Ukuba i-inshorensi yakho yezempilo ihamba kunye neerhafu ezininzi, uza kugqiba ukuhlawula ama-dollar ambalwa ukuya kumawaka angamawaka eedola. Ukuqonda oko oku kuhlawulekayo, indlela esebenza ngayo, xa kufuneka uhlawule, kwaye xa ungenayo ukuyihlawula inxalenye yokusebenzisa i-inshorensi yakho yezempilo ngokufanelekileyo.
Iyintoni i-inshurensi yempilo echithwayo?
Isaphulelo sakho sinani elimisiweyo omele uhlawule unyaka ngamnye malunga neendleko zempilo yakho yebhilidi phambi kokuba u-inshorensi yempilo yakho ikhawule ngokugcwele kwaye uqala ukuhlawula (ukuba ubhalise kwi-Medicare, i- Part A echithwayo isekelwe kumaxesha enzuzo kunokuba unyaka wekhalenda ).
Imisebenzi eDeductible-Umzekelo
Masithi impilo yakho yomshuwalense idinga i-deductible ye-$ 1000 yonyaka, kwaye zonke iinkonzo ezingenakukhusela zibalwa kwi-deductible.
- NgoJanuwari, ufumana i-bronchitis.
- Ixabiso lilonke = $ 200. (Ugqirha, umyalelo.)
- Uhlawula i $ 200.
- Intsholongwane yakho yempilo ihlawula i $ 0.
- I-$ 200 inikwe ingqalelo kwi-deductible yakho.
- Ama-800 asele ngaphambi kokuba athathwe.
- Ngo-Epreli, ufumana isilwanyana esiswini sakho. Isiqhumane siphenduka siphezulu; uphilile.
- Iyonke ibhilidi = $ 4,000. (Oogqirha, iimvavanyo, i-biopsy.)
- Uhlawula i $ 800. (Ngoku udibene ne-$ 1000 yakho echithwayo.)
- Uhlawula nayiphina imali okanye i- coinsurance yakho isicwangciso sezempilo sidinga.
- Intsholongwane yakho yempilo ihlawula lonke i-bill.
- NgoSeptemba, uyaphula ingalo yakho.
- Ixabiso elipheleleyo = $ 2,500. (Igumbi eliphuthumayo, ugqirha, i-X-ray, iphoswe.)
- Uhlawula iikopi kunye ne-coinsurance, kodwa akukho ductible.
- Inshshurensi yezempilo ihlawula i-bill yonkcitho yonkcitho yakho kunye ne-coinsurance yakho.
- NgoJanuwari ozayo, uya kuqalisa inkqubo kwakhona kwakhona.
Kwizicwangciso ezininzi zezempilo, xa uhlawule i-deductible yonyaka, uyenziwe ngeentlawulo ezihlawulelwayo kude kube ngumnyaka ozayo. Unyaka ngamnye, isicwangciso sezempilo sisetyenzisiwe esitsha. Ngamanye amaxesha kunomlinganiselo ofanayo nonyaka ngaphambili; maxa wambi uya kunyuka.
Iintlobo ezahlukeneyo zeDeductible
Ezinye izicwangciso zezempilo zinomlinganiselo ongaphezulu kweyodwa wedata.
- Deductible yonyaka
Olu luhlobo oluqhelekileyo lwe-deductible kwaye oko kuchazwe kumzekelo ongentla.
- I-Per-Episode ichithwe
Ngokungafani ne-deductible yonyaka, i-episode-deductible iyenzeka rhoqo xa ufumana uhlobo oluthile lwenkonzo. Ngokomzekelo, i-inshorensi yakho yempilo ingadinga i-$ 1,000 echithwa rhoqo ngexesha uhlala esibhedlele (ezinye iiplani ziya kubhekisela kulo njengepopay endaweni yoko, kodwa ubukhulu bentlawulo kuthetha ukuba kumbono wabathengi, kufana ne-deductible). Iingqungquthela zengqungquthela engaphantsi kwezinto eziqhelekileyo kunokuba zixhomekeke kwi-deductibles yaminyaka yonke, nangona njengoko kuphawuliwe ngasentla, i-Medicare Part A ihlola amaxabiso athathekayo ngokuxhomekeke kwixesha leenzuzo kunexesha lekhalenda.
- I-Out-Of-Network ichithekile
Ezinye izicwangciso zempilo, i- PPOs ngokukodwa, unomvuzo owodwa wonyaka owenzelwe unyameko owamkelayo kubagqirha be -intanethi kunye nonyaka ophezulu owenyukayo owenzela unonophelo owenzela kubaboneleli be -out-of-network .
Ngokomzekelo, ukuba isicwangciso sakho sezempilo sinemali engama-1 000 kwi-network echithwe ngonyaka kunye ne-2,000 ye-out-of-network deductible, isicwangciso sakho sempilo siza kuqala ukuhlawula ukunyamekela kweempilo zakho kwi-network emva kokuba ukhokhe i-$ 1,000 kwii-bt-inethiwekhi zakho. . Ukuba uqale ufumene ingcali ye-network-out-of-network, kufuneka uhlawule i-$ 2,000 kwi-careless out-of-network ukunakekelwa ngaphambi kokuba isicwangciso sakho sempilo siqale ukuhlawula nayiphi na into yokunakekelwa kwe-out-of-network.
I-$ 1,000 eyayifakile njengokuba inethiwekhi inokutshatyalaliswa ayikho into ekubhekiselele kwi-out-of-network deductible yakho.
Kwezinye izicwangciso zempilo, nayiphi na imali oyihlawulayo kwi-out-of-network deductible yakho inokubakho kwi-in-network deductible yakho. Kwezinye iiplani zempilo, iinqununu ezimbini zihluke ngokupheleleyo (qaphela ukuba ezinye izicwangciso azigcini nje ngononophelo lwentlalo-nkonzo, oko kuthetha ukuba uya kuba noxanduva lwebhilikhithi yonke-ngaphandle kwekhefu ngaphandle Iimali zentlawulo-ngaphandle kokuba imeko yongxamisekileyo).
- Intsapho echithwe
Ukuba umgaqo-nkqubo we-inshorensi yempilo yakho ihlanganisa yonke intsapho yakho, mhlawumbi ivela kunye nosapho echithwayo.
Ukuncitshiswa kweentsapho kusebenze ngokwahlukileyo kunamanani athathekayo kwaye kuza kwiindidi ezahlukahlukeneyo ezifana ne- deductible embedded kunye ne- aggregate deductible . Funda ngakumbi " Indlela Yakho Imindeni Eyayichitha Imisebenzi ." Qaphela ukuba uMthetho wokuNakekelwa ongenakunqwenelekayo ufuna ukuba izicwangciso zempilo zinciphise iindleko zomntu ngamnye zomntu (kwintengiso yonxibelelwano) kunyaka onikezelweyo, nokuba loo mntu uhlanganiswe yiplani yesapho enokutshatyalaliswa kwintsapho.
Ngo-2017, umda ophezulu u-$ 7,150 kwiindleko ezingaphandle kwee-pocket zomntu omnye, kubandakanywa i-deductible, i-copays kunye ne-coinsurance. Ngo-2018, kuya kuba yi-$ 7,350. Ukuchithwa ukuba umntu oyedwa unokufunwa ukuba ahlawule ingaba phezulu njengaloo mali, kodwa akukho phezulu.
Xa Ungayikhokheli i-Deductible?
EUnited States, ngenxa yoMthetho ojongene noNonophelo ongenakunqwenelekayo , akufanele uhlawule imali xa ufumana iinkonzo zokukhusela ezikhuselweyo kwi-in-network udokotela. Izinto ezinjenge-yearly screening mammogram , i-colonoscopy oyifumanayo xa uphendukela kwiminyaka engama-50 ubudala, kwaye ukukhunjulwa komkhuhlane wakho wonyaka akuxhomekeke kwi-deductible. Isicwangciso sakho sezempilo siya kuhlawulela ezo nkonzo zokukhusela nangona ungakhange udibane ne-deductible yakho okwamanje.
Ezinye izicwangciso zempilo, ngokukodwa ii- HMO , azidingeki ukuba zitshathwe ngokupheleleyo. Nangona kunjalo, ezi zicwangciso zihlala zihlawula iifayili zezinto ezifana nokutyelela ugqirha, imiyalelo, ukutyelelwa kwamagumbi okuphuthuma kunye nezibhedlele.
Yintoni engabaliyo kwiDeductible?
Iindleko zonyango ezingenalo inzuzo efunyenweyo yecebo lakho lempilo alithembeli kwi-inshorensi yakho yempilo echithwayo nakuba uhlawule. Ngokomzekelo, ukuba i-inshorensi yakho yezempilo ayifaki ukufaka izihlangu ze-orthotic, ke i-$ 400 oyihlawulele i-pair of orthotics enqunywe ngumgcini wakho we-podiatriyi ayikho into ekubhekiselele kuyo. Ngokufanayo, ukuba isicwangciso sakho sempilo singagcini ukunyamekela inethiwekhi, nayiphi na imali oya kuhlawula ngayo ukunakekelwa kwe-out-of-network ayiyi kubalwa kwi-deductible yakho.
Ukuba i-inshurensi yakho yempilo idinga i-episode-deductible kunye ne-deductible yonyaka, imali ohlawula ngayo kwi-episode-deductible ayinakubalwa ngokubhekiselele kwi-deductible yakho yonyaka.
Ukuba unemivuzo ehlukeneyo yokunakekelwa kwenethiwekhi kunye nokunakekelwa kwe-intanethi, imali oye uyihlawula kwi-in-network deductible yakho ayibonakali kwi-out-of-network deductible yakho. Ngokuxhomekeke kwimithetho yezocwangciso zezempilo, imali oye uyihlawula kwi-out-of-network deductible ingenakubalwa ngokubhekiselele kwi-in-network deductible, nokuba.
Kwiinkqubo ezininzi zempilo, iifayili zingabonakali kwi-deductible yakho yonyaka, nangona zibalelwa kwiindleko zakho zokuphela kwee-pocket zonyaka. Funda kabanzi kwi- "Yenza i-Copayments Count ku-Inshurensi yezempilo yakho echithwe? "
> Imithombo:
> Isebe lezeMpilo kunye neNkonzo zoLuntu, isiKhuseli soMonde kunye noMthetho woNonophelo ojongene noThathaka; Isaziso seNzuzo yeeNzuzo kunye neParameters yokuhlawula i-2018; Izilungiso kwiiNyanga zokuBhalisa eziKhethekileyo kunye neNkqubo yokuCwangciswa kwabasebenzisi . Disemba 22, 2016.
> Medicare.gov. Glossary. Ixesha leNzuzo.
Medicare.gov. I-Medicare 2016 neye-2017 iindleko ngokukhangela.