Abaninzi baseMelika kufuneka bahlale bekhuseleko lwe-inshorensi yempilo
Uninsuredured? Ukubuza ukuba kufuneka uthenge i-inshurensi yempilo ngenxa yoMthetho wokuNakekelwa ongenakuncedo ? Nantsi into efunwa ngumthetho, indlela yokuthobela, indlela yokufumana i-Obamacare ukuba uyayifuna, kunye nantoni na ezinye iindlela zakho.
Ngaba Ndifanele Ndifumane Intshuwalense yeMpilo?
Ukuba awuqinisekanga kwaye awunayo i- inshorensi yempilo , kufuneka ufumane inshorensi yempilo. Ukuba awuyi, uya kuvavanywa isigwebo xa ufaka irhafu yengeniso yakho yerhafu.
Igunya elijongene noNonophelo loNonophelo lomntu ngamnye lifuna ukuba wonke umntu ongenakuxolelwa ukugcina ingxelo yempilo . Oku kuye kwaba njalo ukususela ngoJanuwari 1, 2014.
Ukuba unomshuwalense wezempilo ngomsebenzi okanye kwinkqubo karhulumente efana ne-Medicare, Medicaid okanye iTricare, loo inshurensi inelisekile imfuno yomthetho. Awudingi ukwenza nantoni na enye into.
Ukuba unesicwangciso sezempilo, umgcini wakho womshuwalense unokukuxelela ukuba umgaqo-nkqubo wakho okhoyo udibana nencazelo yobuncinci obuncinci obalulekileyo. Akunjalo into efanayo nokuba yi-ACA-iyathobela. Ukuba unesicwangciso somthengiso ngasinye esasenza ukusebenza ngaphambi ko-2014, ngokuqinisekileyo asiyikuthobela ngokupheleleyo i-ACA, kodwa isabonwa njengobuncinci besikhokelo sokubaluleka kokubambisa nje ngeyona nkampani enkulu yonyango yonyango.
Ukuba ngaba yintloko yinshuwalense yezempilo yonyango kwaye uye wayinayo ukususela ngo-2014, mhlawumbi inkulu okanye inzala . Kuzo zombini iimeko, unako ukuqhubeka nokufumana le ngxelo ngokukhawuleza nje ukuba umphathi womshuwalense wezempilo uyakuvumela, kwaye awuyi kuhlawulwa-nangona iprogram yakho ayihambelani neemfuno ze-ACA zezicwangciso ezintsha.
Ngakolunye uhlangothi, ukuba i-inshorensi yodwa onayo isicwangciso ozithenge sona esingabonwa njengeyona nto incinci yokunika ingxelo, awuyi kuthobela igunya lomntu ngamnye we-ACA, oko kuthetha ukuba uya kuthotyelwa isigwebo ngaphandle kokuba ndinokuxolelwa. Izicwangciso ezingabonakali njengobuncinci bokubhengezwa kubandakanya izinto ezifana ne -inshorensi yempilo yesikhashana , ukuxhaswa kweengozi, izicwangciso zokugula eziphambili (oko kukuthi, umgaqo-nkqubo ojongene nezifo ezithile kuphela), kunye nezicwangciso ezincedisayo.
Ukuba ungathandabuzeki, khangela ngeenkampani ezithengise icebo.
Ukuba awuqinisekanga, kuya kufuneka ufumane inshorensi yempilo. Ukuba akunjalo, uya kuhlawuliswa isohlwayo xa ufaka irhafu yakho, ngaphandle kokuba uxolelwe.
Ngaba kukho indlela yokuthenga i-inshurensi yezempilo?
Ukuba awuqinisekanga kwaye unomdla wokufumana i-inshurensi, ukufumana uxhoso lwe- inshorensi yezempilo kuya kukunceda ukuba ugweme isohlwayo sentela. Ukufumana ukuba ufanelekile ukuxolelwa kunye nendlela yokufumana isitifiketi sokuxolelwa, funda " Ngaba Ndiyakwazi Ukuxolelwa Ngomshuwalense Wezempilo? "U
Yintoni eya kwenzeka xa ndingenayo i- inshurensi yempilo ?
Ukuba awukhululwa kwaye uyakhetha ukuba ungayifumana i-inshorensi yempilo, uza kuhlawulwa irhafu yentlawulo ebizwa ngokuba ngumthwalo wokuhlawula umthwalo . Esi sihlwayo sanda kwangexesha, kwaye isixa sincike kwingeniso yakho.
Isohlwayo saqala ukuvavanywa entwasahlobo ka-2015, xa abantu bafaka ingxelo yabo yentlawulo ye-2014. Ngenxa yokuba abaninzi abantu babanjwe ngoluleko, urhulumente wavuma ukunika ithuba lokubhalisa okhethekileyo kulo nyaka kubantu abangazange bazi malunga nesohlwayo kwaze kwaba yilapho befaka ingxelo yabo yentlawulo ye-2014. Baye kwafuneka bahlawule isohlwayo ngo-2014, kodwa ixesha lokubhalisa elikhethekileyo lanike ithuba lokufumana inqaku le-2015.
Izigwebo ze-2016 ziza kuvavanywa xa abantu befakela iirejista zabo zerhafu ekuqaleni kuka-2017. Kubafakeli beerhafu abahlawuliswe ihlawuliso kwiirhafu zabo zerhafu zango-2014, isixa-mali esiqhelekileyo sasingama-$ 200. Kulindeleke ukuba ukwandise ukuya kuma-dollar ayi-1,000 kubathengisi beerhafu abahlawulwa i-penalty kwi-returns yabo yerhafu ye-2016 .
Imithetho ye-inshorensi yempilo yomshuwalense ingaba nzima. Umzekelo,
- Ingxenye yengeniso yakho ayifakiwe xa iqikelela isixa sembuyekezo-kuphela imali ephezulu ngaphezu kwenani lokufakela irhafu libaliwe.
- Kukho umda ophezulu kwisihlomelo uya kufuneka uhlawule ukuba ucebile-yindleko ephakathi yesizwe isicwangciso sobhedu, esasiyi-2,484 yezigidi ngomntu omnye ngo-2015, kunye ne-12,240 yeentlawulo zeentsapho ezihlanu okanye ngaphezulu.
- Kukho umlinganiselo omncinci oza kuwuhlawula nangona uhlwempu (ucinga ukuba awufanelanga ukukhululwa). Ngo-2016, isigwebo esincinci si-$ 695 kumntu omdala, kunye ne-$ 347.50 ngomntwana, ukuya kuma-2,085 ayi-2,085.
Ingakanani Umgwebo Womshuwalense Wezempilo Owodwa?
Ingakanani Imbuyekezo Yomshuwalense Wezempilo Yentsapho?
Ukuba ulinganisa indleko yokuthenga i-inshurensi yezempilo malunga neendleko zokuhlawula isigwebo se-inshorensi yezempilo, ungalibali ukufumana iindleko ezihambelana nokuxuba. Iindleko ezihamba kunye nokuzikhethela ukuhlala ungaxhaswanga ziquka iindleko zokuhlawula ngaphandle kweefolda kuzo zonke iindleko zonyango lwakho, kungekhona nje ngeendleko zentlawulo yerhafu. Kwakhona, urhulumente we-inshurensi yempilo yonyango , ukuba uyakufaneleka, unokunciphisa iindleko zokuthenga i-inshorensi yempilo.
Ngaba Ndinokufumana Uncedo Lokuhlawula Iminshurensi yezeMpilo ?
Unako ukufumana inkxaso-mali ukuze wenze i-inshorensi yempilo ibe nexabiso eliphezulu. UMthetho woNonophelo ojongene noThathaka udale ezimbini iintlobo zenkxaso-mali ye-inshurensi yezempilo zombini i-income based.
Inkxaso-mali yerhafu ye-premium ihlawula inxalenye yesikhokelo sakho seenyanga zempilo premium ukuze uthenge i-inshurensi yezempilo ingabizi. Kufana nokufumana isaphulelo kwiindleko zinshuwalense yezempilo .
Inkxaso -mali yokwabelana ngeendleko iyanciphisa i- deductible yakho, i- copays kunye ne- coinsurance xa usebenzisa yakho inshorensi yempilo. Isicwangciso sakho sezempilo sihlawulela ezinye iindleko zakho zonyango, kwaye uhlawula ngaphantsi. Kufana nokuphucula ukukhululeka kwinshuwalense yezempilo.
Ekugqibeleni, ukuba ingeniso yakho iphantsi, unokufanelekela kwiMedicaid . Iiprogram ezininzi zeMedicaid azihlawulanga nayiphina i-premium yenyanga, okanye ihlawule imali encinci. I-ACA ifuna ukunyuswa kweMedicaid, kodwa iNkundla ePhakamileyo yenza ukuba kubekho ukukhetha ukuba amazwe athathe inxaxheba. Ukususela ngoJuni ka-2016, i-31 i-DC ne-DC iye yandise iinkqubo zabo zeMedicaid, kodwa iingu-19 azikho.
Funda kabanzi malunga nendlela osebenza ngayo inkxaso kunye nokuba ufanelekile ukuba uncedise ukubhalisa kwi-Obamacare ngokufunda " Ngaba Ndinokufumana Uncedo lokuhlawula i-Intshumo yeMpilo? "U
Ndingayithenga njani i-inshorensi yempilo?
Nangona unako ukuthenga i-inshorensi yempilo ngokukodwa kwiinkampani zomshuwalense wezempilo (oko kukuthi, " ukutshintshiselana ngaphandle "), ukuba uyakrokrela ukuba unelungelo lokufumana inkxaso-mali, yithenga i-inshorensi yakho yempilo ngokusebenzisa utshintshi lwentsharensi yezempilo , endaweni yoko.
Ukuxhaswa kungasetyenziselwa i-inshorensi yempilo oyithengayo ngokutshintshiselana. Kungakhathaliseki ukuba ufuna ukuthatha inkxaso yakho phambi kwenyanga ntlawulo kwi-inshurensi yempilo yakho, okanye ukuyibiza kamva kwimbuyekezo yakho yentela , iyafumaneka kuphela xa uthengisa isicwangciso sakho ngokutshintshiselana.
Ukutshintshisana nako kunokuxelela ukuba ufanelekile yini kwiMedicaid kwaye unokukunceda ukuba ufake isicelo. Kwamanye amazwe, ukubhaliswa kweMedicaid kwenziwa ngokutshintshiselana. Kwamanye amazwe, ungabhalisa ngokuthe ngqo kwiofisi ye-Medicaid, okanye ngokutshintshiselana. Kuzo zonke iindawo, ukutshintshiselana kunokukwazi ukubhalisa kwi-Medicaid ukuba ufanelekile.
Nangona ungakufanelekanga kwi-Medicaid okanye inkxaso-mali, utshintshiselwano lwempilo ye-inshurensi yempilo yenza kube lula ukuthelekisa izicwangciso zempilo. Ekubeni izicwangciso ezinikezelwa ngokutshintshiselana zintsebenziswano ngokuthe ngqo, zingaphantsi kweeprayimari zenyanga zingaphantsi kunezicwangciso zempilo ezifanayo ezivela kwabanye abathwali abanikezelwa ngaphandle kokutshintshiselana (nangona nangaphandle kwezingxoxo, zonke izicwangciso zonyango ezinkulu zifuneka ngokuvisisana ngokupheleleyo ne-ACA).
Fumana indlela yokuqhagamshelana noshishino lwakho lwe-inshurensi yempilo.
Ndingakhetha njani iSicwangciso esihle kakhulu?
Ukukhetha isicwangciso sezempilo esilungelelanisa iimfuno zakho, kuqala ufuna ulwazi olusisiseko malunga nezinto ezikhoyo.
Zonke izicwangciso zempilo ezithengiswa kwiintengiso ze-inshurensi yezempilo - kunye nezo zithengiswa -mali , xa nje zithethwa ngonyango olukhulu-zinikezela ngeenzuzo ezifanayo ezibalulekileyo zezempilo. Ezinye izicwangciso zinokubonelela ngeenzuzo ezingaphezulu naphaya kweenzuzo zezempilo ezibalulekileyo.
Zonke izicwangciso zihlelwe kwicandelo elinye labane. Ezi ntsimbi zixelela ixabiso lecebo. Unokufunda okungakumbi malunga nendlela osebenza ngayo abantwini kunye nokuba ngubani onokuzilungela kangcono " kwiBronze, iSiliva, iGold ne-Platinum-Ukuqonda inkqubo ye-Metal-Tier ." Inkqubo yokongeza impilo yezempilo, inshorensi yezempilo eyingozi , iyafumaneka abantu abangaphantsi kweminyaka engama-30 ubudala, okanye abantu abanokuxolelwa kanzima .
Uninzi lwentsebenziswano lunemizekelo eyahlukeneyo ye-inshorensi yempilo enikezelwa kwixabiso ngalinye. Umzekelo, ukuba ufuna isicwangciso sezempilo sesiliva, unokukhetha phakathi kwe-HMO yesilivere, i-PPO yesilivere kunye nesicwangciso se-POS yesilivere . Ukuba awuqinisekanga ukuba zinjani iintlobo zempilo yomshuwalense wezempilo, funda "i- HMO, i-PPO, i-EPO & i-POS-Yintoni eyahlukileyo kwaye yintoni eyona nto ibhetele? "U
Imithombo:
INkonzo yeNgeniso yangaphakathi, Ukunikezelwa kweMfanelo yoBuntu ngabanye - Ukunika ingxelo kunye nokubala Intlawulo.