Ukuqonda isikweletu sakho sesibhedlela

Uma ngabe usesibhedlela, uzothola umthethosivivinywa obala uhlu lwamacala. Izikweletu zesibhedlela zingaba yinkimbinkimbi futhi zidideke. Yize kungabonakala kunzima ukukwenza, kufanele ubhekisise umthethosivivinywa bese ubuza imibuzo uma ubona okuthile ongakuqondi.

Nawa amanye amathiphu wokufunda isikweletu sakho sasesibhedlela neziphakamiso zalokho okufanele ukwenze uma uthola iphutha. Ukubhekisisa isikweletu sakho kungakusiza wonge imali.

Umthethosivivinywa wesibhedlela uzobala uhlu lwamacala amakhulu ngokuvakasha kwakho. Kubala izinsizakalo ozitholile (ezifana nezinqubo nokuhlolwa), kanye nemithi nempahla. Isikhathi esiningi, uzothola isikweletu esihlukile semali ekhokhwa ngumhlinzeki wezempilo. Kungumqondo omuhle ukucela umthethosivivinywa wesibhedlela onemininingwane eminingi ngawo wonke amacala achazwe ngokwehlukana. Lokho kungakusiza ukuthi uqiniseke ukuthi umthethosivivinywa ulungile.

Uma unomshuwalense, ungathola nefomu kunkampani yakho yomshuwalense, ebizwa nge-Explanation of Benefits (EOB). Lesi akusona isikweletu. Iyachaza:

• Yini embozwe umshwalense wakho
• Inani lokukhokha elenziwe nokuthi ubani
• Ukudonswa kwemali noma ukukhokhelwa kwemali

Okudonswayo yimali okufanele uyikhokhe unyaka nonyaka ukukhokhela izindleko zakho zokunakekelwa kwezokwelapha ngaphambi kokuba inqubomgomo yakho yomshuwalense iqale ukukhokha. I-Coinsurance yinani olikhokhela ukunakekelwa kwezokwelapha ngemuva kokuthi uhlangane nomshuwalense wakho wezempilo odonswayo. Kuvame ukunikezwa njengephesenti.

Imininingwane eku-EOB kufanele ifane nomthethosivivinywa wesibhedlela sakho. Uma kungenjalo, noma kukhona ongakuqondi, shayela inkampani yakho yomshuwalense.

Amaphutha kusikweletu sakho sezokwelapha angakubiza imali. Ngakho-ke kufanelekile isikhathi sokuhlola isikweletu sakho. Hlola izinto ezilandelayo ngokucophelela:

• Izinsuku nenombolo yezinsuku. Hlola ukuthi izinsuku eziku-bill ziyafana yini ngesikhathi usesibhedlela. Uma ungeniswe ngemuva kwamabili, qiniseka ukuthi amacala aqala ngalolo suku. Uma ukhishwa ekuseni, hlola ukuthi awukhokhiswa inani eligcwele lansuku zonke lekamelo.
• Amaphutha ezinombolo. Uma imali ibonakala iphezulu kakhulu, hlola ukuthi awekho yini amanye ama-zero angeziwe ngemuva kwenombolo (ngokwesibonelo, i-1,500 esikhundleni se-150).
• Ukukhokhiswa kabili. Qiniseka ukuthi awukhokhiswa kabili ngensizakalo efanayo, umuthi, noma izimpahla.
• Izindleko zemithi. Uma ufike nemithi yakho ekhaya, hlola ukuthi ayikhokhiswanga yini. Uma umhlinzeki enquma umuthi ojwayelekile, qiniseka ukuthi awukhokhiswanga ngohlobo lwegama lomkhiqizo.
• Izinkokhelo zezimpahla ezijwayelekile. Buza izindleko ngezinto ezifana namagilavu, imijiva, noma amashidi. Kufanele babe yingxenye yezindleko ezijwayelekile zesibhedlela.
• Izindleko zokufunda izivivinyo noma ukuskena. Kufanele ukhokhiswe kanye kuphela, ngaphandle kokuthi uthole umbono wesibili.
• Umsebenzi okhanseliwe noma imithi. Kwesinye isikhathi, umhlinzeki u-oda izivivinyo, izinqubo, noma imithi ekhanselwa kamuva. Bheka ukuthi lezi zinto azikho yini kubhili yakho.

Uma ngabe uhlinziwe noma enye inqubo, kuyasiza ukwazi ukuthi isibhedlela sakho sikukhokhise inani elifanele. Kunamawebhusayithi ongawasebenzisa ukukusiza uthole lolu lwazi. Basebenzisa imininingwane yolwazi kazwelonke yezinsizakalo zezokwelapha ezikhokhisiwe. Ufaka igama lenqubo nekhodi lakho le-zip ukuthola inani elilinganisiwe noma elilinganisiwe endaweni yakho.

• I-Healthcare Bluebook - www.healthcarebluebook.com
• Impilo ye-FAIR - www.fairhealth.org

Uma ukukhokhiswa kwemali oyikhokhayo kuphakeme kunentengo efanelekile noma kungaphezu kwalokho okukhokhiswa ezinye izibhedlela, ungasebenzisa imininingwane ukucela imali ephansi.

Uma ungakuqondi ukukhokhiswa kwemali oyikhokhayo, izibhedlela eziningi zinabeluleki bezezimali ukukusiza ngebhili yakho. Bangasiza ekuchazeni umthethosivivinywa ngolimi olucacile. Uma uthola iphutha, cela umnyango wokukhokha ukuthi ulungise iphutha. Gcina irekhodi losuku nesikhathi osishayile, igama lomuntu okhulume naye, nokuthi utshelwe ini.

Uma uthola iphutha futhi ungazizwa ukuthi uthola usizo oludingayo, cabanga ngokuqasha ummeli okhokhisa imali. Abameli babiza imali yehora noma iphesenti lemali oyilondolozayo ngenxa yokubuyekezwa kwabo.

Uma ungakwazi ukukhokha isikweletu sakho ngokugcwele ngaphambi kosuku olubekiwe, ungaba nezinketho. Buza umnyango wokukhokhisa isibhedlela uma ungakwazi:

• Thola isephulelo uma ukhokha inani eligcwele ngokheshi
• Bala uhlelo lokukhokha
• Thola usizo lwezezimali esibhedlela

I-American Academy of Family Physicians iwebhusayithi. Ukuqonda izikweletu zakho zezokwelapha. familydoctor.org/ ukuqonda-izikweletu- zakho-zokwelapha. Kubuyekezwe ngoJulayi 9, 2020. Kufinyelelwe ngoNovemba 2, 2020.

Iwebhusayithi yeAmerican Hospital Association. Ukugwema isimanga ezindlekweni zakho zezokwelapha. www.aha.org/guidesreports/2018-11-01-avoiding-surprises-your-medical-bill. Kubuyekezwe ngoNovemba 1, 2018. Kufinyelelwe ngoNovemba 2, 2020.

Iwebhusayithi ye-FAIR Health Consumer. Ungayibuyekeza kanjani inkokhelo yakho yezokwelapha. www.fairhealthconsumer.org/insurance-basics/your-bill/how-to-review-your-medical-bill. Kufinyelelwe ngoNovemba 2, 2020.

• Umshwalanse we mpilo