TRIBUNSTYLE.COM - Pelbagai jenis
manusia, pelbagai dalam bentuknya .
Salah seorang daripada mereka adalah penjaga kesilapan orang lain, aka orang
yang bersalah.
Dia berkata "Tidak
apa-apa" tetapi di dalam hatinya dia teringat kesilapan orang lain.
Ada cara istimewa untuk menangani
mereka dan terdapat 7 cara untuk menangani orang yang bersalah.
Terdapat satu jenis dendam yang
apabila kita membuat kesilapan dengannya, dia tidak lagi mahu bercakap dengan
kami.
Ada yang marah, tetapi tidak
memberitahu sebab mengapa mereka marah.
Paling parah adalah mereka yang
menyimpan dendam selama bertahun-tahun lamanya.
Matlamatnya mudah, dia mahu
menghukum orang itu dengan membalas dendam dan kemarahannya. Bagaimana hendak
berurusan dengan seseorang seperti itu?
1. Minta maaf
Jika kita memang bersalah
kepadanya, bertanggungjawablah dengan meminta maaf.
Namun jika kita merasa tidak
bersalah, namun ia bersikukuh kita melakukannya, pastikan dia tahu bahwa kita
mengerti dengan cara pandangnya itu.
Katakan juga kepadanya bahwa kita
tidak pernah berniat untuk membuat masalah dengannya. Tunjukkan ketidaknyamanan
kita dengan situasi itu.
2. Tanyakan padanya apa yang harus
kita lakukan agar hubungan membaik kembali.
Terkadang niat baik dan permintaan
maaf masih kurang bagi mereka.
Karena itu cobalah tanyakan padanya
apa yang harus dilakukan agar dia benar-benar melihat ketulusan hati kita.
3. Jangan posisikan diri kita
sebagai si pendendam.
Jangan pula akhirnya kita yang
menjadi terpuruk karena sifat pendendamnya yang buruk.
Kita harus lebih realistis
menghadapi situasi seperti ini. Namun jangan pula mengabaikannya.
4. Ingatkan dia akan sifatnya itu.
Si pendendam biasanya memiliki
banyak korban yang disalahkan. Ingatkan dia betapa banyaknya orang yang
mengalami kerugian karena sifatnya.
5. Cukuplah dengan minta maaf dan
mengintropeksi diri sendiri.
Tak perlu berkali-kali mengungkit
persoalan itu. Sehingga ia juga menyadari bahwa kita sudah menganggap hal
tersebut selesai.
Biasanya si pendendam juga akan
melupakan persoalan itu. Berusahalah untuk tidak menunjukkan kekhawatiran kita
pada si pendendam.
Semakin kita menunjukkan diri kita
merasa bersalah, semakin kuat ia ingin menyimpan dendam.
6. Cari dukungan positif dari orang
lain.
Bukan berarti membicarakannya pada
orang lain, namun meminta dukungan positif dari orang lain akan membantu kita
untuk mengatasi hal ini.
Tanyakan saran dan dukungan positif
dari orang lain untuk membantu kita.
7. Jangan terlalu berkeras, banyak
hal yang tidak bisa kita ubah dalam hidup ini.
Ada kalanya tidak bisa menghadapi
orang-orang yang menyimpan dendam.
Jangan mau terpuruk dengan hal tersebut
dan jangan pula terlalu banyak berharap.
Sebab dendam adalah bukan saja soal
kesalahan yang telah kita lakukan.
Problem utamanya ada pada diri si
pendendam itu. Untuk memperbaiki hubungan, kedua belah pihak harus saling
membuka diri.
Sumber : Tribunnews
Best Health Insurance Company
There
are so many moving parts when it comes to picking the best health
insurance that it’s hard to know where to turn. However, one thing to
keep in mind when you’re building a list of health insurance companies
is your desired level of coverage: What do you need covered and what’s
your budget? In order to help you find the top health insurance
companies in your area, we’ve put together this tool.
Because
there is no “best” health insurance company for everyone, I’ll instead
focus on finding the best provider and plan for you. I’ll discuss how
geography affects your choice of health insurance and briefly mention
companies that have a good reputation for customer satisfaction.
I’ll
also cover how different types of health plans operate, what major
medical plans must include, and special considerations that may apply
when you’re shopping.
How Geography Affects Your Health Insurance Choices
The
reality of the U.S. health insurance industry means you may not have
much latitude to choose your provider. How much choice you have almost
entirely depends on where you live.
Generally,
if you’re in a big city in a densely populated state, a good number of
insurers will be competing for your business. But in some rural areas,
there may be a single dominant insurer. In fact, in 2010, a single
insurer had gobbled up more than half the market for individual health
care plans in 30 states, according to the Kaiser Family Foundation.
For
example, if I lived in New York City and needed individual medical
coverage, I could choose from more than 150 plans from at least a dozen
health insurance companies on that state’s health insurance exchange. If
I lived in Wheeling, W.Va., I could choose from 14 plans on the federal
health exchange (used by many states, including West Virginia), all
provided by a single insurer: Blue Cross Blue Shield.
The
ACA aims to stimulate more competition across the country, and there
are signs that’s happening in some small measure. In 2015, 86% of
eligible individuals were able to choose from at least three insurers on
the federal health exchange, an increase from 70% in 2014.
Still,
that’s not the case in some parts of the country, where the best health
insurance company for you may be the only one that will take your
business. Aetna’s bid to acquire Humana and Anthem’s bid to buy Cigna
could also significantly shrink choices nationwide.
Can health insurance ‘drop’ you?
This
is a commonly asked question and a contentious issue in our current
political climate. As it currently stands as of the updating of this
article, the current Health Care Reform guidelines prevent insurers from
dropping clients who are sick or seriously ill. They also stop health
insurance providers from setting lifetime financial limits on benefits.
Best Health Insurance Companies for Customer Satisfaction
If
you’re lucky enough to live in an area with a lot of top health
insurance companies offering competitively priced plans, you may be able
to factor in an insurer’s reputation for providing satisfactory
service. Be careful not to put too much stock in individual reviews of
health care companies, however. They are highly dependent on very
personal circumstances, and they are overwhelmingly negative across the
board.
There
are a few resources that allow you to get a wider, more reliable
snapshot of the top health insurance companies. J.D. Power’s 2015 Member
Health Plan Study ranks several providers by U.S. region. Insurers that
come out at or near the top in several states include the Kaiser
Foundation Health Plan and Blue Cross Blue Shield. (Be sure to check
your specific region, as the same insurers that are in the top in some
states may rank at the bottom in other states.)
In
Insure.com’s 2014 customer satisfaction ratings, Kaiser Permanente
(parent company of Kaiser Foundation Health Plan) comes out on top,
followed by Humana, Blue Cross and Blue Shield of Florida, and
UnitedHealthcare.
You
may also obtain rankings for certain plans via Consumer Reports, which
obtains data from the National Committee for Quality Assurance. You can
search for plans in your area by selecting plan type (HMO, PPO,
Medicare, or Medicaid) and your state.
Best Health Insurance Companies by Region
The
following data come from J.D. Power’s 2015 Member Health Plan Study,
which examined more than 31,000 plan members’ satisfaction with coverage
and benefits; provider choice; information and communication; claims
processing; cost; and customer service.
Finding the Best Health Insurance Plan for You
If
you’re in an area with limited choices or your preferred providers are
too expensive, it’s still possible to zero in on a plan that will work
for you, regardless of company. To do so, you’ll need to understand what
types of plans are out there, what kind of coverage is already included
in major medical health insurance plans, and whether you have special
considerations that will affect your decision.
If
your budget is the major driving force behind your decision, be sure to
check out How to Find Affordable Health Insurance in 2016.You’ll find a
more detailed discussion of the shopping process and how to find the
most affordable plan you can without skimping on coverage.
Selecting the right plan type
One
major factor to consider is the type of health care plan that makes
sense for you. But keep in mind that your location will also affect how
much choice you have regarding plan types, just like it does with
providers.
Whatever
plan type you choose, note that the ACA has made lifetime and annual
benefit caps illegal. That means that, with the exception of
non-ACA-regulated short-term health plans, you will no longer be on the
hook for all of your costs after going over a certain dollar amount
during a certain time period — a massive benefit for anyone with health
conditions that require extensive, high-dollar care.
All
plans will also include an out-of-pocket maximum that limits the amount
you have to pay each year before your insurance will cover 100% of your
remaining costs. The ACA requires all deductibles, coinsurance,
copayments, or similar charges to go toward this limit; however, your
premiums and any spending on non-essential health benefits are among
charges that don’t count toward the limit. For 2017, individuals’
out-of-pocket maximums are capped at $7,150 on the federal marketplace,
and family plan maximums are capped at $14,300.
HMO
HMOs
(health management organizations) may be the most infamous type of
health insurance plan. This is likely because they’re the most
restrictive. With an HMO, you must receive your care within your HMO’s
provider network, and you must go through your primary care physician
for a referral if you need to see a specialist. If you receive care out
of your network, you could be on the hook for the entire bill except in
the case of an emergency.
Cost
management is the main goal, and advantage, of going with an HMO. HMOs
are more likely to charge flat copays instead of coinsurance. This means
you could pay anywhere from roughly $5 to $25 each time you need any
kind of medical care or prescription. However, you probably won’t have
to pay a deductible before your insurance kicks in every year — these
can average $250 to $500 for individuals or families, respectively, but
may cost even $1,000 or more if you opt for a plan with lower monthly
premiums.
The
lack of deductible can make HMOs a good choice if you’re on a tight
budget and live in a city with abundant quality medical facilities,
especially if you’re relatively healthy and don’t need a lot of care
from year to year. An HMO can also be a good choice if you know you’ll
need a greater degree of routine care (such as for pregnancy) and all of
your providers are available in network. However, if you know you’ll
need a lot of specialized care, you might find an HMO frustratingly
limiting — and very expensive if you suddenly need to go outside of your
network.
PPO
PPOs
(preferred provider organizations) give you much more latitude to
choose your health providers. You don’t need to go through a single
primary-care physician to receive a referral. Though you still pay less
if you stay in your PPO network, you probably won’t have to pay the
whole bill if you decide to go out of network. If you want to shop
around for doctors or have a condition that demands specialized care, a
PPO could be your best bet.
While
lower costs are the main pro of an HMO, higher costs are the main con
of a PPO. You’ll need to pay your deductible before your insurance kicks
in. As I mentioned above, that can be as little as a couple hundred
dollars a year, or more than $1,000 if you opted for a plan with a lower
monthly premium.
Your
out-of-pocket costs don’t stop there: You’ll pay coinsurance for
certain services instead of a flat copay. That could be roughly 10% for
in-network services and as much as 40% for out-of-network care. If you
go out of network, you may have to pay your bill upfront and then file
for reimbursement, a potentially lengthy and frustrating process.
Ultimately,
PPOs are usually the best choice for anyone who prizes flexibility over
cost savings. If you have a complicated medical history and may need to
see specialists, particularly out of network, a PPO can actually save
you money over a more restrictive HMO. In general, however, you’ll
probably pay a bit more out of pocket to have a greater degree of choice
and control over your care with a PPO.
Hybrid plans: POS plans and EPOs
POS
(point of service) plans aim to blend the characteristics of HMOs and
PPOs. You’ll need to go through a primary-care physician for referrals,
much like an HMO. However, a POS plan also allows you to receive care
outside your network like a PPO.
A
POS plan could be right for you if you really like your primary
physician and don’t mind routing your care through him, but want to keep
out-of-network flexibility. Costs tend to fall in between those of
HMOs, which are on the cheaper end, and PPOs, which are more expensive.
EPOs
(exclusive provider organizations) are the least common plan type.
They’re also a blend of PPOs and HMOs. Like HMOs, you must receive care
within your network. But like PPOs, you won’t need to go through your
primary care physician to get a referral. However, you may need to get
preauthorization for more expensive services.
EPOs
may be a good choice if you expect to stay in network but don’t want to
deal with referral paperwork. Costs also tend to be in the middle
between HMOs and PPOs.
Short-term health plans
Unlike
the other four plans on this list, short-term health plans are not
major medical plans. They are inexpensive, stopgap plans meant to hedge
against catastrophic health disasters, maybe while you’re between jobs
or because you are shopping outside of open enrollment. Your deductible
will likely be very high.
The
major pro here is that short-term plans are the cheapest plans you can
get. But ACA regulations don’t apply to short-term health plans, which
are the only ones for sale when it isn’t open enrollment.
Buyer
beware: These plans are not required to provide benefits such as
preventive care, and there will be a cap on benefits — this is no longer
allowed for major medical plans. You may not even qualify if you have
pre-existing health conditions, which other health plans must
accommodate under the ACA.
Ultimately,
we don’t recommend short-term health plans unless you are young,
healthy, and need coverage to hedge against the high cost of emergency
care simply because you missed open enrollment. Otherwise, the fine
print and exclusions on these plans make them a very flimsy substitute
for major medical insurance.
Essential health benefits
One
of the major requirements of the ACA is that all major medical
insurance plans you can purchase as an individual (excluding short-term
health insurance, discussed above) must cover a set of 10 essential
health benefits. These benefits apply regardless of whether you buy your
plan through a state or federal health exchange, from an insurance
broker, or directly from an insurance company. They are as follows:
Ambulatory
(outpatient) care: This is care you receive on an outpatient basis —
that is, without getting admitted to a hospital. It includes standard
doctor’s office appointments and in-home health visits.
Emergency
care: This includes any care you receive for a potentially debilitating
or fatal condition. Ambulance and emergency-room treatment are common
examples.
Hospital
care: Any care you receive as a patient at a hospital or skilled
nursing facility is covered. This includes lab work, surgery,
medications, and any other treatment you receive as a patient.
Laboratory services: Tests necessary to diagnose, monitor, or rule out certain conditions are covered.
Maternal
health and newborn care: This includes all prenatal care for expectant
mothers, as well as labor, delivery, postnatal care, and newborn care.
Mental
health care and addiction treatment: Whether inpatient or outpatient,
this includes any care necessary to diagnose, monitor, or treat mental
illness or addiction. Some plans limit treatment to a certain number of
days.
Pediatric
services: This includes all care provided to children, including yearly
checkups, vaccinations, dental care, and vision care.
Prescriptions:
Plans must cover at least one medication in every federal category and
class of prescription drugs. Insurers still have preferred-drug lists
and may require generics over name-brand drugs, among other
restrictions.
Preventive
care: This includes physicals, screenings, immunizations and other
services meant to prevent or detect illness or other conditions, as well
as the management of chronic conditions.
Rehabilitative
and habilitative care: These services help you gain or regain abilities
limited or lost to or limited by injuries, illness, or other
conditions. Examples might include physical therapy, occupational
therapy, and speech therapy. Some plans limit treatment to a certain
number of sessions a year.
Will health insurance cover oral surgery?
Typically,
your health insurance policy may cover oral surgery if it is deemed
medically necessary. This could include dental care from a severe mouth
injury or certain diseases. If your needs are deemed more cosmetic in
nature, then your health insurance provider might not be able to help.
Special considerations: Looking beyond essential benefits
While
the list of essential health benefits seems exhaustive, there are still
a number of factors that can affect your coverage depending on where
you live and which provider and plan you choose. For these issues, it’s
especially important to read the fine print to see what’s covered when
you’re shopping for a plan.
Staying in network
If
you have an existing relationship with a certain health care provider
and want to maintain it, never assume that provider will be in network
on your new plan. Likewise, if you don’t want to be restricted to a
small number of providers or certain hospitals, you’ll need to shop
carefully. For instance, all doctors at a certain hospital (or even
within a certain practice) may not be members of the same insurance
networks.
Experts
say many insurers are cutting costs by narrowing their provider
networks. While this might be a good thing if you don’t need much care
and want to save money, it increases the chances that you’ll have to pay
steep out-of-pocket costs for out-of-network care.
Prescription drugs
Yes,
prescription drugs must be covered under the ACA, as noted above. But
there’s no guarantee that the specific drugs you take will be covered,
and what you’ll pay still varies by plan.
If
you take certain medications, you’ll want to check a potential plan’s
preferred-drug list, or formulary, to see whether it’s covered. This
information is typically available on an insurer’s website. If your drug
isn’t covered, your doctor can help you request it by explaining how
it’s necessary for your treatment, but the process may not be a quick
one, and there are no guarantees.
If
you know you’ll need prescriptions filled regularly, you’ll also want
to pay attention to cost. Your plan will likely require either
coinsurance or a copay for prescriptions. Coinsurance means you pay a
certain percentage of each drug’s cost (around 30% is typical). If you
have a copay, you’ll pay a certain fixed amount (usually $10-$30) when
you need a prescription, but it’s independent of the drug’s price. That
usually makes copays a better bet if you know the drugs you take are
expensive.
Mental health coverage
Again,
some mental health care is required in every major medical plan. But
beyond that, what kind of services are covered can vary tremendously by
state.
If
you have a specific need, you’ll need to wade into the fine print of a
plan’s benefits summary to determine whether you’ll be covered. And if
you want to see a specific provider, such as a certain therapist or
psychiatrist, you’ll need to make sure he or she is in your network.
It’s not uncommon for psychiatrists to refuse joining insurance networks
to manage high demand and combat low reimbursements compared with other
services.
Rehabilitative and habilitative care
Like
mental health care, rehabilitative and habilitative care is more of a
gray area for insurers. Even though some coverage is required, what’s
covered and the limits on that coverage will vary by state and by plan.
Experts
say those with chronic conditions need to pay especially close
attention to the fine print. Because treatment tends to be more
expensive, insurers have greater incentive to cap these benefits or skip
them entirely. So while your physical therapy for a back injury may be
entirely covered, speech therapy for your autistic child may not be.
The bottom line
Shopping
through the best health insurance companies is a complex process, but
well worth it in the end. You might need to look into multiple providers
and review their policy prices before you find one that matches your
needs. Another thing to consider is the company’s online reputation as
well as customer support. This can be a huge indicator in how your
experience might turn out.
