Intsholongwane yempilo yongxowankulu ichazwe njengetyala lokukhuseleka kwemali xa unesifo sempilo. Ayayi kuhlawula iingxaki zempilo zemihla ngemihla, kodwa uya kuhlawula xa unesidleko esinake kakhulu sezempilo. Ngenxa yoko, izicwangciso zempilo eziyingozi zihlala zibiza imali encinane kunezinye izicwangciso zempilo.
Ukuba ufuna inshorensi yempilo eya kuhlawula iimfuno zononophelo zempilo njengama-ankles aphuhliweyo kunye nomkhuhlane, isicwangciso esiyingozi asikho kuwe.
Ukuba unakho ukuhlawula iimfuno zakho zonyango lwempilo kwaye ufuna kuphela i-inshorensi yakho yempilo ukuba ikugubungele kwimeko yentlekele yempilo efuna ukuhlinzwa ngokukhawuleza.
I- deductible yonyaka yempilo yomshuwalense yingozi kakhulu kangangokuba abantu abaninzi abanempilo abayi kuhlawula; kunyaka uya kuphelela ngaphambi kokuba bachithe okuninzi kwiinkonzo zempilo. Nangona kunjalo, ukuba unayo imfuno enonyango yempilo yonkqenkqonkqo, icebo eliyingozi liya kukhawuleza kwaye uqale ukuhlawula emva kokuhlawula ixabiso elikhulu.
Ixesha elithi "inhlekelele" lisetyenziselwa ukuchaza nayiphi na isicwangciso sezempilo esinokutsalwa. Kodwa phantsi koMthetho wezoNonophelo ongenakunqwenelekayo, luhlobo oluthile lwesicwangciso, olwahlukileyo ukusuka kwezinye izinto ezikhethiweyo eziphezulu.
Yintoni echaza isicwangciso sezempilo esiyingozi?
Intsholongwane yempilo enobungozi eyenziwa kwiNtsholongwane engabonakaliyo yoshishino lwe-inshurensi yezempilo ( nangaphandle kweengxoxo )
- Unomdaka ophezulu kakhulu.
- Ukhupha zonke iinjongo zempilo ezibalulekileyo.
- Umda ongabhalisa. Akubona wonke umntu ovumelekile ukuthenga isicwangciso esiyingozi.
- Ayikwazi ukusetyenziswa nge-inshurensi yempilo yonyango ukuze uncede ukuhlawula iiprayimari zenyanga.
Izicwangciso ezinobungozi ezinikezelwa kwi-inshurensi yempilo yomshuwalense kunye neseburhulumenteni zinexabiso eliphezulu kakhulu elithengiswayo xa kuthelekiswa nezinye iintlobo zezicwangciso.
Ngokomzekelo, izicwangciso ezinobungozi ezinikezelwa ngo-2017 zine-deductible ye-$ 7,150 ngamnye. Enyanisweni, i-deductible yezicwangciso ezinobungozi zifana ne- out-of-pocket maximum . Ukuchithwa kwesicwangciso sakho sempilo esiyingozi kuza kunyuka ngonyaka njengoko urhulumente evumela ukunyuka kwi-out-of-pocket maximum (ngo-2014, bekuyi $ 6,350, kwaye ikhule minyaka yonke ukususela ngoko).
Emva kokuba uhlawule ngokwaneleyo ephaketheni lakho ukuhlangabezana ne-deductible, isicwangciso sezempilo esiyingozi siza kuqala ukuhlawula iindleko zakho zokunakekelwa kwempilo. Kwiimeko ezininzi, ukuba uhlala kwi-network , icebo lakho elibi liza kuhlawulela i-100% yeendleko zakho zonyango ezikhuselekileyo emva kokuba uhlawule i-deductible.
Ziziphi iindleko zonyango lwempilo? Isicwangciso esiyingozi kufuneka sigubungele iinjongo zempilo ezifanayo ezifunekayo zonke ezinye izicwangciso zempilo ze- Obamacare . Umzekelo, kufuneka uhlawule izinto ezifana nokutyelela ugqirha, ukuhlolwa kwegazi, ukunakekelwa kwababelethi, ukunakekelwa kwempilo yengqondo kunye nokuphathwa kakubi kweziyobisi. Nangona kunjalo, akuyi kuqalisa ukuhlawula ezo ntlawulo kude uhlawule imali eninzi.
Kukho imibini emibini kulo mgaqo:
- Intsholongwane yempilo yomshuwalense kufuneka ihlawule ngokunyamekela kwezempilo nangona ungazange uyihlawule. Oku kufaka izinto ezifana nomkhuhlane wakho wonyaka, ukuhlola i-mammogram , ukutyelela ngokufanelekileyo kwindoda kunye nokukhulelwa .
- Izicwangciso zempilo eziyingozi kufuneka zihlawule wena ukuze ubone umboneleli wakho oyintloko ukhuseleko kathathu ngonyaka ngaphandle kokuhlawula okokuqala.
Abantu abathile kuphela abanelungelo lokuthenga i-inshurensi yezempilo eyingozi edayiswe kwi-inshorensi ye-Care Affordable ye-Care Act. Kufuneka ube ngaphantsi kweminyaka engama-30, okanye ube nokukhululwa kanzima okanye ukukhululeka kwi-ACA. Fumana ukuba ufanelekile "Ngaba Unelungelo leNtshuwalense yezempilo engozini? "U
Ukuba unelungelo lokuxhaswa kwe-inshorensi yempilo kukunceda ukuhlawula iimpompo zomshuwalense wenyanga, awukwazi ukusebenzisa loo mali ngecebo elibi lezempilo .
Ufanele ukhethe ithusi, isilivere, igolide, okanye iplatinum icebo lokusebenzisa inkxaso. Funda kabanzi malunga nabani na abafanelekileyo kwinkxaso-mali ye-inshorensi yempilo kwaye zeziphi iintlobo zenkxaso-mali ezifumanekayo " Ngaba Ndingayifumana Uncedo Lokuhlawula Intshuwalense yezeMpilo? "U
Ezinye izicwangciso zethusi ziyancitshiswa ngokukhawuleza njengezicwangciso ezinobungozi (kunye neendleko zokuphela kwee-pocket ezilingana nezo zicwangciso ezinobungozi), kodwa akukho nkonzo yokutyelela okuphambili ngaphambi kokuba ichithwe. Uxhasomali lwe-Althouh lwe-premium alukwazi ukusetyenziswa kwizicwangciso ezinobungozi, umntu omdala onempilo ongafanelanga ukufumana inkxaso-mali ye-premium angayifumana isicwangciso esiyingozi ukuba ibe yinto engcono kunecebo lobhedu.
Inzuzo Efihliweyo Yomshuwalense Wezempilo Eyingozi
Nangona ungasisebenzisi ngokwaneleyo kwimpilo yononophelo ukuhlangabezana nesicwangciso sakho sezempilo esiyingozi, uya kuhlawula ngaphantsi kwiindleko zonyango ngaphandle kwe-inshorensi yezempilo. Iiplani ezininzi ezinobungozi yi- HMO, PPO, EPO, okanye iplani ye- POS . Ezi zicwangciso zonke zixubusha amaxabiso athatywayo kunye noogqirha, izibhedlele, ii-lab, kunye nee-pharmacy ezisemgangathweni lwabo lwababoneleli. Njengomthengi kwisicwangciso sezempilo esiyingozi, ufumana inzuzo yezi xabiso ezihlisiwe ngaphambi kokuba uhlawule imali yakho.
Nasi umzekelo. Masithi awuzange uhlangabezane ne-7150 ye-plan yezinto ezimbi. Ulimaza i-ankle yakho kwaye udinga i-X-ray. Umyinge we-X-ray uyi-$ 200. Ngaphandle kwe-inshurensi yempilo enobungozi, kufuneka uhlawule i-$ 200 ngaphandle kwe-pocket. Inqanaba lokunciphisa inethiwekhi kumalungu ecwangciso lempilo ngu-$ 98. Ekubeni unelungu lesicwangciso sezempilo usebenzisa isikhungo se-X-ray, kufuneka uhlawule kuphela i-$ 98 ehlawulelwayo. Uya kuhlawula i-$ 102 ngaphantsi kunokuba ubuya kuhlawulwa ukuba awuqinisekanga.
Qaphela xa uthengela iNtsholongwane yeNtsholongwane yeMpilo
Kulula ukwenza impazamo yokucinga ukuba isicwangciso se-inshorensi yempilo yinto efana nesicwangciso esiphezulu sezempilo, okanye i-HDHP. Emva koko, icebo eliyingozi lichithwe kakhulu, ngoko kufuneka libe yiplani yezempilo echithwayo, ilungelo?
Ngalunganga.
I-HDHP efanelekileyo ikhethekileyo yonyhorensi yezempilo eyenzelwe ukuba isetyenziswe nge-akhawunti yokulondoloza impilo. Funda umehluko phakathi kweHDHP kunye nesicwangciso esiyingozi, kwaye kwenzeka ntoni ukuba uthengisa icebo elibi xa ucinga ukuba uthenga i-HDHP.
> Imithombo:
> HealthCare.gov, IziCwangciso zeMpilo eziNtle.