Izicwangciso ze-inshurensi zempilo ze-Indemnity (Health Indemnity Plans Plans) nazo zibizwa ngokuba yi-"-fee-for-service". Le yintlobo yendalo yomshuwalense yinto eninzi yeenkampani zomshuwalense zonyango ezinikezelwa kubasebenzisi bomshuwalense phambi kokusasazeka kwe-PPO (Iinkonzo ezibonelela ngempahla) kunye ne-HMO (Iinkonzo Zokulondoloza Impilo).
Iinqununu ezingakumbi
Ngecebo lomshuwalense wezempilo lendabuko, awuyi kukhawulelwa ekukhethweni kwabanikezeli benkonzo yezempilo abangaphakathi kwoluhlu oluthile lunikelo lomnikezeli njengoko unokuba nePPO okanye icebo le-HMO.
Zininzi kwezi zicwangciso, akukho zicelo ezifunekayo kwaye abaninzi banandipha inkululeko yokukwazi ukukhetha nayiphi na indawo yokunakekelwa kwempilo okanye ugqirha abayifunayo.
Ingaba isebenza kanjani
Isebenza kangangoko njenga-inshurensi yemoto ukuba uza kuhlawula i-inshorensi yakho yempilo phambi kokuba inkampani yomshuwalense ithathe intsalela yebhili yakho. Isixa esicatshulwayo siyahlukahluka ngokusekelwe kwintlobo ethile yemigaqo-nkqubo ye-inshorensi yempilo oyikhethile. Ngesicwangciso se-inshurensi yempilo yenkxaso yemveli, uya kuhlawulwa ngokusekelwe kwii-UCR okanye ngokuqhelekileyo, iintlawulo zesiko kunye neengqiqo.
Ezi zixa-mali ezimisiweyo ziyimali ebekiweyo ukuba inkampani yomshuwalense iya kuhlawula isifo esithile, ukugula okanye inkqubo yonyango. Uya kufuna ukuhlola kwaye ubone ukuba inkqubo yonyango okanye intlawulo ihlanganiswe yintlobo yonyango lomshuwalense ngaphambi kokuba kwenziwe inkqubo. Kwezinye iimeko, le nkqubo kufuneka imiselwe ngaphambili yinkampani yakho yinshuwalense.
Ukuba ungathandabuzeki, yinike inkampani yakho yomshuwalense ifowuni kwaye uthethe kummeli.
Uya kuthi ke ungenise le ntlawulo kwi-inshurensi yakho, okanye ngezinye iimeko umboneleli wezempilo uya kufaka ibhajethi kwinkampani yakho yomshuwalense njengesidima. Inkampani ye-inshorensi iya kuhlawula isahlulo sayo sebhilikhi yezokwelapha esincinci isaphulelo sakho esekelwe kwisixa se-UCRs ephantsi kwesicwangciso sakho se-inshorensi.
Iintlobo zeeNkcazo zeMpilo ye-Intshumo
Iinkqubo ezahlukeneyo zempilo yesikhokelo zempilo zonyango zifumanekayo kuwe kubandakanywa nesibhedlele / utyando lwe-inshorensi yokugonywa, unyango oluphezulu lwe-inshurensi kunye neembalo ezipheleleyo ezidibanisa isibhedlele kunye nokugqithiswa kwezempilo. Izicwangciso zeNtsholongwane yeMpilo ye-Insemnity Health will provide a coverage of the rest of the hospital, iinkqubo zonyango, unyango lwamayeza, ukutyelelwa kogqirha nokunyamekela.
Kuphi ukuthenga
Ukuba ungumntu ofuna inkululeko yokukwazi ukukhetha umboneleli wakho wezempilo kwaye ungabinqandeki kulabo bantu ngaphakathi kwintlangano yomnikeli onyuliweyo, ngoko-ke iSicwangciso se-inshurensi yempilo ye-Indemnity Health is akulungele. Iinkampani ezininzi zeeinshorensi zempilo ezahlukahlukeneyo zinika iMicrosoft Indemnity Insurance Plans eziquka oku kulandelayo:
Pros & Cons
Enye yeenzuzo ezilungileyo kwiSicwangciso seNkxaso yeMpilo yeNtshuwalense yeMpilo yintengiso yinkululeko ekufuneka ukhethe indawo yokunakekelwa kwempilo kunye nomboneleli ngaphandle kwemimiselo. Enye yezinto ezihlawulelayo kule nto kukuba unokufuneka uhlawule ngaphezu kwe-inshorensi yakho yezempilo kunokuba ukhetha iPPO (iProvener Provider Organisation Plan) okanye i-HMO (iSicwangciso seMpilo yoSondlo).
Kukho nokuba kukho ezinye iimpapasho ezibandakanyekayo ekufakweni kwamabango.
Ewe, akukho mntu unokukuxelela uhlobo luni lwesicwangciso esilungile kuwe. Yona khetho oluza kukwenza wena kunye nosapho lwakho ngokusekelwe kwiimfuno zomshuwalense zempilo yakho kunye nemeko yezemali. Unokufuna ukuhlala kunye ne-inshente yentsapho yakho kwaye uxoxe ngeenzuzo zoluhlobo lwe-inshurensi yezempilo ukwenzela ukuba wenze isigqibo esiza kukunika wena kunye nosapho lwakho into ebaluleke kakhulu kwi-inshorensi yempilo.