Iinshurensi zempilo zongeniso kwiiwaka zeedola zenza iikhowyayiti, iintlawulo ezingama-$ 25 ukuya kwii-75 zama-intlawulo ohlawulwa ngaso sonke ixesha xa uya kugqirha okanye uzalisa umyalelo, zibonakala ngathi ziguqule. Kodwa ii-copays ziyakongeza xa unengxaki zempilo. Ingaba i-copays count ngokubhekiselele kwi-inshurensi yempilo yakho? Ngaba uyayikhupha xa uhlawula i-copay ye-$ 30 yakho ye-thyroid okanye i-cholesterol?
Kuyinto engokwemvelo ukuphosa xa ucinga nge-inshorensi yakho yezempilo, ngokuphindaphindiweyo ngamawaka angamawaka eedola. Uhlahlo lwabiwo-mali lwe-inshorensi yakho yempilo luye lwaba yimfuneko kubafundi be-savvy abangabutyebi. Kodwa, kunzima ukulandelela inkqubela yakho ekuhlangabezaneni ne-deductible yakho xa ungaqondi ukuba yintoni, ngokubalulekayo , ukubala kuyo .
Ukuba ingaba akhoyo i-copays count malunga ne-deductible yakho kuxhomekeke kwindlela sakho isicwangciso sempilo esilungiselele ngayo iimfuno zokwabelana ngeendleko . Kwamava am, iiplani ezininzi azibalanga ii-copay zakho kwi-inshurensi yempilo yakho. Nangona kunjalo, isicwangciso sakho sinakho. Izicwangciso zempilo zokwabelana ngeendleko ziguqula unyaka ngamnye njengoko izicwangciso zezempilo zikhangele iindlela ezintsha, ezichanekileyo kunye nabathengi-ndlela ukuseka iimfuno zokwabelana ngeendleko.
Uyazi njani ngokuqinisekileyo? Okokuqala, khangela isishwankathelo seNzuzo kunye noMgangatho. Nika ingqalelo kwiimathematika kwimimiselo. Ukuba kusengacacile, ungadinga ukufowunela inombolo yelungu kwikhadi le-inshurensi yezempilo kwaye ubuze.
Kodwa ngokubanzi, kufuneka ulindele ukuba ii-copay zakho aziyi kubalwa kwi-deductible yakho. Kodwa ke, kuya kubalwa ekugqithweni kwakho kwepakethi (ngaphandle kokuba unesicwangciso esiphezulu okanye esikhulu esisebenzisa imigaqo eyahlukeneyo yeendleko ze-out-of-pocket).
Xa i-Health Plan Credits iCopays eya kwiDeductible
Iikopi zongeza.
Ukuba ubona ugqirha ngokuphindaphindiweyo okanye uzalise imimiselo ngokuqhelekileyo, iikhowyiti ezichazwe ngokuchithwa kwakho ziya kunceda.
Masithi impilo yakho yomshuwalense ihlelwe njengale:
- $ 1,000 echithwayo,
- I-copay ye-$ 30 yokubona ugqirha wakho wokunyamekela ,
- Ikhophi yama-$ 60 yokubona igosa lonyango,
- I-25 ye-copay yokuzalisa imithi yesigqirha ,
- I-copay ye-$ 45 yokuzalisa isigunyaziso segama lomhlaza.
Ngoku, thelekisa iimpembelelo zemali usebenzisa imeko efanayo yokunakekelwa kwezempilo kunye ne-inshurensi yezempilo ebolekisa imali yakho yokuhlawulwa kwi-inshorensi yakho, kunye ne-inshorensi yempilo engabhalisi iikhowyiti zakho kwi-deductible yakho.
NgoJanuwari, ufumene ukuba unesifo sikashukela . Uyabona i-PCP yakho kathathu kwaye unqunywe esinye isiyobisi kunye nesinye sezidakamizwa. Iikhodi zakho zeJanuwari zi-$ 30 + $ 30 + $ 30 + $ 25 + $ 45 = $ 160.
I-PCP yakho ayonwabanga nokulawula isifo sikashukela, ngoko ngoFebruwari, uyathumela ukuba ubone i- endocrinologist , ugqirha ogxininisekile kwisifo sikashukela kunye neengxaki ze-hormone. Uyabona ingcali kwaye uzalise zombini imiyalelo yakho. Iifayili zeeFebruwari zakho zi $ 60 + $ 25 + $ 45 = $ 130.
Ngo-Matshi, ubona i-endocrinologist kabini. Utshintsha imiyalelo yakho; ngoku usebenzise ezimbini iziza zamagama.
Iikhophi zenyanga zakho zoMatshi zi-$ 60 + $ 60 + $ 45 + $ 45 = $ 210.
Ekupheleni kukaKwindla, uhlawule i-$ 500 kwimali-mpayipi. Ukuba isicwangciso sakho sempilo sibabala iifayili zakho malunga ne-deductible yakho, unesiqingatha ekuhlanganiseni i-deductible yakho ye-$ 1,000. Ukuba isicwangciso sakho sempilo singabali iifayili zakho kwi-deductible yakho, uya kuhlawulwa i-$ 1,000 eyi-deductible nangona sele ukhokhele i-$ 500 kwiindleko zonyango kwi-pocket yakho.
IziCwangciso eziQulisekileyo ze-ACA Inani leeCopays kwi-Out-of-Pocket yakho enkulu
Nangona kunqabile ukufumana icebo elibala iipayipi kwi-deductible, zonke izicwangciso ze-ACA ezihambelanayo zibala ikopi (kwiinkonzo ezibhekwa njengezibonelelo eziyimfuneko zezempilo ) ekubhekiselele kwikhompyutheni yakho yangaphandle ye-pocket , kwaye kukho umda ophezulu ngokwemigaqo ukuphakama kwakho kwiphakheji engaphezulu ( i-$ 7,150 kumntu oyedwa ngo-2017 ).
Uninzi lwabantu aluphelelanga ukudibanisa i-po-pack ephezulu. Kodwa ukuba uyayenza, inokuba nayiphi na inhlanganisela ye-copays, deductible, kunye ne-coinsurance eyenza ukuba ube ngumda. Ukuba unayo iinkonzo ezininzi apho i-copay isebenza khona, ungagqiba ukudibanisa umda wakho wokuphuma kwipokethi ngenxa kuphela yecopays, ngaphandle kokuba uhlangabezane ne-deductible yakho yonke into (kwimeko leyo, awuyi kuhlangana ne-deductible yakho kunyaka, nangona ufuna ukunyamekela ukuba i-deductible ingasetyenziswa ngokuqhelekileyo).
Ukuhlaziywa nguLouise Norris.
> Imithombo:
> Amasebe e-Medicare kunye neeNkonzo zeMedicaid, iZiko loLwazi loThengi kunye noLawulo lweNtshuwalense. I-FAQ yoNonophelo olungabonakaliyo Imibuzo yokuSebenza - Setha 18.