Ukuqonda iChibi leNkcazo yeSikolo esiphezulu
Abaninzi baseMelika bafumana i-inshorensi yabo yempilo ngokusebenzisa umqeshi wabo kunye nabanye abaninzi babhalise kwiinkqubo zikaRhulumente ezifana neMedicaid , Medicare , CHIP, kunye nezicwangciso zempilo ezihambelana nemikhosi. Kwakhona, abaninzi abantu abazisebenzisayo bazithengela isicwangciso sabo sempilo ngokuthe ngqo kwiinkampani zomshuwalense wezempilo.
Ukongeza, ngaphezu kwezigidi ezingama-40 zaseMelika abanalo ninshuwalense yezempilo ngenxa yokuba basebenze ixesha elilodwa, umqeshi wabo akanikezeli i-inshurensi yezempilo, okanye abanako ukufumana iiprojama ze-inshorensi yempilo kodwa benze imali eninzi ukuze bakwazi ukufumana iMedicaid.
Kukho namanani amaninzi abantu abanokukwazi ukuthenga i-inshurensi kodwa bachithwa ngamashishini e-inshorensi kuba banemeko ebalulekileyo ekhoyo ngaphambili njengomhlaza, isifo sikashukela, okanye usulelo lwe-HIV. Kwiinkoliso ezininzi, akukho mithetho efuna inkampani ye-inshorensi yempilo ukuba inikezele ngokubhengezwa komntu ngamnye.
Amachibi Aphezulu
Nangona kunjalo, amazwe angama-35 adale iinkqubo ezizodwa kubahlali abaphikiweyo ukukhutshwa ngabatshutshisi ngabangasese ngenxa yemicimbi enxulumene nempilo. Ngokona nxalenye, le nkqubo, eyaziwa ngokuba ngamachibi aphezulu, iqinisekisa ukuba abantu banokuthenga nokubhalisa kwisicwangciso sezempilo kungakhathaliseki imeko yabo yempilo.
UDkt Mike's Bottom Line
Ukuba usemncinci kwaye unempilweni kwaye awunayo ingozi yempilo (njengokubhema), mhlawumbi uya kuba nexesha elilula lokufumana i-inshorensi yempilo efikelelekayo kunye nezicwangciso zempilo ezinqwenela ukuba ube ngumthengi. Nangona kunjalo, ukuba uphathwe ngempilo engapheliyo okanye unxulumene nempilo, izinto ezinobungozi obuphezulu (ezifana nokugqithisa ngokweqile okanye ukutshaya itekisi), awukwazi ukufumana i-inshorensi yempilo nayiphi na intengo.
Uninzi lwezicwangciso zezempilo zishishini ukwenza imali kwaye abafuni ukubhalisa abantu "abagulayo" abaza kusetyenziswa ezininzi iinkonzo .
Yintoni eyenzekayo kwiMithombo ePhakamileyo yengozi phantsi kweNguqulelo yezeMpilo?
Omnye wamalungiselelo amakhulu ebhilidi yokulungiswa kwempilo (UMthetho wokuPhelelwa kweMonde kunye noMthetho ojongene noNonophelo ojongene noThathaka) owatyikityiweyo kumthetho ngoMatshi 2010 ukuphelisa imimiselo yeemeko zangaphambili kwaye unikeze ukufikelela kwizicwangciso zempilo ezifikelelekayo ezingenakukhanyela inkcazo esekelwe kwimeko yezempilo.
Urhulumente ngamnye unokutshintshisiswa kwe-inshurensi yempilo enika ubuncinane amabini okukhetha amalungiselelo ezempilo ngamanqanaba ahlukeneyo kunye neendleko ze-out-of-pocket. Ukutshintshaniswa kunokubakho indawo, okanye ukongezwa kuyo, kwi-pool yakho yangoku yingozi enkulu.
Ixabiso leNtshumo-yindleko ephakamileyo?
Izicwangciso zempilo ezinobungozi kakhulu zibiza kakhulu ukuba urhulumente wakho asebenze. Ngenxa yoko, i-pool enobungozi obuphezulu kwimeko yakho iya kuhlawulisa ngaphezu kweendleko zokuthenga i-inshorensi yempilo yendalo. Ngokuqhelekileyo, amachibi aphezulu kakhulu anika izicwangciso zempilo ezine ukuya kweyesibhozo ngekhontrakthi phakathi kombuso wakho kunye nenye okanye ezininzi iinkampani zomshuwalense wezempilo.
Ngokuxhomekeke kwi-state, i- premium yakho yenyanga yokucwangcisa impilo ephezulu iya kuba yi-125% ukuya kwi-200% ye-premium yesicwangciso esifanayo sobucala-esifana nesicwangciso sezempilo esikukhanyelayo. Umzekelo, ukuba isicwangciso somdabu somntu ngamnye sibiza i-$ 500 ngenyanga nganye, eCalifornia, kufuneka uhlawule i-$ 625 kwisicwangciso esiphezulu (ingozi ye-125%), e-West Virginia i-$ 750 kwisicwangciso esiphakamileyo (150% rate) , naseMaldinals $ 1000 yecebo eliphezulu (i-$ 1000).
Kwiinkoliso ezininzi ezineendawo ezinobungozi obuphezulu, inkampani yomshuwalense nayo iyahlukahluka kweendleko ze-premium yakho ngokusekelwe kwiimpawu zakho zobuqu, ezifana nobudala, isini, isimo sokutshaya, apho uhlala khona kwimeko, kunye nesimo sakho sempilo.
Akunakukukhanyela ukuba unobungozi ukuba unenkinga yempilo, kodwa banokukuhlawula i-premium ephezulu!
Ukongeza kwi-premium yakho yenyanga, uya kuba noxanduva lweendleko ze-out-of-pocket , ezifana nezithintelo zonyaka, ii-copayments kunye ne-inshurensi. Unokulindela ukuba ube ne-deductible yonyaka ubuncinane be-$ 500, kodwa kwiindawo ezininzi i-deductible ingaba phakathi kwe-$ 1000 ne-$ 3000.
Ngaba Amachibi aphezulu aMbono omuhle?
Ibumbi elinobungozi obuphezulu linokukunceda kakhulu ukuba unemeko esele ikhona ngaphambili, unqatshelwe ukukwazi ukubhalisa kwisicwangciso sezempilo, kwaye unokukwazi ukuhlawula iiprayimari zenyanga. Ekubeni ezinye iindawo zibonelela ngoncedo lwezezimali kwiiprayimari, i-pool ephezulu yingozi ingaba ngumkhuseli wokukhusela ukuba ungeke ukwazi ukuthenga isicwangciso sezempilo sabucala.
Nangona kunjalo, kukho ezinye iingxaki ezibalulekileyo ezinamacu aphezulu. Nangona abantu abayizigidi ezili-35 abakwiindawo ezinobungozi obuphezulu bangakwazi ukuthabatha inxaxheba, ukubhaliswa kwamanani - malunga ne-190,000 - sele iphantsi kakhulu. Oku kubangelwa iindleko eziphezulu zeeprayimari kunye neendleko zokuphuma ngaphandle kwexesha-abantu abaninzi abanakukwazi ukuthenga ukufumana ingqalelo kwi-pool ephezulu.
Ekubeni amachibi amaninzi aphezulu kakhulu asebenza kakhulu, amaninzi amaninzi aphelile okanye ayeke ukubhalisa abantu kumachibi.
Izibonelelo
Ekubeni i-35 nganye ichaza ngamachibi amaninzi aphethe imimiselo eyahlukileyo, kubalulekile ukuba uqonde iimfuno zakho zokufaneleka, izicwangciso ezikhoyo ezibonelela nge-inshurensi kwindawo yokubeka ingozi ephezulu, iindleko zonyaka, kunye nokuba kungenzeka ukuba izicwangciso zangoku valiwe.
Amachibi aphezulu aMngcipheko kaRhulumente: Ingqwalasela - uxwebhu olulungileyo oluvela kwi-Kaiser Family Foundation olubandakanya uludwe lwezinto ezinamaqondo aphezulu kunye nolwazi olusisiseko malunga neenkqubo zephondo.
Amanyathelo kaNtsholongwane kaZwelonke weNtsholongwane eNtsholongwane eNtshona Koloni anika uludwe lwabahlali ngamachibi aphezulu okubandakanya ukudibanisa ngqo kwiprogram nganye.