Iintlobo eziDeductibles zihlala zikhona, kodwa ngeMithetho emitsha
I-deductible aggregate ibhekiselele kwinkqubo yezempilo ephezulu (deductible plans -deductible plans) (i-HDHPs) isetyenzisiwe ngokuqhelekileyo kwiintlawulo zentsapho . Isebenza ngokuhlukileyo kunezinto ezidityanisiweyo ezidityanisiweyo ezisetyenziswa kwi-inshurensi yezempilo ye-HDHP.
Ukukunceda uqonde esi sicwangciso, makhe sijonge indlela asebenza ngayo kunye neenguqu zatshintshile kule nkqubo.
Iinguqu ezenza umphumo ngo-2016
Amadalucable ahlukeneyo angasetyenziswa kwaye achazwe ngokucacileyo ngezantsi.
Kodwa ukususela ngowama-2016, zonke izicwangciso zempilo zeentsapho kufuneka zibe nemigxina ye-pocket yangaphandle . Ezi zikwazi ukugqithisa umntu ophezulu ongaphandle kwesikhokelo kulo nyaka. Oku kusebenza kuzo zonke izicwangciso zezempilo ezingenabantwana (kunye nezicwangciso zempilo ezingenakulinganisekanga; izicwangciso zempilo ezikhulu zikhona nakwiindawo ezininzi) kwiimarike ze-inshurensi nganye kunye neqela.
Ngokomzekelo, ngo-2017 umntu ophezulu ongaphandle kwe-pocket u-$ 7,150 . Kungakhathaliseki ukuba izicwangciso zayo zichithwa njani, akukho nanye ilungu lesicwangciso sentsapho elinokubangela uxanduva lwama-$ 7,150 kwiintlawulo zeendleko ezifihliweyo ngo-2017 (oku kuya kwanda ukuya kuma-7,350 ngo-2018, nangona iiplani ezininzi ziza kuba ne-out-of- imida ephakamileyo kakuhle ngaphantsi kwesi sixa).
Oko kuthetha ukuba imihla yezicwangciso ezinama-deductibles angama-R10 000 aphelile. Isicwangciso sinokuthi sibe ne-6,000 ye-total deductible, ngokukodwa, ekubeni iyancinci kunomntu ongaphandle kwipokethi.
Ukongezelela, izicwangciso zinokuthi zinezintsalelo zentsapho eziphezulu kunomntu ongaphandle kwipokethi. Kodwa bekunokudibana kuphela ukuba elinye ilungu lentsapho lifanele libe neebango. Kungenxa yokuba isicwangciso asinakufuna ukuba ilungu elinye lentsapho lihlangabezane nenani elidityanisiweyo lentsapho elingaphaya komntu ongaphandle kwe-pocket (esetyenziswe ngamnye ngonyaka ngeHHS).
Ngaloo nto engqondweni, makhe sijonge indlela i-deductibles ehlanganisiweyo isebenza ngayo.
Usebenza njani usebenze ngokutsha?
Ngohlobo oluthe lwahlukana nentsapho, isicwangciso sezempilo asiqala ukuhlawula iindleko zonyango kwanoma ubani kwintsapho de idibeneyo yonke intsapho. Emva kokuba i-family deductible iyonke idibeneyo, i-inshorensi yezempilo iyaphula kuyo yonke intsapho.
Kukho iindlela ezimbini ezidibeneyo ezinokudityaniswa:
- Njengoko ilungu ngalinye lentsapho lisebenzisa kwaye lihlawulela iinkonzo zonyango, ixabiso abahlawulayo kwi-pocket kulezo nkonzo lixhomekeke kwingxowa yentsapho. Emva kwamalungu eentsapho ezininzi ziye zahlawula iindleko ezidityanisiweyo, ixabiso elidibeneyo lezo ndleko zifikelela kwi-deductible. Isicwangciso sezempilo siqala ukuhlawula iindleko zonyango lonke leentsapho (mhlawumbi ngokupheleleyo okanye kunye nokwahlukana kwemali esetyenziswayo kwisicwangciso emva kokuba idibeneyo idibeneyo).
- Ilungu elinye lentsapho lineenkcitho eziphezulu zempilo. Isixa esihlawulela ngaphandle-se-pocket kulezo ndleko zikhulu ngokwaneleyo ukudibana nenani leentsapho ezidityanisiweyo. Isicwangciso sezempilo siqala ukuhlawula iindleko zonyango lonke leentsapho, nangona ilungu linye lentsapho lihlawule nantoni na kwi-total deductible.
Ziziphi iindleko ezibala kwiNtsapho yoLuntu oluThatywayo?
Iindleko kuphela ze-HDHP yakho ziya kubala kwi-deductible yakho yonke iindleko zokufumana izicwangciso zezempilo. Ngokomzekelo, ukukhwabanisa ngokuqhelekileyo akuqhelekanga inzuzo yezempilo. Ukuba ufumana ukuphakanyiswa ubuso, imali oyihlawulelayo ayiyi kubalwa kwi-deductible yakho yonke.
Inkampani yakho yinshuwalense yezempilo ayinakutyala naliphi na iindleko zonyango ngaphandle kwento enokwenyukayo ukuba ingazi ngabo. Qinisekisa ukuba wena okanye ugqirha lakho lwefayili izicelo kwiindleko zakho zonyango.
Iifayili zefayile nokuba uyazi ukuba kufuneka uzihlawule ngenxa yokuba awukaze udibane ne-deductible yakho.
Nantsi indlela inkampani yakho yomshuwalense yempilo eyazi ngayo ukuba uhlawule kangakanani kwi-deductible yakho.
Ziziphi iindleko eziKhutshwa kwiCandelo eliDeductible?
E-United States, uMthetho wokuNakekelwa ongenakunqwenelekayo ufuna ukuba izicwangciso zezempilo zihlawule iinkonzo zonyango zokukhusela ngaphandle kokufuna nayiphi na indlela yokwabelana ngeendleko . Oku kuthetha ukuba i-inshorensi iya kuhlawula izinto ezifana nomkhuhlane wakho, ukugonywa kwezingane zakho kunye ne-mammogram, nokuba ngaba awuzange uyihlawule imali yakho (inqaku lokuba akusiyo yonke inkunkuma ekhuselweyo ikhutshwe ngaphandle kweendleko).
Indlela iSebenzi eliDeductible eliSebenza ngayo ngo-2016 nangaphezulu
Ngaphantsi kwemithetho emitsha eyaqala ukusebenza ngo-2016, isicwangciso sezempilo asinakufuna umntu ukuba akhokhe i-deductible ephakamileyo kunomda womda we- out-of-pocket for each coverage, nokuba loo mntu uhlanganiswe phantsi idibeneyo yosapho. Ngo-2017, ubuninzi be-out-of-pocket yomntu buncinci kwi-$ 7,150, kwaye ngo-2018 yi-$ 7,350.
Olu lungiso kwimithetho lwasebenza ngokukhawuleza njengoko isicwangciso sakho se-inshorensi yempilo sivuselelwa ngo-2016. Kuya kuqhubeka ukuba imeko iya phambili ngaphandle kokuba imithetho iguqule kwakhona.
Umzekelo ubonisa indlela oku kusebenza ngayo:
Masithi isahlulo esinqunyiwe kwisicwangciso sakho sentsapho sika-2017 yi-$ 12,000. Xa ilungu ngalinye losapho lihlawule i-$ 7,150 kwixabiso elihlawulelweyo, inqaku lomntu othile kufuneka likhabe ngaphandle kokufuna ukwabelana ngeendleko ezifana ne-copays okanye i-coinsurance.
Ukukhawulwa kwalowo mntu ukukhaba ngenxa yokuba sele ufikelele kumyinge ongaphandle komyalelo womntu ngamnye. Nangona kunjalo, ukuhanjiswa kwamanye amalungu entsapho yakho akusayi kukhaba kude kube yinto efunyenwe ngayo yonke intsapho.
Imithombo:
ISebe lezeMpilo kunye neNkonzo zoLuntu, uMkhuseli weMonde kunye noMnxeba wokuNakekelwa ongenakuncedo, iSaziso esiPhakanyisiweyo seNzuzo kunye neParameters Payment for 2016.
ISebe lezeMpilo kunye neeNkonzo zoLuntu, iSaziso sokugqibela seNzuzo kunye neParameters yokuhlawula i-2016 (80 FR 10823). 2015.
ISebe lezeMpilo kunye neeNkonzo zoLuntu, iSaziso sokugqibela seNzuzo kunye neParameters Payment for 2018 . Disemba 17, 2016.