Inshuwaransi yazaumoyo popanda co-pay kapena deductible? – Inshuwaransi

Palibe kuchotsera. Palibe co-pay. Palibe ndalama zazing’ono. Palibe ndalama zogulira mankhwala. Ubwino wonse wa inshuwaransi yazaumoyo.

Ili ndiye lingaliro la njira yatsopano ya inshuwaransi yazaumoyo yomwe idakhazikitsidwa ndi kampani yazaumoyo ya Curative Central Texas Mwezi uno.

Dongosololi ndi la olemba anzawo ntchito omwe ali ndi antchito 51 kapena kupitilira apo akukhala kapena kuwagwirira ntchito Travis kapena Williamson zigawo. Curative, yomwe idapanga dzina lake popanga nsanja zoyeserera za COVID-19, ikuyembekeza kukula mkati mwa chaka kupita kumadera ambiri Central Texas Ndiyeno mu zaka zingapo nthawi zonse Texas isanafutukule dziko lonse.

Zochita zachipatala mu Los AngelesNdipo the Austin Ndipo the Washington DCNdi kuyezetsa ndi katemera kupezeka m’maboma opitilira 40 panthawi ya mliri wa COVID-19. Amayang’ana gawo lotsatira lazaumoyo mliri utatha. Ndidawona kuti machitidwe ambiri azaumoyo sanakhazikitsidwe kuti asamalipitse olembetsa kuti ayezedwe kwaulere kapena katemera waulere yemwe anali gawo la mliri.

Healthcare Executive ‘Siyinakhazikitsidwe kuti ipange zatsopano,’ adatero mkulu wa zaumoyo. Fred Turner. “Chatsatira chiyani? Tikufuna titamanga chiyani zaka khumi zikubwerazi?”

Dongosolo la inshuwaransi yochiritsira yakhazikitsidwa pa lingaliro lakuti ngati anthu achita chisamaliro chodzitetezera msanga, amatha kusunga ndalama, komanso kampani yawo ya inshuwaransi yazaumoyo. Zimatengeranso lingaliro loti opereka chithandizo atha kufewetsa ntchitoyi posafunikira kubweza ngongole kapena kulipira limodzi.

Turner adati makampani a inshuwaransi akachulukitsa ndalama zolipirira ndi kuchotsera, anthu amayimitsa chisamaliro. “Pali kuchepa kwakanthawi kochepa kwa ndalama chifukwa anthu amasiya kulandira chithandizo, koma samasiya kulandira chithandizo. Amasiya kuchita zinthu zodzitetezera – mammograms ndi colonoscopy. Ndalama zachipatala zikukweranso ndi chilichonse chomwe asiya … anakathera m’chipinda chodzidzimutsa, sanafunikire kukhalapo.”

Turner akuyerekeza dongosolo laumoyo la Curative ndi dongosolo la Netflix. Mumalipira mtengo umodzi mwezi uliwonse ndipo mumapeza chilichonse. Mu inshuwaransi, mtengo wa mwezi uliwonse ndi woti abwana azilipira zina ndi wogwira ntchitoyo kulipira ndalama zotsala za mwezi uliwonse. Mukuyerekeza kuti kwa munthu m’modzi, ndalama zambiri zapamwezi pa munthu aliyense zimakhala pakati 400 dollars kwa ine 800 dollars, zomwe Turners adanena kuti zikufanana ndi ma PPO ena. Ndalama zolipirira zimatengera kuchuluka kwa inshuwaransi zakale komanso zowopsa za gulu lililonse la olemba anzawo ntchito. Turner adati ndalama zolipirira mabanja zimasiyana mosiyanasiyana, chifukwa magulu ena a olemba anzawo ntchito amatha kukhala ndi antchito ambiri okhala ndi ana ambiri ndipo ena amakhala ndi ochepa.

Akatswiri amakampani a inshuwaransi Texas Padziko lonse lapansi, idakana kuyankhapo pamalingaliro enieni, koma idafotokoza njira ya Curative ngati yachilendo pamakampani.

Pazopindulitsa zosachotsedwa, zotuluka m’thumba, komanso zolipirira limodzi, anthu akuyenera kuyenderana ndi Curative pachaka mkati mwa masiku 120 kuyambira dongosololi. Pambuyo pa nthawiyi, ngati sapanga ulendo woyambira, adzalandira fayilo 5000 dollars Kuchotsera pa munthu kapena $10,000 kwa banja. Manambalawa amawirikiza kawiri ngati ulendowu uli ndi wopereka kunja kwa intaneti. Ana salipira ndalama zotsalira malinga ngati kholo likuyendera.

“Kupanga ndi chimodzi mwazinthu zolimbikitsa zachuma pazachitetezo,” adatero Turner.

Ulendo woyamba umatsimikizira kuti munthuyo ali ndi dokotala wamkulu ndipo akulandira chithandizo chodzitetezera nthawi zonse. Ngati sanatero, kapena sizinakhalepo, paulendo woyambira, kuyezetsa magazi kudzatengedwa ndipo adzalumikizidwa ndi dokotala wanu wamkulu.

Ngakhale awonana ndi dokotala posachedwa, Curative ipereka zowunikira zapamwamba kwa mamembala ake omwe amayang’ana mozama muzinthu monga kuwopsa kwa mtima komanso kuyesa kwa ma genome onse kuti athandize membala ndi dokotala wawo kupanga zisankho zambiri zachipatala.

Turner adati kuyesaku kungathandize kudziwa kuti ndi mankhwala ati omwe angagwire bwino ntchito kwa munthuyo, kuopsa kwake kwa majini ndi makhalidwe omwe angapatsire ana amtsogolo. Kutsatizana kwa ma genome sikofunikira, koma kudzakhala kwaulere kwa wodwala komanso kupezeka kuti agwiritse ntchito mtsogolo popanga zisankho zachipatala.

“Zonsezi ndi gawo la ndalama zomwe zimaperekedwa kwa nthawi yayitali kwa wodwala,” adatero Turner.

Curative pakadali pano ili ndi netiweki yothandizira yomwe imaphatikizapo St David Healthcare zipatala, Austin Diagnostic Clinic Ndipo the Austin Regional Clinic. Mamembala amakhalanso ndi maola 24 patsiku, masiku asanu ndi awiri pa sabata kwa dokotala wakomweko kudzera pa telefoni.

“Austin Regional Clinic Ndife okondwa kugwirira ntchito limodzi ndi Curative ndi njira yawo yatsopano ya inshuwaransi yazaumoyo. ” Anas DaghestaniPurezidenti ndi CEO wa Austin Regional Clinic. “Kupereka mwayi wopeza chithandizo chapamwamba cholumikizidwa nthawi zonse kwakhala mbali ya kudzipereka kwa ARC kwa odwala athu ndi madera athu, ndikuyang’ana kuti odwala athu azikhala ndi thanzi labwino komanso kuwathandiza kukwaniritsa zolinga zawo. Njira yochiritsira yapangidwa kuti izichita zomwezo. “

Ngati membala akufuna kuwonana ndi dokotala wakunja, amalipira ndalama zolipirira ndikukhala ndi kuchotsera poyendera ofesiyo monganso PPO ina iliyonse. Komabe, ngati angasonyeze kuti palibe njira yapaintaneti kapena ngati dokotala wotumiza angasonyeze kuti dokotala wina ndi wosayenera kuchipatala kwa wodwalayo, katswiriyo adzafotokozedwa ngati ali mu-network.

N’chimodzimodzinso ndi mankhwala. Creative ili ndi mankhwala ake omwe amakufikitsani kunyumba kwanu komanso ntchito AHEB ma pharmacies; Zolemba zimagawidwa m’magulu 1, 2 ndi 3. Gawo 1 ndi A 0 dollar malipiro ogwirizana. Level 2 ndi $50ndi level 3 ndi $250. Pa mtundu uliwonse wa mankhwala, pali mankhwala osachepera a Level 1, koma ngati pali chifukwa chachipatala chomwe mankhwalawa sakugwira ntchito kwa membala, akhoza kukhala ndi Level 2 kapena Level 3 mankhwala omwe ali ndi Level 1.

Ngati munthu akufuna chithandizo chadzidzidzi yemwe sali m’chipatala cha in-network, adzaperekedwabe ngati ali mu-network. Ngati ali ndi opaleshoni yokonzekera, adzafunika kutsimikizira kuti ndikofunika kuchipatala kuti akhale pachipatalacho osati kuchipatala cha in-network kuti alipire. 0 dollar Mtengo wa intaneti.

Curative pakali pano akukambirana ndi opereka chithandizo chamankhwala ambiri ndi machitidwe kuti akwaniritse mgwirizano wowonjezera mndandanda mkati mwa maukonde ake. Januware 1Pamene anthu ambiri amayamba ndondomeko zatsopano zaumoyo. Panopa alibe Austin Zipatala zowopsa za Level 1 za akulu kapena ana zili pa intaneti mpaka pano.

Paulendo woyambira uwu, woyendetsa zaumoyo yemwe membala amakumana naye adzalankhulanso za momwe angapindule ndi chilichonse chomwe chili mu dongosolo lamankhwala komanso zomwe sizinaphimbidwe ndikuwalumikiza kuzinthu zomwe angafunikire.

Zochizira zimatsegulidwanso Zochizira matenda mu january mu 900 Congress Ave. Zomwe zizikhala ndi malo olimbitsa thupi, makalasi ndi upangiri wazakudya kwa mamembala ake.

Curative adayika ndalama zaka zitatu zoyambirira zazomwe akuyembekezeka pa pulogalamu yachipatala. Turner adati adagwiritsa ntchito ndalama zake kuti achite izi. Yawonjezera ntchito 70 kuti ikhazikitse pulogalamu ya inshuwaransi yaumoyo ndipo ikuyembekeza kuwonjezera zina zikamakula.

Curative akuyembekeza kupanga phindu kuchokera ku inshuwaransi yazaumoyo mkati mwa zaka ziwiri kapena zitatu, Turner adatero.

Ndemanga ya mkonzi: Nkhaniyi idawonekera Lachitatu Dziko la Americakoma tikubwereza apa chifukwa mbali ina ya nkhaniyi sinasiyidwe m’matembenuzidwe ena chifukwa cha zolakwika zopanga.

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