Ngaba unenkathazo yokufaka inshorensi yempilo? AWUKHO wedwa.
Intshuwalense yezempilo ingabiza kakhulu kangangokuba abantu abaninzi abaphantsi nabangaphakathi abanako ukukwazi ukuwufumana ngaphandle kokuncediswa. Kodwa, ukuba unayo inshorensi yezempilo, kufuneka uhlawule isohlwayo . Ngoko, wenzenjani ukuba kufuneka uthenge i-inshurensi yempilo kodwa awukwazi ukuwufumana? Ngenhlanhla, kukho uncedo olukhoyo.
UMthetho woNonophelo oNgenakuncedo udale inkxaso-karhulumente ekuncedeni abantu abaphantsi kunye nabangaphakathi-mali abahlawula i-inshorensi yezempilo. Ezi ncediso zikunceda ukuhlawula iimpumlam zomshuwalense zenyanga zempilo, kunye neendleko ezinjenge- coinsurance , i- copays , kunye neengxowa-mali xa unempilo .
Luhlobo luni loNcedo lweMali ondifumanayo?
Kukho iinkqubo ezintathu ezahlukeneyo kubantu abafuna uncedo lokuhlawula i-inshorensi yezempilo.
- I-Medicaid: Inkqubo yokuqala, ukuba unomvuzo ophantsi kakhulu, ubhalisela kwi- Medicaid . Uninzi lwamaxesha amaninzi, iMedicaid inikezelwa mahhala kulabo abafanelekileyo. Ulungelelwano luyahlukahluka ukusuka kummandla ukuya kwilizwe, ngoko awuyi kukwazi ngokuqinisekileyo ukuba ufanelekile de uze ufake isicelo. Kwimihlaba amaninzi, imigaqo yokulungelelanisa iMedicaid ishintshiwe yi-ACA, ngoko ke nangona usebenzise isicelo ngaphambili kwaye uchithekile, kufuneka usebenzise kwakhona ngokusebenzisa utshintshi lwe-inshurensi yezempilo . (Uya kufunda oku ngakumbi malunga nalokhu kamva.) Nantsi imida engenayo ingeniso ye-Medicaid ne-CHIP ukufaneleka, ngo-state.
- IiNkcazo zeNtlawulo zentlawulo: Inkqubo yesibini, ukuba unemivuzo ephantsi okanye ingeniso eyingenelo (kuze kube ngamaxesha amane kwintlupheko), uhlawulela inxalenye yenyanga yee-premium zomshuwalense wezempilo . Kufana nokufumana isaphulelo kwixabiso le-inshurensi yezempilo kuba inkxaso-mali ihlawula inxalenye yeendleko zakho. Le mali yenkxaso-mali ithunyelwa kuRhulumente ngqo kwiinkampani zomshuwalense wakho wezempilo-egameni lakho-awuyifumani imali leyo. Nangona oku kwenza ukuba i-inshorensi yempilo ibe nexabiso elinokuthi, ngokungafani nolu khetho lweMedicaid ngasentla, mhlawumbi uya kufuneka uhlawule okuthile kwiindleko zomshuwalense wakho weenyanga nganye (inqaku lokuba abanye bathi bahlawula iiprimiyam ezizithobekileyo zeMedicaid ababhalise ngenzuzo engenayo intlupheko nqanaba). Iikhredithi zerhafu zeNyanga zisekelwe ekugcineni iindleko zenkxaso-emva kwe-sub-low-cost cost, kodwa zingasetyenziselwa nayiphi na isicwangciso sezinga lesinyithi.
- Ukunciphisa ixabiso lentengo : Kulabo abanemali ephantsi okanye ethobekileyo, inkqubo yesithathu inciphisa iindleko zakho ezingaphandle kwezinto ezifana nokunciphisa , i- copays kunye ne-coinsurance xa usebenzisa yakho ye-inshorensi yempilo (oku kufumaneka kubantu abafumana amaxesha angama-2.5 ubuhlwempu nqanaba). Ngokomzekelo, ukuba uthenge umgaqo-nkqubo we-inshurensi yempilo onokufuna ukuba uhlawule i-copay ye-$ 50 rhoqo xa ubona ugqirha, inkxaso yakho yokwabelana ngeendleko inganciphisa i-copay kwi-$ 30 rhoqo xa u tyelela ugqirha. Inkqubo yokwabelana ngeendleko iyancitshitshitshitshitshi esiphezulu se-pocket oya kuhlawula xa ugqiba usebenzisa i-inshorensi yakho yezempilo. Ekubeni inkampani yomshuwalense ihlawula ipesenteji enkulu yeendleko zonyango lwakho, inkxaso-mali yokwabelana ngeendleko kufana nokufumana ukuhlaziywa mahala kwi-inshurensi yezempilo. Iinkxaso-mali zokwabelana ngeendleko zifumaneka kuphela kwizicwangciso zesilivere, kwaye zizenzekelayo ngokuzenzekelayo kuzo zonke iiplani zesilivere ezikhoyo ukuba ingeniso yakho yenza ukuba ufaneleke kubo. Kulabo abangakufanelekanga, izicwangciso ezibandakanya inkxaso-mali yokwabelana ngeendleko azibonakali kwiindlela ezikhoyo .
Abanye abantu abanomvuzo ophantsi bafumana uncedo kwiinkxaso-mali zentlawulo ye-premium kunye nokunciphisa igalelo yokwabelana ngeendleko ngexesha elifanayo. Abantu abafanelekileyo ukufumana inkxaso-mali yokwabelana ngeendleko baya kudla ukufumana inkxaso ye-premium. Kodwa akusiyo wonke umntu ofanelekileyo kwi-premium yenkxaso-mali ye-premium.
Ndifumana njani Uncedo lokuhlawula i-inshurensi yempilo?
Unokufaka isicelo se-inshorensi yezempilo, kunye ne-Medicaid, ngokusebenzisa utshintsho lwempilo yomshuwalense. Xa ufaka isicelo se-inshurensi yezempilo ngokusebenzisa utshintshi lwempilo yomshuwalense, ichitshintshi iya kugqiba ukuba unelungelo lokuthenga ngetyala lentlawulo ye-premium, ukwabelana ngeendleko, okanye iMedicaid.
Ngaba ndiya kulungela ukuNcedisa i-Intshurensi yeMpilo?
Ulungelelwaniso lwe-inshorensi yezempilo usekelwe ekuqhathaniseni umvuzo wakho kumgangatho wehlwempu . Inqanaba lobuhlwempu lombuso liguquka rhoqo ngonyaka, kwaye lusekelwe kwintlawulo yakho kunye nosapho lwakho.
Unokukhangela kule FPL yonyaka apha.
Uya kufaneleka kwi-credit card ye-premium ukuba ingeniso yakho iphakathi kweepesenti eziyi-100 kunye ne-400 ekhulwini ye-FPL yonyaka odlulileyo (unyaka odlulileyo unxulumene nomnyaka oza kusebenza ngawo, abantu abafaka isicelo se-2018 ye-FPL baya kusebenzisa i-FPL 2017. ukuchonga ukufaneleka kwemali). Qaphela ukuba kumazwe awandise iMedicaid, umgca ongaphantsi wokulungelelanisa inkxaso-mali i-139 ekhulwini kwinqanaba lehlwempu, njengoko abantu abangaphantsi kwesi sihlalo banelungelo lokufumana iMedicaid endaweni.
Ukuze ufanele ukufumana inkxaso-mali ngo-2018, sebenzisa ama-2017 amanqanaba: umntu onomvuzo we-$ 12,060- $ 48,240, izibini ezineemali ezivela kwi-$ 16,240- $ 64,960, kunye nosapho lwabathathu olufumana i $ 20,420- $ 81,680 (kodwa kwakhona, umgca wokufaneleka ophantsi ziphezulu kuzo zonke iimeko kwiimeko eziye zandisa iMedicaid).
Ukusondeza kwakho kwinqanaba lehlwempu, uncediso oluninzi oluya kufumana. Uya kufanelekela ukunciphisa inkxaso-mali yokwabelana ngeendleko xa ukhetha isicwangciso se-silver-tier ekutshintshiseni kwaye ingeniso yakho iphakathi kwe-100 ne-250% yonyaka we-FPL wonyaka odlulileyo. Ukufumana ilungelo lokunciphisa ukwabelana ngeendleko ngo-2018, uya kusebenzisa izikhokelo ze-2017 FPL: umntu ozuza kwi $ 12,060- $ 30,150, izibini ezineemali ezivela kwi-$ 16,240- $ 40,600, kwaye intsapho yabathathu abafumana imali eyi-20,420- i-deductible, i-copayments, kunye neendleko zemali-mali (kwakhona, i-Medicaid ifumaneka kumakhaya anenzuzo engenayo ukuya kuma-138 ekhulwini kwintlupheko e-DC kunye nama-31 aseburhulumenteni awandise iMedicaid; kulawo mazwe, ukufaneleka koxhasomali kuqala apho i-Medicaid ivumelekile khona, ngoko Imingcele ephantsi yokulungelelanisa inkxaso-mali iphezulu kulawo mazwe).
Yintoni eya kuNyanelisa ukungena kwiNkxaso-mali yoMshuwalense wezeMpilo?
Awuyi kufanelekela inkxaso yenkxaso-mali yempilo xa unokufumana i-inshorensi yempilo ngexabiso ngezinye iindlela. Ngokomzekelo, ukuba unokufumana i-inshurensi yempilo ngemali yakho, kodwa unokuba nesicwangciso sezempilo esithengiweyo nge-inshurensi yakho yezempilo, awuyi kufanelekela inkxaso-mali.
Umthetho wenza okungafaniyo ngale nto ukuba umshuwalense wempilo wakho umqeshi unikezelayo, okanye ukuba i-coverage ayithengi. Kule meko, uMthetho ojongene noNonophelo ongenakunqwenela uchaza "ufikeleleka" njengempilo yomshuwalense eyinkokhelo engaphantsi kwe- 9.56% yengeniso yakho ngo-2018 (phawula ukuba oku kubalwa kusekelwe kwindleko yomqeshwa yokuzimela kuphela; Amalungu ayengathatyathwa, oko kubangela intsapho ye-glitch ). Kwaye ukuba ukubonelela ngempilo efumanekayo ngemisebenzi yakho akuboneleli ngexabiso elincinci, ngamanye amazwi ayihlawuli umyinge we-60% weendleko ezigqityiweyo, ngoko akuyi kukukukhuphaza ukuba ufumane inkxaso-mali ngenxa yokuba ikhona.
Nangona kunjalo, ukuba ukhetha ukubhalisa kwi-inshurensi yempilo enikezelwa ngumqeshi nangona ingahlawulwanga okanye ayiniki ixabiso elincinci, awuyi kuba nelungelo lokufumana inkxaso-mali ngexesha loba ubhalisele kwisicwangciso sezempilo. URhulumente akayi kukunika uncedo lokuhlawula i-inshorensi yezempilo ukuba sele sele unomshuwalense wezempilo osekelwe kwimisebenzi.
Awunakufanelekela ukuba uncedise ukuba unelungelo le-inshurensi yempilo exhaswe nguRhulumente, njenge- Child Health Insurance Programme , ulawulo lwezilwanyana, i-Medicare okanye iMedicaid. Qaphela ukuba akudingeki ukuba ubhalise kule nkqubo ukuba ulungele ukufumana inkxaso-mali; Ukufumana nje enye yezi nkqubo kunelungelo lokukungafanelekanga.
Awuyi kufaneleka ukuba uncedise ukuba uncedise ukuba usejele okanye ukuba awuhlali eMelika ngokusemthethweni.
Ukuba utshatile, isimo sakho sokufakela irhafu kufuneka "sitshatile ukudibanisa ngokubambisana" ukuze ufanelekele inkxaso. Awunakufanelekela ukuba uncedise ukuba isimo sakho sokufakela "sitshatile ukufakela ngokwahlukileyo," ngaphandle kweemeko ezincinci ezibandakanya ulwaphulo lwasekhaya okanye ukushiya umtshato.
Ukukhohlisa njengoko kuzwakalayo, awuyi kufaneleka inkxaso yenkxaso-mali ukuba ingeniso yakho ingaphantsi kwe-100% ye-FPL, nokuba unesimo esingakhange sandise iMedicaid (ngaphandle kokuba ungumfuduki osandul ' US iminyaka engaphantsi kweminyaka emihlanu ). Ilungile lo nto; abangamahlwempu kakhulu abafumana iitalenti zerhafu yepresimenti okanye inkxaso-mali yokwabelana ngeendleko.
Kungenxa yokuba abenzi bomthetho ababhala uMthetho ojongene noNonophelo ongenakunqwenela ukwenzela ukuba wonke umntu ofumana ngaphantsi kwe-138% ye-FPL afumane iMedicaid. Nangona kunjalo, iNkundla Ephakamileyo yenze isigqibo sokuba urhulumente wesigqeba awakwazi ukunyanzelisa amazwe ukuba anike bonke abo bantu iMedicaid. Oku kuthetha ukuba urhulumente ngamnye unako ukugqiba ukuba ngaba uya kukwandisa i-Medicaid coverage kumntu wonke ofumana ngaphantsi kwe-138% ye-FPL, okanye ukuwunciphisa kuphela abantu abafanelekayo kwiMedicaid phantsi kweendlela ezikhulile, eziqinileyo.
Ukuba urhulumente wakho ukhethe ukungawandisi inkqubo yayo yeMedicaid kwaye uhlala ngaphantsi komgca-ntlupheko, usekho ekuthiwa yi- Medicaid gap coverage (leyo yayingeyona inxalenye ye-ACA, kwaye yayingalindelanga ukuba yinkinga) kwaye awuyi kufumana ilungelo lokuhlawula i-inshorensi yezempilo. Endaweni yoko, cinga ukusebenzisa i-Centre yeZiko lezeMpilo elinikezela ngononophelo lweenkonzo zokukhathalela kungakhathaliseki ukuba unakho ukuhlawula. Fumana iZiko lezeMpilo lasekuhlaleni.
Ndingafunda phi ngakumbi?
- Inkxaso-mali ye-inshorensi yempilo yengeniso ye- premium
- Ukunciphisa iindleko zokwabelana ekunciphiseni i-deductible yakho, i-copays kunye ne-coinsurance
- Inkxaso ye-out-of-pocket yakho ephezulu
- Indlela i-Medicaid isebenza ngayo
- Ukufumana iMedicaid
- Funda kabanzi malunga neZiko lezeMpilo zoLuntu kwi-Uninsured
> Imithombo:
> Iinkonzo zezeMpilo kunye noLuntu, ngo- 2017 . Juni 12, 2017.
> Ezempilo kunye neNkonzo Zoluntu, i-Ofisi yoNcedisi uNobhala weCwangciso noVavanyo. Izikhokelo zobuhlwempu ngo-2017.
> INkonzo yeNgeniso yangaphakathi. Inkqubo yeNgeniso 2017-36 .
> Medicaid.gov. IiNqanaba zokuLungiswa kweeMvavanyo kunye neCIP. Juni 2016.