Inscription Drug Insurance

Chirongwa chePurcription yeDrug Insurance

Chirwere chemishonga chikamu chikamu chinokosha chehutano hwedu hwehutano. Journal of the American Medical Association (JAMA) yakataura kuti 59 muzana yevaAmerica vaishandisa kadha imwe mishonga yemishonga muna 2011-2012. Saka kunyange iwe usingashandisi mishonga yakareba kwenguva refu kuti uchengetedze chirwere chisingaperi, mikana yakanaka kwazvo kuti iwe unoda mushonga kamwechete kamwe munguva imwechete.

Uye mitemo iyo vanhu vanoitora inowedzera kuodhura, pamwero wekubuda kwepamusoro kwenyika yose (iyi haisi chinhu chitsva; nenyaya yeHealth Affairs kubva muna 1990 inotaura kuti kurapa kwemishonga kwaiva pakati pekuwedzera kwekuwedzera kwekuchengetedza kwehutano hwemhuri yakwegura mumakore makumi manomwe nemakumi mapfumbamwe).

JAMA yakataura kuti kubva muna2013, mari yekushandisa zvinodhaka zvemishonga muUnited States yakanga inopfuura kaviri yeimwe nyika dzakabudirira, uye yakaverenga 17 muzana ye "hutano hwehutano hwehutano hwehutano." Maererano ne 2015 Milliman Medical Index, mutengo wezvinyorwa wakawedzera ne13,6 kubva kubva muna 2014 kusvika muna 2015, iyo ndiyo yainyanya kukonzera kuwedzera kwehutano hwehutano panguva iyoyo.

• Chii Chinobvumirwa Sokushandisa Kwemishonga Pamutero Wenyu?

• Nzira Yokuchengetedza Mishonga Nehurongwa Hhurumende

Zviri pachena, kubhadhara mishonga yemishonga chikamu chikamu chinokosha cheurongwa hwehutano hwehutano hwehutano. Asi kugoverwa kwechiremba mishonga kwakapararira zvikuru mumakumi mashoma mashoma apfuura. Kurapa kwechirongwa chepachirwere kwenguva refu kwave kuchiri pasi pezvizhinji zvehutano inshuwalhu yehutano, asi mumusika mumwe nomumwe pakutanga kwema2000, vamwe vatakuri vakatanga kutamira kune zvirongwa zvisingatauri zvinyorwa zvachose, kana kuti zvinongowanikwa chete nemishonga inogadzirwa. Pakuvamba kwa2013, maererano neEalthPocket kuongororwa, 82 peresenti yemapurogiramu anowanika mumumwe mutengesi akavhara mishonga yemishonga, uye iyo yaisanganisira zvirongwa ne "kugovera zvishoma."

Healthcare Reform & Prescription Drug

Apo Mutengo Wokunetseka Wechirongwa wakanyorwa, vateereri vemitemo vaiziva kuti kurapa mishonga yemishonga inofanirwa kuiswa kune dzimwe zvirongwa, sezvo migumisiro yezvemari uye yezvehutano yekusava nehuwandu hwemishonga inogona kuve yakaoma.

Saka mishonga yemishonga ndeimwe yekubatsira kwehutano hweAACA, iyo inoreva kuti yakave yakafukidzwa pane zvese zvitsva zvezvirongwa zvehutano zvevanhu nehudiki kubvira muna 2014. Zvirongwa zveboka guru (mumatunhu akawanda, zvinoreva vashumiri makumi mashanu, kunyange vashoma vanotaura , zvinoreva vashumiri vanosvika 101) havakwanisi kuvhara mararamiro ehutano eAACA kunze kwekuchengetedzwa kwekudzivirira , asi huwandu hwezvirongwa zveboka guru hwakatove huchivhara mishonga yemishonga pamberi peAACA, uye yakaramba ichiita saizvozvo.

Utano Hwehutano Inofunga Sei Zvinyorwa Zvokuvhara?

Pane zvakawanda zvakasiyana-siyana maererano neurongwa hwehutano hwehutano hunovhara mishonga yemishonga. Iko kune zvinyorwa zvitatu zvakakosha zvigadziriro zvinogona kushandisa:

• Copays yemitemo inotanga pakarepo. Semuenzaniso, chirongwa chinogona kukwereta $ 10 / $ 25 / $ 50/30% yeChipiri 1 / Tier 2 / Tier 3 / Tier 4 madhiragi, asina ductible kana kumwe kugovana-mari .

• Chirwere chinonzi deductible chinoparadzaniswa nemishonga inodonhedzwa, mushure mokunge mapepa acho achishanda zvichienderana nechirwere chechirwere. Muchidimbu chinonzi Benefit uye Payment Parameters ye 2018, HHS yakataura kuti zvirongwa zvakarongwa zvavari kurondedzera zvegore ra2018 zvinosanganisira kupatsanurwa kwezvokurapa uye zvinodhaka zvinodhaka zvinokonzerwa nemari yezvesirivha, "kuratidzira huwandu hwehuwandu hwekugoverana huri muHQP pamatunhu aya kugoverwa. " Mune mamwe mazwi, urongwa hwekugadzirisa hutano hwakatova hwakajairika pane zvirongwa zvinotengeswa mumusika mumwe nomumwe. Nokuda kwezvirongwa zvakarongeka izvo HHS yakarongedza muna 2018, zvirongwa zvesirivha zvingadai zvine $ 500 mishonga yemishonga inobviswa, pamwe ne $ 3,500 yezvokurapa inobviswa.
• An integrated medical / prescription deductible, pamwe nemishonga inorayiridzirwa kana kubhadhara mari inoshandiswa chete mushure mekunge zvakakwana zvakagadziriswa. HSA-mapurogiramu anokwanisa haagoni kupa zvikomborero kunze kwekuchengetedza kwekuchengetedza vasati vatsaurwa, saka zvirongwa izvi zvinongotarisa zvinyorwa mushure mekunge mabhadhara yako yakagadzirirwa kwegore.

Dzimwe hurumende dzakagadzirisa zvirongwa zvekuti chirongwa chehutano chinokwanisa sei kuti mamiriyoni abhadhara madhagiro emishonga, mukuedza kuchengetedza mishonga inobhadharwa kune vanhu vane mamiriro ezvinhu anongorapwa chete nemishonga inodhura zvikuru.

Asi kunyange kana nyika yako isiri, uye iwe wakaramba uchibhadhara chikamu chikuru chemari yezvinodhaka zvinodhura mwedzi mumwe nomumwe, ziva kuti urongwa hwako hwehutano inshuwarheni huchabhadhara chikamu chezana chemishonga yako yepamutemo apo iwe wakasangana newe -of-pocket yepamusoro yegore. Kubva panguva iyo, madhiragi ako achafukidzwa zvakakwana kune zvakasara zvegore.

Zvose Nezve Formularies

The formulary ndiro urongwa hwemishonga iyo hurongwa hwehutano hwako huchafukidza. Mukati ye formulaum, zvirongwa zvehutano zvinopatsanura madhiragi muzvikamu zvitatu, nemishonga inodhura-inodhura inowanzova muChikamu chekutanga uye mishonga inodhura zvikuru iri muTear 4, 5, kana 6, zvichienderana nekugadzirwa kwegadziriro yacho.

Pamusoro-mishonga yemishonga inowanzove yakakosha madhiragi , kusanganisira injectables uye biologics . Nokuda kwemishonga iyi, mutengi anowanzofanira kubhadhara chikamu chemari (kureva, coinsurance panzvimbo yepa copay ), kunze kwekunge mitemo yehurumende iine chikwata chezvinhu zvinodhaka zvinodhaka.

• Zvirwere Zvinotapukira: Ndinogona Kuzvichengetedza paWalmart Uye Mamwe Mabhii Makuru Makuru?

• Utano Inishuwarenzi: Generic Zvinodhaka Kubatsira Kuti Uchengetedze Mari Pamitemo

Pakati pemitemo yakagadzwa neHHS uye hurumende yehurumende, vatsigiri vehutano vane rusununguko kukura dzavo zvekunyora uye vanozvishandura sezvinodiwa munguva.

Pasi peAACA, chirongwa che planry chinofanira kuvhara chikuru che

• pamwe nemumwe mushonga mune zvose US Pharmacopeia muchikwata uye kirasi
• iyo nhamba yakafanana yemishonga munharaunda imwe neimwe uye kirasi seurongwa hwekufananidzira hwakasarudzwa nehurumende
• Zvirongwa zvehutano zvinotarisirwawo kuti uve nekambani yemishonga uye yehutano (P & T) komiti inotarisira kuita kuti formulary yakazara zvakakwana.

Saka kunyange zvazvo mishonga yose yemishonga yakavharwa, izvozvo hazvirevi kuti mishonga chaiyo ichafukidzwa neurongwa hwose, kana kunyange nemaronga chero ipi zvayo munzvimbo inenge yapiwa. Pane nzira yekukumbira inowanika , asi, kana iwe nechiremba wako uchifunga kuti zvakakosha kuti iwe ushandise mushonga usingagone kuronga hurongwa hwehutano hwako.

Medicare & Prescription Zvirwere

Kusiyana neurongwa hwehutano hwehutano hwehutano, Chekutanga Medicare (Medicare Parts A uye B) haifaniri kuvhara mishonga yemishonga. Muna 2003, Congress yakapfuura HR1, iyo Medicare Prescription Drug, Improvement, uye Modernization Act ya2003. Mutemo wakagadzira chirongwa chitsva- Medicare Part D -kubatsira kubhadhara mari yekurapa mishonga yeMedarere enrollees.

Kuti ave nehuwandu hwezvinyorwa, Medicare anonyora anoda kuve nehupfumi hwepachivande. Kune dzimwe nzira shomanana dzekuwana chirongwa chekuongororwa kwechirongwa kana iwe uchikodzera Medicare:

• chiremba-oga Medicare Chikamu D Chirongwa Chekushandisa Drug Plan , icho chinogona kushandiswa muchidimbu neChechi yeMutare
• a Medicare Inobatsira chirongwa chinosanganisira Chikamu D chekushandisa chirongwa chemishonga (idzi Medicare Advantage zvirongwa zvinonzi MAPD)
• Kuwedzera kwekugoverana kubva kune waanoshandira kana wawakaroorana naye

Medicare Chikamu D chine "chikwata chinokonzera" panguva iyo vanhu vanyoresa pakutanga vakanga vachitarisira 100 muzana yemishonga yavo yekushandisa zvinodhaka. Inotengeswa Care Care Act yaisanganisira urongwa hwekuvhara gomba redu; izvo zvishoma nezvishoma zvinoshandiswa, uye ivhu rinopera richaparara ne2020.

Medicaid & Prescription Zvinodhaka

Munyika yose, Medicaid inoshandisa mishonga yemishonga. Kana iwe wakanyoresa muMedicaid (kusanganisira vanhu vakave vatangobhadharwa semugumisiro wekuwedzera kweAACA yeMedicaid ), mirairo yenyu ichazadzirwa zvizere kana nemapepa ekunyora.

Zvisinei, kune vanhu vari vaviri-vanofanirwa neMedicaid uye Medicare , Medicaid yakamira kugadzira mishonga yemishonga muna 2006, apo Medicare Part D yakashandiswa. Vanowirirana-vanogona kukodzera vanogamuchira mitsara yavo kuburikidza neMurereti Dzana D (panzvimbo peMedicaid), asi Chimwe Chimwe Chirongwa Chekubatsira kuripa miriyamisi uye zvizhinji zvekubhadhara mari kune hurongwa hwemishonga.

Prescription Drug Discount Plans & Stand-Alone Plans

Kana iwe uri pane chirongwa chikuru kana chizukuru chisina kuvhara mishonga yemishonga, kana kuti iwe usingabatsirwi, pane dzakasiyana-siyana zvekumira-mishonga mishonga yemishonga inshuwarisi yemishonga uye mapurogiramu ekuderedza pamusika. Zvinogona kupiwa nemakambani einishuwarenzi, ma pharmacy, vatengesi vezvinodhaka, kana masangano ehutano / sangano seAARP.

Kana uri kufunga nezvechirongwa chechirongwa ichi, verenga kuverenga kwakanyatsonaka. Ziva kuti nechirongwa chisingabatsiri, iwe pachako uchange uchiripa mari yakawanda yemishonga inodhura, saka ramba uchifunga kuti kana zvinhu zvokutengesa zvichiti "kusvika 60 kubva muzana," izvo hazvirevi kuti uchawana 60 muzana kubva pamutengo wemishonga chero ipi zvayo yaungada.

Zvirongwa zvemishonga zvinongoraramira hazvirevi sechidimbu chinokosha kugoverwa pasi peAACA, saka kana iwe usina uninsured uye uine inshuwarisi yepiritsi kana chirongwa chekubvisa, ungadai uchiri pachigamba chechirongwa cheAAC chairo, iwe uchifunga kuti uri kwete kusunungurwa.

Tsananguro Inobva

Zvinyorwa zvinodhura, uye kuva nezvakawanda zvakakwana zvinogona kuita kusiyana pakati pekukwanise kutenga mishonga yako uye yekuita kunze.

Kana uri kunetseka kubhadhara mitemo yako, kune mapurogiramu anobatsira ezvinodhaka anogona kubatsira. Kana iwe uchivhiringidzika pamusoro pezvikomborero zvako kana zvipo zvekugovera zvinowanikwa kwauri, svika kune vashandi veH HR yako, kana kune mutengesi kana mufambi wepamberi anogona kukubatsira kuti uenzanise zvirongwa zvakasiyana-siyana. Ndapota usafunga sokuti unofanirwa kuzviona uri woga; rubatsiro runowanikwa munharaunda yako.

> Sources:

> Congress.gov. Medicare Chirapa Chirapa, Kuvandudza, uye Modernization Act ye 2003. 108th Congress (2003-2004).

> Dhipatimendi Rezvoutano uye Human Services, Mutevedzeri Kudzivirirwa uye Anogadziriswa Care Care Act, HHS Chinyorwa Chekubatsira uye Kubhadhara Zvikamu zve 2018 . 9/6/2016.

> Girod, Christopher S., Weltz, Scott A., Hart, Susan K., 2015 Milliman Medical Index, May 19, 2015.

> Kantor, Elizabeth D., MPH; Rhem, Colin D., PhD, MPH; Haas, Jennifer S., MD, MSc; Chan, Andrew T., MD, MPH; Giovannucci, Edward L., MD, ScD. Mitemo yeChirango cheMishonga yekushandisa zvinodhaka pakati pevakuru muUnited States Kubva muna 1999-2012. Journal of the American Medical Association , November 3, 2015, Vol. 314, Nha. 17.

> Kesselheim, Aaron S., MD, JD, MPH; Avorn, Jerry MD; Sarpatwari, Ameet, JD, PhD. Iko Kukosha Kwekushandisa Zvinyorwa Zvitsva muUnited States. Journal of the American Medical Association , August 23/30, 2016, Vol. 316, Nha. 8.