Zama uqhelane nezinto zakho zokutshintshiselana
Ukuba uthenge i-inshorensi yakho yempilo, usenokuba uvile ngezicwangciso ezifanelekileyo, kuxhomekeke kwindawo ohlala kuyo. Uninzi lwee- inshurensi zempilo ze-inshorensi zempilo zivele zibonelela ngezicwangciso ezifanelekileyo. Kodwa xa ubhaliso oluvulekileyo luqala ngoNovemba 1, izicwangciso ezifanelekileyo ziya kufumaneka okokuqala kwiindawo ezisetyenziselwa ukutshintshisana ngokusemthethweni, kunye neqonga leSicwangciso soBuchule.
Usebenza njani ukuSebenza?
Cwangcisa i-standard standardization yinto efana ngayo. Izikhokelo zichazwe ngokwemiqathango ethile yokunika ingxelo, kwaye zonke izicwangciso ezifanelekileyo kufuneka zibonelele ngeendlela ezifanayo kule miba yesicwangciso.
I-Healthcare.gov iyaqulunqa izicwangciso ezilungelelanisiweyo ze-2017, nangona iqela liza kuba likhethekileyo, ubuncinane ekuqaleni. Xa iSebe lezeMpilo kunye neNkonzo zoLuntu lipapashile i-Benefit and Payment Parameters ngo-2017, babeka iinkcukacha zezicwangciso ezi-6 eziqhelekileyo eziza kubakho ukuhambisa (iinkcukacha zikwiphepha 309 leNzuzo kunye neParameters Payment ). Ngangoko kunokwenzeka, i-HHS yasebenza ukugcina isicwangciso esifanelekileyo siyila ngokufana nezicwangciso ezazisetyenziswe ngo-2015.
Kubaphathi bezinto ezisebenzisa ukutshintshiselwa kwasemthethweni (oko kukuthi, i-Healthcare.gov), kuya kuba nekhetho eliqhelekileyo lokhetho kwinqanaba lezethusi, zesiliva kunye negolide , kunye neendlela ezintathu ezongezelelweyo ezicwangcisiweyo ezicwangcisiweyo kwizinga lesilivere kubantu banelungelo lokufumana inkxaso -mali .
Ukutshintshiselwa ngokusemthethweni komgaqo-nkqubo akuyi kuba noyilo lwe-HSA olufanelekileyo oluphambili ngo-2017, nangona iiplani ezifanelekileyo ze-HSA ziza kutholakala ukuthengwa phakathi kwezicwangciso ezingezizo eziza kufumaneka.
Kwiiplani eziQhathanisiweyo eziQhathanisiweyo, ezininzi iinkalo zokubhengezwa ziya kufana noko kungakhathaliseki ukuba ngubani ophethe i-inshorensi yempilo enika isicwangciso.
Ngokomzekelo, zonke izicwangciso zesilivere eziqhelekileyo kwi-exchange exchange-run exchange will have a $ 3,500 ezidityanisiweyo, i-$ 30 zamaziko okunyamekela i-copays, kunye ne-$ 15 / $ 50 / $ 100 yee-copay zegama lomenzi / igama elikhethiweyo / igama elingu- ziya kuba ngama-40 ekhulwini kwiiplani zesilivere eziqhelekileyo).
Xa abathengi bangena kwi-Healthcare.gov okuwa ( ukubhaliswa okuvulekileyo kuqala ngoNovemba 1 ), baya kubona iiplani ezikhethiweyo ezikhethiweyo ziboniswe ngokugqithiseleyo phakathi kwezinto ezikhoyo; utshintshiselwano lenzelwe ukwenza kube lula kubantu ukuba baqaphele ukuba zeziphi iiplani ezichanekileyo kwaye ezingekho.
IziCwangciso eziMiselweyo zihluke njani?
Nangona izicwangciso eziqhelekileyo zenza ii-apples-to-app ziqhathaniswa lula, kufuneka uqaphele iinkcukacha zesicwangciso. Izicwangciso ziyakwazi ukuhlukana kwezinye iinkalo ezingabhekiswanga ngokuthe ngqo kwizikhokelo zokumisela izicwangciso. Unxibelelwano lwee-intanethi kunye nefomula (izintlu zezilwanyana ezikhuselekileyo) ziya kwahluka kakhulu kwicebo elinye.
Ngoko nangona unokuba uqhathanisa nezicwangciso ezintathu zesilivere eziqhelekileyo ukuba zonke zi neendleko ezifanayo zokuphuma kwezidakamizwa, kufuneka ukhangele i-formularies yenkampani nganye ukuchonga ukuba ingaba zibandakanya isilwanyana esithile esiyidingayo, kwaye ukuba kunjalo, yimuphi umyalelo wesigxina osebenzayo.
Kwizicwangciso ezikhethekileyo zokukhetha i-Healthcare.gov ngokuxhomekeka ngo-2017, umnxibelelwano mnye kuphela unikwe imvume ngesicwangciso ngasinye, ngoko akukho zixhobo zoxhumo lwenethiwekhi eziza kubakho zikhethiweyo phakathi kweendlela ezikhethiweyo. Kodwa amanxibelelwano ngokwawo ayahluka kwicebo elinye.
Azikho iziCwangciso zeMpilo sele sele ziqinisekisiwe?
Umthetho ononophelo wokuNakekelwa koMsebenzi sele uvelise iqondo elithile lokumisela kwimarike yempilo yomshuwalense, kunye nokuqaliswa kokuhlelwa kwezinga lezakhiwo zezempilo . Zonke izicwangciso ze-inshorensi zempilo ngemihla ephumelelayo kaJanuwari 2014 okanye kamva-kuquka iiplani ezithengiswa ngaphandle kokutshintshiselana-- nokulungelelaniswa kwinqanaba le-metal-level okanye isicwangciso esiyingozi .
Ngenxa yokuba zonke izicwangciso zezempilo ezintsha zibhedu, isiliva, igolide, iplatinum, okanye inhlekelele, kulula ukuba abathengi baqhathanise iipulo kwiipulo kunexesha langaphambi ko-2014. Kodwa ukuhlelwa kwezinga leziseko kunqunywe kusekelwe kwixabiso le- actuarial (AV) yesicwangciso . Kwaye akusiyo imilinganiselo edla ukuthetha kakhulu kumthengi ngamnye. Izicwangciso zebhonze zi-AV ezingama-60 ekhulwini (ngokwenene ibanzi, ukusuka kuma-58 ukuya kuma-62 ekhulwini; Ama-80 ekhulwini, kunye neeplatinum zicwangciso ze-AV ezingama-90 ekhulwini.
Ngoko ke isicwangciso sesilivere sinokulindela ukuba sihlawule malunga neepesenti ezingama-70 zeendleko zonyango lonke lezempilo. Kodwa oko kungumyinge, kubandakanywa nabantu abanenkcitho encinane yokunakekelwa kwempilo, kunye nabantu abangadinga ukunakekelwa kweengxowa-mali ezigidi ezigidi ngonyaka.
Umntu onenkcitho encinci yempilo angakhokhela ininzi okanye yonke inakekelo lwakhe kunyaka, kuxhomekeke kwisakhiwo sakhe socwangciso (oko kukuthi, ukuba unayo imali engama-3 000 echithwe kwaye isebenzisa kuphela imali eyi-1 000 yempilo enokuthi ichithwe, Ukuhlawula iindleko ngokupheleleyo). Ngakolunye uhlangothi, umntu ojongene neendleko zezempilo ezifikelela kwiidola eziligidi ngonyaka uya kuhlawula iincinci ezincinci zeendleko zakhe, kuba isicwangciso sakhe sempilo siya kuhlawula iipesenti ezili-100 zeendleko zakhe emva kokuba ehlawule i -po-pocket sakhe sicwangciso.
Nangona iiplani zingaphantsi kwinqanaba lezinyithi zinokuba yi-AV efanayo, iifayili ezithile ziyakwazi ukuhluka ngokubanzi kwisicwangciso esinye. Ngokomzekelo, kuqhelekileyo ukubona izicwangciso zesilivere kunye neentengo ezidityanisiweyo ezivela kwi-$ 1,500 ukuya kwii-4,500 zamaRandi. Abanye banakho i- copays ukutyelela iofisi , ngelixa abanye bengabikho . Abanye banesithuba esiphezulu se-pocket evuliwe , ngelixa abanye banamaqhekeza angaphantsi kwe-pocket. Ngamafutshane, kukho iindlela ezininzi ezahlukahlukeneyo ukuba icebo liyakwazi ukuphumeza i-AV kwisinye sezigaba ezilungiselelwe izicwangciso zezinga lesinyithi.
Nangona ngaba abathengi abancinci ukukhangela kwabo kwinqanaba lezinyithi elilodwa baya kuqhathanisa iiplani zonke eziza kunika ixabiso elifanayo ngokubanzi, basenokufumanisa ukuba inkqubo yokuqhathanisa iprogram ingaba yinto emangalisayo, ingakumbi kumazwe aninzi aphethe i-inshurensi yezempilo ethatha inxaxheba.
Ukuqaliswa koyilo lweplani eliqhelekileyo ngumzamo wokwenza inkqubo yokuqhathanisa isicwangciso ibe intuitive, kwaye inokunceda ekunciphiseni ukubaluleka koyilo lokucwangcisa icebo.
Amanyathelo asele aSebenzile
Amaninzi amaninzi sele sele anesicwangciso esifanelekileyo kwiingxoxo zabo. Isicwangciso sokuyila siyahluka ukusuka kummandla ukuya kummandla welizwe, kodwa ukugxila ngokubanzi kukugcina izithintelo, i-copays, i-coinsurance, kunye ne-out-of-pocket yeendleko ezifanayo kuzo zonke izicwangciso eziqhelekileyo kwinqanaba lokunika inkxaso. Ngokomzekelo, zonke izicwangciso zesilivere ezichanekileyo kwi-Oregon zitshintshi ziya kuba nama-2,500 amaxabiso athathekayo ngabanye ngo-2017 kwaye i-ofisi yokunyamekela i-$ 37 yangasese ivakashele ii-copay.
Uninzi lwezicwangciso ezilungelelanisiweyo zijongene nokunakekelwa kwangaphandle kunye nee-copays, kunokuba zifake kwi-deductible. Ininzi echaza ngeendlela ezicwangcisiweyo ezicwangcisiweyo nazo zivumela abathwali ukuba banike izicwangciso ezingezizo ngokufanayo:
- E- California , ukutshintshisa kuphela kuvumela abathwali ukuba banike izicwangciso ezilungelelanisiweyo.I-Covered California-exchange-run-run exchange-does not allow a non-standard standardized to sell, kwaye yayinceda kakhulu ukuqaliswa kwezicwangciso eziqhelekileyo kumazwe asebenzisa i-Healthcare .gov kunokuba baqhube iimali zabo.
- I-New York idinga abaqinisekisi bempilo ukuba banike ubuncinane isicwangciso esisodwa kwisilinganisi ngasinye sensimbi, nangona i-insurers nayo ivumelekile ukuba inikezele kwiiplani ezintathu ezingaqinisekanga. Amaphesenti angama-61 abantu ababhalise kwiNkqubo yezeMpilo eNew York ngo-2015 bakhethe izicwangciso ezifanelekileyo.
- EMassachusetts ivelise izicwangciso ze-inshorensi zempilo zonyango ngo-2010, kwaye ziyaqhubeka zifumaneka ngokutshintshiselwa kwe-state, i-Massachusetts Health Connector. Kodwa abathwali abathengisayo izicwangciso kwi-exchange exchange yaseMassachusetts banokukhetha ukunikezela ngezicwangciso ezingezizo.
- KwiSithili sase-Columbia , ukutshintshiselana-i-DC Health Link- yazisa izicwangciso eziqhelekileyo ngo-2016 , kodwa izithuthi zinezimo ezinzima zokunikezela izicwangciso ezingafaniyo. Ukutshintshana kuphela kudinga umthengisi ukuba anike isicwangciso esifanelekileyo nasiphi na inqanaba lesinyithi apho umphathiswa enika izicwangciso.
- Ukutshintshiselana kwe- Connecticut -Access Access CT-idinga izithwala zokunika ubuncinane isicwangciso esisodwa segolide, ubuncinane isicwangciso sesilivere esisisisiseko (esimele sibe yiplani yexabiso lexabiso eliphantsi kunazo zonke). apho kufuneka i- HSA-iyahambelana . Abathwali abavunyelwe ukuzalisekisa iimfuno zamagcini zezicwangciso zabo ezicwangcisiweyo; Ababhalisi kufuneka bavunyelwe ukutyelela iingcali ngaphandle kokudluliselwa kwirejistri. Ngethuba nje ukuba abathwali badibanise iimfuno zesicwangciso esifanelekileyo, banokunikezela kwiiplatinum ezimbini ezingezizo, kunye nezicwangciso ezintathu ezingezizo eziqhelekileyo kwisigaba ngasinye sebhasi, zesilivere kunye negolide.
- I-Oregon ekuqaleni yayinokutshintshiselwa ngokusemthethweni komsebenzi, kodwa ngoku isebenzisa i-Healthcare.gov njengendlela yokubhalisa iqonga layo. Urhulumente wenza izicwangciso eziqhelekileyo kwiibakala zebhedu, zesilivere kunye negolide, kodwa ama-insurers anikezela ngotshintshiselwano anganisekela kwizicwangciso ezimbini ezingezizo kunye nezicwangciso ezimbini "ezintsha" kwizicwangciso nganye.
- I-Vermont Health Connect, i-Vermont Health Connect, ine- bronze, isilivere, igolide kunye neeplatinum izicwangciso , kunye neeplani ezongezelelweyo eziqhelekileyo kwinqanaba lebheyili nelivavani ezihambelana ne-HSA. Abathwali abathintekayo kwintsebenziswano karhulumente nabo banikela ngeendlela ezingekho phantsi kweenkqubo.
I-HHS yenza izicwangciso ezilungelelaniso kakhulu-kubaxhasi kunye nabathengi-ngo-2017. Ngokuxhomekeke kwindlela efanelekileyo ngayo iiplani zeCandelo eliKhethekileyo, zinokuthi zibe yinto enyanzelisayo ekutshintshisweni ngokusemthethweni kwixesha elizayo.
Kwaye nangona abanye abagxeki baphikisana ngokuthi izicwangciso ezilungeleleneyo zichasisa izinto ezintsha kwiimarike ze-inshorensi yempilo, kubalulekile ukuba uqaphele ukuba phantse onke ama-exchange exchanges-state asele anesicwangciso esimiselweyo esifanelekileyo abuye avumele abathwali ukuba bathengise izicwangciso ezingezizo.
> Imithombo:
> Ukufikelela kwi-CT, Ukucebisa kwiSicwangciso sezeMpilo zokuPhatha iNxaxheba kwiNkqubo yeeNkqubo zeMpilo kunye / okanye kwiNkcenkcesho yezeMpilo kwiShishini .
> I-Covered California, iiNkampani ze-Inshurensi yezeMpilo kunye neRhafu yeeNkqubo ze-2016
> Isebe lezeMpilo kunye neNkonzo zoLuntu, uMkhuseli weMonde kunye noMthetho woKhathalelo ongenakunqwenelekayo, iSaziso seNzuzo kunye neParameters yokuhlawula i-2017 https: //s3.amazonaws.com/public-inspection.federalregister.gov/2016-04439.pdf .
> ISebe lezeMpilo eNew York, Isimemo kunye nezidingo zeNkampani yeNkampani yeeNkxaso-mali kunye neNkxaso-mali yokuBamba iqhaza ngo-2016 .
> I-Oregon Division of Financial Regulation, i-Oregon IziCwangciso zezeMpilo eziMisiweyo, iSishwankathelo soMgangatho.