{"id":797,"date":"2024-12-28T16:20:26","date_gmt":"2024-12-28T16:20:26","guid":{"rendered":"https:\/\/naujienaplius.lt\/index.php\/2024\/12\/28\/nekaltinkite-savo-sveikatos-draudimo-bendroves-del-savo-nieksisko-draudimo\/"},"modified":"2024-12-28T16:20:26","modified_gmt":"2024-12-28T16:20:26","slug":"nekaltinkite-savo-sveikatos-draudimo-bendroves-del-savo-nieksisko-draudimo","status":"publish","type":"post","link":"https:\/\/naujienaplius.lt\/index.php\/2024\/12\/28\/nekaltinkite-savo-sveikatos-draudimo-bendroves-del-savo-nieksisko-draudimo\/","title":{"rendered":"Nekaltinkite savo sveikatos draudimo bendrov\u0117s d\u0117l savo niek\u0161i\u0161ko draudimo"},"content":{"rendered":"<p> <br \/>\n<\/p>\n<div>\n<div class=\"article-gating gated-overlay\">\n<div class=\"article-gating-wrapper\">\n<p>Prisijunkite prie \u201eFox News\u201c, kad gal\u0117tum\u0117te pasiekti \u0161\u012f turin\u012f<\/p>\n<p>Be to, speciali prieiga prie pasirinkt\u0173 straipsni\u0173 ir kito auk\u0161\u010diausios kokyb\u0117s turinio su savo paskyra \u2013 nemokama.<\/p>\n<div class=\"article-gating-legal tablet-desktop\">\u012evesdami el. pa\u0161to adres\u0105 ir paspausdami t\u0119sti, j\u016bs sutinkate su \u201eFox News\u201c naudojimo s\u0105lygomis ir privatumo politika, \u012f kuri\u0105 \u012ftrauktas prane\u0161imas apie finansines paskatas.\n    <\/div>\n<p><span>\u012eveskite galiojant\u012f el. pa\u0161to adres\u0105.<\/span><\/p>\n<footer class=\"article-gating-footer\">Turite problem\u0173? Spauskite \u010dia.<\/footer>\n<\/div>\n<\/div>\n<div id=\"speechkit-wrapper\" class=\"speechkit-wrapper\">\n<p><span class=\"label-bg\">NAUJIENA<\/span>Dabar galite klausytis \u201eFox News\u201c straipsni\u0173!\n  <\/p>\n<\/div>\n<p class=\"speakable\">Visi kaltina sveikatos draudimo bendrov\u0117s godum\u0105 d\u0117l did\u0117jan\u010dio pretenzij\u0173 atmetimo ir kli\u016b\u010di\u0173 r\u016bpintis. Tai naivu. Sekite pinigus, kad surastum\u0117te tikruosius kaltininkus: meluojan\u010dius politikus. <\/p>\n<p class=\"speakable\">Remiantis Amerikos medicinos asociacijos duomenimis, 2013 m., prie\u0161 \u012fsigaliojant \u012eperkamos prie\u017ei\u016bros \u012fstatymo nuostatoms, draudikai atmet\u0117 ma\u017edaug 1,5 % pretenzij\u0173. Ta\u010diau pagal ACA taisykles atsisakym\u0173 padaug\u0117jo de\u0161imt kart\u0173. Dabar beveik 15 % pretenzij\u0173 atmesta, prane\u0161a draudimo konsultant\u0173 \u012fmon\u0117 \u201ePremier\u201c. Kaiser Family Foundation tyrimo duomenimis, kai kurie draudikai neigia tre\u010ddal\u012f ar daugiau pretenzij\u0173. <\/p>\n<p>Draudikai taip pat reikalauja i\u0161ankstini\u0173 leidim\u0173 \u012fvairiems gydymo b\u016bdams ir vaistams, suri\u0161ti gydytojui rankas ir pavojingai atid\u0117ti j\u016bs\u0173 prie\u017ei\u016br\u0105. <\/p>\n<p><strong>V\u0116\u017dIO METAI: 2024 M. PAANKSNIAI, PROGNOZ\u0116S 2025 M.<\/strong><\/p>\n<p>Prie\u0161 prad\u0117damas gydym\u0105 arba u\u017esakydamas vaistus, gydytojas turi paskambinti draudikui. Kitame telefono gale retai kada b\u016bna atitinkamos ligos ar gydymo specialistas. Tai gali b\u016bti OB-GYN, vir\u0161ijanti tai, k\u0105 rekomenduoja j\u016bs\u0173 neurochirurgas, \u012fsp\u0117ja AMA. <\/p>\n<div class=\"image-ct inline\">\n<div class=\"m\"><picture><source media=\"(max-width: 767px)\" srcset=\"https:\/\/a57.foxnews.com\/static.foxnews.com\/foxnews.com\/content\/uploads\/2021\/02\/343\/192\/istock.jpg?ve=1&amp;tl=1, https:\/\/a57.foxnews.com\/static.foxnews.com\/foxnews.com\/content\/uploads\/2021\/02\/686\/384\/istock.jpg?ve=1&amp;tl=1 2x\" height=\"192\" width=\"343\"><source media=\"(min-width: 768px) and (max-width: 1023px)\" srcset=\"https:\/\/a57.foxnews.com\/static.foxnews.com\/foxnews.com\/content\/uploads\/2021\/02\/672\/378\/istock.jpg?ve=1&amp;tl=1, https:\/\/a57.foxnews.com\/static.foxnews.com\/foxnews.com\/content\/uploads\/2021\/02\/1344\/756\/istock.jpg?ve=1&amp;tl=1 2x\" height=\"378\" width=\"672\"><source media=\"(min-width: 1024px) and (max-width: 1279px)\" srcset=\"https:\/\/a57.foxnews.com\/static.foxnews.com\/foxnews.com\/content\/uploads\/2021\/02\/931\/523\/istock.jpg?ve=1&amp;tl=1, https:\/\/a57.foxnews.com\/static.foxnews.com\/foxnews.com\/content\/uploads\/2021\/02\/1862\/1046\/istock.jpg?ve=1&amp;tl=1 2x\" height=\"523\" width=\"931\"><source media=\"(min-width: 1280px)\" srcset=\"https:\/\/a57.foxnews.com\/static.foxnews.com\/foxnews.com\/content\/uploads\/2021\/02\/720\/405\/istock.jpg?ve=1&amp;tl=1, https:\/\/a57.foxnews.com\/static.foxnews.com\/foxnews.com\/content\/uploads\/2021\/02\/1440\/810\/istock.jpg?ve=1&amp;tl=1 2x\" height=\"405\" width=\"720\"><\/source><\/source><\/source><\/source><\/picture><\/div>\n<div class=\"info\">\n<div class=\"caption\">\n<p><span>Pyktis prie\u0161 sveikatos draudimo bendroves yra netinkamas. \u017dmon\u0117s tur\u0117t\u0173 laikyti politikus atsakingais u\u017e j\u0173 sukeltas problemas.<\/span> <span>(\u201eiStock\u201c)<\/span><\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>Gydytoja Debra Patt paskyr\u0117 vaist\u0173 derin\u012f pacientei, sergan\u010diai metastazavusiu kr\u016bties v\u0117\u017eiu, ta\u010diau tur\u0117jo laukti savaites, kol bus gautas i\u0161ankstinis leidimas. Tuo tarpu, kaip prane\u0161a AMA, ji tur\u0117jo pasitenkinti standartine chemoterapija, bet nes\u0117kmingai: jos pacientas mir\u0117. <\/p>\n<p>\u201eTurite sveikatos plano atstov\u0173, kurie niekada nebuvo susitik\u0119 su pacientu, niekada nes\u0117d\u0117jo prie lovos ir nepraktikavo medicinoje, bet dabar priima sprendimus d\u0117l gydymo\u201c, \u2013 teigia Tina Grant, \u201eTrinity Health\u201c, 92 sistemos vie\u0161osios politikos ir gynimo vyresnioji viceprezident\u0117. kataliki\u0161kos ligonin\u0117s. <\/p>\n<p>Remiantis Atstov\u0173 R\u016bm\u0173 Energetikos ir komercijos komiteto liudijimais, 80 % i\u0161ankstini\u0173 patvirtinim\u0173, kuri\u0173 Cigna atmet\u0117 Medicare Advantage klientams, buvo at\u0161aukti pateikus apeliacij\u0105, o tai yra \u017eenklas, kad teis\u0117ta prie\u017ei\u016bra yra sulaikoma. \u201eCigna\u201c naudoja algoritm\u0105, vadinam\u0105 PxDx, kad atmest\u0173 masinius i\u0161ankstinius leidimus. <\/p>\n<p>Atsisakymai ir i\u0161ankstinio leidimo reikalavimai i\u0161augo po to, kai \u012fsigaliojo ACA. Ta\u010diau nekaltinkite pelno didinimo. ACA reguliuoja draudimo peln\u0105, o jei pelnas did\u0117ja, draudikai turi si\u0173sti klientams nuolaidas. <\/p>\n<p>Remiantis IBISWorld pramon\u0117s tyrimais, gigantai, tokie kaip \u201eUnited Healthcare\u201c, i\u0161augo \u012f pinigus u\u017edirban\u010dius behemotus, pirkdami gydytoj\u0173 kabinetus, ligonines ir vaistini\u0173 tinklus, o ne pardavin\u0117dami sveikatos planus. <\/p>\n<p>Tikroji prie\u017eastis, d\u0117l kurios j\u016bs\u0173 sveikatos draudimas tampa nepatikimas, yra ta, kad \u201eObamacare\u201c remiantys politikai s\u0105moningai dav\u0117 pa\u017ead\u0105, kurio buvo ne\u012fmanoma \u012fvykdyti, jei draudikai nesiimt\u0173 grobuoni\u0161kos praktikos. <\/p>\n<p>\u201eObamacare\u201c gyn\u0117jai pa\u017ead\u0117jo, kad visi bus apmokestinti vienodai, nepaisant j\u0173 \u201ebuvusi\u0173 s\u0105lyg\u0173\u201c. <\/p>\n<p>Matematika neveikia. Kiekvienais metais 5% gyventoj\u0173 naudojasi daugiau nei 50% sveikatos prie\u017ei\u016bros paslaug\u0173. Tai gamtos faktas, neskaitant politikos. <\/p>\n<div class=\"image-ct inline\">\n<div class=\"m\"><picture><source media=\"(max-width: 767px)\" srcset=\"https:\/\/a57.foxnews.com\/static.foxnews.com\/foxnews.com\/content\/uploads\/2024\/12\/343\/192\/gettyimages-1451354427.jpg?ve=1&amp;tl=1, https:\/\/a57.foxnews.com\/static.foxnews.com\/foxnews.com\/content\/uploads\/2024\/12\/686\/384\/gettyimages-1451354427.jpg?ve=1&amp;tl=1 2x\" height=\"192\" width=\"343\"><source media=\"(min-width: 768px) and (max-width: 1023px)\" srcset=\"https:\/\/a57.foxnews.com\/static.foxnews.com\/foxnews.com\/content\/uploads\/2024\/12\/672\/378\/gettyimages-1451354427.jpg?ve=1&amp;tl=1, https:\/\/a57.foxnews.com\/static.foxnews.com\/foxnews.com\/content\/uploads\/2024\/12\/1344\/756\/gettyimages-1451354427.jpg?ve=1&amp;tl=1 2x\" height=\"378\" width=\"672\"><source media=\"(min-width: 1024px) and (max-width: 1279px)\" srcset=\"https:\/\/a57.foxnews.com\/static.foxnews.com\/foxnews.com\/content\/uploads\/2024\/12\/931\/523\/gettyimages-1451354427.jpg?ve=1&amp;tl=1, https:\/\/a57.foxnews.com\/static.foxnews.com\/foxnews.com\/content\/uploads\/2024\/12\/1862\/1046\/gettyimages-1451354427.jpg?ve=1&amp;tl=1 2x\" height=\"523\" width=\"931\"><source media=\"(min-width: 1280px)\" srcset=\"https:\/\/a57.foxnews.com\/static.foxnews.com\/foxnews.com\/content\/uploads\/2024\/12\/720\/405\/gettyimages-1451354427.jpg?ve=1&amp;tl=1, https:\/\/a57.foxnews.com\/static.foxnews.com\/foxnews.com\/content\/uploads\/2024\/12\/1440\/810\/gettyimages-1451354427.jpg?ve=1&amp;tl=1 2x\" height=\"405\" width=\"720\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/a57.foxnews.com\/static.foxnews.com\/foxnews.com\/content\/uploads\/2024\/12\/1200\/675\/gettyimages-1451354427.jpg?ve=1&amp;tl=1\" alt=\"Politikai, kaip ir prezidentas Barackas Obama, past\u016bm\u0117jo \u201eObamacare\u201c, \u017einodami, kad tai bus sunku draudimo bendrov\u0117ms. FAILAS: Obama \u0161ven\u010dia po to, kai pri\u0117m\u0117 savo partijos kandidat\u016br\u0105 per Demokrat\u0173 nacionalin\u012f suva\u017eiavim\u0105 \u0160arlot\u0117je, \u0160iaur\u0117s Karolinoje 2012 m. rugs\u0117jo 6 d., ketvirtadien\u012f. (Nuotrauka Christopherio Evanso\/MediaNews Group\/Boston Herald per Getty Images)\" width=\"1200\" height=\"675\"\/><\/source><\/source><\/source><\/source><\/picture><\/div>\n<div class=\"info\">\n<div class=\"caption\">\n<p><span>Politikai, kaip ir prezidentas Barackas Obama, past\u016bm\u0117jo \u201eObamacare\u201c, \u017einodami, kad draudimo bendrov\u0117ms bus sunku. FAILAS: Obama \u0161ven\u010dia po to, kai pri\u0117m\u0117 savo partijos kandidat\u016br\u0105 per Demokrat\u0173 nacionalin\u012f suva\u017eiavim\u0105 \u0160arlot\u0117je, \u0160iaur\u0117s Karolinoje 2012 m. rugs\u0117jo 6 d., ketvirtadien\u012f. (Nuotrauka Christopherio Evanso\/MediaNews Group\/Boston Herald per Getty Images)<\/span> <!----><\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>Liepti draudikams padengti 5 % u\u017e t\u0105 pa\u010di\u0105 kain\u0105, kuri\u0105 jie ima sveikiems \u017emon\u0117ms, prilygsta kasm\u0117nesiniam bakal\u0117jos apr\u016bpinimui liesam modeliui ir Nathano de\u0161raini\u0173 valgymo konkurso nugal\u0117tojui u\u017e t\u0105 pa\u010di\u0105 kain\u0105. Juokinga. <\/p>\n<p>Penkiais procentais daugiau \u012fmok\u0173 mok\u0117toj\u0173 ir 50 procent\u0173 daugiau medicinini\u0173 poreiki\u0173. <\/p>\n<p>Federalin\u0117 vyriausyb\u0117 tur\u0117jo \u012fsiki\u0161ti su papildomais mok\u0117jimais, kad padengt\u0173 \u017emones, turin\u010dius anks\u010diau egzistuojan\u010di\u0173 lig\u0173. Vietoj to, draudikai sulauk\u0117 daugyb\u0117s nauj\u0173 \u017eal\u0173 ir jiems buvo liepta tai padaryti. Jie pri\u0117m\u0117 drakoni\u0161kus i\u0161laid\u0173 ma\u017einimo metodus. <\/p>\n<p>Nugal\u0117tojai? Demokrat\u0173 politikai. Populiaru be jokio papildomo mokes\u010dio padengti esamas s\u0105lygas. <\/p>\n<p>Pralaim\u0117tojai? Visi kiti, kurie turi nerimauti, kad kitas gydymas bus atid\u0117tas arba kitas pra\u0161ymas atmestas. <\/p>\n<p>Deja, did\u017eiausi pralaim\u0117tojai yra sunkiai sergantys, kurie neproporcingai ken\u010dia nuo grie\u017etos valdomos prie\u017ei\u016bros kontrol\u0117s, teigiama Nacionalinio ekonomini\u0173 tyrim\u0173 biuro dokumente apie Medicaid valdom\u0105 prie\u017ei\u016br\u0105. <\/p>\n<p><strong><u>DAUGIAU FOX NAUJIEN\u0172 NUOMON\u0116S rasite SPAUSKITE \u010cIA<\/u><\/strong><\/p>\n<p>Daugiau nei pus\u0117 valstybi\u0173 dabar priima \u012fstatymus, apribojan\u010dius i\u0161ankstin\u012f leidim\u0105. <\/p>\n<p>Tai \u017eingsnis teisinga kryptimi. Ta\u010diau amerikie\u010diai turi i\u0161 naujo \u012fvertinti valdom\u0105 prie\u017ei\u016br\u0105. <\/p>\n<blockquote class=\"pull-quote\">\n<p class=\"quote-text\">Atsisakymai ir i\u0161ankstinio leidimo reikalavimai i\u0161augo po to, kai \u012fsigaliojo ACA. Ta\u010diau nekaltinkite pelno didinimo. ACA reguliuoja draudimo peln\u0105, o jei pelnas did\u0117ja, draudikai turi si\u0173sti klientams nuolaidas. <\/p>\n<p> <!----><\/p><\/blockquote>\n<p>Beveik n\u0117ra \u012frodym\u0173, kad tai pagerina sveikat\u0105. <\/p>\n<p>Prezidento Joe Bideno sveikatos politikos sekretoriaus pad\u0117j\u0117jas giriasi, kad ACA apr\u0117pties i\u0161pl\u0117timas \u2013 daugiausia valdomos prie\u017ei\u016bros srityje \u2013 suma\u017eino \u201esergamum\u0105 ir mirtingum\u0105\u201c. Tai akivaizdus melas. Amerikie\u010diai serga ir gyvena trumpiau nei prie\u0161 ACA. <\/p>\n<p><strong><u>SPAUSKITE \u010cIA, KAD GAUTI FOX NAUJIEN\u0172 PROGRAM\u0104<\/u><\/strong><\/p>\n<p>Viena i\u0161 alternatyv\u0173 yra leisti nebrang\u0173 katastrof\u0173 draudim\u0105, kuris atsiranda tik d\u0117l dideli\u0173 s\u0105skait\u0173. Sveikiems \u017emon\u0117ms, kurie gauna draudim\u0105 darbe, b\u016bt\u0173 naudinga ma\u017eiau bendrauti su draudiku ir gauti didesn\u012f atlyg\u012f namuose, o ne mil\u017eini\u0161k\u0105 25 000 USD plan\u0105, o tai \u0161iais metais kainuoja \u0161eimai. <\/p>\n<p>Demokratai bando katastrofi\u0161k\u0105 draudim\u0105 pavadinti \u201e\u0161iuk\u0161liniu draudimu\u201c. Bideno administracija padar\u0117 beveik ne\u012fmanom\u0105 pirkti. Ta\u010diau amerikie\u010diai pradeda suprasti, kad sveikatos planai, kurie atmeta pretenzijas ir ver\u010dia pavojingai ilgai laukti i\u0161ankstinio leidimo, yra tikra \u201e\u0161iuk\u0161l\u0117\u201c. <\/p>\n<p><strong><u>SPAUSKITE \u010cIA, jei norite SKAITYTI DAUGIAU I\u0160 BETSY McCAUGHEY<\/u><\/strong> <\/p>\n<\/div>\n<p><br \/>\n<br \/><a href=\"https:\/\/www.foxnews.com\/opinion\/whos-blame-your-lousy-insurance-coverage\">Source link <\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Prisijunkite prie \u201eFox News\u201c, kad gal\u0117tum\u0117te pasiekti \u0161\u012f turin\u012f Be to, speciali prieiga prie pasirinkt\u0173 straipsni\u0173 ir kito auk\u0161\u010diausios kokyb\u0117s&hellip;<\/p>\n","protected":false},"author":1,"featured_media":798,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[168],"tags":[2132,59,2131,2130,2133,580,763],"class_list":["post-797","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-pasaulio-naujienos","tag-bendroves","tag-del","tag-draudimo","tag-nekaltinkite","tag-nieksisko","tag-savo","tag-sveikatos"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/naujienaplius.lt\/index.php\/wp-json\/wp\/v2\/posts\/797","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/naujienaplius.lt\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/naujienaplius.lt\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/naujienaplius.lt\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/naujienaplius.lt\/index.php\/wp-json\/wp\/v2\/comments?post=797"}],"version-history":[{"count":0,"href":"https:\/\/naujienaplius.lt\/index.php\/wp-json\/wp\/v2\/posts\/797\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/naujienaplius.lt\/index.php\/wp-json\/wp\/v2\/media\/798"}],"wp:attachment":[{"href":"https:\/\/naujienaplius.lt\/index.php\/wp-json\/wp\/v2\/media?parent=797"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/naujienaplius.lt\/index.php\/wp-json\/wp\/v2\/categories?post=797"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/naujienaplius.lt\/index.php\/wp-json\/wp\/v2\/tags?post=797"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}