Asusun Drug Asibiti

Wani Bayani na Asusun Drug Asibiti

Siyayyun kwayoyi sune wani ɓangare na tsarin kula da lafiyar mu. Jaridar The Association of Medical Association (JAMA) ta bayar da rahoton cewa, kashi 59, cikin 100, na {asar Amirka, sun yi amfani da miyagun} wayoyi, a 2011-2012. Don haka ko da ba ka yi amfani da magani na dogon lokaci don magance yanayin rashin lafiya ba, chances suna da kyau cewa za ku buƙaci takardar sayan magani kowane lokaci a wani lokaci.

Kuma sharuɗɗan da mutane ke dauka suna karuwa sosai, a daidai lokacin da aka yi la'akari da duk farashi mai yawa (wannan ba sabon abu ba ne; asusun kiwon lafiya daga 1990 ya lura cewa farashin kaya ya kasance daga cikin mafi yawan cibiyoyin kula da lafiyar lafiyar tsofaffi a cikin 70s da 80s).

JAMA ya bayar da rahoton cewa, a shekarar 2013, wa] ansu} asashen da ke masana'antar maganin likita, a {asar Amirka, fiye da na biyu ne, kuma suna da kashi 17, cikin 100, na "harkokin kiwon lafiyar jama'a." Bisa ga kimanin Naira miliyan dubu dari da dari biyar, farashin rubutun ya karu da kashi 13.6 cikin 100 daga shekarar 2014 zuwa 2015, wanda shine tushen farko wanda ke haifar da karuwa a halin kaka a lokacin wannan lokacin.

• Mene ne Mawuyaci a matsayin Kudi na Kasuwancin Kuɗin Kuɗin Ku?

• Yadda za a ajiye a kan kwayoyi tare da Shirye-shiryen Gwamnati

A bayyane yake, biyan bashin kwayoyi sune mahimmin ɓangare na tsarin inshora na kiwon lafiya. Amma yawancin kwayoyi sun samo asali a cikin shekarun da suka wuce. Tsare-tsaren rubutun sharaɗi ya kasance yawanci a karkashin mafi yawan ƙididdiga na asibiti na asibiti, amma a cikin kasuwa daya a farkon shekarun 2000, wasu masu sufuri sun fara canzawa zuwa tsare-tsaren da ko dai basu rufe takaddun bayanai ba, ko kuma kawai sun rufe kwayoyin halitta. Da farkon shekarar 2013, bisa ga binciken lafiyar HealthPocket, kashi 82 cikin dari ne kawai na tsare-tsaren da ake samuwa a cikin kasuwar kasuwa da aka rufe da kwayoyi, kuma sun hada da tsare-tsaren da "iyakanceccen ɗaukar hoto."

Gudanar da Lafiya da Sanarwar Kwayoyi

Lokacin da aka rubuta Dokar Kulawa da Kulawa , masu lura da doka sun fahimci cewa dole ne a hada magungunan maganin rigakafin kwayoyi a kan dukkan tsare-tsaren, yayin da kudaden kudi da likita ba tare da ɗaukar takardun magani ba zai yiwu.

Don haka kwayoyi sunadarai sune daya daga cikin amfanin kiwon lafiyar ACA, wanda ke nufin an rufe su a kan dukkanin sababbin tsarin kiwon lafiyar mutane tun shekara ta 2014. Babbar ƙungiyoyi (a yawancin jihohi, ma'ana akalla ma'aikata 51, ko da yake a cikin ƙananan jihohi , yana nufin akalla ma'aikata 101) bazai buƙatar ɗaukar muhimmancin kiwon lafiyar ACA ba tare da kulawa na rigakafi , amma mafi yawan manyan kungiyoyi sun rigaya sun rufe kwayoyi kwayoyi kafin a aiwatar da ACA, kuma sun ci gaba da yin haka.

Ta Yaya Shirye-shiryen Asibiti na Kiwon Lafiya Yarda Shafin Abubuwan Lura?

Akwai bambancin bambanci game da yadda tsarin kiwon lafiyar ke amfani da kwayoyi kwayoyi. Akwai abubuwa uku masu amfani da kima guda uku da tsare-tsaren zasu iya amfani da su:

• Kwafi don takardun da suka fara farawa. Alal misali, shirin zai iya cajin $ 10 / $ 25 / $ 50/30% na magungunan Tier 1 / Tier 2 / Tier 3 / Tier 4, ba tare da wani raba farashi ba ko wani raba farashi .

• Kuskuren takardun magani wanda ya bambanta daga likitancin likita, bayan bayanan da ake amfani dasu a dogara da matakin miyagun ƙwayoyi. A cikin Samfurori Masu Amfani da Biyan Kuɗi don 2018, HHS ya lura cewa shirye-shiryen da aka tsara don 2018 zai hada da wasu maganganun likita da maganin likitanci don tsara shirin azurfa, "yana nuna yawan wannan tsarin raba farashi a QHPs a wadannan matakan ɗaukar hoto. " A wasu kalmomi, wannan tsari ya riga ya kasance da kowa a cikin tsarin da aka sayar a kasuwa daya. Ga tsarin tsare-tsaren da HHS ya tsara don 2018, shirin na azurfa zai sami adadin maganin likita na $ 500, ban da deductible dalar Amurka $ 3,500.
• Ƙwararren likita / takardun magani, tare da takardun magani ko haɗin da suke amfani da su kawai bayan an gama cikakke cikakku. Shirye-shirye na HSA ba zai iya samar da wasu kwarewa ba tare da kulawa a gaban deductible, saboda haka waɗannan tsare-tsaren za su rufe rubutun bayan an biya ku kuɓuta don shekara.

Wasu jihohin sun sanya takunkumi kan yadda shirin lafiyar na iya buƙatar 'yan su biya bashin kayan ƙwarewa, a kokarin ƙoƙarin magance magunguna ga mutanen da ke da yanayin da za a iya magance su tare da ƙananan magunguna.

Amma koda kuwa jiharka ba ta da, kuma kuna da biyan kuɗi mai yawa na tsada mai tsada a kowane wata, ku sani cewa asusun inshorar lafiyar ku zai biya kashi 100 na takardun kuɗin ku a lokacin da kuka sadu da ku -afi-pocket domin shekara. Tun daga wannan lokaci, ana amfani da kwayoyi don cikar shekara.

All About Formulairesies

Tambayar ita ce jerin kwayoyi da tsarin lafiyar ku zai rufe. A cikin wannan tsari, tsarin kiwon lafiya ya raba kwayoyi zuwa wasu mutane, tare da kwayoyi masu tsada mafi mahimmancin kasancewa a cikin Tier 1 da kuma mafi tsada magungunan ƙwayoyi suna cikin Tier 4, 5, ko 6, dangane da yadda aka tsara shirin.

Mafi yawan magungunan ƙwayoyin magungunan sun kasance ƙwayoyi na musamman , ciki har da injectables da biologics . Ga waɗannan kwayoyi, mai sayarwa zai fi yawan kudin (watau, coinsurance maimakon a copay ), sai dai idan dokokin jihar sun yi amfani da farashin ƙwayoyi masu sana'a.

• Kwayoyi na Generic: Zan iya Ajiyewa a Walmart da sauran Big Stores?

• Assurance Kiwon Lafiya: Kwayoyi na Kwayoyin Kwayoyi suna taimaka maka Ajiye Kudi a kan Sharuɗɗa

A cikin jagororin da HHS da gwamnatocin jihohi suka kafa, masu sayen lafiyar jiki suna da 'yanci don bunkasa samfurin su kuma daidaita su kamar yadda ake buƙata a tsawon lokaci.

A karkashin ACA, tsari na shirin ya rufe mafi girma

• a kalla magungunan miyagun ƙwayoyi a kowane nau'in Pharmacopeia na Amurka da kuma aji
• irin wannan magungunan kwayoyi a cikin kowane nau'i da ɗalibai a matsayin tsarin da aka zaɓa na jihar
• Ana buƙatar mahimman labarun kiwon lafiya don samun kundin magani da magani (P & T) da ke da alhakin tabbatar da cewa tsari ya zama cikakke.

Don haka ko da yake an rufe dukkanin nau'in shan magani, wannan ba yana nufin cewa kowace magunguna za a rufe ta kowane shirin ba, ko ma ta kowane shiri a cikin wani yanki. Akwai tsarin samoci , amma, idan kai da likitanka sunyi imanin cewa yana da muhimmanci a gare ka ka yi amfani da miyagun ƙwayoyi wanda ba a kan tsarin tsarin lafiyar ka ba.

Medicare & Drugs Drugs

Ba kamar kamfanonin inshora na asibiti ba, Original Medicare (Parts Medicare A da B) ba ya rufe kwayoyi. A shekara ta 2003, majalisa ta kaddamar da HR1, Dokar Medicare Prescription Drug, Improvement, and Modernization Act 2003. Dokar ta kafa sabuwar shirin- Medicare Sashe na D-don taimakawa wajen biyan kuɗin maganin magungunan maganin kwayoyi na Medicare enrollees.

Don samun ɗaukar hoto game da takardun umarni, Medicare enrollees na bukatar ɗaukar hoto na sirri. Akwai wasu hanyoyi don samun takardar sanarwa idan kun cancanci Medicare:

• Shirin Drug Plan na Medicare Part D , wanda za'a iya amfani dasu tare da Original Medicare
• wani shiri na Medicare Advantage wanda ya hada da wani ɓangare na Dokokin D magani (waɗannan Ma'aikata Medicare Advantage da aka sani da MAPD)
• Ƙarin kulawa daga mai aiki ko ma'aikaciyar mata

Medicare Sashe na D yana da " raƙuman rami " a lokacin da aka dauki nauyin kwayar cutar kashi 100 cikin dari na farashin miyagun kwayoyi. Dokar Kulawa mai Kulawa ta ƙunshi wata tanadi don rufe ɗakin mai kunshe; Ana aiwatar da wannan tsari a hankali, kuma ramin da aka ba shi zai ɓace ta 2020.

Medicaid & Drugs Drugs

A cikin kowace jiha, Medicaid yana rufe maganin gargajiya. Idan an shigar da ku a cikin Medicaid (ciki har da mutanen da suka zama sabon cancanta saboda sakamakon ACA na fadada Medicaid ), za a cika rubutunku da cikakke ko kuma tare da 'yan jarida masu kyau.

Duk da haka, ga mutanen da suka cancanci Medicaid da Medicare , Medicaid ya dakatar da rufe kwayoyi kwayoyi a shekara ta 2006, lokacin da aka aiwatar da Medicare Part D. Masu biyan kuɗi biyu suna karɓar takaddun su ta hanyar Medicare Sashe na D (maimakon Medicaid), amma Ƙarin Taimakon Taimako yana biyan kuɗi da mafi yawan kudaden kuɗi don tsara takardun magani.

Shirye-shiryen Drug Discount da Shirye-shiryen Dama

Idan kun kasance a kan wani tsari mai girma ko babba wanda bai rufe kwayoyi ba, ko kuma idan ba a ba ku izini ba, akwai tsare-tsaren tsare-tsaren magungunan likitanci da dama da ke kan kasuwa. Zasu iya miƙa su ta hanyar kamfanoni masu inshora, masana'antun magani, masana'antun miyagun ƙwayoyi, ko shawarwari / kungiyoyi masu kungiya kamar AARP.

Idan kana la'akari da irin wannan shirin, karanta kullun da kyau sosai. Sanin cewa tare da shirin bashi, za ku biya yawancin kuɗin da ake amfani da su a kan farashi masu tsada, don haka ku tuna cewa idan kayan kasuwancin sun ce "har zuwa kashi 60 cikin dari," wannan ba yana nufin za ku samu Kashi 60 cikin dari na duk wani miyagun ƙwayoyi da kuke bukata.

Shirye-shiryen miyagun ƙwayoyi marasa daidaituwa ba su ƙidayar ɗaukar hoto a ƙarƙashin ACA ba, don haka idan ba a dage ku ba da kuma samun asibiti na asibiti ko shirin bashi, za ku kasance a kan ƙuƙwalwar don ACA ta yanke hukuncin kisa, kuna zaton kuna ba a cire su ba.

A Note Daga

Sharuɗɗa suna da tsada, kuma samun cikakken ɗaukar hoto zai iya haifar da bambanci tsakanin kasancewa iya samun magungunan ku don yin aikin ba tare da.

Idan kuna ƙoƙarin biyan biyan kuɗinku, akwai shirye-shiryen tallafin takardun magani waɗanda zasu taimaka. Idan kun kunya game da amfaninku ko zaɓukan ɗaukar hoto da kuke samuwa, ku isa ga ma'aikata na HR ɗinku, ko kuma wanda zai iya taimaka muku kwatanta shirye-shirye daban-daban. Don Allah kada ku ji kamar kuna dauke da shi a kan ku; Akwai taimako a cikin al'umma.

> Sources:

> Congress.gov. Dokar Magunguna, Inganta, da Saukewa na 2003. Majalisa 108 (2003-2004).

> Ma'aikatar Kiwon Lafiya da Ayyukan Dan Adam, Dokar Tsaro da Dokar Kulawa da Kulawa, HHS Bayanin Harkokin Amfani da Biyan Kuɗi don 2018 . 9/6/2016.

> Girod, Christopher S., Weltz, Scott A., Hart, Susan K., 2015 Milliman Medical Index, Mayu 19, 2015.

> Kantor, Elizabeth D., MPH; Rhem, Colin D., PhD, MPH; Haas, Jennifer S., MD, MSc; Chan, Andrew T., MD, MPH; Giovannucci, Edward L., MD, ScD. Yadda ake amfani da maganin ƙwayoyi a cikin tsofaffi a cikin Amurka Daga 1999-2012. Littafin Journal of the American Medical Association , Nuwamba 3, 2015, Vol 314, No. 17.

> Kesselheim, Haruna S., MD, JD, MPH; Avorn, Jerry MD; Sarpatwari, Ameet, JD, PhD. Babban Hanyoyin Safiyar Aiki a Amurka. Littafin Journal of the American Medical Association , Agusta 23/30, 2016, Vol 316, No. 8.