I-ACA yenza uMyinge wokuPhakamisa ukuFinyelela ngakumbi kunokuba usebenze
Ukuba uthe wavalwa okanye ukuba inkampani yakho ivaliwe, unokukhathazeka ngokulahlekelwa yizinzuzo zakho ezixhomekeke kumqeshi, ngakumbi i-inshurensi yezempilo. Ukungenazo i-inshorensi yezempilo ingaba yinto eyoyikisayo, ingakumbi ukuba isicwangciso sakho sezempilo somqeshi sihlinzekela ngentsapho yakho. Kwakhona, unokukhathazeka kakhulu ukuba wena okanye ilungu lentsapho unesifo esingapheliyo esidinga ukutyelela rhoqo ugqirha wakho okanye isidingo semithi yokugaya imithi ebiza.
Kubalulekile ukuzama nokufumana uhlobo lwenkqubo yomshuwalense wezempilo ngexesha lakho lokungasebenzi. Ukuba wena okanye ilungu lentsapho lifuna unonophelo ngaphandle kwe-inshorensi yezempilo, uya kubambelela ukuhlawula i-bill. Unokuba uthatha ingozi engabalulekanga yemali ngokungena-inshorensi yempilo. Xa uhamba ngaphandle kwe-inshorensi yezempilo kunokubonakala kubonakaliswa ngendleko xa ungenayo okanye ingeniso encinci, kungenjalo! Isizathu esibangeleyo sokubhankanya umntu e-United States kukugula kunye neyonyango.
Kwakhona kubalulekile ukuqonda ukuba i-ACA ibeka isohlwayo semali ukuba unesithuba sokubhengezwa kweenyanga ezingaphezu kweenyanga ezimbini ngonyaka . Ukuze ugweme isohlwayo (ngaphandle kokuba ukhululekile kuyo ), kufuneka ugcine ubuncinci benkcazo ebalulekileyo. Oku kungabandakanya i-COBRA okanye isicwangciso esithengiweyo kwikarhwebo nganye ( ngaphandle okanye ekutshintshiselwano ), kodwa ayifaki i -inshorensi yexesha elifutshane .
Ngethamsanqa, ukuba unikwe i-slip ye-pink, unamanani ongakhetha kuzo ukuba uhlale unesiqinisekiso emva kwexesha elithile emva kokutshatyalaliswa kwakho.
Uqabane okanye i-Inner Health Insurance
Ukufumana i-inshorensi yezempilo kumqeshi wakho (okanye umlingani wakho wasekhaya) inokuba yindlela enokusetyenziswa ngayo. Uninzi lwabasebenzi be-inshorensi yezempilo lwemali luvumela abasebenzi babo ukuba bandise amalungu omndeni asebekwe bucala - iqabane lakho lingakongeza kwisicwangciso sakhe.
Ukuba umsebenzi wakho unikeze i-inshurensi yezempilo kuyo yonke intsapho, iqabane lakho lingayenza i-coverage kwintsapho, kuba ukulahlekelwa kwenkxaso-mboleko yinto efanelekileyo yokubhalisa ixesha elifanelekileyo , kungakhathaliseki ukuba kwenzeka ntoni ngonyaka.
Ukuba unako ukusebenzisa i -inshorensi yempilo yakho yeqabane , qi ni sekise ukuba ufake isicelo kwisithuba seentsuku ezingama-30 zokulahlekelwa kwenkxaso-mboleko yakho yangaphambili-ezinye iinjongo ze-inshorensi zempilo ezixhaswe ngumqeshi ziyakwamkela ukubhaliswa kwakho xa ulinda iintsuku ezingama-30.
COBRA
Ukuba umqeshi wakho wangaphambili unabasebenzi abangama-20 okanye ngaphezulu, inkampani iyadingeka ngumthetho wesigqeba ka-1986 ukukunika ithuba lokuhlawula ukongezwa kwe-inshorensi yakho yempilo ubuncinane ubuncinane kweenyanga ezili-18. Lo mthetho uyaziwa ngokuba ngu-COBRA, omelela uMthetho wokuQiniswa koHlahlo lwabiwo-mali lwe-Omnibus .
Ngelo xesha ulahliwe, umqeshi wakho kufuneka akuxele ngokubhaliweyo ngamalungelo akho phantsi kweCOBRA. Unemihla engama-60 ukusuka ngomhla wezaziso okanye umhla osuselwe kuyo u-inshorensi yezempilo ukuba ubhalise okanye ubhalisele ukufumana ingxelo phantsi kweCOBRA. Ukuba inkampani yakho yaphuma kwishishini okanye yahlaselwa, i-COBRA ayiyi kubakho.
Xa ubhalisela i-COBRA, uya kuqhubeka nokuba ne -inshurensi yempilo enokuyenza ngexesha usebenza.
Nangona kunjalo, kufuneka uhlawule i- premium yomshuwalense wezempilo apho umqeshi wakho wangaphambili wayekuhlawula, ngaphezu kweeprayimari owayekade uzihlawula ngokuhlawula imali. Umqeshi unokudibanisa imali engama-2% yolawulo.
Ngokuxhomekeke kwiimeko zakho, i-COBRA inokubiza kakhulu. Abasebenzi kaninzi abaqapheli ukuba bangakanani abaqeshi abancedisayo egameni labo kwiiprayimari ezipheleleyo. Ngokwe- analysis ye-Kaiser Family Foundation ka-2016 , umqeshi oqhelekileyo onika iingeniso ze-inshorensi yezempilo ihlawula iipesenti ezingama-71 zeendleko zee-inshorensi zempilo yentsapho, kunye ne-82 ekhulwini yeendleko zeempesimenti zabasebenzi abangabodwa.
Ukutshintshela kwi-COBRA kuthetha ukuba unoxanduva lweendleko ezipheleleyo kuwe. Iiprayimari ezipheleleyo, kubandakanywa nenxalenye ehlawulwa ngumqeshwa kunye nomqeshi, i-18,142 yee-R6,22 ezilinganiselwe ngo-2016 ukwenzela ukukhutshwa kweentsapho, kunye ne-$ 6,435 ngokukhawuleza.
Yimali eninzi kwaye mhlawumbi ngaphezu kokulindele ukuba uyihlawule, ingakumbi ukuba ulahlekelwa yimali engenayo kwaye uqokelela inshorensi yokungasebenzi. Kwabanye abasebenzi, iintlawulo ze-COBRA zingafikelela kuma-60 ukuya kuma-70 ekhulwini kwisesheke yabo yokungasebenzi kweenyanga. Abaninzi abasebenza ngokugqithiseleyo abafanelekile ukuqhubeka nokufumana i-inshorensi yezempilo ngeCOBRA abanako ukukwazi ukwenza njalo.
Ukuba awukwazi ukuhlawula i-COBRA, kunokukho ezinye iinkqubo ze-inshorensi yezempilo eziza kunika iingenelo zezempilo ezikufunayo kuwe nentsapho yakho. Oku kuyinyani ngoku ngoku ukuba i-ACA iguqule imarike yempilo yomshuwalense.
I-COBRA ilawulwa yiSebe laseMelika laseMelika. Iwebsite yesebe ineluhlu lwemibuzo ebuzwa rhoqo malunga neCOBRA. Uyakwazi ukubiza i-866-444-3272 ngolwazi okanye uncedo.
Qaphela: I-COBRA ayitshintshi kunye neyesiqendu se-Care Affordable Act
I-Intshumo Yempilo Yobumfihlo: Ukufikelela kwiNkxaso-mali, Qala nge-Exchange kwi-State yakho
Unokuthenga i-inshorensi yempilo ngokutshintshiselwa kwimeko yakho (phawula ukuba le yindawo kuphela apho inkxaso-mali ye-premium kunye neenkxaso -mali zokwabelana ngeendleko zifumaneka), ngokuthe ngqo kwiinkampani zomshuwalense wezempilo, njenge-Blue Cross, okanye nge-inshurenti yomthengisi omele iinkampani ezininzi zomshuwalense.
Kufuneka uqwalasele ukubonisana nomthengisi we-inshurensi elayisenisi onokukwazi ukukunceda ufumane isicwangciso se-inshurensi yezempilo engabizi ngaphaya kwe-COBRA kwaye ihambelana neemfuno zakho. Uya kufuna ukuqinisekisa ukuba umthengisi uvumelekile ukutshintshiselwa kwimeko yakho, ukwenzela ukuba angakunceda ukuba ubhalise ngechitshintshi ukuba ingeniso yakho iza kukunika ilungelo lokuncedisa iindleko zokunika ingxelo, kwaye mhlawumbi iindleko zakho zangaphandle.
Unokuqhathanisa ngokulula ii-premiums kunye neenzuzo zempilo kwi-intanethi, ngakumbi xa usebenzisa iwebhusayithi ye-exchange (qala kwi-HealthCare.gov, kwaye iya kukukhokelela kwisiza esisebenzayo ukuba i-state isebenzise iqonga layo lokubhalisa). Iinkampani ze- inshorensi zempilo ziyahlukahluka kwiziphi izicwangciso zempilo abazinikeleyo kwaye ngokuthenga ngeenxa zonke, unokukwazi ukugcina imali. Umzekelo:
- UJohn Skillset, oneminyaka engama-36 ubudala, waxhaswa kwiindawo eziphambili zolawulo kwiqumrhu lokutsalwa kwebhanki. Ubume bakhe bentsapho ngeCOBRA yi $ 1450 ngenyanga. Wayenako ukufumana ukubonelela ngokwaneleyo kwintsapho yakhe kwiinkampani zomshuwalense ongeyena inzuzo nge $ 785 ngenyanga. Nangona esi sicwangciso sifuna ukuba ahlawule i-$ 3000 yokuqala yeendleko zonyango (i-deductible), intsapho yakhe iphilile kwaye iyancipha iindleko zonyango kwixesha elidlulileyo.
- UJenny Techwhiz, oneminyaka engama-24 ubudala, wavalwa ngexesha lokunciphisa inkampani yekhompyutha. Ukwaziswa kwakhe ngabanye ngeCOBRA yi-$ 390 ngenyanga. Wayekwazi ukufumana isicwangciso esikhethekileyo esivela kwiBlue Cross kubantu abaneminyaka eyi-18-26 ukuya kwi-280 yeenyanga ngenyanga.
I-Obamacare Yaye yagqitywa ukubhaliswa kwabasebenzi abanezimo eziPhambi kwexesha
Isiqinisekiso soMonde kunye noNonophelo ojongene noThathaka (ACA) satshintshile umhlaba ngokubhekiselele ekufikeleleni kwintengiso yomshuwalense. Ngaphambi kuka-2014, i-inshurensi yempilo nganye yemarike (uhlobo oluzithenga ngalo, ngokuchasene nokufumana kumqeshi) lwalugqirha ngokusisigxina kwizilwanyana ezininzi. Oku kwakuthetha ukuba abantu abaneemeko zangaphambili bebehlawuliswe iiprayimamu eziphezulu, abaphikisiwe ukufumana ingqalelo, okanye banike izicwangciso ezingabandakanyi izimo zabo ezenzeka ngaphambili.
Kubantu ababekwe bucala kwaye babekho imeko ekhoyo ngaphambili, oku kwakusoloko kuthetha ukuba i-COBRA yodwa yinketho yokwenene, nangona itekiti yentengo ephezulu.
Kodwa ukususela ngo-2014, i-inshurensi yonyango yomntu ngamnye kwilizwe ibe yinto eqinisekisiwe; abaqinisekisi abasayi kuvunyelwa ukunyanzelisa nayiphi na imingcele yemeko esele ikhona . Ukubhalisa ngoku kunqamle ngendlela efanayo ukuba ulungelelaniswe kwizicwangciso ezixhaswe ngumqeshi. Abantu bangabhalisela ukufikelela kwiimarike ekupheleni (Novemba 1 ukuya kuDisemba 15 yiseshedyuli eya kulandelwa ukususela ekupheleni kuka-2017 nokuya phambili), ukwenzela ukufumana ingxelo efanelekileyo ngoJanuwari olandelayo. Okanye bangabhalisa naliphi na iphuba ngexesha lonyaka xa befumana isiganeko esifanelekileyo esenza ukuba kubhalwe ixesha elilodwa lokubhalisa .
Ukulahlekelwa kwesicwangciso esixhaswe ngumqeshi kuthathwa njengesiganeko esifanelekileyo, nokuba unako ukufikelela kwiCOBRA. Unokunciphisa i-COBRA kwaye ubhalise kwisicwangciso ngasinye somrhwebo (okanye ukutshintshiselana, kodwa ugcine engqondweni ukuba inkxaso-mali ukufumana ixabiso elinokufumaneka kuphela ngokutshintshiselwa), kodwa kufuneka wenze njalo kungakapheli iintsuku ezingama-60 ngokulahlekelwa ngumqeshi oxhaswe ngumqeshi. cwangciso. Ukuba ulinde ixesha elide kunoko, ixesha lakho lokubhalisa elikhethekileyo liya kuphelile, kwaye uya kufuneka ulinde kude kube lixesha lokubhalisa elilandelayo.
Ubungqina bomshuwalense weeNtsholongwane wexesha elifutshane: Uncinci ukuya kwiinyanga ezintathu
Imigaqo-nkqubo ye-inshorensi yexesha elifutshane, eyaziwayo njenge-inshurensi ye-gap okanye i-inshurensi yesikhashana, yenzelwe ukukunika inqanaba elithile lempilo yexesha elifutshane. Ukususela ngo-Apreli 2017, izicwangciso zexesha elifutshane azikwazi ukuba nexesha elingaphezulu kweentsuku ezingama-90. Zininzi zezi cwangciso zijongene nxamnye nxamnye nempembelelo enxulumene nempilo, kubandakanywa ukuhlala esibhedlele, kunye neyeza kwiimeko zempilo ezinzima.
Nangona ezi zicwangciso zingabizi ngaphantsi kwe-inshorensi yempilo, ziba nemilinganiselo embalwa ebalulekileyo, kubandakanywa ukukhutshwa kweemeko ezikhoyo ngaphambili kunye nokunakekelwa kwezempilo rhoqo, kunye nezindleko eziphezulu kunye nezindleko ezingaphandle. Akukho siqinisekiso sokuba unokuhlaziya isicwangciso emva kwexesha lokuqala lokunika ingxelo.
Umgaqo-nkqubo womshuwalense wexesha elifutshane ungasifaneleka ukuba unendlela yokuphila enempilo, ungenayo iimeko zonyango ezikhoyo, kwaye ulindele ukuba uphinde usebenze okanye ukwazi ukuthenga i-inshurensi yezempilo rhoqo ngaphambi kokuphela kwexesha lokunika ithuba lokugqibela.
Qaphela ukuba isicwangciso sexeshana esifutshane asiqwalaselwe njengobuncinci benkcazo ebalulekileyo phantsi kwe-ACA. Oku kuthetha ukuba ukuba uthembele kwisicwangciso sexesha elifutshane malunga neenyanga ezimbini, uya kuthotyelwa kwisigwebo somntu ngamnye se-ACA , ngaphandle kokuba uvumelekile ukuxolelwa kwisihlwayo.
Iindleko eziphantsi okanye iiNkonzo zamahhala: Ukwandiswa kweMilicaid kwenza uMyinge ufumaneke ngakumbi
Ukuba ingeniso yakho iyancipha kakhulu kwaye awukwazi ukuthenga i-inshorensi yempilo, unokufumana ilungelo lenkqubo yendawo, yelizwe okanye yezemfundo.
Ngaphantsi kwe-ACA, amazwe angakwandisa ukulungelelanisa iMedicaid ukuya kuma-138 ekhulwini kwinqanaba lehlwempu (malunga ne-$ 28,000 kwintsapho yabathathu ngo-2017). Ukuba ingeniso yakho yehla ngaphantsi kweli nqanaba ngenxa yesiphumo sakho sokulahlekelwa ngumsebenzi, unakho ukufaneleka kwiMedicaid, kuxhomekeke kwindawo ohlala kuyo. Kukho ama-19 athi awunakwandanga iMedicaid, kwaye ngo-18 kulawo mazwe, kukho "igalelo lokungena" kubantu abanenvuzo engaphantsi kwinqanaba lehlwempu.
Ukuba awukwazi ukufumana i-Medicaid kwaye unako ukufumana ukuthengwa kwintsebenziswano kunye nenkxaso-mali ekhoyo, indawo enokuqala ukukhangela ulwazi yiwebhusayithi yeSiseko soMgangatho wezeMpilo. Le ntlangano engeyiyo inzuzo inikeza amathuluzi asebenzayo ekuncedeni ukuba ufumane i-inshurensi yempilo enokuhlawulekayo okanye ezinye iindlela ongakhetha kuzo kwimeko yakho. Isiza sinika nokufikelela kwi-Uninsured Hot Line (800-234-1317) evumela ukuba uthethe kumsebenzisi ophilileyo naliphi ixesha-iiyure ezingama-24 ngosuku, iintsuku ezingama-7 ngeveki.
Ukuba awunayo nayiphi na i-inshorensi yezempilo, kukho iindawo onokuya kuzo kwiinkcitho eziphantsi okanye ukunyamekela. Ezi zikhethi ziquka:
- Intshuwalense yabantwana: Ukuba inzala yakho yentsapho ingaphantsi kwinqanaba elithile, abantwana bakho (abangaphantsi kweminyaka engama-19) banako ukufumana umgaqo-nkqubo we-inshorensi yempilo okanye ixabiso eliphantsi. Le migaqo-nkqubo, enikezelwa nguRhulumente wombuso kunye nelizwe lakho, ihlanganisa zonke iinkonzo zempilo zentlalo kubandakanya ukunakekelwa kwamazinyo kunye nombono . Umyinge wabantwana ufumaneke nakwiindawo ezingama-18 apho kukho iqondo lokungena kwi-Medicaid kubantu abadala. Ukuze ufumane ulwazi, qhagamshelana neSebe lezeMpilo kwiSebe lezeNtlalo okanye kwiSebe leeNtwana neNtsapho. Unokufunda okungakumbi malunga nolu hlobo lomshuwalense wezempilo kwaye ufikelele kwinkqubo yesimo somntu ngamnye kwi-InsureKidsNow!
- IiNkonzo zezeMpilo zasekuhlaleni: ezilawulwa nguRhulumente wephondo, amaziko empilo oluntu angatholakala kwiindawo ezininzi zelizwe. Ezi kliniki zinikela ngononophelo kubantu abangenayo i-inshorensi yempilo kunye neesalathisi zokuhlawula isiseko esekelwe kwingeniso. Uninzi lwezi kliniki zinenkonzo zengcebiso ukunceda abantu bathole i-inshorensi yezempilo okanye ukunakekelwa kweendleko eziphantsi. Fumana iziko lempilo kwindawo yakho.
- Iikliniki zamahhala : Ezi klinikhi, ezihlala kwiindawo ezininzi, zinikezela ngononophelo lwempilo mahhala okanye iindleko ezincinci kubantu abangaqinisekanga. Zihlala zixhaswa ngamagqirha kunye nabahlengikazi kwaye zixhomekeke kwiminikelo evela kuluntu. Fumana iklinikhi yamahhala kwindawo yakho.
- IiNzuzo zoLutsha: Isebe loLawulo lweeVeterans (VA) linikezela ngononophelo okanye unyango oluphantsi lwezonyango kunye nolwabizo lweziyobisi olunezilwanyana ezifanelekileyo kwiindawo zalo zonyango ze-VA. I-website ye-VA inolwazi malunga nokufaneleka kunye neendawo ze-VA iiofisi.
Zikhathalele
Ukulahlekelwa ngumsebenzi wakho, ingeniso yakho kunye neenzuzo zakho zempilo kunokubangela uxinzelelo kwaye, ngenxa yabantu abaninzi, bahlaselwa ngokuzithemba. Enye yezinto ezibaluleke kakhulu omele uyenze uyayigcina!
Kukho amanyathelo onokuthatha ukukunceda ngeli xesha:
- Qinisekisa malunga nokufumana i-inshorensi yempilo kunye nokukhangela umsebenzi omtsha
- Hlala uxhamene nosapho kunye nabahlobo
- Fumana iqela lokuxhasa abanye basekhaya abaye balahlwa
- Thetha ugqirha wakho malunga nokuchithwa kwakho kunye nemeko yomshuwalense wezempilo. Uyakwazi ukuphakamisa ezinye iindlela zokulondoloza indleko ezifana nokutshintsha amayeza egama lakho kwii-generic versions okanye ukwenza icebo lokuhlawula iindleko zakho zonyango.
Kwaye, okubaluleke kakhulu, gcina indlela yokuphila enempilo ngokuzilolonga rhoqo kunye nokutya okulungileyo! Uyakuziva ulunge kwaye awunamathuba okufuna iinkonzo zempilo!
> Imithombo:
> Isebe leNondyebo; KwiSebe lezeMisebenzi; ISebe lezeMpilo kunye neNkonzo zoLuntu. Izibonelelo ezingekho; Umyinge weMpilo kunye neNyaka; kunye neNkxaso-mali yexesha elifutshane, eliNcinci . 2016
> Kaiser Family Foundation. Inguqu yeeNtsholongwane yezeMshuwalense yezeMpilo: Ingxaki eqinisekisiwe. Juni 2012.
> Kaiser Family Foundation. I-Gap Coverage: Unesurance Abakhulileyo abakwiiNkampani ezingenakwandisa iMedicaid. Oktobha 19, 2016.