Ukulinda de ugule kungabi kubiza
I-inshurensi yezempilo iyabiza, ngoko kutheni ungalindeli kwaye uthenge i-inshorensi yempilo xa uyayidinga? Kutheni uhlawula iinyanga zeeprimi xa ungasidingi ukuyisebenzisa?
Ukususela kwimimiselo ye-Care Affordable ye-Care Act ifuna ukuba uthenge i- inshorensi yezempilo kwi-corporation, kunokuba umgaqo-nkqubo oxhaswa ngu-one-payer nkqubo ofunyenwe kumazwe amaninzi athuthukileyo, unokubonakala ungabizi kwaye ukhuselekile ukulibala ukuwuthenga uze uwufune.
Kodwa, kukho izizathu ezinyanzelisayo zokungalindi.
Ubhaliso oluvulekileyo aluvulekanga
Unokuthenga kuphela i-inshorensi yempilo kwimarike nganye (ebandakanya nge- inshurensi yempilo yomshuwalense kunye nangaphandle kwemicimbi yokubhalisa) , ixesha lokuba wonke umntu angathenga i-inshorensi yempilo.
Ukuba awuyithengi i-inshurensi yakho yempilo ngexesha lokubhalisa okuvulekileyo, kufuneka ukulinde de ubhaliso oluvulekileyo olulandelayo olunye ithuba. Ukuba uyagula ngeli xesha, mhlawumbi uya kuba yintlanzi.
Ixesha lobhaliso oluvulekileyo liba lifutshane. Ukuqala ngo-2018, ukubhaliswa okuvulekileyo kuya kuba malunga neeveki ezintandathu kwixesha elide, ukusukela ngoNovemba 1 ukuya kuDisemba 15 ngamnye ngonyaka, ngo-Januwari 1 wonyaka ozayo ( ngo-2018 ukufikelela kuphela, kukho iinguqu ezithoba eziseburhulumenteni eziye zandisa Ukubhaliswa okudlulileyo kuDisemba 15).
Ngo-2014, xa izicwangciso ze-ACA ezilungele ukuqala, ukubhaliswa okuvulekileyo kwadlula iinyanga ezintandathu.
Ukususela ngo-2015 ukuya ku-2017, ukubhaliswa okuvulekileyo kwakuneenyanga ezintathu ngonyaka.
Ngaphandle kokubhalisa okuvulekileyo
Ukuguquka kwemiqathango ebomini bakho (kodwa kungatshintshi kwimeko yakho yempilo) kuya kudala ixesha lokubhaliselwa okhethekileyo apho ungathenga i-inshorensi yempilo okanye utshintshe isicwangciso sakho sezempilo. Ezi ziganeko ezifanelekileyo zibandakanya:
- Ukulahlekelwa ukufikelela kwisicwangciso se-inshorensi yezempilo yakho esele ikhona ngenxa yezizathu ngaphandle kokuhlawulwa kwe-premium okanye ubuqhetseba (umzekelo, ukushiya umsebenzi wakho nokulahlekelwa ukufikelela kwi-inshurensi exhaswe ngumqeshi).
- Ukufumana uxhomekeke okanye ube ngumxhomekeke. Ukutshata, nokuba nosana, okanye ukufumana umntwana ngumzekelo.
- Ukufudukela ngonaphakade kunokudala ixesha lokubhalisa okhethekileyo. Oku kusebenza nakubantu bakhululwa entolongweni. kodwa ukususela phakathi konyaka ka-2016, oku kusebenza kuphela ukuba sele usuqinisekisiwe kwindawo yakho yangaphambili-uza kuba nethuba lokutshintsha i-inshurensi ukuba uhamba, kodwa ungafumani ukufumana ingxelo yokuqala.
Izikhathi zokubhalisa ezizodwa zikhawulelwe ixesha, kwaye unemizuzu engama-60 kuphela ukusuka ngomhla wokuba ubhalise kwisicwangciso esitsha.
Iimviwo zeeNkcazo zeeNtsholongwane zempilo
Inkonzo yomshuwalense wezempilo ayifuni ukusebenza ngomhla owuthengayo. Ingaba uqinisekisiwe ngomsebenzi okanye ngeenkampani ozifumene kwi-exchange exchange, ngokuqhelekileyo ixesha lokulinda ngaphambi kokukhawulwa kwekharityhulam. Ngokomzekelo:
- Ukuba ubhalisa ngexesha lokubhalisa oluvulekileyo ukubhaliswa kwakho kuza kuqala ngoJanuwari 1 (inqaku lokuba kwintetho esithoba ezongezelele ukubhaliswa okuvulekileyo kwithuba lokubhalwa kwe-2018 kuphela, kukho ezinye izinto ngaphandle kwalokhu )
- Ukuba ubhalisa ngaphandle kobhaliso oluvulekile (usebenzisa ixesha lokubhalisa okhethekileyo) kwaye ubhalisa ngaphambi kwe-15 kwinyanga leyo, i-coverage yakho iya kuqala ekuqaleni kwenyanga ezayo
- Ukuba ubhalisa emva komhla we-15 wenyanga, ukufihla kwakho kuya kuqalisa ukuqala kwenyanga yesibini elandelayo. Ngokomzekelo, ukuba ufumana isiganeko esifanelekileyo kwaye ubhalise ngoMatshi 25, 2018, ukufihla kwakho akuyi kusebenza ukususela ngo-Meyi 1, 2018 (ngaphandle kokuba umcimbi wakho ofanelekileyo ulahlekelwa yinto ethile okanye umtshato, kwimeko apho imithetho ekhethekileyo isebenza ngomhla osebenzayo, kwaye ukufikelela kwakho kungasebenza ngo-Apreli 1, 2018; phawula ukuba kuzo zonke iimeko, unokufumana ukufikelela ngokukhawuleza kwintsana okanye umntwana owamkelweyo emva kokuzalwa okanye ukuthatha umntwana emva kokuba ubhalise ngaphambi kokubhalisa okhethekileyo ixesha liphela).
Intshurensi yezeMpilo kwiimeko ezingalindelekanga
Isicwangciso esibi sokulinda ukuthenga i-inshorensi yezempilo uze ufune ukuyisebenzisa. Nangona unobutsha kwaye unempilo, izinto ezimbi zisenokwenzeka.
Kuthekani ukuba wucoca isandla sakho xa iglasi yewayini ephuka xa uhlamba? Ukugxininisa kwigumbi elingxamisekileyo kunokubiza kakhulu. Kuthekani ukuba unqabile ikati ngelixa uhamba phantsi ezitebhisini? I-ankle ephukile ayikwazi ukulinda unyango kwaye isenokufuna ukuhlinzwa.
Nangona kukho into enjengaleyo eyenzekayo xa unako ukubhalisa kwirejista ngokukhawuleza (ngexesha lokubhalisa okuvulekileyo okanye ngexesha lokubhalisa okhethekileyo), i-coverage yakho ayiyi kusebenza ngokukhawuleza. Akungabazeki ukuba ufuna ukulinda iiveki ukuya kwindawo yokuphucula. Uya kufuneka ulinde inyanga nje ukuba ubhalise.
Iindleko zeNtshurensi yezeMpilo
Isizathu esivakalayo abantu abanika ngenxa yokungena-inshurensi yezempilo kukuba kubiza kakhulu. Kodwa i-ACA iye yanceda ukwenza uhlaselo olunokuthengeka kakhulu kubantu abaneemali eziphantsi kunye nephakathi.
Ukuba ingeniso yakho yayingaphantsi kwama-16,642 ayi-$ 20,642 ngo-2017 (umntu oyedwa), unokufumana ilungelo lokufumana iMedicaid. Kuxhomekeke ekubeni ingaba urhulumente wakho wandile iMedicaid, kodwa i-31 kunye ne-DC sele sele ikhetha ukwandisa iMedicaid phantsi kwe-ACA.
Ukuba umvuzo wakho uphakeme kakhulu kwi-Medicaid kodwa ukuya kumaxesha amane kwintlupheko, unokufumana ilungelo lokufumana inxalenye ye-premium yakho kwintsebenziswano. Umyinge ongeniso-mali ngowama-2017 ukwenzela inkxaso-mali ye-2018 yomntu omnye kwaba malunga ne-48,240 zamawaka-ngokuqinisekileyo kwinqanaba eliphakathi komntu oyedwa (kwintsapho yezine, umyinge wokufumana umvuzo unyulela yonke i-$ 98,400).
Ukuze unelungelo lokufumana inkxaso, kufuneka uthenge i-inshurensi yakho yezempilo ngokusebenzisa utshintshiselwano. Unako ukuthatha inkxaso-phambili phambi kwakho, uhlawulwe ngqo kwinkonzo yakho yomshuwalense unyaka wonke, okanye unakho ukuhlawula ixabiso elipheleleyo lokubhengezwa kwakho kwaye unokubango incediso yakho yerhafu yakho .
Izicwangciso ezimbi
Ukuba uneminyaka engama-30 ubudala, okanye ukuba unobunzima bezemali, unokufumana isicwangciso sezempilo esiyingozi . Nangona ezi zicwangciso zinexabiso eliphezulu kakhulu kunye neendleko ze-pocket ezivunyelwe phantsi kwe-ACA, iiprayimari zazo ziphantsi kunezinye iindlela ezikhoyo, kwaye ubuncinci uya kuba negalelo.
Izicwangciso ezinobungozi azikwazi ukuthengwa ngabantu abangaphezu kwe-30 ngaphandle kokuba banelungelo lokuxolelwa. Kwaye kubalulekile ukuba uqaphele ukuba inkxaso-mali ayinakusetyenziswa ekuncedeni ukuhlawula izicwangciso ezinobungozi, ngoko ke akayiyo ikhethelo elungileyo kunoma ubani ofanelekileyo ukufumana inkxaso-mali ngokusekelwe kwingeniso.
> Imithombo:
> Imihla kunye nemihla yokugqibela ye-2018 yeNtsholongwane yeMpilo. HealthCare.gov. https://www.healthcare.gov/quick-guide/dates-and-deadlines/.
> IPACACA, Izilungiso kwixesha eliKhethekileyo lokuBhaliswa kweeNyanga kunye neNkqubo yoCwangciso lwaBathengi esebenzayo kunye neCwangciso esivunyiweyo . ISebe lezeMpilo kunye neNkonzo zoLuntu. https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-11017.pdf.
> Isikhathi sokuBhalisa esikhethekileyo (SEP). HealthCare.gov. https://www.healthcare.gov/glossary/special-enrollment-period/.