Iyintoni Inkonzo Yomshuwalense Wezempilo?
I- inshorensi yempilo yongezelelo yinkampani yomshuwalense wongezwayo ekwenzeni ukwandisa i-inshurensi yempilo yakho ebanzi , enkulu-yonyango. Inceda ukuzalisa ikhefu ekukhuselweni kwemali oyifumana kwi-inshorensi yempilo yakho enkulu.
Iintlobo ze-Intshurensi yezeMpilo
Kukho iintlobo ezininzi ze-inshorensi yempilo, kwaye udidi ngalunye lusebenza ngokuhlukileyo.
Ezinye zezona ntlobo zee-inshorensi zezempilo zonyango ziqhelekileyo:
IziCwangciso eziZodwa
Izicwangciso zee-inshorensi zempilo zongezelelekileyo zempilo zihlawula isamba emva kokuba ufumene isifo esithile. Ngokomzekelo, i-inshorensi yomhlaza iya kuhlawula xa sele ufumene ukuba unomdla womhlaza odweliswe kumgaqo-nkqubo.
Ngokungafani ne-inshorensi yezempilo okanye iiplani ze- Medigap, isicwangciso esithile sesifo sibonelela ngenzuzo yemali ngokuthe ngqo kuwe, kungekhona kumboneleli wakho wezempilo. Ungayisebenzisa nayiphi na into oyifunayo kwaye akunyanzelekanga ukuyisebenzisa ukuhlawula iibhilidi zonyango. Abantu abaninzi basebenzise ukuba bancede ngeendleko ezihambelana nezifo ezinjengama-copays, ama-deductibles, kunye neendleko zokuhamba kunye neendawo zokungena xa beya kwiyunivesiti okanye kwiziko lokunonyango lokunakekelwa ngononophelo oluphezulu. Nangona kunjalo, ukuba ufuna ukuyisebenzisa ukuthenga i-Harley Davidson endaweni yoko, ukhetho lenu.
Izicwangciso ezithile zezifo zihlobo oluthile lwe-inshorensi yokuhlawula i-indemnity insensity, oku kuthetha ukuba inani lemali umshwalense uya kuhlawula; ayifani ukuhluka ngokusekelwe kubukhulu beebhilidi zakho zonyango.
Ukuba umgaqo-nkqubo uthi ufumana i-$ 20,000 xa ufumene unomdlavuza, uhlawula i-$ 20,000 ukuze uhlolisise ukuba ngaba iibhilidi zakho zonyango ziyi-$ 500 okanye i-$ 500,000 (nangona iipolisi ezikhethekileyo zempilo zihlawula kuphela umhlaza xa zingenasifo, oku kuthetha ukuba iindleko kuya kuba neyona nto ibalulekileyo; i-basal cell carcinoma isuswe kwisithuba sokugula kwaye ayifuni ukuba kubekho unyango olongezelelweyo aluyi kubangela ukuhlawulwa kwisicwangciso sakho sokugula.
Intsholongwane yokugula
I-inshorensi yokugula engundoqo ifana nezicwangciso ezithile zezifo ngaphandle kokuba iquka iintlobo ezahlukeneyo zezifo. Ngokomzekelo, umgaqo-nkqubo wokugula obaluleke kakhulu unokuhlawula isibonelelo semali xa ufumene unesifo senhliziyo, isifo, umhlaza, isifo sesigxina sesigxina, okanye ufuna ukufakelwa komzimba. Izifo ezithintekayo zihambelana nomgaqo-nkqubo. Iintlawulo zepolisi yokugula engundoqo ziphezulu kunama-premium ngenzuzo efanayo efanayo kumgaqo-nkqubo othile wesifo ngenxa yokuba umgcini-mali unomngcipheko omkhulu ngenxa yesibalo sezifo umgaqo-mali uya kuhlawula.
Insurance Insurance
I-inshurensi ye-Intemnity Insurance ihlawula imali echanekileyo kuwe xa ukhulelwe esibhedlele. Ezinye iiplani zihlawula isamba semali esibhedlele ukuba usibhedlele iintsuku ezimbini okanye iintsuku ezingama-20. Ezinye iiplani zihlawula umyinge wemihla ngemihla uhlala esibhedlele, umzekelo, i-$ 100 ngosuku. Kwimeko nayiphi na imeko, imali ohlawulwayo isetyenziswe ngumgaqo-nkqubo we-inshorensi yesibonelelo se-bhedlele; ayinanto enokuyenza ngayo ngokubakho i-bill bill yesibhedlele. Ungasebenzisa imali nangona ubona kufanelekile.
Ezinye izicwangciso zezibonelelo zezibhedlele ziquka izibonelelo zokuhlinzwa okwangaphandle.
Le nto ingaba yimali esisixa-mali esincinci kunesibalo semali esihlawulelwayo esibhedlele esibhedlele.
Yomshuwalense wengozi
I-inshorensi yengozi iyakubuyisela iindleko zonyango ezingaphandle kwezonyango ezinxulumene nengozi okanye ukulimala. Kwiimeko ezininzi, kuya kufuneka ukuba ubonise iibhilikhi zonyango, iirisithi, kunye / okanye inkcazo yeenzuzo kwi-inshorensi yakho yezempilo ukuqinisekisa ubungqina bakho bezonyango.
Ukuxhaswa kweengozi ngokuqhelekileyo kunomvuzo ophantsi kakhulu (i-$ 5,000 ixhaphake), njengoko zenzelwe ukukhupha ixabiso lakho kunye ne-coinsurance ukuba ulimaze kwaye kufuneka ufune unyango.
Kodwa ngokuqhelekileyo ziya kuhlawulela kuphela inani lemali oyenzayo, ukuba iindleko zakho ziphantsi kunexabiso eliphezulu. Ngokomzekelo, ukuba unayo imali engama-6,000 e-deductible kwi-inshurensi yakho yezempilo kwaye ugqiba ukuzinqanda kwaye ufuna izibonda ezibiza i-$ 1,500, umrhumo wengozi uza kuhlawula kuphela i-$ 1,500 (ngaphantsi kwexabiso elincinciweyo, ukuba isicwangciso sengozi sinokudityaniswa), ukuba inzuzo eninzi i $ 5,000.
Ukufa ngokuPhepha nokuCandwa
Ukufa ngokuzenzekelayo inxalenye yenkqubo ye-AD & D ihlawula isibonelelo semali kumntu oye wabiza ngokuba ngumzuzi ukuba ubulawe engozini. Kukho ezinye iimbono ezifana nokuba kwenzeka ingozi xa wenza into engekho mthethweni.
Inzuzo yokufa komgaqo-nkqubo we-AD & D uhlukile kwi-inshorensi yomshuwalense ngenxa yokuba imbangela yokufa kufuneka ihambelane ngqo neengozi yomgaqo-nkqubo we-AD & D, kodwa umgaqo-nkqubo wexesha-mali uya kuhlawula inzuzo nokuba ukufa kungenxa yengozi, umhlaza, ukuhlasela kwentliziyo, okanye into efana ne-Ebola. Xa unomshuwalense wobomi kunye ne-inshurensi ye-AD & D kwaye ufa ngengozi, umxhamli wakho uyafumana iintlawulo kwiimigaqo-nkqubo.
Ingqungquthela inxalenye yenkqubo ye-AD & D ihlawulela isibonelelo semali kuwe xa ingozi ikushiya ngaphandle kwesilungu, inxalenye yesilungu, okanye ishiya imfama. Ukufunda umgaqo-nkqubo we-AD & D ngumsebenzi onzima kakhulu njengoko ubonisa inani elithile lamadola okulahlekelwa ngumlenze omnye, imilenze emibili, inyawo olunye, iinyawo ezimbini, ingalo enye, iimbono ezimbini, iliso elinye, zombini amehlo, njalonjalo.
Isixa-mali esihlawulwa ngumgaqo we-AD & D sinokusetyenziswa nangayiphi na indlela wena (okanye umxhamli wakho xa usufa) ukhetha.
Intshurensi yamazinyo
Ngezinye iiNtsholongwane yamazinyo zibhekwa njengoluhlobo lwe-inshorensi yezempilo. Ihlawulela inzuzo ngqo kwizinyango zakho zamazinyo xa ufumene iinkonzo zamathambo. Iiplani ezininzi zamazinyo zilawulwa izicwangciso zokunyamekela kwaye zifuna ukuba usebenzise ababoneleli abakwi -network kunye nesicwangciso. Abanye bakhusela ukunakekelwa kwamazinyo ngaphandle kwe-network , kodwa isabelo sakho salo mthetho siya kuphakama.
Njenga-inshurensi yempilo epheleleyo, unakho ukuhlawulela, ukuhlawulwa kwemali okanye i-coinsurance ngesicwangciso sezinyo. Ukongezelela, ezininzi izicwangciso zamazinyo zinomlinganiselo ophezulu wonyaka woncedo. Ngokomzekelo, umgaqo wamazinyo ungathi iinjongo zikhawulelwe kuma-2,000 $ ngonyaka. Kwimeko apho, icebo liyeka ukuhlawula xa sele lihlawule i-$ 2,000 ukuya kwinyango yakho yamazinyo ngaloo nyaka. Uya kuba noxanduva lweyiphi na iinqununu zamazinyo ezishiywe zingabhatalwa emva kokuba ufikelele umyinge wokuhlawula umvuzo wakho wonyaka.
Umthetho ojongene noNonophelo ongenakunqwenelekayo otyunjwe ngamazinyo kubantwana njengenzuzo yempilo ebalulekileyo, kodwa ukufihla kwamazinyo kubantu abadala akugunyaziwe. Ezinye iinkampani ze-inshorensi zempilo ngoku zibandakanya ukukhutshwa kwamazinyo emantwini kwiinkqubo zabo, ngelixa ezinye ziqondisa amalungu ukuba athenge ukuhlawula kwamazinyo ahlukeneyo kwezilwanyana.
Umshuwalense Umbono
Umbono womshuwalense ubonelela inzuzo yembono yesicwangciso esipheleleyo sezempilo. Uninzi lwezicwangciso ze-inshorensi zempilo zonyango zihlawulela iinkathalo ezinxulumene nokuxilongwa kunye nokunyangwa kwezifo zeso iso njenge glaucoma okanye ukutshabalalisa kwamanzi kunye nokulimala kwiso. Nangona kunjalo, ezininzi iinkqubo ze-inshorensi zempilo aziyi kuhlawula ukulungiswa kombono rhoqo.
I-inshurensi yemboniso eyongezelelweyo iphakamisa i-slack apha kwaye inceda ukuhlawula iiglasi, ii-lens zokudibanisa kunye nokuhlolwa kweemviwo ezifunekayo ukuze zichane ngokuchanekileyo. Ezinye iinjongo ze-inshurensi zembono zikunceda ukuhlawula ukuhlinzwa okulungiswa kombono njengoLASIK .
Njengoko ngokugqithisa kwamazinyo, ukunakekelwa kwimbono yabantwana kuyimfuneko ebalulekileyo yezempilo phantsi koMthetho wokuNakekelwa ongenakunqwenelekayo, kodwa umboniso womntu omdala awukho.
Medigap
I-Medigap liqela lezicwangciso zezempilo ezongezelelweyo ezenzelwe ngqo abo bane-United States Medicare Part A kunye ne- Medicare Part B inshorensi. Abantu abangenayo i-US Medicare abakulungele ukuthenga isicwangciso seMedigap.
Izicwangciso zeMedigap zinceda abaxhamli be-Medicare bahlawula izinto ezifana nokunciphisa , i- copays , i- coinsurance , kunye nokunakekelwa ngxamisekileyo xa behamba phesheya. Ngaphandle kwenkxaso yokunakekelwa kwenkxalabo yangaphandle, i-Medigap inzuzo inamathele ekusebenziseni inshuwalense ye-Medicare. I-Medigap ihlawula ezinye zeemali zokwabelana ngeendleko ezifunekayo emva kokuba i-Medicare ihlawule isabelo sayo seendleko zonyango. Ngokomzekelo, i-Medigap inokuhlawula imali yakho xa uhlala esibhedlele.
I-Caveat Emptor kunye neNkxaso-mali yoMshuwalense wezeMpilo
I-inshorensi yempilo yongezelelo ayifaki indawo ye-inshorensi yempilo epheleleyo njenge- Obamacare , icebo lezempilo leqela olufumana kumqeshi wakho, i-Medicare, Medicaid, okanye i-Tricare. Kuthethwa njengongeziweyo kwisicwangciso sezempilo esiqhelekileyo, kungekhona njengomnye omnye.
I-inshorensi yempilo engabonakaliyo ihlanganisa zonke iinkonzo ezibalulekileyo zempilo, kwaye ayiqwalaselwe ubuncinci benkcazo ebalulekileyo, ngoko ayiyi kuyanelisa imfuneko yoMthetho weNonophelo loNonophelo ukuba ube ne-inshurensi yezempilo kwaye ayikukunceda ukuba ugwebe isohlwayo serhafu ukuba ungagqithwanga. ukuba nangona ibhaso yerhafu ye-GOP eyenziwe ngasekupheleni konyaka we-2017 ekugqibeleni igqithise isigwebo somntu ngamnye, okwenzekayo kude kube ngowama-2019; abantu abangaqinisekisiwe ngo-2018 baya kuhlawula isohlwayo xa befake irhafu yabo ngasekuqaleni kuka-2019, ngaphandle kokuba bafanele ukukhululwa ).
Ezinye iintlobo ze-inshorensi yezempilo zingabangela impatho zerhafu ozonandiphayo ngokuba neAkhawunti yokuThengisa impilo kunye neCandelo eliPhezulu leMpilo eliDeductible. Ukuba unayo i-HSA, jonga umcwangcisi wakho werhafu ngaphambi kokuthenga nayiphi na enye inhlobo yinshuwalense yezempilo ukuqinisekisa ukuba uyayiqonda impembelelo enokuthi ibe nayo kwi-HSA yakho. Unokufunda ngokubanzi malunga nalokhu kwi-IRS Publication 969.
Izicwangciso zezempilo ezongezelelweyo azilawulwa ngokungqongqo njengezicwangciso ze-inshorensi zempilo. Ukukhuselwa kwabathengi kubandakanywa nomgaqo-nkqubo we-inshurensi yempilo yenkxaso-mali iyahlukahluka kuxhomekeke ekubeni uyithenga umgaqo-nkqubo ngokusebenzisa umsebenzi wakho, okanye njengomntu ngamnye. Uninzi lwezicwangciso ze-inshorensi zempilo alinalo ukukhuselwa kwabathengi abafanayo abasebenzisa kwi-inshurensi yempilo.
Ngokomzekelo, ezinye iintlobo zee-inshorensi zempilo zongezelelekileyo zibandakanya iimeko ezikhoyo ngaphambili okanye zinemizuzu yokulinda ngaphambi kokuba kubekho ukukhutshwa kwezimo zangaphambili ezikhokhayo. Kukho ngokubanzi ngonyaka okanye ukuhlawulwa kwemali ephezulu, kwaye bahlala bephantsi kakhulu kunani elipheleleyo elifunekayo ukuze ukuphatha izifo ezahlukeneyo okanye ukulimala (yingakho ezi zicwangciso kufuneka zixhaswe kwezinye i-inshurensi yezempilo, kunokutshintshwa kwenye inshuwalense yezempilo). Ukukhutshwa kungaqinisekiswa ukuba kuhlaziywe, oku kuthetha ukuba unako ukukwazi ukubhalisa ngonyaka emva konyaka. Ezinye iindidi zemigaqo-nkqubo ayinakuqinisekiswa kwintlawulo , oku kuthetha ukuba umgcini-mali angakwenqaba ukukuqinisekisa ukuba ucinga ukuba unomngcipheko omkhulu.
Ekugqibeleni, abaqinisekiso-mali bavunyelwe ukwenza inzuzo enkulu kwinkokhelo yezempilo engaphezulu kunezona nkampani zomshuwalense jikelele. Izicwangciso ezininzi zezempilo ezithengiswayo eUnited States kufuneka zisebenzise i-80-85% yemali abayibuthayo kwiiprayimari ekuhlawuleni iinkonzo zempilo okanye imisebenzi yokuqinisekiswa kwemigangatho, eshiye i-15-20% kuphela kwiindleko zokulawula, ukuthengisa kunye neenzuzo. Izicwangciso ezongezelelweyo azilawulwa ngaloo ndlela. Basenokuchitha isahlulo esincinci semali esithathwe njengama-premiums ekuhlawuleleni iintlawulo, beshiya inxalenye enkulu kwiinkomishoni zee-arhente, ukuthengisa, ukulawula, kunye neenzuzo.
> Imithombo:
> I-Cornell Law School, i-Legal Information Institute. 45 CFR 148.220, ngaphandle kweNzuzo.
> Jost, Tim. Imiba yezeMpilo. Ukuphunyezwa kweMpilo yeNguqu: Iingeniso ezingeNcediso zokugqibela. Septemba 29, 2014.