Imisebenzi eDeductible Family iyahlukahlukana neHDHP kunezinye iindidi zeeNkqubo
Ukuba i-inshorensi yentsapho yakho yiplani yezempilo echithwe ngokukhawuleza, intsapho yakho echithwayo ingasebenza ngokuhlukileyo kunokuba yenzayo xa uneminye inshuwalense yezempilo. Ukuba awuqondi kakuhle indlela intsapho echithwe ngayo kwi-plan ephezulu yezempilo (HDHP), unokumangaliswa. I-inshorensi yakho yezempilo ayinakuqala ukuhlawula iingeniso xa ucinga ukuba kuya kwenzeka, okanye ilungu lentsapho linye kufuneka lihlawule ngaphezu kokulindeleke.
Ukuba awukucaci ngokucacileyo kwizinto ezisiseko ze-deductible, yintoni ekhankanywe kuyo, kwaye kwenzekani emva kokuba uhlawule imali yakho, funda "I- inshurensi yezeMpilo echithwe-yintoni na kwaye isebenza ngayo " ngaphambi kokuba uhambe nayiphi ngakumbi. Uya kuluqonda ukuqonda okusemgangathweni kokudityaniswa kwemali phambi kokuba uya kukwazi ukuqonda indlela inkunkuma ye-HDHP yentsapho eyahlukileyo ngayo.
Indlela iNtsapho eLawula ngayo imisebenzi kwiSicwangciso esiPhezulu seMpilo esiThuthiweyo
Ngenkxaso yeentsapho kwi-HDHP, izibonelelo zecandelo lezempilo aziqalanga nayiphi na ilungu lentsapho de ihlawulelwe yonke intsapho, okanye ide ilungu lentsapho lifumene unyango liye lafikelela kumda ovumelekileyo wokuphela kwee-pocket wonyaka (ngo-2017, loo mda u-$ 7,150; ngo-2018, i-$ 7,350). Umngcipheko ovimbela ilungu lentsapho elilodwa ukuba lingenise ngaphezu komntu ngamnye ongaphandle kwe-pocket laphunyezwa ngo-2016, kwaye ichazwe ngezantsi.
Njengokuba ilungu ngalinye lentsapho lenza iindleko zonyango, inani elihlawulayo kule ndleko lixhomekeke kwintsapho echithwayo. Xa ezi zindleko zongeza kwi-family deductible, i-HDHP isaphulo kwaye iqala ukuhlawula isabelo sayo seendleko zeendleko zonyango ngalinye kwintsapho.
Kwi-HDHP, intsapho echithwayo inokudibana neendlela ezimbini ezahlukeneyo:
- Ilungu lentsapho linye lineendleko zonyango eziphezulu. Ngokuhlawula iindleko zonyango lwempilo, ufikelela kwintsapho echithwayo kunye nokukhatyelwa kwinqanaba lekhaya. Kodwa ukuba intsapho echithwayo iphezulu kuneyona nto ingenakuvunyelwa ngaphandle komntu omnye, iintlawulo ziya kukhawulela ilungu elinye lentsapho emva kokuba umda lowo udibeneyo, nangona ukuba i-deductible edibeneyo ayifumana.
- Amalungu omalungu ahlukeneyo entsapho anenkcitho encinci yezempilo. Intsapho edibeneyo idibeneyo xa ezi ntlawulo ezincinci zidibene kunye zifikelela kwinani elithintekayo lentsapho.
Uhluke Kanjani Kwedlula Intsapho Engahlanjululwa kwiNkqubo engekho yeHDH?
Kulolu hlobo lwemveli lwenkqubo yesicwangciso sezempilo, ilungu ngalinye losapho linomntu ngamnye ochithwayo kwaye intsapho iyonke inokutshatyalaliswa kwintsapho. Yonke into ehlawulwa kwii-deductibles ngabanye ikwaziswa kwintsapho echithwayo.
Kukho iindlela ezimbini ezi cwangciso zezempilo ze-HDHP eza kuqala ukuhlawula iintlawulo zomntu othile ngaphakathi kwintsapho.
- Ukuba umntu udibana nomntu ngamnye ochithwayo, izicwangciso zezempilo zikhawuleza kwaye ziqale ukuhlawula iindleko zonyango kuloo mntu kuphela, kodwa kungekhona kwamanye amalungu entsapho.
- Ukuba intsapho edibeneyo idibeneyo, izibonelelo zezempilo zikhawulwa kuyo yonke ilungu lentsapho nokuba ingaba zidibene neentlawulo zabo.
Unokufunda okungakumbi malunga nendlela usondeza ngayo intsapho kwiingcebiso ezingekho kwiHDHP " Indlela iNtsapho Eyayichitha Imisebenzi ."
Ukwahluke phakathi kohlobo lwendabuko lwenkqubo ye-inshurensi yempilo kunye neentsapho ezichithwe kwi-HDHP isicwangciso sonyango sokuba umntu ochithwayo uyasuswa kwi-HDHP yentsapho . Kukho indlela enye kuphela yeprogram yezempilo yeHDHP eya kuqala ukuhlawula inzuzo kwanoma yiphi ilungu losapho: ukuxhatshazwa kweentsapho kuye kwadibana. Kodwa ngaphantsi kwemithetho emitsha eyaqala ukusebenza ngo-2016, iinqununu ziya kukhawulela ilungu ngalinye losapho xa edibana nomda wokuphuma kwipokethi waloo nyaka, nangona intsapho echithwayo ingazange ifumaneke.
Ngokwahlukileyo, ngesicwangciso esingenayo i-HDHP, inkunkuma yekhaya ayikwazi ukudibana neendleko zonyango lwelungu lentsapho elinye. Kuthatha ama-deductibles anongeziweyo amalungu omzimba amaninzi kunye nokufikelela kwintsapho echithwayo.
Imithetho yaguqulwa ngo-2016
ISebe lezeMpilo kunye neNkonzo zoLuntu liye lathintela imithetho encinci kwizicwangciso zezempilo ezingenakulinganiswa ngokusebenzisa i-deductible. Oku kuyachaphazela ezininzi izicwangciso zezempilo zeHDHP. Ukongezwa okongeziweyo yilo: isicwangciso sezempilo asikwazi ukuba umntu ahlawule umrhumo ongezantsi kunomda womda we- out-of-pocket for each coverage, nangona loo mntu uhlanganiswe phantsi kwentsapho edibeneyo. Ngo-2016, ubuninzi bokuphuma kwipokethi kumntu buncinane kwi-$ 6,850.
Umzekelo: Masithi isahlulo esinqunyiwe kwisicwangciso sakho sentsapho sika-2016 yi-$ 12,000. Xa ilungu lentsapho linye lihlawule i-$ 6,850 kwiirhafu ezithintekayo, umrhumo womntu othile kufuneka ukukhaba ngaphandle kokufuna ukwabelana ngeendleko ezifana ne-copays okanye i-coinsurance. Ukukhawulwa kwalowo mntu ukukhaba ngenxa yokuba sele ufikelele kumyinge ongaphandle komyalelo womntu ngamnye. Nangona kunjalo, ukuhanjiswa kwamanye amalungu entsapho yakho akusayi kukhaba kude kube yinto efunyenwe ngayo yonke intsapho.
Olu lungiso kwimithetho lwenzeka ngokukhawuleza xa isicwangciso se-inshorensi yakho sivuselela ngo-2016. Kuze kube ngoko, isicwangciso sakho sezempilo siya kulandela imigaqo emide. Urhulumente uphakamisa umda ophezulu kumaphumo angaphandle kwipokhwe kancane ngonyaka ukwenzela ukuphendula ngexabiso lentengo.
Uyazi Njani Indlela Yakho Imisebenzi Yakho Imveliso Eyichithwayo?
Uninzi lwe-HDHP lusebenzisa inkqubo ye-deductible yentsapho apho kungekho ncitshulwa yodwa kwaye akukho nanye kwintsapho enokufumana inzuzo de kube yintsapho idibeneyo. Oku kwaziwa njenge- aggregate deductible .
Kodwa kwakhona, ngoku kuya kuxhomekeka ekubeni ingaba intsapho echithwayo iyaphakama okanye iphantsi kweyona mingeni ephezulu yokukhutshwa komntu ngamnye kulo nyaka. Umzekelo, ukuba intsapho yeHDHP ine-$ 6,000 yentsapho echithwayo, ilungu lentsapho linye lingafuneka ukuba lihlangabezane ngokupheleleyo ne-2017. Kodwa ukuba intsapho ichithwe i-$ 10,000, ilungu lentsapho linye lingafanele lichithe ngaphezu kwama-7,150 ngaphambi kokuba kufikelelwe uza kukhaba kulowo mntu, nangona intsapho echithwayo ingekafiki. Ngoko ingaba lo mgaqo omtsha ungatshintshi nantoni na malunga nokukhutshwa kwentsapho yakho kuxhomekeke ekuphakanyeni kwakho okuphezulu.
Uninzi lwezicwangciso zezempilo ze-HDHP zisebenzisa inkqubo apho izibonelelo ziqala kubantu abahlangabezana nomntu ngamnye owenyulwayo phambi kokuba ususwe intsapho. Oku kwaziwa njenge- deductible embedded . Uyakhumbula eli gama ukuba ucinga ngalo njengamanani athathwe ngokukhawuleza angene ngaphakathi kwintsapho enkulu.
Uncwadi lwakho lwezempilo luyakukuxelela indlela osebenza ngayo intsapho yakho. Ingasebenzisa imimiselo, okanye ingasebenzisa imigqaliselo yemigqaliselo echithwe ngokubanjiswa ngokutsha. Ukuba akucaci, fowuna isicwangciso sezempilo uze ucele okanye, ukuba iyimpilo yomshuwalense wezempilo-based, hlola kunye neenkonzo zesebe lakho.
Ukuba iHHHH yakho Isishwankathelo seNzuzo kunye noPhulo lweeNcwadi zombini ixabiso elichithwayo kunye kunye nenani elithintekayo lentsapho , musa ukucinga nje ukuba isebenzisa i-deductible system. I-deductible enye ingaba ngabantu abangabhalisi nentsapho yonke kunabantu ngabanye kwimigaqo yentsapho.
Eyona nto ilungileyo, i-Aggregate Deductible okanye i-Deductible efakiwe?
Njengomgaqo-jikelele, ama-deductible ashicilelweyo athambekele ekusindiseni iintsapho kwiindleko ezingaphandle kwee-pocket kuba i-health coverage ikhatywe-kwamanye amalungu entsapho ngaphambi kokuba yonke intsapho idityaniswe. Oku kubangela amalungu omzimba ogula kakhulu aneentlawulo ze-inshorensi zezempilo ezikhatywayo-ngokukhawuleza kunye neentsapho ezifakwe kwi-family deductible kunokuba zibe zikhange-ekusebenziseni indlela yeHDHP yentsapho edibeneyo.
Nangona kunjalo, indlela ngalinye ilungu ngalinye lentsapho lisebenzisa ngayo iinkonzo zonyango lihlukile. Jonga ukuba yintoni inkqubo isebenza bhetele kwintsapho yakho ngokusekelwe kwintsapho yokusebenzisa i-inshorensi yezempilo.
Qaphela-Hhayi zonke iiplani eziphezulu eziDeductible zi-HDHP
Ungacingi ukuba, ekubeni unomvuzo ophezulu, kufuneka ube nesicwangciso sezempilo esiphezulu. I-HDHP luhlobo oluthile lwe-inshurensi yezempilo (i- HSA-qualified qualification ), kungekhona nje na isiphi isicwangciso esidala esinokutsalwa kakhulu. Njengoko i-HDHP iyakulungele ukuba uthathe inxaxheba kwi- Akhawunti yokuThengiswa kweMpilo yeRhafu, ineminye imithetho ekhethekileyo eyabahlula kwiiplani ezingekho kwi-HDHP. Nangona unokuba ne-HDHP PPO okanye i-EPO ye-HDHP, iya kulandela yonke imimiselo ekhethekileyo eyenza i-HDHP, kungekhona nje into echithwayo.
Ukuba isicwangciso sakho siyi-HDHP, izicwangciso zakho zezempilo kufuneka zibhekise kuyo njengeHDHP okanye isicwangciso sezempilo esicatshulwa kakhulu. Ukongezelela, inokuthi ibhekiselele ekudibaniseni i-inshorensi yakho yezempilo kunye ne-HSA.
Umngcipheko wezeMpilo weNkcazo iVs HDHP - ayikho enye into efanayo
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