Ukuqonda Inkcazo yeNkxaso-mali yeNkxaso-mali yeNkxaso-mali ye-Premium ye-ACA
UMthetho woNonophelo olunganakuncedo uquka inkxaso-karhulumente yokunceda abantu bahlawule iindleko zomshuwalense wezempilo. Enye yezibonelelo ze-inshurensi yezempilo yintengo yemboleko yerhafu ye-premium ekunceda ukuhlawula iimpesimali zakho zenyanga zenyanga.
Ngaphantsi kolawulo lweTrump, abameli beRiphabhliki bachitha ixesha elide le-2017 bazama ukuphelisa i-ACA nokuyifakela ngezinye iziphakamiso ezahlukahlukeneyo, kodwa abazange baphumelele.
UMthetho weCandelo loCwetho kunye neMisebenzi (HR1), owenziwe ngoDisemba 2017, ekugqibeleni uyawususa isigwebo somntu ngamnye we-ACA, kodwa oko akuyi kusebenza ukususela ngo-2019 ( kusekho isohlwayo sokungaqinisekiswa ngo-2018 ). Kwaye isicwangciso sesabelomali sokuqhubeka sonyaka sikaJanuwari sagxotha iintlawulo ezimbalwa zeerhafu ze-ACA, kuquka neRadillac Tax .
Kodwa ngenye indlela, akukho nto ishintshile malunga ne-ACA. Ukunciphisa iindleko kusekhona kubhaliso abafanelekileyo, nangona ukuba ulawulo lweTrump luphelile inkxaso-mali kubo ekupheleni kuka-2017 (oomatshini bantsholongwane bafaka nje iindleko kwiimali-mali endaweni leyo, ekhutshwe kakhulu ngokuxhaswa nge-premium inkxaso). Kwaye inkokhelo yentlawulo ye-premium, i-aka premium yenkxaso-mboleko, ihlala isasebenza, kwaye isabakho kubantu abathenga ukuthengwa ngokutshintshiselana .
Ikhredithi yerhafu yepresimenti / inkxaso-mali iyinkimbinkimbi. Ukuze ufumane uncedo lwezemali kwaye ulisebenzise ngokuchanekileyo, kufuneka uqonde indlela incediso yenkxaso-mali ye-inshurensi yezempilo.
Ukuba awuyikusebenzisa ngokufanelekileyo, unokuphelisa kwi-pickle yezimali. Nantsi into ekufuneka uyazi ukuba ufumane uncedo olufanelekayo kwaye ulisebenzise olu luncedo ngoncedo.
Ndingayifaka njani iSibonelelo seNkxaso-mali ye-Intshuwalense yeMpilo yeNtlawulo yeNkcazo?
Faka isicelo sekhredithi yerhafu ye-premium ngokusebenzisa utshintsho lwempilo yomshuwalense wezempilo .
Ukuba ufumana i-inshorensi yakho yonyango kwenye indawo, awukwazi ukufumana ityala lentlawulo ye-premium (iiSenators uLamar Alexander kunye noBob Corker, bobabini abaRiphabhlikhi abamele iTennessee, bazisa uMthetho we-American Health Care Act ka-2017, oya kubavumela ukuba babhalise ukufumana i-premium ikhredithi yentlawulo malunga nezicwangciso ezithengiweyo ngaphandle kokutshintshiselana, kwimeko apho kungekho bhorensi enikeza izicwangciso ekutshintshiseni kwintsimi ethile; umthetho awuzange uphumelele kwiseseshoni ye-2017, kwaye zonke iindawo zelizwe zagqitywa zizicwangciso ezifumanekayo ngokutshintshiselana 2018).
Ukuba awunakulungele ukuzisebenzisela ngokwakho i-inshurensi yezempilo ngokusebenzisa utshintshiselwano lombuso wakho, unokufumana uncedo kumthengisi we-inshorensi yempilo eqinisekisiwe yintengiso, okanye evela kumntu obhalisiweyo / uncedisayo. Aba bantu banokukunceda ubhalise kwisicwangciso kwaye uzalise inkqubo yokuqinisekisa ukufaneleka kwemali ukuchonga ukuba ngaba unelungelo lokufumana inkxaso-mali (akukho ntlawulo encedo lwabo).
Ngaba ndiya kulungela iNkxaso?
Abantu abaphakathi kwamaphesenti angama-100 no-400 kwinqanaba lehlwempu lombuso banokufumana ilungelo lokufumana inkxaso-mali ye-inshorensi yemali yerhafu ye-premium (umyinge ophantsi ungama-139 ekhulwini kwintlupheko xa uhlala kwimeko eye yawandisa iMedicaid, njengoko i-Medicaid ifumaneka ngaphantsi kwelo nqanaba).
Inqanaba lobuhlwempu baseFransi litshintsha minyaka yonke, kwaye lusekelwe kwingeniso yakho kunye nobukhulu bentsapho. Unokukhangela kule FPL yonyaka apha.
Uya kusebenzisa amanani e-FPL ale nyaka ukuze afake inkxaso-mali yomshuwalense wonyaka ozayo. Ngokomzekelo, ukuba ufake isicelo se-2018 Isicwangciso se- Obamacare ngexesha lokubhalisa okuvulekileyo ekupheleni kuka-2017, OKANYE ukuba ufuna isicelo se-2018 ukukhawuleza phakathi no-2018 usebenzisa ixesha lokubhalisa elikhethekileyo (elibangelwa ngumcimbi ofanelekileyo), uya kusebenzisa inani labafundi be-FPL ukususela ngo-2017. Kungenxa yokuba ukubhaliswa okuvulekileyo kwa-2018 kwenziwa ngo-2017 ngasekupheleni kwee-2017, ngaphambi kokuba amanani e-2018 FPL atholakale. Ukulungelelaniswa, inamba efanayo yeFPL isetyenziswe kunyaka opheleleyo wokukhawulela.
Amanani amasha e-FPL aphuma ngonyaka ngamnye ngasekupheleni kukaJanuwari, kodwa ayasetyenziselwa ukufumana inkxaso yokuxhaswa kwe-subsidy kuze kufike ngoNovemba, ukwenzela ukuba ufikeleleko olusebenzayo kunyaka olandelayo.
Ukuze ufikeleleke ngokukhawuleza ngo-2018, usebenzisa amanqanaba e-2017 FPL, kwilizwekazi lase-US (i-FPL iphakamileyo e-Alaska naseHawaii), uya kufumana inkxaso-mali ye-inshorensi yempilo njengomntu onomvuzo:
- I-12,060 ukuya kwi-48,240 yee-akhawunti enye yomntu omnye (umda ongaphantsi ngu-$ 16,763 xa unesimo esandise iMedicaid)
- I $ 16,240 ukuya kwii-64,960 zama-dollar (isibini esingaphantsi i-$ 22,823) xa unesimo esandise iMedicaid
- $ 24,600 ukuya kwii-98,400 zamawaka kwiintsapho ezine (umda ongaphantsi ngu-$ 33,194 xa unesimo esandise iMedicaid).
Ukuba udibana neemfanelo zokufumana umvuzo, usenokungenakufaneleka ukuba uncedise. Oku kuya kwenzeka ukuba:
- Isicwangciso sesilivere esiphantsi-indleko ephantsi kwendawo yakho ithathwa njengexabiso elifanelekileyo kwiholo lakho lemali engenayo, ngaphandle kwenkxaso-mali.
- Uyakulungelelanisa isicwangciso esincinci sexabiso, esisisiseko kumqeshi (owakho okanye umlingane wakho). Qaphela ukuba ukufumaneka kwezicwangciso ezixhaswe ngumqashi kubalwa kusekelwe kwiindleko zomqeshwa, kungakhathaliseki ukuba kuyintoni ukubiza umlingane kunye nabaxhomekeke kuyo. Kodwa umlingane kunye nabaxhomekeke kubo abafanelekile ukuba bancedise imali xa kuthengiswa ukuba umsebenzi wokubambisa uhlawuleka kumsebenzi kwaye unikezelwa kumalungu entsapho. Oku kubizwa ngokuba yi- glitch yasekhaya .
Ndingakanani Imali?
Ukuze ufumanise ukuba i-credit card yakho yerhafu iya kuba yintoni, kufuneka ukwazi ezimbini izinto:
- Igalelo lakho elindelekileyo kwiindleko zeminshurensi yakho yempilo
Unokukujonga kule tafile ngasezantsi kwephepha. Qaphela ukuba utshintsho unyaka ngamnye. Ipesenti zengxowankulu ka-2018 zichazwe kwiNkqubo yeRhafu yeNgeniso ye-IRS 2017-36 , kwaye ngokwenene iyancipha ukusuka kwipesenti zenkxaso ngo-2017 (le yithuba lokuqala lokuba ipesenteji ziye zancipha ukusuka kunyaka ukuya kutsho, kunoko zanda). - Iindleko zesicwangciso sakho sempilo yesicwangciso sempilo
Isicwangciso sakho sokulinganisela isicwangciso sezempilo esiliva kunye neyesibini zeeprayimari zenyanga zenyanga. Ukutshintshwa kwe-inshorensi yakho yempilo kunokukuxelela ukuba yiyiphi iplani le nto kwaye ixabisa kangakanani. Unokuzifumana ngokwakho ngokuzifumana izicatshulwa ngokwakho ekutshintshiseni, ukuzihlenga ngentengo (ngokuqhelekileyo i-default), kwaye ukhangele kwisicwangciso sesilivere-indleko esezantsi.
Imali yakho yoxhaswa ngumlinganiselo phakathi kwegalelo lakho elilindelekileyo kunye neendleko zesicwangciso sokutshekisha kwindawo yakho. Bona umzekelo wendlela yokubala iindleko zakho zenyanga kunye nesibonelelo sakho semali esezantsi kwiphepha (kodwa yazi ukuba utshintsho luya kwenza zonke ezi zibalo kuwe-umzekelo ukukunceda uqonde indlela esebenza ngayo, kodwa akudingeki ukuba wenze ezi zibalo ukufumana i-credit premium yakho yerhafu!).
Ngaba Ndingayithenga Isicwangciso Singabizi Sokugcina Imali, okanye Ngaba Ndimele Ndiyithenge?
Kungenxa yokuba isicwangciso sokulinganisela sisetyenziselwa ukubala i-subsidy yakho akuthethi ukuba kufuneka uthenge isicwangciso sokwenza uphawu. Ungathenga nayiphi na ibhedu, isiliva, igolide, okanye iplatinum icebo elibhalwe kwi-inshurensi yezempilo. Awuyi kusetyenziswa isibonelelo sakho ukuthenga isicwangciso esiyingozi , nangona kunjalo.
Ukuba ukhetha icebo elibiza ngaphezu kwecebo lokubonisa, ngaphezu kwegalelo lakho elilindelekileyo, uza kuhlawula umda phakathi kweendleko zesicwangciso sokutshekisha kunye neendleko zesicwangciso sakho esibi kakhulu. Ukuba ukhetha icebo elingancinci kunecebo lokutshatyalaliswa, uza kuhlawula encinci ukususela ngemali yenkxaso-mali iya kubandakanya isahlulo esikhulu se-premium yenyanga. Ukuba ukhetha icebo elingancinci kangangokuba libiza ngaphantsi kwe-subsidy yakho, awuyi kuhlawulwa nayiphi na into yinshuwalense yezempilo. Nangona kunjalo, awuyi kufumana inkxaso-mali engaphezulu (phawula ukuba abantu kwiindawo ezininzi banokufikelela kwizicwangciso zethusi ngaphandle kweprayimari ze-2018-emva kokusetyenziswa kweerhafu zabo zerhafu-ntlawulo ngenxa yeendleko zokunciphisa ukwabelana ngeendleko. yongezwa kwisiqulatho sesilivere yeprayimari ngo-2018).
Ukuba uzama ukugcina imali ngokukhetha isicwangciso ngexabiso elincinane le- actuarial , (njengecebo lobhedu endaweni yesicwangciso sesilivere), qaphela ukuba uya kuba ne- coinsurance ephezulu kunye ne- copays xa usebenzisa i-inshorensi yakho yempilo. Kodwa ngezinye izibhengezo ze-2018, izicwangciso zegolide kwezinye iindawo zithengwa kakhulu kunezicwangciso zesilivere (ekubeni ixabiso lokunciphisa iindleko liye longezwa kwi-premium plan plan yesilivere), nangona iiplani zegolide zinexabiso eliphezulu le- actuarial value .
Nangona kunjalo, ukuba unemali engenayo engaphantsi kwe-250 ekhulwini ye-FPL-kwaye ingakumbi xa ingaphantsi kwe-200 ekhulwini ye-FPL-qwalasela ukhetha icebo lesilivere-mali, njengoko ixabiso le-actuarial yesicwangciso liza kuba ngcono kunecebo legolide, okanye kwezinye amatyala, nokuba ngcono kunecebo leplatinum. Kungenxa yokuba kukho inkxaso-mali eyahlukileyo eyenza i-copays, i-coinsurance, kunye neengxowa-mali ezincinci kubantu abanemali engaphantsi kwe-250% yezinga lehlwempu. Abantu abafanelekile bayayisebenzisa ngokubhekisele kwenkxaso-mali yerhafu ye-premium. Nangona kunjalo, ifunyanwa kuphela kubantu abakhetha icebo lesiliva.
Ngaba Ngaba Ndimele Ndize Ndifake Iiflawulo Zami Ukufumana I-Subsidy Njengoko Iingxola Zentela?
Akumele ulinde de uze ufake ifayile yakho. Unako ukufumana ityala lokubambisa irhafu ye-premium kwangaphambili. Nangona kunjalo, ukuba ungathanda, unokukhetha ukufumana iitaliti yakho yerhafu ye-premium njengembuyekezo yerhafu xa ufaka iirhafu zakho endaweni yokuba uhlawule kwangaphambili. Olu khetho lufumaneka kuphela xa ubhalise kwisicwangciso ngokutshintshiselana. Ukuba uthengisa isicwangciso sakho ngqo kwiinkampani zomshuwalense, awuyi kufumana inkxaso-mali ye-premium, kwaye awuyi kukwazi ukufaka isicelo se-subsidy kwi-tax return yakho.
Ukuba ingeniso yakho iphantsi kangangokuthi akudingeki ukuba uyifake irhafu, usenokufumana inkxaso-mali, nangona awuyi kufumana inkxaso-mali ukuba ingeniso yakho ingaphantsi kwinqanaba lentlupheko (okanye ngaphantsi kwe-139 ekhulwini lentlupheko) kwimibandela eye yandise iMedicaid).
Kungakhathaliseki ukuba uthatha inkxaso yakho phambi komnyaka okanye kwisixa esithile sokubuyela kwerhafu yakho, kuya kufuneka ufake ifomu 8962 ngentlawulo yakho yentlawulo. Leyo ifom yokubuyisana (okanye ukufunwa ngokugcwele) yakho mboleko yentlawulo ye-premium.
Ndingayifumana njani Imali?
Ukuba ukhetha ukufumana ikhredithi yentlawulo ye-premium kwangaphambili, urhulumente uthumela imali ngqo kwiinkampani zomshuwalense wakho wezempilo egameni lakho. I-insurer yakho yempilo yenkxaso yemali kwiindleko ze-inshorensi yezempilo, ukunciphisa ukuba uza kuhlawula phi inyanga.
Ukuba ukhetha ukufumana iitaliti yentlawulo ye-premium njengembuyekezo yerhafu, imali iya kufakwa kwimbuyekezo yakho xa ufaka irhafu yakho. Oku kunokuthetha umvuzo omkhulu werhafu. Kodwa, uya kuhlawula ngaphezulu inshorensi yempilo inyanga nganye kuba uya kuhlawula isabelo sakho sesahlulo-mali kunye nesabelo esiya kuhlanganiswa yenkxaso-mali ukuba ukhetha ukhetho lokuhlawula oluphambili. Kuza kuphuma nangona ekupheleni, kodwa ukuba ungezantsi kwi-cash-in-hand, ungayifumana inketho yokuhlawula kwangaphambili ngaphezulu komsebenzisi.
Kutheni Umele Uze Ndifake Iiflawulo Zami Ukufumana Inkxaso?
Uninzi lwabantu alufuni ukulinda; bakhetha ukukhetha ukhetho lokuhlawula kwangaphambili. Nangona kunjalo, cinga ukukhetha ukufumana inkxaso-mali kunye nembuyekezo yakho yentela xa:
- Ingeniso yakho isondele kuma-400 ekhulwini weFPL.
- Ingeniso yakho iyahlukahluka unyaka ngamnye ukwenzela ukuba awuqinisekanga ukuba uza kwenza phi.
Xa isibonelelo sihlawulwa kwangaphambili, isixa semali sincike kwisilinganiselo semali yakho engenayo kunyaka ozayo. Ukuba uqikelelo lungalunganga, imali yesibonelelo ayilunganga.
Ukuba ufumana imali encinane kunokuba uqikelele, inkxaso-mali ephakamileyo iya kuba ngaphantsi kunokuba bekufuneka ibe. Uya kufumana yonke into njengembuyekezo yentela.
Ukuba ufumana imali engaphezu kokuqikelelwa, urhulumente uzakuthumela imali eninzi kakhulu kwiinkampani zomshuwalense wezempilo. Uya kufuneka uhlawule inxalenye okanye yonke imali engaphezulu kwemali xa usenza iirhafu zakho. Okubi nakakhulu, ukuba ingeniso yakho yangempela iphelile ngaphezu kwama-400 ekhulwini we-FPL, uya kufuneka uhlawule yonke ipenisi yenkxaso . Oku kungaba ngamawaka eedola.
Ukuba ufumana inkxaso yakho xa ufaka irhafu yengeniso yakho kunokuba ngaphambili, uya kufumana isixa-mali esilungileyo ngenxa yokuba uyazi ngokuthe ngqo ukuba ungakanani umvuzo walo nyaka. Akuyi kuhlawulwa nayiphi na into .
Yintoni Endiyifunayo Ukuba Ndiyazi Ngendlela Imali Yenkxaso Yomshuwalense Wezempilo?
Ukuba isibonelelo sakho sihlawulwa kwangaphambili, yazisa utshintshi yakho yempilo yomshuwalense ukuba ingeniso yakho okanye usapho lwakho luguquka kunyaka. Ukutshintshiselwa kunokuhlaziya kwakhona inkxaso yakho yonyaka wonke ngokusekelwe kolwazi lwakho olutsha. Ukungaphumeleli ukwenza oku kunokubangela ukufumana inkxaso-mkhulu kakhulu okanye encinci, kwaye kufuneka wenze utshintsho olusisiseko kwimali yenkxaso-mali ngexesha lerhafu.
Umzekelo Wendlela Yokubala Inkxaso-mali Yomshuwalense Wezempilo
Gcina ukhumbule ukuba utshintsho luya kwenza zonke ezo zibalo. Kodwa ukuba unomdla malunga nokuba zivela njani ngemali yakho yenkxaso, okanye ukuba ufuna ukuphindaphinda kabini ukuba isibonelelo sakho sichanekile, nantsi oku kufuneka ukwazi:
- Bonisa indlela umvuzo wakho owufane ngayo neFPL.
- Fumana izinga lakho legalelo elilindelekileyo kwitheyibhile elingezantsi.
- Bala ixabiso lemali oyikulindelekileyo ukufaka isandla.
- Fumana imali yakho yenkxaso-mali ngokukhupha igalelo lakho elilindelekileyo kwiindleko zesicwangciso sokutshekisha.
UTom unomntu ongenayo i-$ 23,000 ngonyaka. I-FPL ye-2017 (esetyenziselwa ukuhanjiswa kwe-2018) yi-$ 12,060 yabantu abangatshatanga.
- Ukufumana indlela engenayo yengeniso kaTom kwiFPL, sebenzisa:
ingeniso ÷ FPL x 100.
$ 23,000 ÷ $ 12,060 x 100 = 191.
Ingeniso kaTom yi-191 ekhulwini yeFPL. - Ukusebenzisa ithala elingezansi, uTom kulindeleke ukuba abe negalelo phakathi kwe-4.03 ukuya ku-6.34 ekhulwini lomvuzo wakhe. Sifanele sithole ukuba yeyiphi ipesenteji yendlela endleleni leyo enayo ingeniso ye-191 ekhulwini ye-FPL. Senza oko ngokuthatha u-191-150 = = 41, uze uhlule ukuba ngu-50 (umlinganiselo opheleleyo phakathi kwe-150 ne-200 ekhulwini kwi-FPL.) 41/50 = 0.82, okanye i-82 ekhulwini.
- Emva koko, sinquma ukuba yeyiphi inamba engama-82 ekhulwini kwendlela phakathi kwe-4.03 no-6.34. Sisebenzisa 6.34-4.03 = 2.31, kwaye sithatha ama-82 ekhulwini. 2.31 yanda nge 0.82 = 1.89. Ngoko siqala nge-4.03 kwaye songeza i-1.89, kwaye oko kusenza sibe ngamaphesenti angama-82 endlela kule ndlela. 4.03 + 1.89 = 5.92
- UTom ulindeleke ukuba ahlawule i-5.92 pesenti yengeniso yakhe kwisicwangciso sesilivere yesivumelwano.
- Ukubala ukuba u-Tom ulindeleke ukuba anike igalelo, sebenzisa eli lingano:
5.92 ÷ 100 x ngeniso = inxaxheba kulindelekileyo kaTom.
5.92 ÷ 100 x $ 23,000 = $ 1,361.60.
UTom ulindeleke ukuba anike imali eyi-1,361.60 ye-$ ngonyaka, okanye i-$ 113.47 ngenyanga, malunga neendleko ze-inshurensi yezempilo. Inkxaso-mali yesibonelelo sentlawulo ye-premium ihlawula lonke iindleko zesicwangciso sezempilo. - Isicwangciso sempiliso yezempilo kwi-inshurensi ye-inshurensi ye-Tom ixabisa i-$ 3,900 ngonyaka okanye i-$ 325 ngenyanga. Sebenzisa le equation ukufumana isixa semali:
Iindleko zesicwangciso sokulinganisela - inzuzo ekulindelekileyo = inani le-mali.
$ 3,900 - $ 1,361.60 = $ 2,538.40.
Inkxaso-mali yentlawulo ye-premium yentlawulo ye-Tom iya kuba ngu-2,538,40 ngonyaka okanye i-$ 211.53 ngenyanga.
Ukuba uTom ukhetha isicwangciso sokutshekisha, okanye enye iplani ye-325 ngenyanga, uya kulihlawula i-113 113.47 ngenyanga ngenyanga yakhe yinshuwalense yezempilo. Ukuba ukhetha icebo elibiza i-$ 425 ngenyanga, uya kuhlawula i-$ 213.47 yenyanga ngenyanga. Ukuba ukhetha icebo elibiza i-$ 225 ngenyanga, uya kuhlawula i-$ 13.47 ngeenyanga kwi-inshurensi yezempilo.
Igalelo lakho elilindelekileyo kwiiNkcazo zeeNtshumo zeMpilo ze-2018
| Ukuba wakho umvuzo: | Igalelo lakho elilindelekileyo liya kuba: |
|---|---|
| I-100% -132% yezinga lehlwempu | 2.01% yengeniso yakho |
| 133% -149% yezinga lehlwempu | 3.02% -4.03% yengeniso yakho |
| 150 -% - 199% yezinga lehlwempu | 4.03% -6.34% yengeniso yakho |
| 200% -249% yezinga lehlwempu | 6.34% -8.1% yengeniso yakho |
| 250% -299% yezinga lehlwempu | 8.1% -9.56% yengeniso yakho |
| I-300% -400% yezinga lehlwempu | 9.56% yengeniso yakho |
> Imithombo:
> Congress.gov, S.761, uMthetho wokuNakekelwa kwezeMpilo kuMthetho we-2017.
> Isebe lezeMpilo kunye neNkonzo zoLuntu, uMkhuseli weMonde kunye noMthetho ononophelo loNonophelo: iMakethe yokuzinza . Ngo-Apreli 13, 2017.
> INkonzo yeNgeniso yangaphakathi, iNkqubo yeNgeniso 2016-24 .
> Isevisi yangaphakathi yeNgeniso, iNkqubo yeNgeniso yeNgeniso 2017-36 .