IziCwangciso eziKhulu eziCwangcisiweyo zokuCwangcisa ukuPhelisa ekupheleni kuka-2018
Xa i-ACA isayinwe kumthetho ngowama-2010, ifuna ukuba utshintsho oluphawulekayo kwiimarike ze-inshorensi yezempilo kunye neyodwa. Amalungiselelo akhiwe kumthetho ukuvumela izicwangciso ezazisele zikho ngo-Matshi 23, 2010 ukuba ziqhubeke zisebenza ngokusisigxina, nje ngokuba akukho tshintsho oluphawulekayo lwenziwe kwisicwangciso, kwaye nje kuphela ukuba umphathiswa aqhube ukunikela cwangciso.
Ezi zicwangciso ziye zazala kwaye zikhululekile kwiimfuno ezininzi ze-ACA.
Kodwa ii-ACA azizange zenze izibonelelo ezithile malunga neeplani zeqela kunye namancinci asebenzayo emva komhla wama-23 Matshi 2010, kodwa ngaphambi kokuba ubuninzi beemigaqo-mali ze-ACA zenzeke ngo-2014. Kwakulindeleke ukuba baya kuphelisa ekupheleni konyaka ka-2013 kwaye ithathelwe endaweni yecala lokubambisana ne-ACA.
Ukuxhaswa kweTshintsho loTshintsho lwakhiwe "IziCwangciso eziMkhulu"
Kwaye ekupheleni kuka-2013, njengoko i-inshurensi yempilo yentsholongwane yayiqhutyelwa-kunye ne-glitches ebalulekileyo yezobuchwepheshe-kwaye njengoko izaziso zokukhansela eziqhelanisiweyo ziqale ukubonakaliswa kwiibhokisi zeeposi zabathengi, uboya malunga nokucinywa kwamalungiselelo kufinyelele kwi-fever-pitch .
Ekuphenduleni, iHHS ikhishwe inkululeko yenkxaso eyenza amazwe ukuba avumele izicwangciso ezingenakuzaliswa ukuba zivuselelwe kwakhona ngokukhawuleza ngo-Oktobha 1, 2014, kunye nokunika inkxaso okuvumelekileyo ukuba kuqhubeke ukusebenza kuze kube ngoSeptemba 30, 2015.
Ngenyanga engaphantsi kwezine, ngo-Matshi 2014, i-HHS yakhupha ukongezwa kwenkxaso yenguqulelo, inika inketho yokuvumela ezi zicwangciso (ezibizwa ngokuthi "yenguqulelo" okanye "izicwangciso ezinkulu") ukuhlaziya ngokukhawuleza ngo-Oktobha 1, 2016, ukuba ngoko ke unokuvunyelwa ukuba uhlale usebenza ngokukhawuleza ngoSeptemba 30, 2017.
NgoFebruwari 29, ngo-2016, i-CMS yakhupha isongezelelo esongezelelweyo esavumele ukuba izicwangciso ezinkulu zihlale zisebenza ngokukhawuleza ngo-Disemba 31, 2017. Kodwa esinye isandiso sakhishwa ekuqaleni kuka-2017, ukuvumela iiplani ezinkulu ukuba zihlale zisebenza kude kube sekupheleni kuka-2018.
Ngenxa yoko, kwininzi yezizwe, kusekho izicwangciso zeqela kunye kunye namancinci azinakwenzeka, kwaye azihambisani ngokupheleleyo ne-ACA. Ezi zicwangciso zenguqu, okanye zikhulu, zihlala zisebenza kude kube nguDisemba 31, 2018. Nantsi oku kufuneka ukwazi ngabo:
1. Izicwangciso ezizikhulu zincinci azikho into efana nezicwangciso ezinokuzala . Zineemfuno ezahlukileyo ngokuhambelana nemimandla eyahlukeneyo ye-ACA, kwaye abavunyelwe ukuba bahlale besebenza ngokungapheliyo. Izicwangciso ezigqithisileyo ziphelelwe usuku, ngokungafani nezicwangciso ezininzi, ezinokuthi-zize zisebenze ngokusisigxina xa ngaba bathuthi bekhetha ukuhamba kuloo ndlela ( okungenakwenzeka ).
2. Ezinye iindawo zikhethile ukuba zingavumeli izicwangciso eziphezulu, abanye baziphelisa phambi ko-2018 . Kumazwe awaye avumela iiplani ezinkulu ukuba ziqhubeke zivuselela, abanye abathwali baphela phantsi izicwangciso zabo, kwaye bafaka endaweni yabo nge-ACA-ehambisanayo.
Amalungiselelo enkonzo yenkxaso-thutyana akhutshwe ekupheleni konyaka ngo-2013, xa abanye bethetha kunye nabathwali bebekude kakhulu endleleni ye-ACA-yokuphunyezwa abaye bayigqiba ukuba ayiyi kuba ngumdla ongcono kwiinqununu zokuguqula inkqubela kwilo xesha. Kwimizuzu eyi-15 kunye ne-DC, akukho zicwangciso ezinkulu ezikhoyo ngo-2016. Yaye nangona ezinye iindawo zivumele iiplani eziphezulu ukuba ziqhubeke, kukho ubuncinane ezine kwezo ndawo apho kungekho zicwangciso ezikhulu.
3. Izicwangciso eziphezulu zibandakanya ukunakekelwa kokukhusela ngaphandle kokwabelana ngeendleko, kodwa akudingeki ukuba zibandakanye ezinye zeenzuzo zezempilo ze-ACA .
I-ACA iqalile ifuna zonke izicwangciso zezempilo ukuba zibandakanye ukunakekelwa kokukhusela ngaphandle kokukwabelana ngeendleko (okt, ikhululekile ngexesha leenkonzo zinikezelwa) kuzo zonke izicwangciso iminyaka ukususela okanye emva kweSeptemba 23, 2010. Oku kusebenza kwizicwangciso ezintsha kunye nokuhlaziywa, nangona akuzange isetyenziswe kwizicwangciso ezinkulu . Izicwangciso ezininzi eziza kusebenza emva koMatshi 23, 2010 kodwa ngaphambi koSeptemba 23, 2010, kwafuneka ziqale ukugquba ukunakekelwa kokukhusela ngaphandle kokwabelana ngeendleko njengosuku lokuqala lokuvuselela. Kwaye zonke izicwangciso ezinkulu zisebenza ngomhla okanye emva kweSeptemba 23, 2010 ziquka ukunakekelwa kokukhusela ngaphandle kokunikwa imali kwi-go-go.
4. Izicwangciso eziphezulu azikwazi ukuthengiswa . Izicwangciso zezobukhulu ziza kuqala emva kukaMatshi 23, 2010, kodwa nge-Okthoba 1, 2013, okanye kwezinye iimeko, ngoDisemba 31, 2013. Emva kwaloo nto, kwakungasakwazi ukuthenga isicwangciso kwaye kuqwalaselwa njengezikhulu. Ngomhla kaJanuwari 2014 ejikeleze ngeenxa zonke, akukho qela elincinane okanye izicwangciso zonyango eziphambili ezinokuthengiswa kuzo zonke (kubandakanywa nokutshintshiselana) ukuba bezingagqibekanga ngokupheleleyo kwi-ACA. Qaphela ukuba abaxhomekeke kubo banokungeniswa kwisicwangciso esikhulu (ukuba unesicwangciso esiphezulu kwaye unomntwana, unokongeza umntwana kwisicwangciso), kunye nabasebenzi abasandula ukufumana inkxaso banokufumana ukufumana ingxelo phantsi kwesicwangciso se-grandmothered plan . Kodwa izicwangciso ezintsha zangezizukulwana azizange zifumaneke ukuthengwa ukususela ekupheleni kuka-2013.
5. Izicwangciso zokufumana izibonelelo eziphezulu azifanelekanga kwiinkxaso-mali okanye iinkonzo zerhafu ye-inshurensi yezempilo . Azingathengiswanga ngokutshintshiselana, oko kuthetha ukuba abafanelanga ukufumana inkxaso-mali ye-premium. Ukuba unesicwangciso somntu ngamnye, uhlawula i-premium ngokwakho.
6. Ukuba isicwangciso sakho esikhulu singabandakanyi izimo zakho ezikhoyo ngaphambili, lelo lungiselelo lisasebenza . Kuzo zonke iindawo ezintlanu zithetha, inshorensi yonyango ngamnye yonyango-yabhalwa phambi ko-2014. Kwaye kumazwe amaninzi, ukukhutshwa kweqela elincinci kunokwenziwa ngeeprayimari eziphezulu ezisekelwe kwimbali yezobugcisa. Nangona akusekho iiplani ezintsha, imigaqo yesicwangciso sakho esikhulu sitshintshi-ukuba ingabandakanyi imeko yakho esele ikhona okanye ihlawulise i-premium ephezulu ngenxa yembali yakho yonyango, eqhubekayo namhlanje.
7. Xa isicwangciso sakho esikhulu siphela (okanye uvuselela kwakhona), uya kufumana ithuba lokubhalisa okhethekileyo . Nangona isicwangciso sakho sezempilo siphela ngaphandle kobhaliso oluvulekile, uya kukwazi ukubhalisa kwisicwangciso esitsha kulelo nqanaba , kungekho sithuba esiphephayo. Ngaphantsi kolawulo olukhutshwe yi-CMS ekuqaleni kuka-2017, izicwangciso ezinkulu zivunyelwe ukuhlaziywa ngokukhawuleza ngo-Oktobha 1, 2018, kodwa i-coverage kufuneka iphele ngaphandle kweDisemba 31, 2018. Ukuba isicwangciso sakho sezempilo silandela le shedyuli kwaye sivumela isicwangciso sakho ukuba siqhubeke ukuba ufike ngoDisemba 31, 2018, uya kubhalisa ngexesha lokubhalisa okuvulekileyo ngo-2019, kwaye ube negalelo elingagqibekanga phantsi kwe-ACA-icebo elihambelanayo elisebenza ngoJanuwari 1, 2019.
Kodwa ukuba isicwangciso sakho sisenomsebenzi ongekho-khalenda wonyaka (umz., Uqala ukususela ngoJuni ukuya kuMeyi, umzekelo, uphinde uvuselele ngoJuni 1 unyaka ngamnye), umgcini wakho womshuwalense unokukhetha ukuphelisa isicwangciso ngomhla wokuhlaziya, endaweni ukuvuselela oko kunyaka owamanqanaba kwaye uvumele ukuba uhlale usebenza ngawo wonke u-2018. Kwimeko apho, uya kufumana ithuba lokubhalisa okhethekileyo ngexesha ongakhetha ngayo isicwangciso esitsha, esabangela ukulahlekelwa kwenkcazo, isiganeko esifanelekileyo .
Ukongeza, unako ukubhaliswa okhethekileyo ngexesha apho ungakhetha khona isicwangciso esitsha esilungelelaniso se-ACA, ukuba isicwangciso sakho sonyaka ongekho-ikhalenda (okanye esikhulu) sivuselela phakathi konyaka, nangona isicwangciso singagqiba loo ngongoma.
> Imithombo:
> Amasebe e-Medicare kunye neenkonzo zeMedicaid, iSebe lezeMpilo kunye neNkonzo zoLuntu. Incwadi kubakhomishinala boMshuwalense-iSicwangciso soNcedo lweTshintsho . Novemba 16, 2013.
> Amasebe e-Medicare kunye neenkonzo zeMedicaid, iSebe lezeMpilo kunye neNkonzo zoLuntu. Imiqulu ye-Intshulamu ye-Bulletin Series-ULWAZI-Ukongezwa kweeNkcazo zeTshintsho ngoNyaka weKhalenda 2018 . NgoFebruwari 23, 2017.
> I-Cornell Law School, i-Legal Information Institute. 45 CFR 155.420 (d) (1) (ii).