Kutheni Ndifuna Iminshurensi yezeMpilo?
Kubalulekile ukufumana i-inshorensi yempilo kunye namalungu osapho lwakho olusondeleyo. Ininshurensi inceda ukukukhusela kwiindleko zonyango eziphezulu, ngakumbi ezo zihambelana nezimo zonyango ezingapheliyo okanye isidingo sokubhedlelelwa esibhedlele.
Kufuneka ufumane i-inshorensi yempilo ngesizathu esifanayo sokuba unomshwalense womshuwalense okanye abanomnini-inshurensi yomshuwalense- ukukhusela imali kunye neengeniso zakho .
Kodwa ufuna kwakhona i-inshurensi yempilo ukuqinisekisa ukuba uya kufumana ukunyamekelwa kwezonyango eziphezulu ukuba kwaye kwaye xa ufuna. Kwizibhedlele ezamkela i-Medicare (eziphi izibhedlele), umthetho wesigqeba ufuna ukuba bahlole kwaye bazinze nabani na abakubonayo kumaziko abo aphuthumayo, kubandakanywa nomfazi osebenzayo. Kodwa ngaphaya kovavanyo kunye nokuzinza kwisebe lexakeka, akukho mfuneko yokuba izibhedlele zibonelele abantu abanakho ukuhlawula. Ngoko ukungabikho kwinshuwalense yezempilo kunokuphela kokuba ngumqobo obalulekileyo wokufumana unonophelo.
Ndingayifumana njani i-inshorensi yempilo?
Ngokuxhomekeke kwiminyaka yakho, isimo somsebenzi kunye nemeko yezemali, kukho iindlela ezininzi onokufumana i-inshorensi yempilo, kuquka:
- Iinshurensi yezempilo enikezwe ngumqeshi. Iinkampani ezinkulu e-US zifuneka ukuba zinike i-inshurensi yempilo enokuhlawuleka njengenzuzo yomqeshwa, kwaye abaninzi abaqeshi abancinci banika nokubonelela kubasebenzi babo. Kuya kufuneka ukuba uhlawule inxalenye ye- premium yenyanga , okanye indleko yomshuwalense wezempilo, ingakumbi xa ungeze intsapho yakho kwisicwangciso sakho.
- Intshuwalense yezempilo oyithenga kuwe. Ukuba uqeshwe okanye usebenzela inkampani encinci engaboneleli ngomshuwalense wezempilo, kuya kufuneka uyithenge ngokwakho. Unokuyifumana nge- inshurensi yezempilo kwimeko yakho, okanye ngqo kwiinkampani zomshuwalense, kodwa inkxaso-mali ye-premium (ukunciphisa imali ofuneka uyihlawule ngayo inkxaso yakho) kunye nenkxaso-mali yokwabelana ngeendleko (ukunciphisa imali omele uyihlawule xa ufuna uncedo lwezokwelapha) lufumaneka kuphela xa ufumana ingxelo yakho ngokutshintshiselana.
- Iinshurensi yezempilo enikezelwa nguRhulumente. Ukuba uneminyaka engama-65 okanye ngaphezulu, ukhubazekile, okanye unokufumana imali encinci okanye engenayo imali, unakho ukufumana ilungelo lokufumana i-inshurensi yempilo ehlawulwa nguRhulumente, njenge- Medicare neMedicaid .
Ukuba awunayo inshuwalense yezempilo okanye umshuwalense wezempilo ongeyaneleyo, uya kuba noxanduva lokuhlawula zonke iindleko zakho zezempilo. Isiqinisekiso soMonde kunye noNonophelo ojongene noNonophelo olungabonakaliyo (ACA), owamiselwa ngo-Matshi 2010, uqinisekisa ukuba abaninzi baseMelika banokufikelela kwi-inshurensi yempilo efikelelekayo.
Kukho ezinye izinto ngaphandle koko, nangona kunjalo. Ezinye zibangelwa yimpembelelo kwi-ACA, kubandakanywa nentsapho ye-glitch kunye nokuba inkxaso ye-premium ifunyenwe kuma-400 ekhulwini kwinqanaba lehlwempu, okubangelwa ukuhanjiswa okungenakulungelelaniswa kwabanye abantu abanomvuzo ongaphantsi kwelo mda. Kodwa ezinye zibangelwa yimimiselo, izigqibo zenkundla, kunye nokuchasene ne-ACA, kubandakanywa i-gcafi yokukhawulelana neMedicaid ekhoyo kwi-18 ithi ayizange yamkele inkxaso yemali yokwandisa iMedicaid.
Ndingakhetha njani iSicwangciso seMpilo?
Kukho izinto ezininzi ekufuneka uziqwalasele xa ukhetha i-inshurensi yezempilo. Le miba ingaba yinto eyahlukileyo xa ukhetha olunye lwezicwangciso zezempilo zomqeshi okanye ukuthenga i-inshorensi yakho yempilo.
Yenza umsebenzi wesikolo sakho ngaphambi kokuba uthenge nayiphi na ipolisi yomshuwalense wezempilo! Qinisekisa ukuba uyazi ukuba isicwangciso sakho se-inshurensi yempilo siya kuhlawula ntoni ... kwaye oko akuyi kuyenza.
Umshuwalense wezeMpilo oyiNkxaso-mali
Ukuba umqeshi wakho unika i-inshurensi yezempilo, unokukwazi ukukhetha phakathi kwezicwangciso ze-inshorensi zempilo. Ngokuqhelekileyo, ezi zicwangciso ziquka uhlobo oluthile lwenkqubo yokunyamekela , njengentlangano yokugcinwa kwempilo (HMO) okanye umbutho onikezelweyo umboneleli (PPO). Ukuba ukhetha i-HMO, icebo liza kuhlawula kuphela ukuba unokusebenzisa ugqirha okanye isibhedlele kwintanethi yesicwangciso. Ukuba ukhetha i-PPO, icebo liza kuhlawula ngakumbi xa ufumana unyango lwakho lwezempilo ngaphakathi kwintanethi yesicwangciso.
I-PPO iya kuhlawula inxalenye yenkathalo yakho ukuba uya ngaphandle kwintanethi, kodwa kuya kufuneka uhlawule ngaphezulu.
Umqeshi wakho unokubonelela ngeenjongo ezahlukeneyo zezempilo ezibiza ngaphezulu okanye ngaphantsi kuxhomekeke kwisixa seendleko ze-pocket ozenzayo ngonyaka. Ezi ndleko zingabandakanya i- copayment rhoqo xa ubona ugqirha wakho okanye ufumene umyalelo ogqityiweyo kunye nokunyulwa konyaka , yimalini oya kuhlawula iinkonzo zonyango ekuqaleni kwonyaka ngamnye ngaphambi kokuba i-inshurensi yezempilo ikhawuleze.
Ngokuqhelekileyo, isicwangciso esidinga ukuba usebenzise umnikezeli wenethiwekhi, sinokukhutshwa ngokuphezulu, kunye neepayimenti eziphezulu ziya kuba nama-premium aphantsi. Isicwangciso esivumela ukuba usebenzise naliphi na umniki-mboleko, unako ukuhlawula okuncinci, kunye neepayipi zephantsi ziya kuba neeprayimari eziphezulu.
Ukuba usemncinci, ungenayo isifo esingapheliyo, kwaye ube nokuphila ngendlela enempilo, unokucinga ukuba ukhetha isicwangciso sezempilo esinemithwalo ephezulu yokunciphisa kunye ne-copayments, kuba unganakudinga ukunakekelwa kwaye iiprayimari zakho zenyanga zingaphantsi.
Ukuba ukhulile kunye / okanye unesifo esingasigxina, njengesifo sikashukela, esidinga ukutyelelwa kwamagqirha amaninzi kunye nezidakamizwa zonyango, unokuqwalasela isicwangciso sempilo kunye neentlawulo eziphantsi kunye neepayili. Unokuhlawula ngaphezu kwenyanga nganye ngesabelo sakho seprayim, kodwa oku kungakhohliswa ngeendleko ezingaphantsi kwee-pocket kulo nyaka. Ukuchithwa kwamanani ukuze ubone ukuba ungalindelwa kangakanani ukuba uhlawule kwiindleko ezingaphandle kwee-pocket (qwa lasela inani elikhulu apha, ukuba ucinga uya kufuna uncedo oluninzi lwezonyango), kwaye wongeze loo iiprayimari ezipheleleyo ukuze uthelekise izicwangciso ezininzi. Awufuni nje ukucinga ukuba isicwangciso esiphantsi kweendleko (okanye, kuxhomekeke kwimeko, isicwangciso esincinci seendleko) siya kusebenza kakuhle.
Ukuze ufunde kabanzi malunga neendlela zakho zezempilo, khetha ummeli weSebe loluntu okanye ufunde izixhobo ezibonelelwe ngesicwangciso sezempilo. Ukuba bobabini kunye neqabane lakho / iqabane lakho lisebenza kwiinkampani ezibonelela nge-inshorensi yempilo, kufuneka uqhathanise nenye inkampani enikezelayo kwaye ukhethe icebo elivela kuyo nayiphi na inkampani ehlangabezana neemfuno zakho. Kodwa ke, qaphela ukuba ezinye iinkampani zibandakanya umrhumo ophezulu xa iqabane lakho lifikelela kwisicwangciso somqeshi walo kodwa sigqibo sokongezwa kwisicwangciso sakho endaweni yoko. Nazi ezinye malunga ne-ins kunye nokuphuma kwe-inshurensi yezempilo kubantu abatshatileyo .
Intshurensi yeMpilo
Ukuba ungumqeshi, umqeshi wakho akaboneleli ngomshuwalense wezempilo, okanye awuqinisekanga kwaye awufaneleki kwinkqubo yomshuwalense wezempilo karhulumente, unokuthenga i- inshurensi yempilo ngokwakho.
Unokuthenga i-inshorensi yempilo ngokukodwa kwiinkampani zomshuwalense wezempilo, njenge-Anthem okanye iKaiser Permanente, nge-inshente ye-inshurensi emele inkampani yomshuwalense, okanye nge- inshurensi yezempilo kwimeko yakho. Qhagamshelana nommeli wakho womshuwalense onokukwazi ukunceda ufumane i-inshorensi yempilo ehambelana neemfuno zakho.
Ekubeni iindleko zidla ngokuba yinto ebaluleke kakhulu xa ukhetha isicwangciso sezempilo, iimpendulo zakho kule mibuzo zilandelayo zinokukunceda wenze isigqibo sokuba yisiphi isicwangciso sokuthenga.
- I-premium yenyanga (emva kweyiphi na inkxaso-mali ye-premium, xa unelungelo lokwenza enye. Ngo-2018, inkxaso-mali iyafumaneka kubantu abafumana imali engama-$ 48,240, kunye neentsapho ezihlanu ezifumana imali eyi-115,120).
- Ndingakanani na ukuba ndihlawule ngaphambi kokuba isicwangciso sezempilo siphume?
- Ingakanani i-copay yokutyelela ugqirha kunye nemithi yokugonywa kwemithi?
- Ukuba ndikhetha i- PPO , ngaba kufuneka ndihlawule malini xa ndisebenzisa oogqirha okanye izibhedlele ngaphandle kwe-Intanethi ye-PPO?
- Yintoni eyona nto ndiza kufuneka ndihlawule kwiindleko ezingaphandle kwee-pocket xa ndiphela ndifuna ukunakekelwa okuninzi? Oku kufakwe kuzo zonke izicwangciso ze-ACA ezifanelekileyo kwi $ 7,350 kumntu omnye ngo-2018 .
- Ingaba isicwangciso sezempilo sinomfomfom wefayili oquka amayeza endiyisebenzisayo?
- Ngaba ugqirha wam kwisixhobo somncedisi wezempilo?
Qaphela iiNkqubo ezingavumelekanga ze-ACA
Zonke izicwangciso zonyango ezinkulu zempilo kunye neentsuku ezifanelekileyo zikaJanuwari 2014 okanye kamva zifuneka ukuba zihambelane ne-ACA. Oku kusebenza kuwo onke amazwe, kwaye isebenza kwizicwangciso ezithengiswa ngaphakathi kwintengiso kunye nezicwangciso ezithengiweyo ngqo kwiinkampani zomshuwalense yezempilo.
Kodwa kukho iindlela ezininzi zokucwangcisa ezingekho kwi-ACA. Kwaye ngamanye amaxesha ezo zicwangciso zithengiswa ngamaqhinga ahlukileyo, zikhokelela abathengi ukuba bakholelwe ukuba bathenga i-inshorensi yempilo yangempela, xa bengenjalo.
Ukuba ukhangele iiplani zexesha elifutshane, izicwangciso ezincitshiswe phantsi , izibonelelo zokufumana ingozi, izicwangciso zokugula, izicwangciso zokunciphisa unyango, okanye nayiphi na uhlobo lwesicwangciso esingavumelaniyo, uya kufuna ukuhlawula ngokuthe ngqo ukushicilela okulungileyo, kwaye qinisekisa ukuba uyayiqonda into oyithengayo. Qaphela ukuba ezi zicwangciso azidingeki ukuba zigubungele ii-ACA ezibalulekileyo zeempilo, akufuneki uhlawulele iimeko ezikhoyo ngaphambili, unganciphisa iindleko zakho zonke ngonyaka okanye ngaphezulu kwexesha lokuphila kwakho, kwaye ngokubanzi unoluhlu olude lokubhengezwa ngaphandle .
> Imithombo:
> Amasebe e-Medicare neeNkonzo zeMedicaid. Unyango lwezoNyango oluPhezulu kunye noMthetho wezabasebenzi.
> Imindeni yaseU.SA. Izikhokelo zeNtsholongwane yeNtlupheko yokuQinisekisa ukuFaneleka kweMedicaid, i-CHIP, kunye neNkxaso kwi-Exchanges.