Ngokumalunga nokulahlekelwa yinshurensi yezempilo esekelwe kwimisebenzi? Ukuqwalasela i- COBRA , kodwa ingaqinisekanga into ebhetele, i-COBRA okanye i- Obamacare ? (I-Obamacare yodwa nje igama loMthetho woNonophelo ongenakuncedo.) Impendulo ixhomekeke kwimeko yakho, kodwa yile ndlela i-COBRA kunye ne-Obamacare ithelekisa ngayo.
Isicwangciso Sempilo esifanayo kunye neSicwangciso seMpilo eyahlukileyo
Xa ukhetha i-COBRA, uhlawula ukuqhubeka nokuhanjiswa phantsi kweprogram yomshuwalense wezempilo oxhaswe ngumqeshi oye wawafumana.
Uyazi ukuba kusebenza njani noko ukulindela. I-curve kuphela yokufunda iquka ukufunda nini kunye nendlela yokwenza i-premium yakho ye-COBRA.
Ukuba ukhetha isicwangciso sezempilo sase-Obamacare kwi- inshurensi yempilo yomshuwalense wezempilo (okanye ngaphandle kokutshintshiselana, apho izicwangciso zihambisana ne-ACA), uya kuyeka isicwangciso sakho esidala kwaye uya kuba nezicwangciso ezintsha ezinokukhetha kuzo. Uya kuthenga isicwangciso kwikarhwebo nganye, ngokuchasene nemakethi exhaswe ngumqeshi (edlalwa ngokuba yinto engekho iqela ngokumelene neqela). Ngoko kuya kufuneka ufunde ukuze uqonde indlela isicwangciso sakho sempilo esitsha sisebenza ngayo ukuba luhlobo oluthile lwesicwangciso kunelo lakho elidala. Umzekelo, ukuba isicwangciso sakho somqeshi siyi - PPO kodwa isicwangciso sakho esitsha se-Obamacare yi- EPO , kuya kufuneka uqonde indlela ahluke ngayo ukuze ukwazi ukusebenzisa isicwangciso esitsha ngokufanelekileyo.
Ukuba uqhubeka nesicwangciso sakho samanje phantsi kweCOBRA, uyazi ukuba ugqirha wakho uya kuba kwinethiwekhi ngoba awuguquli isicwangciso sakho sezempilo.
Ukuba ukhetha isicwangciso esitsha se-Obamacare kunoko, kuya kufuneka uqinisekise ukuba ugqirha wakho use-network kunye nesicwangciso sakho esitsha, okanye kufuneka utshintshe oogqirha. Uya kufuneka ukhangele ukuba imishanguzo yakho yonyango ifakwe phantsi kwefom yefom yefom entsha, okanye kufuneka uhlawulele i-out-of-pocket.
Oku kuyinyaniso nokuba ngaba isicwangciso ngasinye ozikhethayo sinikwe yinkampani efanayo yomshuwalense eyinike icebo lakho elixhaswe ngumqeshi.
Ngokomzekelo, umqeshi wakho unokuba nesicwangciso esinikezwa yi-Blue Cross Blue Shield umkhenkethi kwimeko yakho, kwaye unokugqiba ukutshintshela kwisicwangciso somntu ngamnye onikezelwa yiloo bhukhriji yeBlue Cross Blue Shield. Kodwa isicwangciso sakho esitsha sinokungafani ngokupheleleyo nesicwangciso sakho esidala. Iintlobo, inethiwekhi yomboneleli, uludwe lweziyobisi, uluhlu lwesicwangciso (i-HMO, i-PPO, i-EPO, njl.) -iyo yonke into ingafani kakhulu phakathi kweemarike kunye nemakethi axhaswe ngumqeshi, nangona ukhangele nkampani efanayo yomshuwalense.
Ukuhlawula i-Premium epheleleyo kunye nokufumana isibonelelo sokukunceda ukuhlawula
Ukuba ukhetha i-COBRA yokuqhubekeka kwenkcazo, uya kuhlawula i- premium yenyanga epheleleyo yaloo mali, kunye ne-2 yepesenti yemali yokulawula (gcina ingqalelo ukuba i-premium epheleleyo ithetha inxalenye oye uyihlawula ngaphezu kwendawo umqeshi wakho ohlawula ngayo, okubonakala ukuba yinxalenye enkulu yeprayimenti). Akukho zibonelelo zokuncedisa ukuhlawula iintlawulo ze- COBRA , kwaye zibiza.
Ukuba ulahla i-COBRA kwaye uthenge i-inshorensi yakho yezempilo kwishishini lomshuwalense wakho wezempilo, unokufumana ilungelo lokuncedisa i- premium yenyanga.
Ukongezelela, unokufumana inkxaso-mali ukuze unciphise i-out-of-pocket yakho ephezulu okanye ukunciphisa imali echithwayo, iipayili kunye ne- coinsurance . Ezi ncediso zifumaneka kuphela kwi-inshorensi yempilo ethengwe nge-Care Affordable Act, enoba unokuthenga i-ACA-plan inyanzelisayo ngaphandle kokutshintshiselana, awufumani nayiphi na inkxaso.
Zonke ezi zibonelelo zisekelwe kwingeniso yakho. Xa ufumana ngaphezulu, isibonelelo sakho sezantsi siya kuba. Ukuba ufumana imali eninzi, awukwazi ukufumana inkxaso-mali. Kodwa ukuba ingeniso yakho imodareyitha, unokukwazi ukufumana uncedo.
Ukuba nelungelo lesibini lokukhetha
Ukuba ufanelekile kwi-COBRA , unokufumana ixesha elilinganayo lokubhalisa.
Iwashi iqala ukukhawuleza umcimbi wesiganeko esenza ukuba uvumelekile kwi-COBRA, umzekelo, ngosuku oye waqhawula ngayo okanye wavalwa. Ukuba awusebenzi phambi komhla wokugqibela, uya kulahla ithuba lakho.Awufumani ithuba lesibini.
Ukuba ulahlekelwa yinshurensi yempilo-based-based, uza kufumana ithuba lokubhalisa okhethekileyo kwi-intanethi yoshishino lwakho lokutshintshiselwa yinshuwalense (okanye kwisicwangciso somntu ngamnye ngaphandle kokutshintshiselana, ukuba ngaba ukhetha), kungakhathaliseki ukuba ukuqhubeka kweCOBRA kufumaneka eya kuwe. Njengethuba lokunyulwa kwe-COBRA, eli xesha lokubhalisa elikhethekileyo lilinganiselwe ixesha. Nangona kunjalo, ukuba ulahlekelwa ngumhla wokugqibela, uya kuba nethuba lesibini lokubhalisela i-inshurensi yezempilo kwintsebenziswano ngexesha lokubhalisa ngonyaka ovulekileyo . Akukho xesha lokubhalisa elivulekile leCOBRA.
Ubude bexesha
I-COBRA ayihlali ngonaphakade. Yenzelwe njengenkqubo yokufumana ude ukhusele ezinye iifowuni. Kuxhomekeke kukuphi uhlobo lwesiganeko esenza ukuba uvumelekile kwi-COBRA, ukukhutshwa kwe-COBRA yakho kuya kuhlala kwiinyanga ezili-18 ukuya kwezi-36. Emva koko, kuya kufuneka ufumane enye inshorensi yempilo.
Ungabhalisela i-Obamacare (intengiso nganye) yonyaka wekhalenda (okanye ucime utshintshiselwano ). Ukuba ubhalisa ngexesha lokubhalisa okhethekileyo, ungatshintshela kwisicwangciso esitsha ngexesha lokubhaliswa kwonyaka ovulekileyo. Ukuba ufuna ukuqhubeka nesicwangciso sakho esitsha ngaphezu konyaka kwaye umgcini wakho womshuwalense uyaqhubeka ukunikela, unokuyivuselela. Ukuba i-insurer yakho inqamla isicwangciso, uya kukwazi ukubhalisela isicwangciso esithile kwishintshiselwano sakho, okanye ngqo ngqo ne-insurer yakho yempilo xa ukhetha ukukhutshwa kwe-exchange exchange (khumbula ukuba inkxaso ayifumaneki xa uthenge isicwangciso ngaphandle utshintshiselwano).
Ixesha leMali yoKhuseleko lokuNyanga
I-COBRA ayivumeli amathuba okwesibini. Ukuba usufikile kwi-premium payment yakho yokuqala, uya kulahlekelwa ilungelo lakho kwi-COBRA kwaye awukwazi ukuwubuyisela. Ukuba usuphelile kwintlawulo ye-premium yenyanga ngaphandle kweyokuhlawula kwakho yokuqala, i-inshorensi yakho yempilo yomshuwalense iya kukhutshwa ngaloo mini. Ukuba wenza inkokhelo yakho kwisithuba seentsuku ezingama-30, umrhumo wakho we-COBRA ungabuyiselwa. Nangona kunjalo, ukuba ungenzi inkokhelo kwixesha lobabalo, awuyi kukwazi ukufumana i-inshorensi yakho ye-COBRA.
Ukuba oku kwenzeka kuwe, uya kubambisana. Ukulahlekelwa kwekharityhulam yakho ye-COBRA ngokuhluleka ukuhlawula i-premiums yakho akukuvumeli ukuba ubhalise ixesha elilodwa lokubhaliselwa kwe-inshurensi yezempilo, okanye ngaphandle kokutshintshiselwa. Uya kufuneka ulinde de ubhaliso oluvulekileyo lokubhalisa (Novemba 1 ukuya kuDisemba 15 kwiindawo ezininzi) ukubhalisa kwisicwangciso se-Obamacare; uya kuba ngumngcipheko wokungaqinisekanga ngexesha elifanelekileyo.
Ngoxa ama-inshurensi athengisa i-inshurensi yempilo kwi-inshurensi ye-inshurensi yempilo yakho yeluntle ilindele ukuhlawulwa ngexesha ngalinye inyanga, ixesha lobabalo lwexesha elide lide lide kuneCOBRA kubantu abathile. I-Care Affordable Act ivumela ixesha leentsuku ezingama-30 ukuba lihlawulwe ngokukhawuleza kuzo zonke izicwangciso zezempilo ezithengiswayo ngeengxoxo. Kodwa oku kwandiswa kwiintsuku ezingama-90 ukuba ufumana inkxaso-mali yinshorensi yempilo (nangona kufuneka uhlawulwe ngokupheleleyo ekupheleni kweentsuku ezingama-90; ayikuvumeli ukuba ube neenyanga ezintathu emva kweeprisimenti zakho).
Ngubani na iQumrhu Elilawulayo?
Izicwangciso ze-COBRA kunye ne-inshorensi yempilo yisebe-phantsi ilawulwa yiSebe lezeMisebenzi. Ukuba unengxaki ebalulekileyo kwisicwangciso sakho seCOBRA, emva kokulandela inkqubo yezibheno kunye nezikhalazo, unokugqiba ukujongana neSebe lezeMisebenzi ngenzame yokulungisa umba.
Izicwangciso zezempilo ezithengiswa kwi-intanethi yoshishino lomshuwalense wezempilo zilawulwa yilizwe ngalinye. Ukuba unengxaki ebalulekileyo ngesicwangciso sakho sempilo esekelwe kwintsebenziswano, emva kokulandela inkqubo yezibheno kunye nezikhalazo, ungagqiba ukujongana neSebe lakho le-Intshumo okanye kwiSebe le-Inshorensi okanye kumkomishinala we-Intshu.
> Imithombo:
> Isebe Lemisebenzi. IziCwangciso zeMpilo kunye neNzuzo: Ukuqhubela phambili kweMpilo -COBRA.
> Kaiser Family Foundation. 2017 Uphando lwezeMpilo lwaBasebenzi. NgoSeptemba 19, 2017.