Kwimeko ethile, kungcono nokuba kuyimfuneko ukuba ube nezicwangciso ezahlukeneyo
Iziqabane zivame ukugqitywa kwi-inshorensi yempilo efanayo. Kodwa oko akunakwenzeka njalo, kwaye akusoloko kukhethwa kukho okwenza ingqiqo. Makhe sijonge imigaqo echaphazelekayo yokubambisana nomtshato, kunye nemibandela omele uyibuze ngaphambi kokuba unqume ukuba ngaba wena kunye neqabane lakho kufuneka-okanye unako ukufumana umgaqo-nkqubo we-inshorensi.
Ukuphuma kwePocket Exposure
Iintsapho kufuneka ziqwalasele ukugqitywa kokuphela kweefowuni kwanaluphi na isicwangciso sezempilo okanye izicwangciso zabo okanye zicinga. Ixabiso elingabonakaliyo loMthetho woLonophelo lweMali kuMyingcele weendleko ezingekho ngaphaya kwamaRandi ayi-14,700 kwintsapho ngo-2018 , kwaye ivimbela nayiphi na ilungu lentsapho ekuhlawuleleni ngaphezulu kwiindleko ezingaphandle kwee-pocket (kwi-network network) ezingaphezu kwe-$ 7,350 . Kodwa umda wentsapho ongaphandle kwesikhokelo usebenza kumgaqo owodwa ohlanganisa amalungu osapho.
Ukuba intsapho ikwahlula kwiiplani ezininzi-kubandakanya i-inshurensi exhaswe ngumqeshi, ukuthengwa kwemakethe nganye, okanye iMedareri-imida yokuphuma kwimizi ekhutshwayo isebenza ngokwahlukileyo kumgaqo ngamnye. Ngoko ukuba intsapho ikhetha ukuba neqabane elinye kwisicwangciso esinye kunye nesinye isiqabane kwisicwangciso esisodwa kunye nabantwana besibini, isicwangciso ngasinye siya kuba nomda we-post-pocket limit, kwaye ukubonakaliswa okupheleleyo kunokuba kuphakamileyo kunokuba yonke intsapho yayisisicwangciso esinye.
Izidingo zeMpilo
Ukuba elinye iqabane liphilile kwaye elinye linemibandela ebalulekileyo yonyango, isigqibo esona siphumo sezimali singabakho ukuba babe nemigaqo-nkqubo emibini eyahlukileyo.
Umlingane ophilileyo unokukhetha icebo eliphantsi kweendleko kunye nenethiwekhi yomnikezeli okhuseleyo kunye nokugqithiswa kwe-pocket-out, ngelixa iqabane elijongene nezokwelapha lingafuna isicwangciso esincinci esiphezulu esinomncedisi ophezulu ngakumbi iindleko.
Oku akuyi kuba njalo, ngokukodwa ukuba elinye iqabane likwazi ukufikelela kwisicwangciso esixhaswe ngumqeshi ophezulu oza kubakhonkxa zombini ngeprayim efanelekileyo. Kodwa kuxhomekeke kwiimeko, ezinye iintsapho zifumanisa ukuba kukuqiqa ukukhetha izicwangciso ezihlukeneyo ngokusekelwe kwiimfuno ezithile zonyango.
Impembelelo zeeAkhawunti zokuSindisa impilo
Ukuba unayo i- Akhawunti ye-Savings Health (HSA) okanye unomdla wokuba unomnye, uya kufuna ukuqonda ingqalelo yokuba unesicwangciso se-inshorensi yezempilo.
Unokwenza igalelo ukuya kuma-6,900 ukuya kwi-HSA ngo-2018 ukuba unayo "incwadana" engaphantsi kwe-HSA-uphuculo oluphezulu olufanelekileyo lwezempilo (HDHP). Ukukhutshwa kweentsapho kuthetha ubuncinci amalungu amabini entsapho ahlanganiswe phantsi kwesi cwangciso (okt, nantoni na enye ngaphandle kwe-"self-kuphela" phantsi kwe-HDHP).
Ukuba unesicwangciso esifanelekileyo se-HSA phantsi kweliphi ilungu elikuphela kwinshurensi, umda wakho wegalelo we-HSA ngo-2018 yi-$ 3,450. Wena kunye neqabane lakho nonke ningaba nee-HSA ezihlukeneyo kunye nezicwangciso zezempilo ezichanekileyo ze-HSA ezihlukeneyo. Kodwa ukuba omnye wenu unesicwangciso esifanelekileyo se-HSA (kungekho namalungu entsapho esongezelelweyo kwisicwangciso) kwaye enye inesicwangciso se-inshurensi yezempilo engekho i-HSA-ifanelekileyo, inkxaso yakho ye-HSA iya kufikelela kuma-3,450 ayi-2018.
Umshuwalense wezeMpilo oyiNkxaso-mali
Phantse isiqingatha sabo bonke abaseMerika bafumana i-inshorensi yabo yezempilo kwiplani exhaswe ngumqashi-ngokugqithiseleyo kunokuba luhlobo olunjani olulodwa olubanzi. Ukuba bobabini bomtshato basebenzela abaqeshi ababonelela ngokukhawuleza, ngamnye unokuba kwisicwangciso sakhe. Ukuba ngabaqeshi banikezela ngokubhengezwa kwabatshatileyo, isibini sinokugqiba isigqibo sokuba ngaba iinjongo zabo, okanye ungeze elinye iqabane kwelinye icebo elixhaswe ngumqeshi.
Kukho izinto ezininzi zokugcina engqondweni xa usenza isigqibo sezona zinto zihamba phambili:
- Abaqeshi abafunwa ukuba banikezele ukuxhaswa kwabatshatileyo. Umthetho ojongene noNonophelo ongenakunqwenelekayo ufuna abaqeshi abakhulu (abasebenzi abangama-50 okanye ngaphezulu ) ukuba banikezele ukuxhaswa kwabasebenzi bexesha elizeleyo, kwaye bafuna ukuba nabo banikeze ukunika ingxelo kubantwana abaxhomekeke kubasebenzi. Kodwa akukho mfuneko yokuba abaqeshi banikezela ukuhanjiswa kwabafazi bomqeshwa.
- Oko kwathiwa, uninzi lwabaqeshi ababonelela ngenkonzo bavumela ukuba abatshatileyo babhalise kwisicwangciso. Abanye abaqeshi banikela ngokukhawulwa komtshato kuphela xa iqabane lingenakho ukufikelela kwisicwangciso sabo esixhaswe ngumqeshi.
- Ngaphantsi kwe-ACA, umqeshi omkhulu wabaniki banikezela kubasebenzi bexesha elizeleyo kufuneka kuthathelwe ingqalelo kwixabiso, okanye umqeshi ubhekane nokuba netyala lezemali. Kodwa ukuzimisela ukuzinyuka kusekelwe kwiindleko ze-premium yomqeshwa, kungakhathaliseki ukuba neendleko zokongeza abaxhomekeke kuyo okanye iqabane kwisicwangciso . Oku kwaziwa ngokuba yintsapho ye-glitch , kwaye iziphumo kwezinye iintsapho zijongene neendleko ezibalulekileyo zokongeza intsapho kwisicwangciso esixhaswe ngumqeshi, kodwa nangokungekho mfuneko yokufumana inkxaso-mali ekutshintshisweni.
- Kodwa abaqeshi abaninzi bahlawula isabelo seengonyama seendleko zokongeza amalungu omndeni, nangona kungenjalo ukuba bafune ukwenza njalo. Ngo-2017, iiprayimari eziqhelekileyo zokubhengeza iintsapho ngaphantsi kwezicwangciso ezixhaswe ngumqeshi kwakuyi-$ 18,764. Kwaloo mali, abaqeshi bahlawula umyinge wama-13,049, okanye ama-70 ekhulwini. Kodwa oku kuyahluka kakhulu kuxhomekeke kubukhulu bombutho; Amafemu amancinci awanako ukuhlawula inxalenye ebalulekileyo yeprayimenti yokongeza abaxhomekeke kubo kunye nabatshatileyo kubasebenzi babo.
- Abanye abaqeshi bongeza iirhafu kwiipresimenti abazihlawulela umtshato ukuba umlingane unelungelo lokufumana indawo yokusebenzela emsebenzini. Ukuba ngaba umqeshi wakho wenza oku, iindleko ezipheleleyo ziza kufuneka ziqwalaselwe xa ugxininisa amanani ukuba ubone ukuba kungcono ukuba bobabili abatshatileyo kwisicwangciso esifanayo, okanye ukuba omnye umlingane asebenzise isicwangciso sakhe esixhaswe ngumqeshi.
- Ngakolunye uhlangothi, malunga neepesenti ezili-10 zabaqeshi banikeza isinxephezelo esongezelelweyo kubasebenzi babo ababhalisa kwisicwangciso somlingane kunokuba babhalise kwisicwangciso somqeshi esixhaswe ngumqeshi. Le mibuzo uyakufuna ukujongana neSebe lakho lobutyebi ngexesha lobhaliso lwenkqubo yokuqala kunye nexesha lakho lokubhalisa lokuvula. Xa uqonda ngakumbi malunga nesimo somqeshi sakho kwisiganeko somtshato (kunye nesimo somqeshi womlingane wakho), ulungele ukulungelelanisa ukuba uya kuthatha isigqibo.
Intshurensi yeMpilo
Ukuba uthenge i-inshorensi yakho yempilo, mhlawumbi ngokutshintshiselana okanye ukutshintshiselana , ukhona kwizinto ezibizwa ngokuba yimarike nganye. Unenketho yokubeka abini bomtshato kwisicwangciso esinye, okanye ukhetha izicwangciso ezimbini ezahlukeneyo.
Unokukhetha izicwangciso ezihlukeneyo nangona ubhalisa ekutshintshisweni kunye nenkxaso-mali ye-premium Ukufumana ilungelo lokufumana inkxaso-mali, abhalisile abashadile kufuneka bafake i-return tax tax, kodwa akudingeki ukuba babe ne-inshorensi yempilo efanayo. Utshintshiselwano luya kubala inani lakho leenkxaso-mali ngokusekelwe kwingeniso yakho yekhaya kwaye uyisebenzise kwimigaqo oyikhethayo. Uya kuxolelana neenkxaso-mali kwi-tax return yakho ngendlela efanayo ukuba unokwenza ukuba unomgaqo-nkqubo onobuhlobo bentsapho yakho, kwaye isixa-mali esisonke esifumanayo siya kufana nanjengokuba wawukudibene kwisicwangciso esinye (isixa olihlawulayo kwiiprayimali ziya kuhluka, nangona kunjalo, ekubeni ixabiso elipheleleyo le-pre-subsidy iindleko zezicwangciso zimbini ziya kuba zihluke kwiindleko zangaphambili zenkxaso-mali zokuba zinezibini zomtshato kwisicwangciso esinye).
Unokukhetha kwakhona ukuba elinye iqabane lifumane isicwangciso sokutshintshanisa kunye nesinye isicwangciso sokutshintshiselana. Oku kunokuba yinto yokuqwalasela ukuba, umzekelo, elinye iqabane lifumana unyango lwezonyango kubaboneleli abaphela kwintanethi kunye nabathwali bokutshintshiselana nabo. Kodwa khumbula ukuba akukho mali engabikho ngaphandle kokutshintshiselwa, ngoko iqabane elinesicwangciso sokutshintshiselana ngaphandle liya kuhlawula ixabiso elipheleleyo le-coverage. Nangona iqabane elijongene neengxelo zenkxaso-mali liyakulungele ukufumana inkxaso-mali ngokusekelwe kwinani lemali yengeniso kunye nenani labantu abasemakhaya, inani lemali-mali lilonke lingaphantsi ( apha imizekelo ukubonisa indlela oku kusebenza ngayo ).
Ukuba elinye iqabane likwazi ukufikelela kwisicwangciso esixhaswe ngumqashi kwaye elinye iqabane livumelekile ukuba longezwe kwisicwangciso kodwa ukhetha ukuthenga isicwangciso somntu ngamnye, akukho mali inkxaso yeprayimenti ekhoyo ukuze ihlawule iindleko zesicwangciso ngasinye, ekubeni inkxaso ayifumanekanga kubantu abanokufikelela kwiinkcukacha ezixhaswe ngumqeshi.
Iinshurensi yezeMpilo exhaswa nguRhulumente
Kwezinye iimeko, elinye iqabane lingakwazi ukufumana i-inshorensi yempilo exhaswa nguRhulumente, ngelixa enye ingekho. Ezinye imizekelo ziquka:
- Elinye iqabane liphendukela kuma-65 kwaye lifanelekile kwi- Medicare , ngelixa elinye liseneminyaka engaphantsi kwama-65. Nangona bobabili bobabili bafanelekile kwi-Medicare, yonke inzuzo yokugulisa i-Medicare yedwa, kunokuba yintsapho. Umlingani ngamnye uya kuba neenkcukacha ezihlukeneyo phantsi kweMedarethayo, kwaye ukuba bafuna ukuxhaswa kwenkxaso-mali (mhlawumbi ngokusebenzisa iSicwangciso seMpilo ye-Medicare, okanye iMedigap kunye ne- Medicare Part D ukuxhaswa kwi-Medicare yase-Original), iqabane ngalinye liya kuba nemigaqo-nkqubo yalo.
- Elinye iqabane likhubazekile kwaye lifanelekile kwiMedicaid okanye kwi-Medicare, ngelixa elinye linamandla.
- Owesifazane okhulelwe angakwazi ukufumana iMedicaid okanye i- CHIP (izikhokelo zihluka ngohlobo), ngelixa iqabane lakhe lingenalo.
Xa elinye iqabane lilungele i-inshorensi yempilo exhaswe nguRhulumente, enye inokuqhubeka i-inshurensi yezempilo yangasese. Olu hlobo lwesimo lunokutshintsha ngokuhamba kwexesha. Ngokomzekelo, owesifazane okhulelweyo akanakho ukufumana imvume yokufumana iMedicaid okanye i-CHIP emva kokuba umntwana azalwe, kwaye unokufuna ukubuyela kwisicwangciso se-inshurensi yezempilo yangasese.
Akukho bukhulu bomntu obunamanqanaba-ngokubambisana nokuba ngaba abatshati kufuneka babe kwi-inshurensi yonyango yempilo. Kwezinye iimeko, abanakho ukufikelela kwizicwangciso ezifanayo, kwaye kwezinye iimeko, kunenzuzo kubo ukuba babe nezicwangciso ezahlukeneyo, ngezizathu ezahlukeneyo.
> Imithombo:
> Isebe Lempilo Neenkonzo Zoluntu. Ukhuseleko lomonde kunye noMthetho woNonophelo ojongene noThathaka; Isaziso seNzuzo yeeNzuzo kunye neParameters yokuhlawula i-2018; Izilungiso kwiiNyanga zokuBhalisa eziKhethekileyo kunye noMsebenzi oThengiweyo kunye neNkqubo eQinisekisiweyo. Disemba 22, 2016.
> INkonzo yeNgeniso yangaphakathi, iNkqubo yeNgeniso 2017-37 .
> I-Kaiser Family Foundation, Umyinge weeNyanga zeMpilo zeeNtsapho zeNyanga zeNyanga eziKhaya Ziya kuthoba i-3% ukuya kwi-18,142 kwi-2016; Abasebenzi abangakumbi Bhalisa kwiziCwangciso eziPhezulu eziDeductible kunye neOption Savings Ngaphezulu kweminyaka emiBini edluleyo.
> Kaiser Family Foundation, iiNzuzo zezeMpilo zabaSebenzi, 2017 isishwankathelo seziFundo.
> I-Kaiser Family Foundation, iNgcaciso yoMshuwalense wezeMpilo yoBonke abantu.
> Medicaid.gov. IiNqanaba zokuLungiswa kweeMvavanyo kunye neCIP.