Izicwangciso ezininzi zempilo zifuna zombini i- deductible kunye ne- coinsurance . Ukuqonda umahluko phakathi kwe-deductible kunye ne-coinsurance yinxalenye ebalulekileyo yokwazi oko uza kufumana xa usebenzisa yakho inshorensi yempilo.
Ukuchithwa kunye ne-coinsurance yintlobo ye- inshorensi yempilo yomshuwalense ; uhlawula inxalenye yeendleko zempilo yakho, kwaye isicwangciso sakho sezempilo sihlawula inxalenye yeendleko zokunyamekela kwakho.
Ahluke kwindlela asebenza ngayo, ingaba kufuneka uhlawule kangakanani, kwaye xa ufanele uyihlawule.
Yintoni eDeductible?
I-deductible yinani elimisiweyo olihlawulayo ngamnye ngaphambi kokuba i-inshorensi yempilo ikhatywe ngokupheleleyo (kwimeko yeCandelo le- Medicare Part A- kuba unakekelo lwezonyango-i-deductible isebenza "kumaxesha ancedo" kunokuba unyaka). Emva kokuba uhlawule imali yakho, isicwangciso sakho sezempilo siqala ukuqokelela isabelo salo sezempilo. Nantsi indlela esebenza ngayo.
Unayo imali engama-2,000. Ufumana umkhuhlane ngoJanuwari uze ubone ugqirha wakho. Ibhilikhi yegqirha i-$ 200. Unembopheleleko yecalamente yonke kuba awuzange uyihlawule imali yakho okwehlwayo kulo nyaka (kulo mzekelo, sicinga ukuba isicwangciso sakho asinayo i- copay yokutyelela iofisi, kodwa kunoko, kubalwa iirhafu eziye zachithwa ) . Emva kokuhlawula i-bill ye-$ 200 ye-bill, unayo i-$ 1,800 ehambayo ukuya kwi-deductible yakho ngonyaka.
Ngo-Matshi, uyawa kwaye uphule ingalo yakho.
Umthetho-mali u-$ 3,000. Uhlawula i-$ 1,800 yaloo ntlawulo phambi kokuba udibane ne-$ 2,000 yakho ngonyaka (i-$ 200 ukusuka kwonyango lomkhuhlane, kunye ne-1,800 yeendleko zengalo ephukileyo). Ngoku, i-inshorensi yakho yezempilo iyakkhahlela kwaye inokukunceda ukuhlawula yonke ibhajethi.
Ngo-Apreli, usususwe ukukhutshwa kwakho. Umthetho-mali u-$ 500.
Ekubeni sele sele udibene ne-deductible yakho yonyaka, akufanele uhlawule nayiphi na into echithwayo. Intsholongwane yakho yempilo ihlawula isabelo sayo esigcwele kule bhili-mali.
Nangona kunjalo, oku akuthethi ukuba i-inshorensi yakho yempilo iya kuhlawula yonke ibhajethi kwaye awuyi kuhlawula nayiphi na into. Nangona ukwenzile ukuhlawula i-deductible yakho kunyaka, usenokufuneka uhlawulwe i- copayment okanye i-coinsurance.
Yintoni yoQinisekiso?
Ulwabiwo-mali lunye uhlobo lokwabelana ngeendleko apho uhlawula khona inxalenye yeendleko zokunyamekela kwakho, kwaye i-inshorensi yakho yemali ihlawulela inxalenye yeendleko zokunyamekela kwakho. Ngokuqinisekisana, uhlawula umlinganiselo ochaseneyo, ipesenti nganye ye-bill yezempilo. Nantsi indlela esebenza ngayo.
Masithi kufuneka uhlawule i-30% ye- coinsurance yamayeza omyalelo . Ugcwalisa imithi yesigqirha esibangela i-$ 100. Uhlawula i-$ 30 yaloo bhili-mali; yakho inshorensi yempilo ihlawula i $ 70.
Ekubeni i-coinsurance yipesenti yeendleko zokunyamekela kwakho, ukuba ukunyamekela kwakho kuyabiza, uhlawula kakhulu. Ngokomzekelo, ukuba unesiqinisekiso-mali se-25% sokubhedlelelwa esibhedlele kunye nesibhanki sakho esibhedlele ngu-$ 40,000 uza kuhlawulwa i-$ 10,000 ye-coinsurance-kude kube ngu-Care Affordable Act oguqulwe inkqubo yethu yinshurensi.
Iindleko ze-Coinsurance zaloo mkhulu azivumelekanga ngaphandle kokuba unesicwangciso sezempilo esiphezulu.
Zonke izicwangciso ezingenakulinganisekile kufuneka zithinte iindleko zomntu ngamnye zomntu (ngaphandle kwee- deductibles, i-copays, kunye ne-coinsurance) ngaphandle kweyiphi na into engaphandle kweso sikhundla. Ngo-2016, yi-$ 6,850. Ngo-2017, i $ 7150.
Deductible vs Coinsurance-Zihluke njani?
Iiphelo ezidityanisiweyo, kodwa i-coinsurance iyaqhubeka kwaye (kuze kube yilapho ubetha i-out-of-pocket maximum).
Emva kokuba udibene ne- deductible yakho kunyaka, awuhlawulwanga nayiphi na intlawulo ehlawulelwayo kuze kube ngumnyaka ozayo (okanye, kwimeko ye-Medicare Part A, de kube yithuba lakho elizayo). Kusenokwenzeka ukuba uhlawule ezinye iintlobo zokwabelana ngeendleko ezifana neentlawulo okanye i-coinsurance, kodwa i-deductible yakho yenzelwe unyaka.
Uza kuqhubeka nokuhlawula i-coinsurance rhoqo xa ufumana iinkonzo zonyango. Ixesha elilodwa kuphela le-coinsurance liyeka xa ufikelela kwi-inshorensi yempilo yakho ye-inshorensi. Oku kuqhelekanga kwaye kwenzeka kuphela xa unemali ephezulu yokunakekelwa kwezempilo.
I-deductible is fixed, kodwa i-coinsurance iyatshintsha .
Ixabiso lakho lichithwayo, kodwa imali yakho yemali iyinani eliguqukileyo. Ukuba unayo imali engama-$ 1,000 echithwayo, kusekho i-$ 1,000 kungakhathaliseki ukuba ibhajethi inkulu kangakanani. Uyazi xa ubhalisa kwisicwangciso sempilweni ngokuqinisekileyo ukuba uza kuhlawulelwa kangakanani.
Nangona uya kuqonda ukuba imilinganiselo yakho yepesenti ye- coinsurance xa ubhalisa kwisicwangciso sezempilo, awuyi kuqonda ukuba uninzi kangakanani imali oyenzela yona nayiphi inkonzo uze ufumane le nkonzo kunye neyayilwayo. Ekubeni i-coinsurance yakho ingumlinganiselo ochaseneyo, ipesenteji yowiso-mthetho, iphakamileyo yowiso-mthetho, uhlawule ngokugqithiseleyo. Oku kubangela ukuba u-coinsurance aphephe ngenxa yakho kuba kunzima ukuya kubhajethi. Ngokomzekelo, ukuba unayo i-bill ye-20,000 ye-bill, u-30% we-coinsurance uya kuba ngu-6,000 zamaRandi (kodwa kwakhona, iindleko zakho ezipheleleyo ezingekho kwii-pocket ayikwazi ukudlula i-$ 7,150 ngo-2017).
Deductible vs Coinsurance-Zifana njani?
Uhlawula inxalenye yeendleko zempilo yakho.
Ukutshatyalaliswa kunye ne-coinsurance kokubili ukunciphisa isixa sakho sezempilo sihlawulela ukunakekelwa kwakho ngokukwenza uthathe inxalenye yecandelo. Ezi zinzuzo izicwangciso zakho zezempilo kuba zihlawula ngaphantsi, kodwa nangenxa yokuba ungekho amathuba okufumana iinkonzo zonyango ezingadingekile ukuba kufuneka uhlawule imali yakho kwilwayo.
Ukuhlawula ngokusekelwe kwisilinganiselo esiphuculwayo, kungekhona isilinganiso esiqhelekileyo.
Uninzi lwezicwangciso zezempilo zixubusha izaphulelo ezivela koogqirha kunye nabanye ababoneleli ngezempilo kwinkonzo yabo yomnatha . Zomibini ezithengiswayo kunye ne-coinsurance yakho ifumaneka kwisilinganiso esiphuculwayo, kungekhona kwizinga eliqhelekileyo.
Ngokomzekelo, masithi izinga eliqhelekileyo lokujonga i- MRI yi-$ 500. Isicwangciso sakho sezempilo sixoxisana nesilinganiso sokunciphisa i-$ 350. Xa ufumana i-MRI, ukuba awukadibana ne-deductible yakho, uhlawula i-$ 350 kwi-MRI. I-$ 350 idalwe kwi-deductible yakho yonyaka. Ukuba udibene ne-deductible yakho kakade kodwa uhlawuliswe i-coinsurance ye-20%, unetyala le-70% (leyo ngu-20% yezinga lokunciphisa ama-350).
Iphutha lokuhlawula eliqhelekileyo lenzeke xa ababoneleli bezempilo behlawula ixabiso lentengo kwixabiso eliqhelekileyo kunokuba ixabiso elihlawulelwe . Le mpazamo ibangela ukuba uhlawule ngaphezu koko kufuneka, ngoko rhoqo ujonge kwakhona iindleko kunye neengxelo ozifumanayo kumboneleli wakho wezempilo kunye nenkampani yakho yomshuwalense.
Ukuhlaziywa nguLouise Norris.
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