Andiqinisekanga ukuba yiyiphi into ekufuneka uyikhethe, i- Obamacare okanye i-inshurensi yempilo eyenziwa ngomsebenzi wakho? Kufuneka ufumanise oko kukunika ingxowa yakho yebuck yakho, i-Obamacare ngokubhekiselele kwinshuwalense yezempilo esekelwe kwimisebenzi? Nantsi indlela yokuqhathanisa i-inshurensi yempilo yenkxaso-mboleko kunye neeplani ze-Obamacare ezifumaneka kwi- Care Affordable Act .
1 -
Isinyathelo soku-1-Misela ukuxabiseka kweNkqubo yezeMpilo eSebenziUkuthelekisa iinkcukacha ezichanekileyo zokukhawuleza zinzima kakhulu xa uzama ukukhetha phakathi kwezicwangciso ezininzi zezempilo. Nangona kunjalo, kunqunyulwe umfutshane omncinci lula: qhathanisa ixabiso le-actuarial values .
Ixabiso le-actuarial yecebo lempilo likuxelela ukuba yeyiphi iipesenti zendleko zonyango zempilo zonyaka, ngokuqhelekileyo, isicwangciso sezempilo sihlawulela amalungu ayo. Iphakamileyo yexabiso le-actuarial value, eyona nto ibaluleke kakhulu inzuzo yezempilo. Ngokomzekelo, isicwangciso sezempilo esinenani le-actuarial ye-85% liya kuhlawula malunga nama-85% kuwo onke amaxabiso enkonzo ekhuselekileyo. Amalungu kulindeleke ukuba ahlawule amanye ama-15% eendleko zabo zenkxaso zempilo ngeemfuno zokwabelana ngeendleko ezifana nokuncitshiswa , i- copays kunye ne-coinsurance .
Ukufumanisa ukubaluleka kwexabiso leempilo ezikhoyo kumsebenzi wakho, kuya kufuneka ucele. Isebe lakho elixhamlekileyo lisebe okanye isebe loluntu lusetyenziso lokuqala. Enye inketho kukubiza inombolo yenkonzo yabaxhasi kwisicwangciso sempilo esekelwe kwimisebenzi ocinga ngayo kwaye ufumane ixabiso le-actuarial kwisicwangciso sezempilo somsebenzi wabathengi.
Emva kokuba wazi ixabiso le-actuarial yesicwangciso sakho sempilo esekelwe kwimisebenzi, ulungele ukuqhubela phambili kwisinyathelo 2.
2 -
Isinyathelo 2-Thelekisa i-Job Based based Health Plan & Obamacare PlanEmva kokuba wazi ixabiso le-actuarial yesicwangciso-sempilo esisekelwe kumsebenzi wakho umqeshi uyanikela, khetha isicwangciso okanye ezimbini zexabiso elifanayo le-actuarial kwi-Obamacare exchange exchange. Unokuxelela isicwangciso se-Obamacare se-actuarial value nge- metal-tier yayo .
- Izicwangciso zempilo zeBronze zinenani elingu-60%.
- Izicwangciso zempilo zesilivere zinenani eli-70%.
- Izicwangciso zempilo zeGolide zinenani elilinganiselwa kuma-80%.
- Izicwangciso zezempilo zePlatinum zinexabiso elingu-90%.
Umzekelo, ukuba i-inshorensi yempilo enomsebenzi wakho umqeshi unikezela ngexabiso le-72%, uya kukhetha i-Obamacare encinane yesilivere isicwangciso sokuyithelekisa kwaye ekubeni izicwangciso zesilivere zinenani elikufutshane nomsebenzi wakho cwangciso.
Ngokuthelekisa izicwangciso zezempilo zeempawu ezifanayo ze-actuarial values, uqinisekisa ukuba uthelekisa iipulo kwiipulo. Ukuba uthelekisa i-90% yexabiso le-actuarial yesicwangciso sezempilo esitholakalayo emsebenzini kunye ne-60% ye-actuarial value plan based health exchange based plan, kuya kuba yinto enjenge-Porsche 911 ngeFranny Mustang. Kunoko, kufuneka uqhathanise i-Honda Accord kunye neToyota Camry ukuze ufumane ubungakanani bokuba ufumana ibhakede lakho xa uthelekisa isicwangciso sakho sempilo esekelwe kwisicwangciso se-Obamacare.
Emva kokuba sele ukhethe isicwangciso se-Obamacare okanye amabini kunye nexabiso elifanelekileyo le-actuarial ukushintshana, ulungele ukuqhubela phambili kwisinyathelo esithathu.
3 -
Inyathelo 3-Qinisekisa iindleko zakho ze-Obamacare kunye ne-Injine-Based Based Health InsuranceUkuqulunqa iindleko zeNyanga zeNyanga zeNtshuwalense yeMpilo eXhaswa nguMqeshi
Intsholongwane yempilo yinshorensi yentsebenzo yenkxaso-mboleko ixhaswa ngumqeshi. Umqeshi wakho uhlawula inxalenye yendleko yenyanga yomshuwalense wakho wezempilo, kwaye uhlawula inxalenye. Isiqendu sakho sisoloko sithathwe kwi-payche pre-tax yakho ukuze uhlawule irhafu yerhafu kuwo.
Buza isebe lenkxaso yakho yempesheni ukuba uncedo olunjani kwiindleko zee-insumama ze-inshorensi yezempilo ziya kuba inyanga nganye ukuba ukhetha i-inshorensi yempilo.
Ukuqulunqa iindleko zeNyanga zeNyanga zeNtshurensi yezeMpilo
Ukugqiba iindleko zakho kwiiplani zempilo ze-Obamacare, uya kubuyela kwi-inshurensi yezempilo. Unokufuneka ubhalise ngokutshintshisana kwaye wenze i-akhawunti ngokufaka ulwazi lwakho lwezentlalo. Ekubeni izicwangciso zempilo ezisekelwe kumashishini zivunyelwe ukuba ziguqulwe iiprayimari zazo ezisekelwe kwiminyaka yakho, apho uhlala khona, nokuba ingaba ungashunyi, kuya kufuneka ukondle olu lwazi kwi-intanethi ye-intanethi yokutshintshela i-inshurensi yempilo ngaphambi kokuba ukwazi fumana nayiphi na ulwazi malunga neendleko.
Nangona i-inshorensi yezempilo yase-Obamacare isoloko ixhaswa, akunakunikwa inkxaso . Ukuba unikwe i-inshorensi yempilo ngumqeshi wakho, awufanelanga ukufumana inkxaso-mali ye-Obamacare ngaphandle kokuba umshuwalense wempilo wakho umqeshi anikezela ngokukhethekileyo okanye akanakulungiswa.
Kulo mzekelo, i- lousy ngokukhethekileyo ithetha isicwangciso sakho sempilo esekelwe kwimisebenzi inexabiso le-actuarial elingaphantsi kwama-60%. Intsholongwane yempilo yakho yomqeshi iya kuthathwa ingenakulungiseka xa isabelo sakho seendleko zokubhengezwa ngokwakho, kungekhona kwenkxaso yeentsapho, ixabisa ngaphezu kwe-9.56% yengeniso yakho yomzi.
Unokufanelekela ukufumana inkxaso-mali yenkxaso-mali yerhafu ye- premium ukuze uncede ukuhlawula i-inshorensi yempilo oyithengayo ekutshintshiseni ukuba
- Ukuba ingeniso yakho iphakathi kwama-100% kunye no-400% kwinqanaba lehlwempu , kunye
- umshuwalense wezempilo wakho umqeshi unikezela ngexabiso le-actuarial ngaphantsi kwama-60% okanye
- isabelo sakho seprayimari ye-inshorensi yezempilo esekelwe kwimisebenzi ingaphezu kwe-9.56% yengeniso yakho yomzi.
Ukuba udibana nale miqathango, indlela efanelekileyo yokujonga iindleko zakho kwiiplani ze-Obamacare oziqhathanisa nesicwangciso sakho sempilo esisekelwe kwimisebenzi kukufaka isicelo se-subsidy ngokusebenzisa utshintshi lwezempilo. Njengoko kubhalisa nokudala i-akhawunti kunye ne-inshurensi yezempilo yakho ayikubophekisi ukuba uthenge isicwangciso se-Obamacare, kwaye ungasifaki isicelo se-subsidy kufuneka ukuba uthenge i-inshurensi yezempilo okanye wamkele uncedo lwezemali. Unokwenza isigqibo sokukhetha isicwangciso sempilo yomqeshi, endaweni yoko.
Inkonzo Yenkxaso-mali Yomshuwalense Wezempilo Injani?
Nangona ungafanelanga ukufumana inkxaso-mali ye-Obamacare, kuya kufuneka usebenzise i-Insurance Affordable Act yakho yoshishino lomshuwalense ukuze ufumane amaxabiso angabikho phantsi kwecebo lezempilo ozikhethile.
Emva kokuba unayo iindleko zenyanga kwinqanaba lakho elikhethiweyo le-Obamacare kunye ne-inshorensi yempilo yakho esekelwe kwimisebenzi, ulungele ukuqhubela phambili kwisinyathelo 4.
4 -
Inyathelo 4-Thelekisa iindleko ze-Obamacare Vs Intsholongwane yezeMpilo yaseNtsholongwaneKhetha Iindlela Ezilungileyo
Emva kokuba ufumene ukuba uza kuhlawula phi inyanga nganye kwi-inshorensi yempilo yakho esekelwe kwimisebenzi kunye neenjongo ze-Obamacare othelekisa ngazo, sele usuphelile. Ukuba isicwangciso esinye sinokubiza kakhulu kunabanye, ekubeni zizo zonke iimpawu ezifanayo ezifanayo, isicwangciso esincinci esincinci sinokukunika i-bongo engcono kwi-buck yakho. Khetha ukuba isicwangciso se-inshurensi yezempilo ukuba ufuna into engcono.
Ukuba i-Obamacare kunye neNkxaso-mali yase-Job-Based Job Iintlobo ezifanelekileyo
Ukuba iindleko zakho kuzo zonke izicwangciso ziyafana, ngoko unokusekela isigqibo sakho kwisakhiwo socwangciso lwempilo oyithandayo. Hlola indlela efanele ngayo iimfuno zakho ngokujonga
- Uhlobo lwesicwangciso sezempilo.
- Indlela yokwabelana ngeendleko kuhlelwe ngayo.
- Umncedisi wenkonzo yezempilo.
- Isicwangciso seziyobisi zesicwangciso sezempilo.
- Isicwangciso sezempilo impilo kunye nokwaneliseka kweziphumo.
Ukuba uthanda inkululeko yokuphuma-ye-intanethi kwaye uzimisele ukuhlawula encinane xa uyenzayo, qwa lasela i-PPO okanye iplani ye-POS. Ukuba awuyi kucinga ukuhlala kwinethiwekhi ukugcina iindleko zakho ziphantsi, i-HMO okanye i-EPO inokukunceda. I-HMO, i-PPO, i-EPO ne-POS-Yintoni eyahlukileyo kwaye yintoni eyona nto iphezulu?
Ukuba awunayo imali okanye ayikwazi ukuhlawula ixabiso elikhulu, isicwangciso sezempilo esinokuhlawulelwa esezantsi kodwa iireyibhile eziphezulu okanye iirhafu ze-coinsurance zingenza uzive ukhululekile.
Ukuba unentliziyo yakho isetyenziselwe ukugcina ugqirha wakho wokunakekelwa ngokusisiseko okanye uphando, khangela nganye inethiwekhi yomboneleli wesevisi. Ngaphambi kokuya kwisicwangciso sezempilo i-PCP yakho in-network , yambiza iofisi yegqirha ukuqinisekisa ukuba kusekhona inethiwekhi kunye nesicwangciso sonyango kwaye abacwangcanga ukuphuma kwintanethi yayo naliphi ixesha kungekudala.
Ukuba uthatha imishanguzo yonyango, qwalasela nganye ifom ye-drug formulary ukuze uqinisekise ukuba izidakamizwa zakho zonyango zihlanganisiwe. I-Drug My Drug Akuyiyo kwiMpilo yam Isicwangciso seMithi yeDrams. Yintoni ngoku?
Okokugqibela, khangela ubungakanani kunye nokwaneliseka kweziphumo zezempilo ozicingayo. Unokwenza oku kunye namakhadi okunika ingxelo yezempilo ekhoyo kwiKomiti yeSizwe ye-website yoQinisekiso lweMigangatho. Zonke ezinye izinto zilingana, ukuba umntu unokulinganisela xa omnye ephethe ukulinganisa, isigqibo siya kuba lula.