Ufulu wa ogula ndi kuteteza

The Affordable Care Act (ACA) idayamba kugwira ntchito pa Seputembara 23, 2010. Inaphatikizaponso ufulu ndi chitetezo china kwa ogula. Ufulu ndi chitetezo chimenechi zimathandizira kuti kufotokozera zaumoyo kukhala kosavuta komanso kosavuta kumva.

Ufuluwu uyenera kuperekedwa ndi mapulani a inshuwaransi ku Msika wa Inshuwaransi Yazaumoyo komanso mitundu ina yambiri ya inshuwaransi yazaumoyo.

Ufulu wina sungaphimbidwe ndi mapulani ena azaumoyo, monga mapulani a agogo. Dongosolo la agogo ndi inshuwaransi yazaumoyo yomwe idagulidwa pa Marichi 23, 2010 kapena asanafike.

Nthawi zonse onetsetsani mapindu anu azaumoyo kuti mutsimikizire mtundu wa zomwe mwapeza.

UFULU NDI CHITETEZO

Nazi njira zomwe malamulo azaumoyo amatetezera ogula.

Muyenera kuphimbidwa, ngakhale mutakhala ndi vuto lomwe mulipo kale.

• Palibe dongosolo la inshuwaransi lomwe lingakukanizeni, kukulipiritsani zambiri, kapena kukana kulipira zabwino zofunika pachipatala chilichonse chomwe mudali nacho musanayambike.
• Mukalembetsa, dongosololi silingakane kuti likufunsani kapena kukweza mitengo yanu kutengera thanzi lanu.
• Medicaid ndi Program ya Ana Health Insurance Program (CHIP) nawonso sangakane kukuphimbirani kapena kukulipirani zambiri chifukwa cha zomwe mudalipo kale.

Muli ndi ufulu wolandila chithandizo chaulere.

• Ndondomeko zaumoyo ziyenera kuyang'anira mitundu ina ya chisamaliro kwa akulu ndi ana popanda kukulipirani chindapusa kapena chiphaso.
• Chisamaliro chodzitchinjiriza chimaphatikizapo kuwunika kwa magazi, kuyezetsa magazi, katemera, ndi mitundu ina yazisamaliro zodzitetezera.
• Chisamaliro ichi chiyenera kuperekedwa ndi dokotala yemwe amachita nawo dongosolo lanu laumoyo.

Muli ndi ufulu wokhalabe ndiumoyo wanu ngati simunakwanitse zaka 26.

Nthawi zambiri, mutha kulowa nawo dongosolo la kholo ndikukhalabe mpaka mutakwanitsa zaka 26, ngakhale mutakhala:

• Kwatiwa
• Khalani ndi mwana
• Yambani kapena siyani sukulu
• Khalani m'nyumba kapena kunja kwa kholo lanu
• Sizinenedwa kuti ndimadalira msonkho
• Pewani mwayi wokhudzana ndi ntchito

Makampani a inshuwaransi sangachepetse kupezeka kwapachaka kapena kwamoyo phindu lililonse.

Pansi pa ufuluwu, makampani a inshuwaransi sangakhazikitse malire pazandalama zomwe zimagwiritsidwa ntchito pazofunikira zonse nthawi yonse yomwe mwalembetsa.

Maubwino ofunikira azaumoyo ndi mitundu 10 ya mautumiki omwe mapulani a inshuwaransi yaumoyo ayenera kubisa. Zolinga zina zimakhudza ntchito zambiri, zina zimatha kusiyanasiyana pang'ono ndi mayiko. Onetsetsani mapindu anu azaumoyo kuti muwone zomwe zikukwaniritsa.

Zopindulitsa zofunika paumoyo ndizo:

• Kusamalira odwala
• Ntchito zadzidzidzi
• Chipatala
• Mimba, umayi ndi chisamaliro chatsopano
• Matenda amisala komanso kugwiritsa ntchito mankhwala osokoneza bongo
• Mankhwala osokoneza bongo
• Ntchito zothandizira ndi zida
• Kusamalira matenda aakulu
• Ntchito zantchito
• Njira zodzitetezera
• Kusamalira matenda
• Kusamalira mano ndi masomphenya a ana (masomphenya achikulire ndi chisamaliro cha mano sanaphatikizidwe)

Muli ndi ufulu wolandila chidziwitso chosavuta kumvetsetsa chazaumoyo wanu.

Makampani a inshuwaransi ayenera kupereka:

• Chidule Chachidule cha Mapindu ndi Kuphunzira (SBC) cholembedwa mchinenero chosavuta kumva
• Gulu la mawu ogwiritsidwa ntchito pachipatala komanso kufotokozera zaumoyo

Mutha kugwiritsa ntchito izi kuti mufananize mapulani mosavuta.

Mumatetezedwa ku kuchuluka kwa inshuwaransi kosayenera.

Ufuluwu umatetezedwa kudzera mu Rate Review ndi lamulo la 80/20.

Review Review zikutanthauza kuti kampani ya inshuwaransi iyenera kufotokozera pagulu kuchuluka kulikonse kwa 10% kapena kupitilira apo musanakulitse ndalama zanu.

Lamulo la 80/20 limafuna kuti makampani a inshuwaransi azigwiritsa ntchito ndalama zosachepera 80% zomwe amalandira kuchokera kumalipiro amitengo yazaumoyo komanso kukonza bwino. Kampani ikakanika kutero, mutha kulandira kuchotsera ku kampaniyo. Izi zimakhudzanso mapulani onse a inshuwaransi yazaumoyo, ngakhale omwe amakhala ndi agogo

Simungakanidwe kufalitsa chifukwa munalakwitsa pa pulogalamu yanu.

Izi zikugwira ntchito pazolakwa zazing'ono zachipembedzo kapena kusiya zidziwitso zosafunikira kuti muthe kufalitsa. Zolemba zimatha kuthetsedwa pakakhala zachinyengo kapena zolipiridwa kapena zolipirira mochedwa.

Muli ndi ufulu wosankha wopereka chithandizo choyamba (PCP) kuchokera pa netiweki yazaumoyo.

Simukusowa kutumizidwa kuchokera ku PCP yanu kuti mulandire chithandizo kuchokera kwa azamba / azachipatala. Simuyenera kulipira zochulukirapo kuti mulandire chithandizo chadzidzidzi kunja kwa netiweki yanu.

Mukutetezedwa ku kubwezeredwa kwa olemba anzawo ntchito.

Wolemba ntchito wanu sangathe kukuthamangitsani kapena kukubwezerani:

• Ngati mulandira ngongole yamisonkho yoyamba pogula msika wamsika
• Ngati munganene zakuphwanya lamulo la Affordable Care Act

Muli ndi ufulu wopempha chigamulo cha kampani ya inshuwaransi yazaumoyo.

Ngati dongosolo lanu laumoyo likukana kapena kutha kufalitsa, muli ndi ufulu wodziwa chifukwa chake ndikupempha chisankhocho. Ndondomeko zaumoyo ziyenera kukuwuzani momwe mungachitire apilo zisankho zawo. Ngati zinthu zili zachangu, dongosolo lanu liyenera kuthana nalo munthawi yake.

UFUMU WOWonjezera

Ndondomeko zaumoyo pa Msika wa Inshuwaransi ya Umoyo ndipo mapulani ambiri azaubwana akuyeneranso kupereka:

• Zipangizo zoyamwitsa ndi uphungu kwa amayi apakati ndi oyamwitsa
• Njira zolerera ndi upangiri (kusiyanasiyana kumachitika kwa owalemba ntchito anzawo ndi mabungwe azipembedzo osachita phindu)

Ufulu wa ogula zaumoyo; Ufulu wa wogwiritsa ntchito zaumoyo

• Mitundu ya othandizira azaumoyo

Tsamba la American Cancer Society. Ndalama za wodwala. www.cancer.org/treatment/finding-and-paying-for-treatment/understanding-financial-and-legal-matters/patients-bill-of-rights.html. Idasinthidwa pa Meyi 13, 2019. Idapezeka pa Marichi 19, 2020.

CMS.gov tsamba. Kusintha kwa msika wa inshuwaransi yazaumoyo. www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Market-Reforms/index.html. Idasinthidwa pa June 21, 2019. Idapezeka pa Marichi 19, 2020.

Healthcare.gov tsamba. Ufulu ndi inshuwaransi yazaumoyo. www.healthcare.gov/health-care-law-protections/rights-and-protections/. Idapezeka pa Marichi 19, 2020.

Healthcare.gov tsamba. Zomwe mapulani a inshuwaransi yamsika Msika zimakwirira. www.healthcare.gov/coverage/what-marketplace-plans-cover/. Idapezeka pa Marichi 19, 2020.