwa kana EPO haingabhadhari. Zvisinei, EPO inowanzoita kuti iwe uwane kutumirwa kubva kuchiremba wekuchengeta vana kuitira kuti ushanyire mumwe muongorori. Funga nezve EPO yakafanana nePPO asi pasina kubhadhara kunze kwe-network.
- POS = Chimwe Chebasa: Zvirongwa zvePOS zvakafanana neHMO asi hazvina kudzivirirwa mune zvekuti iwe unobvumirwa, mune mamwe mamiriro ezvinhu, kuti uchengetedze kunze-ye-network sezvamungaita nePPO. Kufanana neHMO, zvirongwa zvakawanda zvePOS zvinoda iwe kuti uve nekutumira kwePPP kune vose vane hanya kana zviri mukati kana kunze kwe-network.
Nokutaura, zvirongwa zvisina kuchengetedzwa zvekutarisira zvinodanwa hurongwa hwekubhadhara.
Idzi zvirongwa zvehutano izvo zvisingakwanisi kupa mitero, uye zvinongodzorera chikamu chemhosva dzako chero ipi zvayo inobata mishonga. Zvirongwa zvekusununguka hazvina kufarira pamakumi mashoma emakore apfuura uye hazviwanzoitiki nhasi. Dental repemnity plans zvichiri kuwanzoitika, asi zvinenge zvose zvirongwa zvekurapa zvirwere zvinoshandisa kuchengetedzwa kwakagadzirirwa
[Zvirwere zvakagadziriswa zvigadziriswa zvirongwa zvinongororwa kunze kwezvikomborero pasi peChinotengeswa Care Act, uye hazviisi pasi pemitemo yayo; Kuparidzirwa pasi pegadziriro yekusimwa kwekusimbiswa hakusi kunotarisirwa kushandiswa kwakanyanya kunokosha, izvo zvinoreva kuti vanhu vane zvirongwa izvi havakwanisi kufungidzirwa, uye vanozviisa pasi pemutemo weAACA wega chirango .].
Cherechedza kuti rimwe rinowanzoshandiswa-shanduro, HSA , hairevi kurudzi rwekutarisira kunotarisirwa. HSA inomirira nyaya yehutano yekuchengetedza utano, uye zvirongwa zveHSA-zvakakodzera zvinogona kuva HMOs, PPOs, EPOs, kana zvirongwa zvePOS. HSA-zvirongwa zvakakodzera zvinosangana nehumwe hurongwa hwekugadzirisa zvirongwa zvakarongwa ne IRS, asi hazvirevi maererano nemhando yekuchengetedzwa kwakachengetedzwa kwavanoshandisa.
Kuti usarudze nzira yakanakisisa yehutano hwehutano hwemamiriro ako ezvinhu, unofanira kunzwisisa nzira nhanhatu dzinokosha zvirongwa zvehutano zvinogona kusiyana uye kuti imwe neimwe yeiyi inokukanganisa iwe.
Zvadaro, unoda kudzidza kuti HMOs, PPOs, EPOs, uye POS inoronga mabasa ose, maererano nematanhatu matanhatu ekuenzanisa.
Points of Differentiation
Nzira nhanhatu dzinokosha HMOs, PPOs, EPOs uye zvirongwa zvePOS zvakasiyana ndezvi:
- Zvichida kana kwete iwe unofanirwa kuva nechiremba wekuchirapa (PCP)
- Ungave kana kwete iwe unotarisirwa kuva nekutumira kuwona nyanzvi kana kuwana mamwe mabasa
- Zvichida kana kwete iwe unofanira kunge uine utano hwehutano hwakagara hwagadzwa
- Zvichida kana kwete chirongwa chehutano chichabhadhara nekuda kwekuchengetedza kwaunowana panze kwekunopa mutevedzeri wayo
- Iko mari yakawanda -kugoverana iwe unotarisirwa kubhadhara paunoshandisa utano hwako hwehutano
- Zvichida kana kwete iwe unofanira kuisa inshumo yehutano uye kuita mapepa
Kuenzanisa Kwakaita Sei?
Inishuwarenzi yehutano mitemo yakasiyana kubva kune imwe nyika kuenda kune imwe nyika uye dzimwe nguva chirongwa hachizosimbise zvakasimba kune imwe yakarongwa hurongwa hwokugadzira. Shandisai tafura semutungamiri mukuru, asi verenga zvinyorwa zvakanakisisa paChidimbu cheBatsiro neKubatsira kwerongwa rimwe nerimwe raunofunga usati wanyoresa. Nenzira iyo iwe uchaziva zvechokwadi kuti chirongwa chega chega chinotarisira kubva kwauri, uye chaunogona kutarisira kubva pauri.
| Inoda PCP | Inoda kudzokorora | Inoda pre-mvumo | Anotarisira kunze kwe-network | Kugovana-kudhura | Iwe unofanirwa kutora mapepa mapepa here? | |
|---|---|---|---|---|---|---|
| HMO | Ehe | Ehe | Hazviwanzodiwa. Kana zvichidiwa, PCP inozviita. | Aihwa | Kazhinji zvishoma | Aihwa |
| POS | Ehe | Ehe | Kwete kazhinji. Kana zvichidiwa, PCP inogona kuzviita. Kunze-kwe-network kutarisira kungave nemitemo yakasiyana. | Hungu, asi inoda kutumira PCP. | Kazhinji zvakaderera mu-network, yakakwirira kune kunze kwe-network. | Chete nokuda kwekutaura kwemashoko. |
| EPO | Aihwa | Aihwa | Ehe | Aihwa | Kazhinji zvishoma | Aihwa |
| PPO | Aihwa | Aihwa | Ehe | Ehe | Inonyanya kukwirira, kunyanya kune kunze kwe-network. | Chete nokuda kwekutaura kwemashoko. |
Physician Requirement
Mamwe marudzi ehutano inshuwarheni inoda kuti iwe uve nechiremba wepamusoro. Mune zvirongwa izvi zvehutano, basa rePPP rinokosha kwazvo kuti urongwa huchapa PCP kwauri kana usingakurumidza kusarudza rimwe kubva pane urongwa hwerongwa. HMO nePOS zvirongwa zvinoda PCP.
Mune zvirongwa izvi, PCP ndiye chiremba wako mukuru uyo anorongedzawo mamwe mabasa enyu ose ezvehutano. Semuenzaniso, urongwa hwePPP huno hunodiwa sehupi hwehutano kana hunoti oxygen. Iyewo anorongedza kutarisira kwaunogamuchira kubva kune vanyori.
Nokuti PCP yako inofunga kuti kana iwe haufaniri kuona nyanzvi kana kuti une chirongwa chaiyo chekuchengetedza hutano kana kuedza, mumagadziro aya PCP yako inoshanda somuchengeti wegedhi achidzora kuwana kwako kune hutano hwehutano hwakakosha.
Muzvigadziro zvisina purogiramu yePPP, kuwana ruzivo rwehutano hwehutano hungave huri pasi pekutambudza, asi iwe une basa rakawanda rekugadzirisa kutarisira kwako. EPO nePPO zvirongwa hazvidi kuti ipo PCP.
Referral Requirement
Kazhinji, zvirongwa zvehutano zvinoda kuti iwe uve nePPP zvinodawo kuti uve nekutumira kubva kuPPP usati waona nyanzvi kana kuwana chero imwe mhando yehutano husingasviki hwehutano hwehutano. Kuda kuburitswa ndiyo inyanzvi yehutano yekambisi yehutano inshumo yekuchengetedza mari yekuongorora kuburikidza nekuita chokwadi kuti iwe unoda chaizvo kuona chiremba kana kuwana iyo inodhura kushumira kana kuedza.
Dhiyabhorosi kune izvi zvinosanganisira kusanonoka pakuona nyanzvi uye mukana wekusawirirana nePPP yako pamusoro pekuti iwe kana kwete iwe unoda kuona nyanzvi. Mukuwedzera, murwere angave ane mari yakawedzerwa nekuda kwekopayidi inotarisirwa kushanyirwa kwePPP pamwe chete nehanzvadzi inoshanyira.
Batsiro kune zvinodiwa zvinosanganisira kuvimbiswa kuti uri kuenda kune imwe nzira yakarurama yeyanyanzvi uye nyanzvi kubatana kwekutarisira kwako. Kana uine nyanzvi dzakawanda, PCP yako inoziva izvo nyanzvi imwe neimwe inokuitira iwe uye inoita kuti zvirongwa zvakasiyana-siyana zvisingawirirane.
Kunyangwe zvave zvakajeka kune HMO uye POS inoronga kuva nekutumira zvido, dzimwe zvirongwa zvekuchengetedza zvakagadzirirwa izvo zvakagara zvichida kuti PCP dzitumire dzakashandura kune "mukana wokuwana" iyo inobvumira nhengo kuti dzione nyanzvi mukati memurongwa weurongwa pasina kutumira. Saka kunyange zvazvo pane zvizere pamusoro pezvirongwa zvekutarisira zvinotarisirwa, hapana chinotsiva kuverenga zvakanakisisa papurogiramu yako pachako kana zvirongwa zvaunofunga.
Pre-Authorization
Kambani-kutenderwa kana kugadzwa kwemvumo kunoreva kuti kambani ye inshuwarisi yehutano inoda kuti iwe uwane mvumo kubva kwavari kune mamwe marudzi ehutano hwehutano usati wabvumirwa kutarisira izvozvo. Kana iwe usingaitori isati yabvumirwa, urongwa hwehutano hunogona kuramba kubhadhara kwebasa.
Urongwa hwehutano huripo huripo hunotarisa kuburikidza nekuita kuti iwe unoda chaizvo zvese zvauri kuwana. Muchigadziro chinoda kuti iwe uve nePPP, chiremba iyeyo ndiye anonyanya kutarisira kuve nechokwadi kuti iwe unonyatsoda iyo micheche yauri kuwana. Zvirongwa zvisingashandisi PCP (zvakadai sePOO nePPO zvirongwa) shandisa kushandiswa kwekugadzwa sechirongwa chekuita chinangwa chimwe chete: chirongwa chehutano chinongorayira kutarisirwa kunotarisirwa.
Zvirongwa zvinopesana nezvekuti ndeapi mapoka ehutano anofanira kunge akafanirwa kubvumidzwa asi asi munharaunda yose inoda kuti zvipatara zvisiri izvo zvinotumirwa uye zvivhiya zvive zvakagadzwa kare. Vakawanda vanodawo kutenderwa kwezvinhu zvakadai seMRI kana CT scans, zvinodhaka zvinodhaka zvinodhaka, uye midziyo yezvokurapa yakadai semusha weokisijeni nemibhedha yezvipatara.
Pre-authorization dzimwe nguva inoitika nokukurumidza uye iwe uchava nemvumo usati waenda kuhofisi yechiremba. Kazhinji, zvinotora mazuva mashoma. Mune zvimwe zviitiko, zvinogona kutora mavhiki.
Kunze kwe-Network Care
HMOs, PPOs, EPOs, uye POS zvirongwa zvose zvinopa mitambo. Iyi nhungamiro inosanganisira vanachiremba, zvipatara, mabhizimisi uye vamwe vateresi vanove vane chibvumirano nehutano hwehutano kana, pane dzimwe nguva, vanoshandiswa nehutano hwehutano. Zvirongwa zvinopesana nezvokuti iwe uchava nehuwandu hwehutano hwehutano kubva kune vapeji vasiri mumutambo wavo.
Kana iwe ukaona chiremba kunze-we-network kana kuti kuongorora ropa kwako kunoitwa kunze kwe-network lab, dzimwe zvirongwa zvehutano hazvizobhadhara. Iwe uchave wakaramba uchibhadhara chikwereti chose chekutarisira kwawakawana kunze kwe-network. Kusiyana neizvi ndiko kuchengetedzwa kwekukurumidzira. Zvirongwa zvekuchengetedza zvirongwa zvichabata kuchengetedzwa kwekukurumidzira kwakagamuchirwa mune imwe nzvimbo yekunze-network inosangana nedambudziko rehutano chero bedzi chirongwa chehutano chibvumirana kuti kutarisirwa kwaikosha zvechokwadi uye kwakagadzira dambudziko (nhamba yekuti kunze kwe-network mvumo inogona kukubhadhara iwe musiyano pakati pezvavanenge vatengesa uye izvo zvakakweretwa nemubhadhari wako).
Mune dzimwe zvirongwa, mubhadhadzi wekwereti achabhadhara kwekunze kwe-network. Zvisinei, iwe unofanirwa kubhadhara chikamu chikuru chemari yaunogona kubhadhara kana iwe wakagamuchira kutarisirwa kwakafanana mu-network.
Pasinei neurongwa hwekugadzira, kunze kwe-network providers haisi kusungwa nezvipi nezvibvumirano nekambani yehutano inshuwarisi. Kunyange kana POS yako kana PPO yiripo inopa chikamu chemari, mutapi wezvokurapa anogona kukubhadhara iwe kuti musiyano uri pakati pezvinowanzopomerwa uye iyo inishuwarenzi yako. Kana vakadaro, iwe uri mutoro wekuripa. Izvi zvinonzi kuenzanisa kubhadhara , uye zviri pamutemo mune nyika dzakawanda zvekunze-kwe-network kuchengetedza, kunyange mumamiriro ezvinhu akaoma.
Kutora-Kugovana
Kugovana-kudhura kunosanganisira kubhadhara chikamu chehutano hwako hwekutarisira-iwe unogovana mari yehutano hwako nekambani yehutano inshuwarisi. Deductibles , copayments , uye coinsurance ndezvenhando dzekugovana mari.
Zvirongwa zvehutano zvinopesana mumhando ipi uye mari yakawanda yekugovana yavanoda. Kazhinji, zvirongwa zvehutano zvinoremedza zvinokupa mubayiro wekudhura-kugovana zvinodiwa, asi zvimwe zvirongwa zvehutano zvinogamuchirwa zvinoda iwe kutora chikamu chikuru chebhadha kuburikidza nemadhora ekuwedzera, coinsurance, kana kuti mapepa.
Asi izvi zvave zvichinja sezvo nguva inofamba. Mumakore makumi mapfumbamwe nemakumi matatu nemana makumi mana, zvaive zvakajairika kuona HMOs pasina ductible zvachose. Nhasi, HMO inoronga ne $ 1 000 + inokwaniswa inowanikwa (mumusika mumwe nomumwe, HMOs ndiyo yakava zvirongwa zvakakosha munzvimbo dzakawanda, uye dzinogara dzichipiwa nemabhadharo e $ 5,000 kana kupfuura).
Muchigadziro chinobhadhara chikamu chemari yako, iwe paunoona kunze-kwe-network providers, zvikwereti zvako zvepamusoro-soro zvinowanzove zvakanyanya kunyanya (kazhinji kaviri) kupfuura zvaizova kana iwe ukaona mu-network vanachiremba. Saka semuenzaniso, kana hurongwa hwako huine $ 1 000 inotengwa, inogona kunge yakabhadharwa $ 2,000 yekunze kwe-network.
Iko kumucheto kwepamusoro pane zvaunofanira kubhadhara kunze kwemari yehomwe (kusanganisira coinsurance) ingangove yakakwirira zvikuru paunenge uchienda kunze kwepurogiramu yako. Zvakakoshawo kuziva kuti dzimwe PPO uye zvirongwa zvePOS zvakashandura kusvika kune chikwata chisingagumi pazvinenge zvisingabhadharwi pahomwe apo nhengo dzinotsvaka kunze kwe-network. Izvozvo zvinogona kuguma kuve yakadhura zvikuru kune vese vasina kuziva kuti chirongwa chegadziro chekubuda kwemahomwe (sezvinodiwa neAACA) inoshanda chete mukati memurongwa wekupa mutevedzeri.
Kudhinda zvirevo
Kana iwe uchitarisira kunze-ye-network, iwe kazhinji unotarisirwa kutumira mapepa ekutsvakurudza neinishuwarensi yako. Kana iwe ukagara uri-network, chiremba wako, chipatara, lab, kana mumwe mupiro achapa chero zvikodzero zvakakodzera.
Muchigadziro chisingatauri kunze kwe-network kuchengetedza, kazhinji hachisi chikonzero chekuisa chikwata kunze kwekuti iwe wakagamuchira kuchengetedzwa kwekukurumidza kunze-kwe-network kubvira apo wako inshurensi haazokuripizve nekuda kwekubhadhara.
Zvichiri kukosha kuchengetedza zvawakabhadhara, zvisinei, sezvo iwe uchikwanise kubvisa mari yako yekurapa pamutero wako wekubhadhara (kana ivo vanopfuura 7.5 muzana yemari yako; izvi zvichawedzera kusvika 10 muzana kubva muna 2019 ). Kana, kana iwe uine HSA , unogona kuzvitsiva iwe pachako (panguva kana basa, kana nguva ipi zvayo mune ramangwana) nemutero usati watere kubva kuHSA yako, uchifunga kuti hausi kubhadhara mari yako yezvokurapa pamutero wako wekubhadhara (iwe unogona 'Tinoita zvose zviri zviviri; izvo zvingava zvakapetwa kaviri).
Maitiro Anoita Chiremba Wako Anobhadhara
Kunzwisisa kuti chiremba wako anobhadharwa kunogona kukubvunzei mamiriro ezvinhu mune mamwe mazano ari kukurudzirwa kupfuura zvaunoda, kana mamiriro ezvinhu ayo iwe ungada kusundira kuti utarisire kupfuura kumwe kuri kupiwa.
Mune HMO, chiremba anowanzova mushandi weHMO kana kubhadharwa nenzira inonzi capitation . Kufuridzira kunoreva kuti chiremba anopiwa imwe mari yemwedzi wega wega wega weHMO nhengo dzaanofanira kutarisira. Chiremba anowana mari yakafanana yemari kune nhengo imwe neimwe kana iyo nhengo inoda mabasa mwedzi kana kwete.
Kunyange zvazvo hutsika dzekubhadhara dzinotora hurumende dzinorambidza kurongedza kuongororwa uye kurapwa kusingadikanwi, dambudziko nekunyorera ndezvokuti pane zvakawanda zvinokurudzira kuronga izvo zvinodiwa , kana. Kutaura zvazviri, tsika inobatsira zvikuru inogona kuva nevarwere vakawanda asi kwete kupa mazano kune chero ipi zvayo.
Pakupedzisira, izvo zvinokurudzira kuchengetedza zvakakosha muHMO ndezvechido chechokwadi chekupa kutarisira kwakanaka kweutano, kuderera kwenguva yakareba mari nekuchengetedza nhengo dzeHMO hutano hwakanaka, hutano hwevanhu uye kukwanisa kugutsikana nevatengi, uye kutyisidzira kwekusavhiringidza kwakakodzera.
Mune EPOs uye PPOs, vanachiremba vanowanzobhadharwa nguva imwe neimwe pavanopa basa. Kunyanya varwere vanoona zuva, mari yakawanda yavanoita. Uyezve, zvimwe zvinhu izvo chiremba anoita panguva yekushanyira kwega imwe neimwe, kana kushandiswa kwakaoma kurapwa kwechiremba kunoshanya kunoda, kunyanya chiremba anobhadharwa nokuda kwekushanya ikoko. Iyi nzira yekubhadhara inozivikanwa semari-ye-kushanda.
Kunyorera kwekubhadhara-kwe-kushanda kubhadhara urongwa ndechokuti inopa mari yekukurudzira kuti chiremba ave nehanya zvakanyanya pane zvingada. Kunyanya kushanyira kunoenda iwe unoda, mari yakawedzerwa nachiremba. Uyezve, sezvo chiremba ari kubhadharwa zvakanyanya pakushanyira kwakaoma, hazvishamisi kuti varwere vane dzakawanda zvekuongorora ropa, X-ray, uye rurefu rwematambudziko asingagumi.
Nokuti vanhu vanogona kutarisirwa zvakanyanya kupfuura zvinodiwa, kubhadharwa-kwe-kubhadhara mari yekugadzirisa kunotungamirira kuwedzera kwehutano hwehutano uye zvikwereti zvepamusoro zveinishuwarenzi yehutano .
Medicare uye Medicaid
Anofungidzirwa 36.7 muzana yevanhu vemuUnited States vanyoresa muMedicaid kana Medicare. Izvi ndizvo zvirongwa zvehutano zvine hurumende. Nenzira, hurumende (federal for Medicare; federal uye nyika yeMedicaid) yakangobhadhara vatapi vezvoutano zvakananga apo vanyori vakanyorerwa.
Asi mumakumi emakore achangopfuura, kwakave nekushandura kunotarisira kutarisirwa mu Medicaid uye Medicare. Kubva muna 2014, zvinopfuura zvitatu zvekamuri zveMedicaid zvakanyora zviri muMedicaid zvirongwa zvekuchengetedza zvakanaka (hurumende yehurumende ine imwe kana zvirongwa zvehutano zvakawanda; vanyori vanogona kugamuchira Bhuku reBlue Cross Blue Shield, kusiyana nekadhi yeAdhi kubva munyika Medicaid program). Muna 2017, chikamu chimwe chete pazvikamu zvitatu zveMedricare zvakanyoresa zvirongwa zvekutarisira (Medicare Advantage).
Ndeipi Yakanakisisa?
Izvo zvinoenderana nekusununguka kwaunove nemiganhu uye kuti unoda kubhadhara zvakadini. Kunyanya chirongwa chehutano chinogadzirisa rusununguko rwako rwekusarudza, somuenzaniso, nekurega kubhadhara kunze kwe-network kutarisira kana nekukumbira iwe kuti utumire kubva kuna chiremba wako usati waona nyanzvi, zvishoma zvichange zvichitenga muzvikwereti uye mukugovana-kugovana. Kana rusununguko rwokusarudza urongwa hunobvumira, iwe unowedzera kubhadhara rusununguko irworwo.
Basa rako nderokuwana huwandu hwaunonyatsonakidzwa nawo. Kana uchida kuchengetedza mari yako shoma uye usakanganwa zviremera zvekugara iwe-network uye uchifanira kuwana mvumo kubva kuPPP yako kuti uone nyanzvi, pamwe zvichida HMO ndeyako. Kana iwe uchida kuchengetedza mari shoma, asi inokukurudzira iwe kuti uwane kutumira kune unyanzvi, funga EPO.
Kana iwe usingafungi kubhadhara zvakanyanya, zvose mumwedzi yepamwedzi yepuraimari uye kugovana-kudhura, PPO ichakupa iwe zvose kusununguka kwekubuda-kwe-network uye kuona nyanzvi pasina kutumira. Asi, PPOs inouya nebasa rakawedzerwa rinofanira kutanga kutumirwa kubva kune inshuwarisi yemari inodhura, uye inowanzova iyo yakashata yakasarudzwa.
Kana uri kutenga iwe pachako kugoverwa (kusingapi kuitora kubva kumushandi wako), iwe unogona kunge usina hupi hupi hupi huripo hwePPO, sezvo zvirongwa zvemashamba pachake zvinowedzera kushanduka kune muenzaniso weHMO. Uye kana uri kuwana kugoverwa kubva kune waunoshandira, huwandu hwehutano hwako huchaita hunoenderana nehukuru hweushandi wako. Vashandi vakuru vanowanzopa humwe zvirongwa zvekugadzirira, asi mushandi muduku angangova nepurogiramu imwe chete inowanika kuvashandi kugamuchira kana kuderera.
Shoko Rinobva
Zvinenge zvese zvemazuva ano zvirongwa zvehutano hwehutano zvinotarisirwa zvirongwa zvekuchengeta, asi pane kuchinja kukuru maererano nehukuru hwomuperekedzi network uye izvo zvinoda kuti zvirongwa zvive nekushandiswa kwevashandi.
Chinokosha: hapana chirongwa chehutano hwakakwana. Chimwe nechimwe chinongova chikamu chakasiyana chepakati pezvibatsiro nezvipikiso uye pakati pekushandisa mari yakawanda vs. kushandiswa kudarika. Kunzwisisa musiyano pakati pePPO, EPO, HMO, uye POS ndiyo danho rokutanga pakusarudza kuti ungasarudza sei hurongwa hwehutano hwehutano huchashanda zvakanaka iwe nemhuri yako.
> Sources:
> Congress.gov. HR1 - Mutemo wekugadzirisa kuyananiswa maererano nemazita II uye V echisarudzo chakaenderana nehuwandu hwegore rehupfumi gore ra2018 >. Yakagadzirwa 12/22/2017.
> Gaba, Charles. ACA Signups, Health Care Coverage Kupararira kweVanhu veUnited States vose muGati rimwe. March 2016.
> HealthCare.gov, Health Insurance Plan uye Network Types: HMOs, PPOs, nezvimwe.
> Kaiser Family Foundation, Medicare Advantage Spotlight 2017: Kunyoresa Market Market. June 2017.
> Kaiser Family Foundation, Total Medicaid Yakatungamirirwa Nekunyorwa Kunyoresa, 2014.