Imibuzo Yomshuwalense kunye neBoneleli beMiboniso
Inshoni yomshuwalense ingenakho okanye ingenakucwangciswa kwisicwangciso se-inshurensi yezempilo okanye kwiprogram yomshuwalense .
Kwiiphakheji zempilo ezibandakanya izicwangciso zembono, umshuwalense wombono onikeziwe awunako ukufikelela ngokwaneleyo kuwe kunye nabaxhomekeke kuyo. Ukuba kunjalo, unakho ukhetho lokuthenga umgaqo-nkqubo womshuwalense wemibono. Inshoni yomshuwalense ingagcina iindleko zakho zokuphuma ngaphandle kwezinto ezifana nokunyamekela kwamehlo kunye nezinye iindleko eziquka iingubo okanye iinkqubo ze-LASIK.
Iinzuzo zoMshuwalense weMboniselo kunye neNkqubo yoMgaqo-nkqubo
Umgaqo-nkqubo we-inshorensi yombono unokukunceda ukuhlawula iindleko ezinxulumene nokunyamekela kwamehlo njengesiqhelo seminyaka yokuhlolwa kwamehlo, ukugqala kweso sigqibo, uvavanyo lwe-lens, ukulungiswa kwamehlo kunye nokunye. Abanikezeli be-inshorensi abangaphezulu kwangoko baqala ukwandisa izibonelelo zombono kwiimfuno eziguqukayo zabanikazi beemigaqo kunye neentsapho zabo njengendlela yokuhlinzwa yamehlo yokulungisa isigxina sombono ngokusisigxina. Izinzuzo kunye nenketho yomgaqo-nkqubo iyahluka ngokuthwala. Unako ukufumana imali eninzi ngokugcina ukhetha ukusebenzisa umboneleli wenyango odweliswe kwinethiwekhi yakho yenkampani yomninimshuwalense oyikhethayo (PPO) .
Laba "abanikezeli abakhethiweyo" banikezela ngeenkonzo kunye neenkonzo ngezinga elithengiweyo kumalungu esicwangciso somboniso esithatha inxaxheba.
Amalungiselelo amaninzi amanqaku ngoku anikezela ngeengcombolo zeengxelo zokuchitha imali (FSA) ukuvumela ukuba usebenzise iidola zangaphambili zerhafu ezichithwe ngokuzenzekelayo kwi-checkroll yakho yokutshekisha ukuze uncede ukuhlawula umboniso wendleko yokukhathalela.
Unokufuna ukuxoxa ngezibonelelo zesicwangciso esinjalo kunye ne-preparer yakho yentlawulo kwangaphambili ukuze ubone ukuba isicwangciso sinengqiqo kuwe. Kubalulekile ukuba uqaphele ukuba imali egcinwe kwi-FSA ayinakugqithiselwa kunyaka ozayo.
Umbono oqhelekileyo weNtsholongwane
Zonke iinkqubo ze-inshorensi ziye zahlula i-exclusions ukuze ufunde imigaqo-nkqubo yakho ngenyameko ukuze ukwazi ukuba yintoni umshuwalense wakho wokubambisa. Iintetho ziya kuhluka ngokusekelwe kwinkampani yomshuwalense kodwa enye yezinto ezingekho phantsi kwepolisi eziqhelekileyo ziquka:
- Iimvavanyo zamehlo zinikezelwa ngexesha lokuhlala esibhedlele
- Uqhagamshelwano lwe-lens
- Imigaqo
- I-LASIK kunye neenkqubo ezifanayo zokulungisa umboniso
- IiLense ezinokukhanya
- Umbono wonyango
- I-Eyeglass tinting
- Ukutshintshwa kweelayisensi okanye iifowuni ezilahlekileyo okanye ezibiweyo
Kungenxa yokuba le nto ingabandakanywa kwimigaqo yomshuwalense wembono yakho ayithethi ukuba i-coverage ayifumaneki. Uyakwazi ukongeza ukuxhomekeka kumgaqo-nkqubo walezi zinto ngemvume yomgaqo - nkqubo (umgibeli womgaqo-nkqubo) kwi-premium eyongezelelweyo. Hlola nommeli we-inshorensi ukuba unokungabaza malunga nokubonelelwa kwintengiso yomshuwalense.
Izicwangciso zeSaphulelo sokuBala
Isicwangciso sokuphuhlisa umbono sibonelela "isaphulelo esicacileyo" kwiinkonzo zembono ngokuqhelekileyo kubandakanywa izaphulelo zeemviwo zamehlo, iinkqubo ezithile zokugqirha, iingubo zamehlo kunye nama-lens oqhagamshelwano kunye nokunye.
Unembopheleleko yokuhlawula ibhalansi eseleyo yeendleko zeenkonzo emva kokuba isaphulelo sisetyenziswe. Enye inzuzo yesicwangciso sokusaphuhlisa umbono oqhathaniswa nomgaqo-nkqubo womshuwalense wembono kukuba i-premium yakho yomshuwalense iya kuba sezantsi. Kuyinkolelo enkulu yokuqwalasela intsapho ekwabiwo-mali.
Iindleko zoBononongo ngeMboniso kunye kunye ngaphandle kweNinshurensi
Intshuwalense yembono yomshuwalense onokungabibizi. Ngokomyinge, umgaqo-nkqubo we-inshorensi yombono onikwe ngumqeshi wakho unokubiza ngeyona mali engama-$ 3 ngenyanga. Izicwangciso zomshuwalense ngabanye ziyakwazi ukususela kwi-$ 15- $ 75 zama-dollar ngenyanga kunye nabantu kunye neentsapho. Ngenkqubo yomshuwalense yombono, unokulindela iintlawulo zentsebenziswano ezincinci, iinzuzo kunye nezibonelelo ezibanzi. Ngokuqhelekileyo, izicwangciso zomshuwalense yombono ziza kuhlawula i-$ 15 ukuya kwi-test kunye ne $ 100-
Ngaphandle kwenkonzo yomshuwalense yaluphi na uhlobo, unokulindela ukuba uvavanyo oluqhelekileyo luya kuhlawula i-$ 50 ukuya kwi-dollar ayi-100 kuye kuxhomekeke kumniki-nkonzo. Amanani ama-eyeglass okanye ama-lens axhumene nawo aqala malunga ne-$ 100 kwaye angaya kwi-$ 500 okanye ngaphezulu.
Ukufumana Uninzi Kwimbono Yomshuwalense
Ukuze ufumane uncedo olugqithiseleyo kwintengiso yomshuwalense, kufuneka uqonde iingenelo ezibonelelwe kunye neenkonzo ezingabandakanywa. Kwakhona, ezinye iinkonzo zigqitywa phantsi kwesicwangciso se-inshurensi yempilo ezifana nezifo zamehlo athile kunye nokulimala kwamehlo angalindelekanga kwaye akuyi kubakho ukufunwa kwimigaqo yomshuwalense wembono wakho. Funda umgaqo-nkqubo ngokufanelekileyo. Ezinye izicwangciso ziquka izibonelelo eziphelelwa yisikhathi ngonyaka, oku kuthetha ukuba xa ungayisebenzisi, ulahlekelwa yiyo; ezifana nokufumana uviwo lwangonyango lwamaxesha olwenziwa rhoqo. Ukuba unayo imali egcinwe kwi-akhawunti ye-FSA, qinisekisa ukuyisebenzisa loo mali ekunyamekelweni kwamehlo ngaphambi kokuba iphelelwe yisikhathi.
10 Iinkampani Zomshurensi Ukunikezela Ngomso
- I-VSP ngqo : I-VSP Direct iyamkelwa ngababoneleli abangabalingisi abangaphezu kwama-36,000 kwaye iyafumaneka kumaphakheji enzuzo yomqeshi okanye ngokuthenga umgaqo-nkqubo womshuwalense womntu ngamnye. Umgangatho oqhelekileyo uquka isicwangciso esiphezulu sokufuna iimfuno zamehlo enjengeemvavanyo zamehlo zonyaka kunye nokukhethwa kweelensi zokudibanisa ezintsha okanye iziglasi zamayeza zonke kwiinyanga ezili-12. I-VSP Direct inikezela nesibonelelo seenkqubo zeLASIK.
- I-EyeBenefits : I-EyeBenefits yindlela eyahlukileyo yohlobo lwe-inshurensi yombono ngemali yonyaka kunokuba i-premium yenyanga nganye kufuneka uyihlawule. Akukho mida kumlinganiselo wamaxesha ongasebenzisa ukukhutshwa ngawo ngonyaka. Inkampani iya kuhlawula ipesenteji yeendleko zokunyamekela kwamehlo kunye neenkqubo. Unokuthenga ukuthengwa ukusuka kwinye ukuya kwiminyaka emithathu. Ubulungu buyakuvumela ukuba ufumane isaphulelo sama-20 ekhulwini kwiimviwo ze-eyeglass kunye neepesenti ezingama-30 kwiimvavanyo ze-lens zoqhagamshelwano. Isaphulelo esikhona siya kuxhomekeka kumniki-benzisi oyisebenzisayo. Isaphulelo se-LASIK sinokuba ngama-50 ekhulwini kuye kuxhomekeke kumboneleli. Inethwekhi ye-EyeBenefit ineendawo ezili-12,000 eziquka indawo ezidumileyo njengeLensCrafters, VisionWorks kunye nokunye. Enye into yokuba akukho saphulelo sifikelele kubaboneleli bee-out-of-network.
- Isicwangciso seMelika : iMboniselo yeSicwangciso seMelika inikezela ngokukhawuleza kwezinga lokuhlawula kunokuba lihlawule ipesenteji yemali yentlawulo yokunakekelwa kombono. Le nkampani isekelwe eCalifornia yaye iseshishini ukususela ngo-1986. Inika iinketho zongezelelekileyo zentsimbi xa kuthengwa ama-glass and $ 190 ekuthengeni iilensi eziqhubekayo. Amaxabiso ayengqiqo; Nangona kunjalo, unokukhetha kuphela umboneleli oyinkathalo yeso si cwangciso.
- Humana : I-Humana inika iingenelo kwiqondo eliphantsi. Iirhafu ze-Premium zifaniswa nabanye ababoneleli bomshuwalense obona phambili kwaye zihlawulwa njenge-premium ngenyanga. Iiliso ezithengisiweyo zifumaneka kubaphathi be-Humana ngokusebenzisa i-FramesDirect.com. Izinga eliphantsi lokuhlolwa kweziliso, ukubeka endaweni kwamehlo ngonyaka, iiprayimali eziphantsi kunye nexabiso le-copay kwenza uHumanana ithuba lokuqwalasela xa ekhetha umgaqo-nkqubo winshorensi yombono. Umbono kaHumanana Ukujoliswa kweplani ihlawulisa umrhumo wexesha elilodwa.
- I-Aflac : I-Aflac ngumnikezeli owaziwayo we-inshorensi yezicwangciso ze-inshorensi kwaye unikezela ngomshuwalense wombono ngokusebenzisa icebo lomqeshi okanye ngokuthenga umgaqo-nkqubo womshuwalense. I-Aflac iya kuhlawula i-cash benefit rhoqo ngonyaka kwiimvavanyo zamehlo. Iinzuzo zihlawulwa ngqo kumnini-nkqubo. Izinzuzo, ukunciphisa kunye nokungafihliyo kuyahluka ngohlobo kodwa u-Aflac ophakathi uya kuhlawula i-$ 45 kwiimvavanyo zamehlo kunye ne-175 zama-glass glass.
- U-UnitedHealthcare : Umbono Womshuwalense we-UnitedHealthcare ubhalwe phantsi kwi-Golden Rule Insurance Company. Akukho zihlandlo zokulinda kunye nekharityhulam iyafumaneka kuwo onke amaxesha. Ungagcina xa usebenzisa omnye wabanikezeli abakhethiweyo kodwa ukufumana ingqalelo kuyakhona xa usebenzisa umboneleli wokunakekelwa kombono wangaphandle. Isixa sokuhlawula i-Eye co-pay is $ 10 kwaye izaphulelo zifumaneka kwi-optical surgery. Umbono womshuwalense ubonakala njengomgibeli kwisicwangciso sezinyo kodwa i-insalone yomshuwalense wembono iyatholakala kumazwe athile.
- I-Aetna : I-Aetna inikezela ngomshuwalense wembono kulo lonke nge-intanethi yeenkulungwane zama-omele azimeleyo. Ngumniki-nkonzo okhethiweyo womshuwalense wabasebenzi kubasebenzi baseburhulumenteni. Cwangcisa iimpawu kunye nokufumaneka kuhluka ngurhulumente. Abaphathi be-Aetna babonelela ngokugcina imali xa behlala kwi-intanethi kwimibono yokunakekelwa kweenkonzo, kubandakanywa isaphulelo se-retinal imaging, isaphulelo se-LASIK eyehlotywe, iipesenti ezingama-40 kwiiyilesi zakho zesibini kunye nezinye izaphulelo ezizodwa kunye namakhuphoni atholakala kuphela kumalungu e-Aetna.
- I-Blue Cross : i-Blue Cross inikeza isicwangciso sombono nge-EyeMed Vision Care. Amalungu anokufikelela kumaziko angama-18,000 kwiindawo ezili-10 ezibandakanya i-optometrists, i-ophthalmologists kunye nama-opticist. Izaphulelo nge-EyeMed Vision Care zikhangayo kwaye zinokuba ngama-50 ekhulwini kwiinkonzo zamehlo kunye nokunakekelwa kwamehlo. Utyando lwe-Laser lufumaneka kwakhona kwizinga elihlawulelwayo. Amalungu anokufumana i-lens yokufowunelwa ngokutsha ngeenkonzo zeposi.
- Umbono ka-Davis : Umbono ka- Davis ugxile kumbono wokunyamekela kwaye unamathuba amanyathelo okujonga umgangatho wokuphila kunye neemfuno zokunyamekela umbono. Ukutshintshwa kweeLayigineli zetayitile zifumaneka kuphela kumalungu e-Davis Vision ngokuhlawulwa kwe-$ 65. Ngomnye wezicwangciso zembono ezikhoyo, unemiba yokuhlolwa kwemiboniso yamehlo, i-eyewear, ukuphathwa kwamehlo kunye nokuphathwa kwempilo kunye neenkqubo zokukhusela i-eyewear. Inkqubo ye-Discount Programme inikezela izaphulelo ezinkulu kunye neemviwo kunye neenyawo.
- Ameritas : I-Ameritas inikezela ngomshuwalense wembono ngokusebenzisa izicwangciso zabaqeshi okanye njengomgaqo-nkqubo womshuwalense womntu ngamnye kwaye unikezela ukufikelela kumnatha kubanikezeli babini abawona mkhulu kunabo bonke; VSP kunye ne-EyeMed. Isicwangciso esiphezulu se-20/20 somntu ngamnye kunye neentsapho kukuvumela ukuba ukhethe umboneleli wakho kodwa unike imali yokugcina amafowuni kunye nokuthengwa kwamalensi ukusuka kwiiWalmart Vision Centers kwilizwe lonke. Azikho iirhafu kwaye akukho zihlandlo zokulinda kwaye zihlawulela i-$ 40 kwiimviwo zonyaka.
Iingcamango zokugqibela kunye nokuqwalaselwa kokukhetha iMboniselo Umboneleli womshuwalense
Umbono womshuwalense uvame ukunikezelwa njengomgaqo-wongezelelo kwisicwangciso se-inshorensi yezempilo. Unokuthenga intengiso yomshuwalense njengongezwayo kumgaqo wakho okhoyo okanye njengomgaqo-nkqubo wedwa. Uninzi lwemigaqo-nkqubo ekhoyo kwaye luyakwazi ukulungelelanisa ukuhlangabezana nemfuno yentsholongwane yentsapho yakho. Ukuba uthatha isigqibo sokuthenga i-inshurensi yembono, funda umgaqo-nkqubo wakho ngokucophelela kuquka yonke inzuzo yomshuwalense yembambano kunye nokungafunyanwa. Ukuba awuqinisekanga nantoni na, qhagamshelana nommeli wenkampani yomshuwalense okanye ummeli wakho we-inshorensi ukuqinisekisa ukuba wena kunye nosapho lwakho banomdla wokukhusela.