Isicwangciso seSiliva sinikeza amaxabiso angama-70 e-Actualarial Value
Kwiqela le-inshurensi yezempilo yodwa kunye neyincinci , isicwangciso sempilo yesilivere sihlawula, ngokwesilinganiso, malunga nama-70 ekhulwini kwiindleko zonyango lwakho. Uhlawula ezinye iipesenti ezingama-30 zeendleko zakho zenkathalo zempilo ngendlela yokuhlawulwa kwemali, i- coinsurance kunye ne- deductibles .
Oku kwaziwa ngokuba ne-70% yexabiso le-actuarial , okanye i-AV. Oku akuthethi ukuba wena, ngokwakho, uya kufumana iipesenti ezingama-70 zeendleko zakho zokunakekelwa kwezempilo ezihlawulwe ngesicwangciso sakho sesilivere.
Kunoko, icebo lihlawula iipesenti ezingama-70 zeendleko eziqhelekileyo kwizinga eliphakathi. Kodwa baya kuhlawula ipesenti eziphantsi kakhulu zeendleko zokubhalisa okunempilo kunye nokusetyenziswa kancinci kweenkonzo zonyango, ngelixa ziza kugqiba ukuhlawula imali engaphezulu kwama-70 eendleko zeendleko zomntu obhalisa kakhulu ogqirha izigidi zeedola kwiibango .
Qaphela ukuba ngelixa isicwangciso sesilivere siza kuba ne-AV engama-70 ekhulwini, kukho i-minimus ibanga elivumelekileyo, kuba kuya kuba ngumceli-mngeni kubagcini bomshuwalense ukuba baqulunqe izicwangciso ezibethe ngqo iipesenti ezingama-70 AV. Ngo-2017, i-minimus range yayiyi-+/- 2, ngoko iiplani zesilivere zine-AV kwi-68 ukuya kuma-72 ekhulwini. Kodwa ngo-Ephreli 2017, i-HHS iphelelise imimiselo yokuzinzisa imarike eyandisa umnqamle wezantsi, uvumela iiplani zesilivere ukuba zibe ne-AV ukusuka kwi-66 ukuya kuma-72 ekhulwini.
Iindleko zonyango ezingabandakanywayo azibandakanyi xa kuqikelelwe ixabiso leprogram yezempilo.
Ngokomzekelo, ukuba isicwangciso sakho sezempilo esiliva-mali singanikezeli ukuxhaswa kwamachiza angaphezu kwee-counter , iindleko zazo azibandakanyi xa zibala ixabiso lecebo lakho. Iinkonzo ezingaphandle kweenethiwekhi nazo azibalanga, kwaye akukho nkathalo engenzi phantsi kwecazo ye-ACA yeenzuzo zezempilo ezibalulekileyo .
Amanqanaba okuBaluleka okuQinisekiswa koLondolozo lweNqanaba loNonophelo
Ukwenza kube lula ukuba uqhathanise ixabiso ofumene ngayo imali oyisebenzisayo kwiimali-mali ze-inshorensi yezempilo, uMgangatho woNonophelo olungabonakaliyo amanqanaba afanelekileyo amanani kwizicwangciso zempilo kwiimarike zeqela kunye namancinci. Ezi nqanaba, okanye iinqanaba, zi:
- ithusi
- si livere
- golide
- iplatinum
Zonke izicwangciso zempilo ngaphakathi kwinqanaba elinikeziweyo zinika inani elifanayo lilonke:
- Izicwangciso ze-Silver-tier zibonelela ngexabiso le-actuarial value (i-68 ukuya kwi-72 ekhulwini, efikelela kuma-66 ukuya kuma-72 ekhulwini ngo-2018).
- Izicwangciso zebhonze zinika ixabiso le-actuarial (i-58% ukuya kwi-62%, ifikelela kwi-56 ukuya kuma-65 ekhulwini ngo-2018; izicwangciso zethusi zine -4 / + 5 de minimus range ukusuka ngo-2018 ).
- Izicwangciso zeGolide zinika ixabiso le-actuarial (i-78 ukuya kuma-82 ekhulwini, efikelela kuma-76 ukuya kuma-82 ekhulwini ngo-2018).
- Izicwangciso zePlatinum zinika ixabiso le-actuarial (i-88 ukuya kwi-92 yeepesenti, efikelela kuma-86 ukuya kuma-92 ekhulwini ngo-2018)
Yintoni eya kufuneka ndiyihlawule ngesicwangciso seSiliva?
Iiplani zeplani zesiliva zihlala zingabibizi ngaphezu kwegolide okanye iplatinum-tier plans ukusuka kwizicwangciso zesilivere zilindele ukuhlawula ngaphantsi kwimiqathango yezempilo.
Ukongeza kwiipresimenti zakho zenyanga, ngexesha ngalinye usebenzisa i-inshorensi yakho yezempilo, uya kufuneka uhlawule ukwabelana ngeendleko ezifana nokuncitshiswa, u- coinsurance kunye ne-copays .
Isicwangciso ngasinye sesilivere senza ukuba uhlawule isabelo sakho seendleko ziyahluka. Ngokomzekelo, isicwangciso esinye sesilivere sinokuba ne-$ 4000 echithwe ngokubambisana kunye ne-20% ye-coinsurance. Isicwangciso sesilivere esilukhuphisanayo sinakho ukuhlawula imali engaphantsi kwama-$ 2000, kodwa sibhanqa kunye ne- coinsurance ephezulu kunye ne-$ 40 copay yemimiselo.
Kodwa kubantu abathengayo ukuthengwa kwemarike nganye ekutshintshisweni kwaye banemali engenayo phakathi kweepesenti eziyi-100 zentlupheko (ama-138 ekhulwini kumazwe awandise iMedicaid) kunye nama-250 ekhulwini kwintlupheko, ukunciphisa iindleko (ukwabelana ngeendleko zenkxaso-mali) ziyafumaneka ukwenza isilivere izicwangciso-kunye neeplani zesilivere kuphela-zine AV eziphezulu ngaphezu kwama-70 ekhulwini.
Kubhaliso lwabafundi abancinci, i-AV iyenyuka ifikelela kuma-94 ekhulwini, okwenza ukuba kubekho ukugqithisa ngaphezu kwesicwangciso seplatinum, kungabi neendleko ezongezelelweyo kubhaliso (urhulumente wephondo uhlawulela abaqinisekisi ukuba banike le ntlawulo).
Kutheni Ndifanele Ndikhethe Isicwangciso Sesiliva?
Khetha isicwangciso sezempilo sesilivere ukuba:
- bajonge ukulinganisela indleko zeeprayimari zakho zenyanga kunye neendleko zeendleko zakho zokuphuma ngaphandle
- Ufuna ukuphepha iindleko eziphezulu ze-premium zegolide kunye neeplatinum izicwangciso , kodwa ufuna ukuzikhusela ekubeni unokuhlawula iinqununu eziphezulu ezithatha izicwangciso zobhedu ,
- banelungelo lokunika inkxaso -mali-mali , kuba kufuneka ukhethe icebo lesiliva ukufumana inkxaso. Le yenye yezizathu ezibalulekileyo zokukhetha icebo lesilivere. Ukuba ingeniso yakho ayidluli kuma-250 ekhulwini kwinqanaba lehlwempu (kwaye ingakumbi ukuba lingadlulanga ngaphezu kwe-200 ekhulwini lentlupheko), isicwangciso sesilivere kunye nenkxaso-mali yokwabelana ngeendleko kuya kuba yinto ebaluleke kakhulu kuwe.
Ukwabelana ngeendleko zenkxaso-mali kunciphisa i-deductible yakho, i-copays, i-coinsurance, kunye ne-out-of-pocket ephezulu ukuze uhlawule xa usebenzisa i- inshorensi yakho yempilo . Bandisa ukwanda kwexabiso le-actuarial yesicwangciso sakho sezempilo ngaphandle kokuphakamisa i-premium.
Kutheni Ndifanele Ndiphephe i-Silver Pan?
Akufanele ukhethe isicwangciso sempilo yesilivere ukuba:
- Uyazi ukuba uzakufumana iindleko zonyango ezibalulekileyo kunyaka kwaye unqume ukuba igolide yegolide okanye iplatinum kunye ne-down-of-pocket ephezulu iyakusindisa imali, nangona xa kubalwa iiprayimari eziphezulu.
- Uzama ukunciphisa iindleko zakho rhoqo ngexesha usebenzisa i-inshorensi yakho yempilo - kwakhona, icebo legolide okanye iplatinum lingaba lukhetho olungcono.
- Ukuba usebenzisa i-inshorensi yakho yezempilo kwaye wazi kwangaphambili iindleko zakho ezingaphandle kwee-pocket ziza kudlula i-out-of-pocket ephezulu, unokukwazi ukugcina imali ngokukhetha isicwangciso sebheyili- ephakamileyo ipokhethi kodwa iiprayimari eziphantsi . Iindleko zakho zonyaka eziphuma ngaphandle kweendleko ziya kuba zifanayo, kodwa uya kuhlawula i-premiums.
- Awunelungelo lokufumana inkxaso-mali nokwahlula kakhulu kwiindleko zokunakekelwa kwempilo kunyaka ozayo. Isicwangciso sobhedu sinokuba yinto enhle kakhulu, njengoko iya kuba neeprayimari ezisezantsi kunecebo lesilivere, kwintengiso ye-coverage encinci.
Unokufunda ngokubanzi malunga nendlela le ndlela isebenza ngayo, " Indlela Yokugcina Umshuwalense Wezempilo Ukuba Ufikelela Kwangaphandle Kwipokhethi ."
> Imithombo:
> Isebe Lempilo Neenkonzo Zoluntu. Isiqinisekiso soMonde kunye noNonophelo ojongene noNonophelo olungabonakaliyo: I-Market Stabilization . Epreli 2017.
> HealthCare.gov. Funda uMthetho woNonophelo ongenakunceda. Icandelo 1402.