Ngaba ungathanda ukwazi ukuba yintoni a i-inshurensi yentlekele kwaye isebenza njani? Kweli nqaku sikunika ulwazi oludingayo ukuze ukonwabele olu hlobo lwe-inshurensi, ebaluleke kakhulu kuxolo lwengqondo lwabantu.
I-Inshurensi eyintlekele
UMbutho wezeMpilo weHlabathi (i-WHO) uchaza impilo ngolu hlobo lulandelayo:
Impilo yimeko yokuba sempilweni ngokupheleleyo ngokwasemzimbeni, ngokwasengqondweni nangokwentlalo kwaye ingekuko nje ukungabikho kwezifo okanye ubulwelwe.
Ukuqwalasela ukuba impilo iyimpahla esemthethweni eyimfuneko ekhuselweyo nguRhulumente waseChile, xa iimeko zenzeke ezenza impilo ibe yingozi okanye ibeke engozini, i-collaterally ibangele ukungalingani kwezoqoqosho, iinkonzo ziphunyezwa ukuchasana nesi senzo, esifana nento ebizwa. i-inshurensi yempilo eyintlekele. Ukuba unomdla kwi-inshorensi yobomi, funda inqaku elilandelayo Kutheni kubalulekile ukuqesha i-Inshurensi yoBomi?
Yintoni i-inshurensi eyintlekele?
El khu selekile intlekele Luhlobo lwesicwangciso sezempilo esibonelela ngokhuseleko ngamaxesha kaxakeka, kodwa sikwabonelela ngokhathalelo lothintelo. Ezi zicwangciso zempilo ziyintlekele zineendleko eziphantsi zentlawulo yenyanga, kodwa zitsalwa kakhulu.
Umsebenzisi womgaqo-nkqubo kufuneka ahlawule nayiphi na imeko engxamisekileyo yonyango efunyenweyo ukuya kuthi ga kwixabiso le-deductible kwaye uninzi lokhathalelo lothintelo lufakwe kwi-100%.
Ngokumalunga nokhuselo lwempilo oluyintlekele, luyafumaneka kubantu abangaphantsi kweminyaka engama-30 abajonge ubuncinci bokhuseleko kunye neentlawulo eziphantsi zenyanga, kunye nabo baneminyaka nayiphi na ubudala abafanelekileyo ngenxa yobunzima bezoqoqosho, okanye ukucela ukuxolelwa ebunzimeni.
Esi sicelo sokurhoxisa sithetha ukungakwazi ukuhlawula i-inshurensi yokhathalelo lwempilo ngenxa yeemeko ezingalindelekanga ezifana nokulahlekelwa yindlu okanye ukufakwa kwefayile yokubhanga okanye ezinye iindlela zokuqwalasela.
Ngale ndlela, ukuba ne-inshurensi eyintlekele kuthetha indlela yokhuseleko ebalulekileyo, ukuthintela ukhathalelo lwezonyango olusemgangathweni kunye nokunciphisa iindleko ezikhokelela kukhathalelo lonyango kuso nasiphi na isiganeko esingalindelekanga sendalo yezempilo. uhlobo lwe-inshurensi, indlela esebenza ngayo kunye nemilinganiselo yokuqwalasela xa ukhetha enye.
Iinkonzo ezinxulumene nempilo eChile zibiza kakhulu, ngoko kulungele ukuba nepolisi ye-inshurensi yezempilo ehambelanayo esebenza njengenkxaso yemali ukuhlangabezana neendleko ezivela kwiindibano kunye nonyango.
Nangona kunjalo, xa kuziwa kwimigaqo-nkqubo, injongo yayo ikhusela ngokumalunga nokunciphisa impembelelo yezoqoqosho, evela kwingxaki enkulu yempilo, yithuba apho i-inshurensi yentlekele iqala ukusebenza, abemi baseChile kwiimeko ezininzi azicaci kakuhle iinzuzo zayo.
Kwimarike yaseChile, kukho iindidi ezimbini zolu hlobo lwe-inshurensi eyintlekele:
- Ibandakanya ukufaka isandla kwi-inshurensi yezempilo ehambelanayo kunye nesicwangciso sezempilo, nokuba ivela kwiNgxowa-mali yezeMpilo yeSizwe (i-Fonasa) okanye i-Isapre.
- Ibandakanya iziganeko ezithile zempilo eziyingozi.
Ukunikezelwa kolu hlobo lwe-inshurensi kwiRiphabhlikhi yaseChile kukhuthazwa yiNgxowa-mali yeSizwe yezeMpilo (i-Fonasa) kunye ne-isapre kunye nazo zonke iinkampani ze-inshurensi zabucala; kuyabonisa ukubhentsisa ezinye zezinto zayo.
Iindlela ze-inshurensi eyintlekele
Kukho iintlobo ngeentlobo ze-inshurensi yentlekele, esiya kuyichaza ngezantsi:
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I-Inshurensi eyintlekele yeNgxowa-mali yezeMpilo yeSizwe
Iimpawu, kunye neenzuzo zale ngxowa-mali, ngokutsho kweNtsumpa yezeMpilo, ibhonasi yentlekele ye-Fonasa ene-100% yeendleko kodwa kuphela ukuba uya kumaziko amiselwe yiNgxowa-mali.
Kuyimfuneko ukuqonda ukuba ukhuseleko lwakho luqinisekisiwe kumaziko ezonyango anxulumene nengxowa-mali. Ukongeza, le-inshurensi ye-Fonasa isebenza kuphela kwezi zifo zilandelayo, ngokutsho kweMed Guide portal:
- I-Hemodialysis kunye ne-Peritoneodialysis
- IiNzuzo zeCardiosurgical
- IiNzuzo zeNeurosurgical
- I-Scoliosis
- Ufakelo lwezintso
- uqhaqho-fakelo lwesibindi
- Ukhathalelo oluBanzi lweSigulana esiHletyiweyo
- Ukhathalelo oluNgxamisekileyo lweSigulana esitshileyo
- Iinzuzo zeQela leKhemotherapy
- Iinzuzo zeQela leRadiotherapy
- Unyango lwe-HIV lwe-Pharmacological
- Ukhathalelo oluNgxamisekileyo lwezigulana ezine-Complex Trauma
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Isapre Catastrophic Inshorensi
- I-Caverage eyongezelelweyo yeZigulo zeNtlekele (CAEC) yenza inzuzo eyongezelelweyo eyenziwa yi-ISAPRE, ikwazisa i-Health Superintendence. Uncedo lwayo lubandakanya ukuthomalalisa iimeko zeendleko eziphezulu, kungakhathaliseki ukuba zihlobene nesifo esithile, nangona kukho ezinye iinzuzo ezingabandakanywanga.
- Ukuzalisekisa iimfuno ezithile ezichaziweyo, i-CAECs ihlawulela i-100% yeendleko zelungu ezingaphezulu kwe-deductible, okanye isixa esihambelana nokuhlawula i-inshorensi.
- Kubalulekile ukuqaqambisa ukuba olu khetho luyafumaneka phantse kuzo zonke isapre, bambalwa abantu abaluvulayo olu khuselo. Izizathu zokuba kutheni amaqabane ambalwa athatha ithuba le-CAECs kukunqongophala kolwazi kunye nenkolelo yokuba benza iindleko ezingaphezulu.
3.-I-Inshurensi yeCatastrophic enikezelwa ziinkampani zeinshorensi
Ukuba i-Qué Plan yezempilo yokuthelekisa iplani yeplani ithathwa njengesalathiso, ukunyuswa kwezi mveliso kubonisa indlela yokukhetha i-coverage, oko kukuthi, ukuba iyingxenye okanye iyonke yeendleko eziveliswa yiziganeko eziyingozi ezinxulumene nempilo; Lo mqathango awubonakali kwimigaqo-nkqubo enikezelwa yiFonasa kunye ne-Isapre.
Nangona kunjalo, kubalulekile ukwazi ukuba i-inshurensi yentlekele isebenza okanye isebenza njengembuyekezo, emva kokuba i-coverage ye-Fonasa kunye ne-isapre idlulile, kodwa i-CAEC iqwalasela kwiipolisi zabo ukhetho lwentlawulo ye-deductible.
Phakathi kweempawu zolu hlobo lomgaqo-nkqubo obonelelwa ziinkampani ze-inshorensi, ngokuqhelekileyo bacinga ukonwabela le nzuzo kubantu abaphakathi kweminyaka eyi-18 ukuya kwengama-80 ubudala, begweba ngokuchanekileyo ukukhutshelwa ngaphandle kokhuselo lwabantu abanezifo esele zikho, ubuhle bobuhle. okanye unyango ngokwasengqondweni.
Isebenza njani i-inshurensi eyintlekele?
Ngexesha apho umsebenzisi ethatha isigqibo sokwenza isivumelwano solu hlobo lwe-inshurensi yempilo eyintlekele, kufuneka azi iimpawu zomgaqo-nkqubo ngaphambi kokuba asayine isivumelwano, imibuzo kufuneka ibuzwe njengale: ubukho okanye ukungabikho kwe-deductible kunye nemali yayo, yintoni na amabango acingelwayo kunye nemiqathango yokuqatshelwa kwawo.
I-inshurensi yentlekele ye-Fonasa isebenze ngokuzenzekelayo, ngaphandle kobukho bekhontrakthi yokufikelela kweli bango, kuphela umgangatho we-affiliate wanele; Yimeko esisiseko kulo mgaqo-nkqubo ukuya kwiziko lezempilo likarhulumente.
Ukuba umsebenzisi uthatha isigqibo sokuthatha i-inshurensi yentlekele exhaswe yi-ISAPRE, i-inshorensi kufuneka isebenze ngaphambi kokuba ilahleko yenzeke okanye xa ukuxilongwa kwezonyango kunokujika kube sisifo esiyingozi esisekelwe kwiindleko zamabango azenzayo. Ukuba kunjalo, umsebenzisi makaye kwiziko lakhe aze azalise ifom “Isicelo sokufakwa kunxibelelwano oluvaliweyo lwe-CAEC ne-GES-CAEC.
I-inshurensi eyintlekele ngakumbi
Okulandelayo, siya kuphendula eyona mibuzo isoloko ibuzwa onokuthi uzibuze yona njengomxhamli we-inshurensi eyintlekele okanye ukuba unomdla wokufumana ikhontrakthi yolu hlobo lwe-inshurensi.
Loluphi uhlobo lokhathalelo lwezonyango olukhuselwa yi-inshurensi yempilo eyintlekele?
Nje ukuba isicwangciso sakho sitsalwe imali, ukhuseleko oluyintlekele kufuneka luhlawulele iingozi, ukwenzakala okungalindelekanga, izigulo ezingxamisekileyo. Ezi zicwangciso zinokuba ne-100% yokhuseleko lweenkonzo zothintelo, ukudutyulwa komkhuhlane, uhlolo lwesiqhelo, okanye uhlolo lonyaka. Uninzi lwezi zicwangciso lubandakanya ubuncinci utyelelo oluthathu kugqirha wokhathalelo lokuqala.
Indlela yokukhetha eyona inshurensi yentlekele efanelekileyo?
Ngoku uyazi ukuba yintoni i-inshurensi eyintlekele, yeyantoni kwaye isetyenziswa njani, sivumela ukuba sicebise iingcebiso eziluncedo xa ukhetha eyona ndlela ilungileyo ukonwabela izibonelelo zepolisi yakho.
- Cinga ngokugubungela imimandla. Ukwamkelwa kwamaziko ezempilo abekwe kuwo wonke ummandla wesizwe.
- Jonga imbuyekezo kunye nokuba luthini ulwabiwo lwakho (okubandakanya isibhedlele, ugqirha, izigulane ezingaphandle kunye neendleko zoxubo-mayeza).
- Ngalo lonke ixesha funda umbhalo oqingqiweyo kwaye ungasayini nantoni na de ube uqinisekile ukuba uyaziqonda zonke iimpembelelo zepolisi.
- Funa inombolo yepolisi kwaye uyigcine kwindawo ekhuselekileyo ngombono wokuyisebenzisa kwisiganeko esiyingozi esingalindelekanga kwaye waziwe zizalamane zakho.
- Kubalulekile ukuqonda ukuba zeziphi iimpawu kwaye azifakwanga kwisicwangciso sokhetho lwakho.
Khumbula ukuba uMbutho wezeMpilo weHlabathi ubonisa impilo njengento edibeneyo, umphumo wayo ulungelelaniso lwe-harmonic ye-well-being projection person ngaphakathi kwi-conglomerate yabantu apho asebenzisana khona.
Ngendlela efanayo, iqwalasela impilo njengelungelo lomntu kwaye ifakwe kumthetho waseChile, ngenxa yoko uRhulumente waseChile unoxanduva lokuqinisekisa ukuba eli lungelo lithotyelwe ngokupheleleyo. Ngumsebenzi wentlalo kunye nabemi bazo zonke iindidi ezenza uluntu.
Nantsi enye imathiriyeli ebaluleke kakhulu ye-audiovisual ukuze uqhubeke ufunda malunga ne-inshurensi eyintlekele.