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Tm ܮc mt bc s chnh thܩng l/bc s gia nh tha mn ܮc nhng nhu cu y t ca gia nh bn l mt iu quan trng. Tt nht l duy tr lu di mi lin h ny vi bc s bn chn la...
C nhiu thay ǰi , ang v s tip tc xy ra i vi cch thc gia nh bn s dng dch v y t trong tng lai. Mt s thay ǰi quan trng l vic cc ch nhn c s doanh thng v cc chng trnh Medi-Cal ca tiu bang bt u dng nhng chng trnh bo him y t qun tr qua cc cng ty bo him sc khe HMO v cc t chc y t hp ng ǥc bit theo gi nht nh PPO.

gia nh qu bn ܮc hiu r v cc chng trnh y t qun tr sau y l mt danh sch cc cu thܩng ܮc hi nhiu nht. Tuy nhin, nhng d kin nh ܮc trnh by trong cc cu tr li khng nn ܮc dng Nj thay th nhng d kin v tin tc bn c th tm thy trong t hp ng bn k vi hng bo him sc khe.

1. Lm sao ti chn la mt bc s gia nh (tc mt y s chnh thܩng xuyn) cho ti?

Bn nn chn mt bc s no mun bit r khng nhng v cuc sng hin ti ca bn, m cn ch ljn tiu s sc khe ca bn v ca gia nh bn. Bn hy tm mt bc s sn lng dnh th gi Nj gii thch cho bn v cc th nghim, nhng phng thc y khoa, cch iu tr v nhng nh hܪng ca bnh tnh i vi c nhn bn. Chn la tm mt bc s no c th gii thch nhng cu hi ca bn v tr li cc thc mc trong mt ngn t m bn hiu ܮc d dng. Nhng yu t quan trng khc bn phi cn nhc khi tuyn chn mt bc s thܩng xuyn/y s gia nh l kinh nghim hc vn v s o to chuyn mn ca bc s , cng nh uy tn cha tr, cung cp nhng dch v vi phm cht cao; v bc s ܮc hi ng chuyn khoa chng nhn cha, hoc c hi iu kin Nj thi ly chng ch chuyn mn ton quc cha?

2. Vai tr ca bc s gia nh/bc s chnh thܩng xuyn ca ti trong phng thc chng trnh y t qun tr nh th no?

L mt bc s chnh hng u, bc s ny cung cp y t phng nga, gii quyt v gip ǫ khi bn b bnh hay b thng, v chn bnh cng nh iu tr mt s bnh tnh cp k hoc di hn, kinh nin. Ngܩi bc s , khi cn, cng gii thiu bnh nhn mnh ljn nhng chuyn vin khc, v iu hnh tt c nhng dch v khc trong vn NJ sc khe tng qut ca bn.

Chng trnh bo him sc khe ca bn c th i hi bc s chnh ny phi cho php trܧc v k giy chp thun cho mt s dch v. Thiu nhng giy php , bn s phi t tr cho mt phn hoc cho tt c cc tn ph ca nhng dch v lin quan.

3. Nu ti mun thay ǰi bc s th sao?

Tm ܮc mt bc s chnh thܩng l/bc s gia nh tha mn ܮc nhng nhu cu y t ca gia nh bn l mt iu quan trng. Tt nht l duy tr lu di mi lin h ny vi bc s bn chn la. Tuy nhin, hon cnh c th thay ǰi v c lc bn phi chn la mt bc s gia nh mi. Tt c cc chng trnh bo him y t cho php bn la mt bc s khc trong danh sch nhng ngܩi c tn tham gia. Bn hy lin lc vi hng bo him ca bn Nj bit cch thc.

Bn phi bo cho hng bo him y t bit mi khi bn thay ǰi bc s gia nh/y s chnh thܩng l ca bn. Mt s hng v chng trnh ch cho php bn thay ǰi bc s trong mt thi gian hn nh no m thi.

4. Trܩng hp cp cu tht s l g?

a s cc chng trnh bo him sc khe nh ngha mt "trܩng hp cp cu y khoa," l mt tnh trng y khoa xy ra bt ng, khng gii thch ܮc, v c th nguy him ljn tnh mng, hoc mt chng bnh rt trm trng hay nhng thng tch khng cho php bn kp thi gi bc s gia nh ca mnh.

a s cc chng trnh y t qun tr s tr cho dch v iu tr ti phng cp cu, trong trܩng hp cp cu tht s. Cc dch v k tip (nh tr li nh thng Nj ct ch) phi ܮc thi hnh ti phng mch bc s gia nh ca bn. Cc dch v chm sc k tip nu xy ra ti phng cp cu (emergency room) s khng ܮc cc chng trnh bo him y t qun tr bi hon.

5. Trong trܩng hp cp cu tht s, ti c th i u?

Ngay t by gi, bn nn tm hiu xem nhng nh thng hay chn y vin no, tham gia vo chng trnh bo him y t ca bn, Nj chun b cho trܩng hp cp cu. Trong trܩng hp cp k nguy him ljn tnh mng, bn hy ljn thng nh thng no gn nht! a s cc chng trnh s vn tr y cho cc dch v xy ra sau gi lm vic thܩng l ti cc phng cp cu ca mt bnh vin d bnh vin ny khng tham gia vi chng trnh bo him ca bn, min l mt trܩng hp cp cu tht s. Ngܮc li, nu bn dng nhng dch v ca mt nh thng khng tham gia chng trnh bo him ca bn Nj tr mt bnh trng hay thng tch tuy cn ܮc iu tr, nhng khng tht s nguy him ljn tnh mng, bn s phi t tr vi tin ti ca mnh.

6. Ti c quyn la chn nh thng khng?

Hy tham kho vi bc s gia nh ca bn, khi tm mt nh thng thuc chng trnh bo him. Nu ljn iu tr ti mt nh thng khng c tn trong danh sch ca chng trnh bo him v khng xin php trܧc, bn s phi t tc cho mt phn hoc ton phn cc tn ph ca nhng dch v y.

7. Nu ti ang i xa nh, vn NJ y t ca ti c ܮc i th khng?

Nhng vn NJ y t trm trng thܩng hay ܮc chng trnh bo him i th, gn nh chc chn, s ܮc bao tr. Cc trܩng hp khn cp tht s s ܮc bao tr. Tuy nhin, bn cn phi hi thm v thu thp y chi tit t hng bo him ca bn, chng hn nh c cn phi ܮc s chp thun ca bc s gia nh trܧc khi bn nhn nhng dch v y t tuy cp bch, nhng khng nguy kch v khn cp tht s.

Ti liu: " How to Use your Managed Care Plan Effectively: Questions and Answers for Families with Children." American Academy of Pediatrics.

("Lm th no Nj dng chng trnh bo him y t qun tr mt cch hu hiu. Vn p cho nhng gia nh c con em nh." Vin Hn Lm Hoa K v Nhi ng

"Directory of Physicians." Physicians Medical Group of San Jose

("Danh sch ch dn ljn cc bc s." Nhm y s ca San Jose)

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