Eminye iMithetho eyahlukeneyo Faka isicelo seMedicaid kunye neNkxaso ye-Premium
Ukuba ungumfuduki ofika e-US, enye yezinto zokuqala ukwenza uluhlu lwenu ukufumana inshuwalense yezempilo. Ngokungafani namanye amazwe amaninzi, i-US ayinayo inkcazo yempilo yonke, kwaye nangona i-Medicare kunye neMedicaid izicwangciso zempilo ezixhaswe nguRhulumente, azifumaneki kubafuduki abatsha.
Ngoko makhe sijonge ngeminye imibuzo ehlala ibuzwa malunga nezinto ezifumanekayo kubafuduki, kubandakanywa abafikayo kunye nalabo abaye base-US ixesha elide.
Ngaba ii-ACA Premium Subsidies Limited kumaZiko ase-US?
Inkxaso-mali ye-Premium (iikhredithi zerhafu ye-premium) kwiingxoxo ziyafumaneka kubahlali abemi ngokusemthethweni, okubandakanya uluhlu olude lweemimiselo zokufuduka (inqaku lokuba iNkqubo eDluliweyo yoLuntu -I-DACA-ayithathwa njengesimo sokufuduka esifanelekileyo sokuthengwa utshintshiselwano).
Enyanisweni, inkxaso-mali ye-premium ifumaneka kubafuduki abasandul 'ingeniso engaphantsi kwinqanaba lehlwempu, okungekho imeko kwabangengabo abafudukayo okanye abafuduki abaye bahlala endaweni yase-US iminyaka engaphezu kwemihlanu.
I-ACA ibiza abantu abanomvuzo ongaphantsi kwinqanaba lehlwempu ukuze bafumane iMedicaid endaweni yezicwangciso zangebucala ekutshintshisweni, kungenxa yoko inkxaso-mali ye-premium ayifumaneki kubafakizicelo abanomvuzo ongaphantsi kwinqanaba lehlwempu. Kodwa abafudukayo abasandul 'ukuhambela abasafanelekanga kwiMedicaid exhaswa ngemali kuze kube yilapho beye e-US ubuncinane ubuncinane iminyaka emihlanu (bathi banokukhetha ukusebenzisa imali yabo yokwandisa i-Medicaid coverage kubafuduki abasandul abafazi abakhulelweyo).
Xa i-ACA ibhaliwe, abagwebi baqaphela ukuba i-ACA ephantsi kwemali yokufumana inkxaso-mali ye-premium (okt, inqanaba lentlupheko) yayiza kubashiya abafudukayo abasandul 'ukufumana imali engenayo ngaphandle kweendlela ezikhoyo zokufikelela. Ngoko ke banikezela ngokukodwa inkxaso-mali ye-premium eya kubangenisa abafuduki abatsha kunye ne ngeniso engezantsi kwintlupheko.
Kule meko, ingeniso yomfaki-sicelo iphathwe njengokuba kwintlupheko (okanye iipesenti ezingama-133 zentlupheko kwiimeko eziye zandisa i-Medicaid, apho leyo ingeniso ephantsi kunazo zonke eyenza umntu afanelekele ukufumana inkxaso-mali ekutshintsheni esikhundleni seMedicaid) . Ngo-2017, oko kuthetha ukuba umntu obhalisile uza kuhlawula iipesenti ze-2.04 zeengeniso zakhe kwisicwangciso sesilivere esiphantsi kwesindleko ekutshintshiseni (nantsi inkcazo yeendlela izibalo ezisebenza ngayo).
Okumangalisayo kukuba, i- gap yokungabikho komthetho abazame ukukhusela abafudukayo abasandul 'ukugqibela baye bafaka isicelo endaweni yezigidi ezingama-2,6 ezingengabemi basemaphandleni kwi-18 bathi bakhetha ukungamkeli inkxaso yenkxaso-mali yokwandisa iMedicaid. isigqibo sokubangela ukuba urhulumente wephondo unelungelo lokuxhaswa ngemali kwinkxaso-mali yokuxhaswa kweMedicaid ngokuzimisela kombuso ukwandisa i-coverage).
Ngenxa yokuba ezo zizwe azange zandise iMedicaid, abantu abadala abangenabantwana abaxhomekeke kunabo bonke abavumelekanga kwiMedicaid kungakhathaliseki ukuba i-income yabo iphantsi kangakanani. Kwaye ngenxa yokuba inkxaso-mali ye-premium ayifumaneki kubantu abanemali engaphantsi kwinqanaba lehlwempu (kuba bekufuneka babe ne-Medicaid phantsi kwe-ACA), abo bantu abanakho ukufikelela ngokusemgangathweni kwinshuwalense yezempilo, njengoko ukuhlawula ixabiso elipheleleyo le-coverage Ngokuqhelekileyo kusebenza kubantu abanemali engaphantsi kwinqanaba lehlwempu.
Kodwa kuzo zonke iindawo, abafudukayo abasandul 'ukuvela kwiimeko ezifanelekileyo ngokusemthethweni bafanelekile kwiinkxaso ze-premium nangona iholo yabo ingaphantsi kwinqanaba lehlwempu.
Ukutshintshana Kukwazi Njani ukuba Abafakizicelo Banikezela Ngokusemthethweni?
Ngexesha lobhaliso lwenkqubo, ukutshintshana kufuneka kuqinisekiswe ukuba ubhaliso luyabonakala ngokusemthethweni e-US Kukho icandelo kwisicelo apho abemi abangenabemi bangena kwisimo sabo sokufuduka kwaye ba ndakanye iinkcukacha ezifana nenani elingaphandle okanye inombolo ye-I-94. uluhlu olupheleleyo lweempepha ezingasetyenziselwa ukubonakalisa isimo sokungena kwamanye amazwe, nokuba ungangenisa njani ukuba ubhalisa nge-HealthCare.gov; ukutshintshana kombuso kunemisebenzi efanayo.
Ukuba awukwazi ukufaka inombolo yombhalo okanye ufumane iphutha, uya kuba nenketho yokulayisha ikopi yamaxwebhu akho okufuduka, okanye uthumele i-imeyli ekutshintshisweni. Ukuba awukwazi ukubonelela ngamaxwebhu okufuduka kuwo onke, ukufikelela kwakho kungagqiba ukucinywa ngokukhawuleza.
Ngo-2014, kwakukho abantu abangaba ngu-109 000 abanokubhaliswa kwabo kwi-HealthCare.gov xa bengakwazi ukubonelela ubungqina bendawo yokuhlala yaseMelika. Kwaye phakathi konyaka ka-2015, ukugqithiselwa kwavalwa kubantu abathathu abangama-306,000 ababhalise kwi-HealthCare.gov izicwangciso ze-2015 kodwa babengabanikanga amaxwebhu afanelekileyo okufudukela kwamanye amazwe.
Ngoko ukuba ubhalisa kwaye unenkathazo kunye nenkqubo eqinisekisa isimo sokuthuthela kwelinye ilizwe, musa ukuyivumela ukuba islayidi, njengoko ukugqithiswa kwakho kungagqitywa xa ukwenza. Fumana ekutshintshiseni uncedo, nokuba kufowuni okanye ngomntu kumziko obhaliso, kwaye qi ni sekise ukuba amaxwebhu akho avunyelwe.
Nguwuphi umthombo onokufumaneka kubantu abafudukayo?
Ngaphambi ko-2014, bekukho iindlela ezimbalwa zokusuka kwamanye amazwe aneminyaka engama-65 okanye ngaphezulu. Imigaqo-nkqubo ye-inshorensi yempilo yabucala ngokubanzi ayifumanekanga kumntu oneminyaka engama-64 ubudala, kwaye njengoMedicaid, uneminyaka emihlanu elinde ngaphambi kokuba abafudukayo bangabhaliswa kwi-Medicare. Ngenxa yoko abafuduki beza kubadala babefanele bathembele kwi-inshorensi yokuhamba kwangexesha elide, ngaphandle kokuba babe nokufikelela kwisicwangciso esixhaswe ngumqeshi e-US.
Nangona emva kweminyaka emihlanu, i-Medicare yayisoloko ingenakulungiseka kubantu abavela kwamanye amazwe. Ekubeni i-Medicare ixhaswa ngemali ngeentlawulo zeentlawulo zabasebenzi base-United States ekuhlawuleleni ngexesha labo, iMarrharenti Part A (i-inshurensi yesibhedlele) ayikho i-premium-free kubantu abaye bahlawula irhafu ye-Medicare ubuncinane ubuncinane iminyaka elishumi (abahlala ekhaya basebenzela I-Medicare esekelwe kwimbali yomsebenzi womlingane).
Emva kweminyaka emihlanu, abafuduki abaneminyaka engama-65 okanye ngaphezulu bangathenga i-Medicare nokuba ngaba abazange bahlawule kwinkqubo ye-Medicare ngeentlawulo zerhafu. Ngo-2017, i-Medicare Part A yi-$ 413 / inyanga kubantu abangenazo iimbali zomsebenzi, kwaye i-Medicare Part B yi-$ 134 / inyanga (wonke umntu uhlawula i-premium ye- Medicare Part B , kungakhathaliseki ukuba yintoni umlando wembali). I-Medigap kunye ne- Medicare Part D zibonelelo ezibalulekileyo ezingenakongezwa kwi-Medicare, kodwa ziza neeprayimari ezongezelelweyo.
Kodwa ngokusemthethweni-abavela kwamanye amazwe bangabhalisa kwizicwangciso zabucala kwiimarike zodwa xa befika e-US, kwaye ngenxa ye-ACA, abasayi kuvinjelwa ukuba benze njalo xa bengaphezu kweminyaka engama-64 (iimarike ngamnye Ingxelo ifumaneka kungakhathaliseki ubudala, ngokungakhathaliseki ukuba umntu angabhaliswa kwi-Medicare). Ukongezelela, inkxaso-mali ye-premium ikhona ngaphandle kwaneminyaka yobudala, kwaye njengoko kuchazwe ngasentla, inkxaso-mali iyafumaneka kubafuduki abasandul 'ingeniso engaphantsi kwinqanaba lehlwempu.
Okwangoku, phantsi kwe-ACA, ii-premiums zeqela kunye namancinci amaqela asekudala abhalisiwe athathwe ngaphezulu kwamaxesha amathathu kwi-premium ehlawulwe umntwana oneminyaka engama-21 ubudala. Ngoko unyaka oneminyaka engama-85 uya kuhlawuliswa umlinganiselo ofanayo nomntwana oneminyaka engama-64 (kumabini omabini, amaxesha amathathu ahlawulwe umrhumo oneminyaka engama-21 ubudala, ngaphandle kokuba urhulumente ufuna ixabiso eliphantsi; ephakamileyo kunamithathu ukuya kwelinye).
UMthetho wezeMpilo we-American Health Care (AHCA), owawudlulisela iNdlu ngo-Meyi 2017 kwaye uphantsi kweNgxowa-mali , kuya kukwandisa umlinganiselo, nangona kunjalo, ukuze abhalise abadala bahlawulwe ngokuphindwe kabini kubhaliso abancinci (okanye ngaphezulu, ukuba urhulumente kufuneka afune ukukhishwa kunye nokuphumeza umlinganiselo ophezulu).
Kukho izicwangciso ze-inshurensi zokuhamba kunye nezicwangciso zezempilo ezifikelelekayo, kodwa zivame ukuba zilinganiselwe kunezicwangciso ezikhoyo ekutshintshisweni, kunye neefowuni zenkxaso kunye nemeko ekhoyo ngaphambili. Ezi zicwangciso azithathwa njengento encinci yokubhengezwa ngokubalulekileyo, oku kuthetha ukuba i- ACA isohlwayo yokungafihli- mali ihlolwe ngokusemthethweni kwabangaphandle abazithembele kwezi zicwangciso, ngaphandle kokuba banelungelo lokuhlawulwa.
I-AHCA iya kuphelisa isigwebo se-ACA ngokukhawuleza ekuqaleni kuka-2016, kodwa kude kube ngumthetho wokuqeda isigwebo senziwe, kusekho isohlwayo sokungabikho koqweba olubalulekileyo olufunekayo ngo-2017 , ngaphandle kokuba ufanele ukufumana imvume yokuhlawulwa .
Ngaba uMfuduki angabhalisa kwiNgaphandle ngaphandle koBhaliso oluvulekileyo?
Ewe. Ukuba ngummi wase-US okanye ukufumana imeko esemthethweni e-US ngumcimbi ofanelekayo, owenza umntu ukuba angene kwi-60 yesicwangciso se-inshurensi yezempilo (qaphela ukuba le ngenye yeziganeko ezimbalwa ezifanelekileyo ezingabangeli ixesha lokubhalisa okhethekileyo kwizicwangciso zokutshintshiselwa ngaphandle ; ixesha lokubhalisa elikhethekileyo lifumaneka kuphela kwintsebenziswano).
Abanye abafuduki bavela kwangoko banokufikelela kwizicwangciso ezixhaswe ngumqeshi, kwaye ezo zicwangciso zinexesha elizodwa lokubhalisa kubantu abaqeshwe ngaphandle kobhaliso oluvulekile okanye amava okufumana isiganeko esifanelekileyo . Ngoko nangona ubhaliso oluvulekileyo- kubini izicwangciso ezixhaswe ngumqeshi-kuphela ziza ngeenxa zonke kanye ngonyaka, abatsha abavela kwamanye amazwe banethuba lokubhalisa kwi-coverage kungakhathaliseki ukuba bafudukela phi.
Ngaba Abangenayo Abangabikho Abangenayo Abangenayo Abanokufumana Umyinge?
Ngaphansi kwemigaqo ye-ACA, abemi basemthethweni bangabhalisa kwizicwangciso ezinikezelwa ngokutshintshiselana, kwaye banokufumana inkxaso-mali ye-premium ukuba i-income yabo ibenokufaneleka. Kodwa i-ACA ayinawo amalungiselelo avumela abafuduki abangabhalwa phantsi ukuba bafumane ingxelo.
Umthetho ukhubaza ngokucacileyo abaphambukeli abangabonakaliyo ukuba bangathengi ukuthengiselana-nokuba bahlawula ixabiso elipheleleyo; jonga icandelo 1312 (f) (3) le-ACA . Abafuduki abangabonakaliyo nabo bavumelekanga kwiMedicaid. Ekubeni abanako ukubhalisa kwiingxoxo okanye kwiMedicaid, abafuduki abangabhalwanga ngabangaphantsi bayaxoshwa kwi- ACA .
ICalifornia yaqalisa ukusebenzisa inkxaso-mali yelizwe ukwenza iMedicaid (Medi-Cal) ifumaneke kubantwana abangabhalwanga ngabangaphandle kwamanye amazwe ngo-2016, kwaye abantwana abangama-170 000 bafumana ukufumana ingxelo ngenxa yoko.
Amagosa aseCalifornia ayefuna ukuthatha eli nyathelo kwaye avumele abantu abadala abangabangaphandle ukuba bathenge ukuthengwa (ngaphandle kwemali-mali) kwi-exchange exchange, eCovered California. Urhulumente wamisela umthetho (SB10) ngoJuni 2016 ukufumana ibhola ejikelezayo kulo, kwaye wangenisa isiluleko sika-1332 sokushiya uhulumeni wesigqeba ngoSeptemba 2016 , ekubeni ukuvunyelwa komgaqo-mvume kuyimfuneko ukuze utshintshe imigaqo okwangoku ibhade abafuduki abangabonakaliyo ekuthengeni kwanezicwangciso zentengiso epheleleyo.
Kodwa ngoJanuwari 2017, iintsuku ezimbini ngaphambi kokuba kuqaliswe uDonald Trump, iCalifornia yashiya isiphakamiso sayo se-1332 sokukhuphaza phakathi kweenkxalabo ukuba ulawulo lweTrump lungasebenzisa idatha yaseColumbia eCapefornia ukuba ifumane kwaye ixoshe abafuduki abangabhalwanga phantsi.
Abafuduki abangenayo iifayile bangakwazi ukufumana inkcazo phantsi kwezicwangciso ezixhaswe ngumqeshi okanye izicwangciso zempilo zabafundi ukuba ngaba zifanelekile, kwaye ziyakwazi ukuthenga ukuthengwa kwemakethe nganye xa zizithenga. Kodwa ngeli xesha, abanako ukubhalisa kwirejista ngokusebenzisa utshintsho lwempilo yomshuwalense kunoma yiphina imeko.
> Imithombo:
> Healthcare.gov. Isimo sokufuduka kunye neMakethe.
> INkonzo yeNgeniso yangaphakathi, iNkqubo yeNgeniso 2016-24 .
> I-Kaiser Family Foundation: I-Gap Coverage: AbaNcinci abaNcinci kwiiNkampani ezingenakwandisa iMedicaid. Oktobha 19, 2016.
> Medicare.gov. Uncedo lweMida kwi-2017 Iindleko kwiSikhumbuzo.
> Isizwe soMthetho woLwazi lwabaFundisi. "Misela Ngokusemthethweni" Abantu abafanelekayo phantsi koMthetho wokuNakekelwa ongenakunciphisa.