Ungaqiniseki ukuthi yini okufanele ukhethe, i- Obamacare noma umshuwalense wezempilo owenziwe ngomsebenzi wakho? Kudingeka ukuthi uthole ukuthi ikuphi okukunika ingxube engaphezulu kwesikhwama sakho, i-Obamacare ngokubhekisana nomshuwalense wezempilo osekelwe emisebenzini? Nansi indlela yokuqhathanisa umshuwalense wempilo esekelwe emisebenzini ngezinhlelo ze-Obamacare ezitholakalayo kwi- Care Affordable Care Act yakho yomshuwalense wezempilo ezinyathelweni ezingu-4 ezilula.
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Isinyathelo 1-Qinisekisa Ukubaluleka Kwamanje Kwempilo Yokwenza UmsebenziUkuqhathanisa imininingwane eqondile yokuhlanganisa kunzima kakhulu uma uzama ukukhetha phakathi kwezinhlelo ezimbalwa zezempilo. Kodwa-ke, kunesikebhe esifushane esilula kakhulu: qhathanisa amanani we-actuarial .
Inani le-actuarial yecebo lempilo likutshela ukuthi yimaphi amaphesenti wezindleko zokunakekelwa kwezempilo ngonyaka, ngokwesilinganiso, uhlelo lwezempilo lukhokhela amalungu alo. Inani eliphakeme le-actuarial value value, okubaluleke kakhulu izinzuzo zezempilo. Isibonelo, uhlelo lwezempilo olunenani lama-85% luzokhokhela cishe ama-85% azo zonke izindleko zokunakekelwa kwezempilo ezihlanganisiwe. Amalungu kulindeleke ukuthi akhokhe amanye ama-15% wezindleko zabo zokunakekelwa kwempilo ngokubaluleka kokwabelana ngezindleko ezifana nokudonswa kwemali , ama- copays kanye ne-coinsurance .
Ukuthola ukubaluleka kwamanje kwezinhlelo zezempilo ezitholakala ngomsebenzi wakho, kuzomele ucele. Umnyango wakho wezibonelelo zabasebenzi noma umnyango wezisebenzi zomuntu yindawo okuzoqala ngayo. Enye indlela ukubiza inombolo yesevisi yamakhasimende ohlelweni lwezempilo olusekelwe emisebenzini olucubungulayo futhi uthole inani le-actuarial kusuka kumsebenzi wezezimali kwamakhasimende.
Uma usuwazi ukubaluleka kwe-actuarial yecebo lakho lempilo elisuselwa emsebenzini, usulungele ukuqhubekela phambili kwisinyathelo sesi-2.
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Isinyathelo 2-Qhathanisa ne-Job-Based Health Plan & I-Obamacare Plan Plan Actuarial ValuesUma usuyazi ukuthi inani le-actuarial yezempilo elisuselwa emsebenzini lihlela ukuthi umqashi wakho uyanikeza, khetha uhlelo noma ezimbili zenani elifanayo le-actuarial kusuka ekushintsheni kwakho kwe-Obamacare. Ungatshela inani le-Obamacare plan actuarial nge- metal-tier yayo .
- Izinhlelo zezempilo ze- bronze zinenani elingama-60%.
- Izinhlelo zezempilo zesiliva zinenani elingama-70%.
- Izinhlelo zezempilo zegolide zinenani elilinganiselwa ku-80%.
- Izinhlelo zezempilo zePlatinum zinenani elingu 90%.
Isibonelo, uma umshuwalense wempilo esekelwe emisebenzini umqashi wakho enikezayo unenani elilinganiselwa ku-72%, ungakhetha amapulani amabili we-silver-tier Obamacare ukuwaqhathanisa nawo kusukela izinhlelo zesiliva zinenani elilinganiselwe elisondele emsebenzini wakho plan.
Ngokuqhathanisa amapulani ezempilo ezinamagugu afanayo, uqinisekisa ukuthi uqhathanisa ama-apula nama-apula. Uma uqhathanisa uhlelo lwezempilo lwe-actuarial value lwe-actuarial olutholakala emsebenzini ngomsebenzi wezempilo we-actuarial value we-actuarial value we-60%, kungaba kuhle ukufanisa iPorsche 911 neF Ford Mustang. Esikhundleni salokho, udinga ukuqhathanisa i-Honda Accord neToyota Camry ukuze ukwazi ukuthola ukuthi uthola kangakanani ibhola lakho uma uqhathanisa uhlelo lwakho lwezempilo olusekelwe emisebenzini ngecebo le-Obamacare.
Uma usukhethile uhlelo lwe-Obamacare noma amabili ngenani elifanele le-actuarial kusuka ekushintsheni, usukulungele ukuqhubekela phambili kwisinyathelo sesi-3.
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Isinyathelo 3-Khetha Izinkokhelo Zakho Zomshwalense Wezempilo Ne-Job Based Based InsuranceUkunquma Indleko Yenyanga Yenyanga Yomshwalense Wezempilo Oxhaswe Ngumqashi
Umshwalense wezempilo osekelwe kuJobe uvame ukusizwa ngumqashi wakho. Umqashi wakho ukhokha ingxenye yezindleko zenyanga zomshuwalense wakho wezempilo, futhi ukhokha ingxenye. Ingxenye yakho ivame ukukhishwa ngaphambi kwentela yakho yokukhokha ukuze ungakhokhi intela yentela kuwo.
Buza umnyango wakho wezinzuzo zomsebenzi ukuthi imali yakho engakanani mayelana nezindleko zemishwalense yakho yomshuwalense wezempilo izoba inyanga ngayinye uma ukhetha umshuwalense wezempilo osekelwe emisebenzini.
Ukunquma Indleko Yenyanga Yenyanga Yomshwalense Wezempilo Eshintshiselwe
Ukuze unqume izindleko zakho zezinhlelo zempilo ze-Obamacare, kuzodingeka uphindele emuva ku-exchange insurance yakho. Kungadingeka ukuthi ubhalise nge-exchange bese udala i-akhawunti ngokufaka imininingwane yakho yabantu. Njengoba izinhlelo zezempilo ezisekelwe ekushintsheni zivunyelwe ukushintsha amaphrimiyamu abo ngokususelwa eminyakeni yakho, lapho uhlala khona, nokuthi ngabe ungabhemi noma awubheki, kuzodingeka ukondle lolu lwazi kwi-portal exchange portal exchange portal ngaphambi kokuba ukwazi thola noma yiluphi ulwazi mayelana nezindleko.
Nakuba umshuwalense wezempilo u-Obamacare uvame ukuxhaswa, akunakwenzeka ukuba uxhaswe ngawe . Uma unikezwa umshuwalense wezempilo ngumqashi wakho, awufanelekile ukuthola usizo lwe-Obamacare ngaphandle kokuba umshuwalense wezempilo umqashi wakho anikeze ngokukhethekile noma ongenakulungiswa.
Kulesi sibonelo, i- lousy ngokukhethekile isho ukuthi uhlelo lwakho lwezempilo olusekelwe emisebenzini lunenani elingu-60%. Umshuwalense wezempilo womqashi wakho ungabhekwa njengokungenakulungiswa uma isabelo sakho sezindleko zokuzikhokhela wena, hhayi ukufakwa komndeni, kubiza okungaphezu kuka-9.56% wemali engenayo yomndeni wakho.
Ungase ufanelekele isibonelelo somshuwalense wempilo yesikweletu se- premium ukuze ukhokhe ukukhokhela umshuwalense wezempilo oyithengayo ekushintsheni uma
- Uma imali yakho engenayo iphakathi kuka-100% no-400% wezinga lobuphofu lombuso , futhi
- umshuwalense wezempilo umqashi wakho onikezelayo unenani elilinganiselwe elingaphansi kuka-60% noma
- isabelo sakho semishanguzo ye-umshuwalense wempilo esekelwe emisebenzini ingaphezu kuka-9.56% yengeniso yakho yomndeni.
Uma uhlangabezana nalezi zindlela, indlela engcono kakhulu yokuthola izindleko ze-Obamacare uhlela ukuthi uziqhathanise nesicwangciso sakho sempilo esekelwe emsebenzini ukufaka isicelo somxhaso ngokusebenzisa ukushintshwa komshuwalense wezempilo. Njengokubhalisa nokudala i-akhawunti ngemali yomshuwalense wezempilo yakho ayikuphoqeleli ukuba uthenge uhlelo lwe-Obamacare, futhi ukufaka isicelo soxhaso akuphoqe ukuba uthenge umshuwalense wezempilo noma wamukele usizo lwezezimali. Ungasenza isinqumo sokukhetha uhlelo lwezempilo lomqashi wakho, kunalokho.
Usizo Lwezimali Zomshuwalense Wezempilo?
Ngisho noma ungafanelekile kumsizi wenkampani ye-Obamacare, uzodinga ukusebenzisa i-Affordable Care Act yakho yokushintshaniswa kwempilo yomshuwalense ukuze uthole amazinga angenasiphelo ohlelweni lwezempilo ozikhethile.
Uma unezindleko zenyanga zonke zezinhlelo zakho ezikhethiwe ze-Obamacare kanye nomshuwalense wakho wempilo esekelwe emsebenzini, usulungele ukuqhubekela phambili kwisinyathelo 4.
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Isinyathelo 4-Qhathanisa nezindleko ze-Obamacare Vs Imishanguzo Yezempilo YomsebenziKhetha I-Best Deal
Uma usufumene ukuthi kuzodingeka ukuthi ukhokhe malini inyanga ngayinye ngomshuwalense wakho wempilo esekelwe emisebenzini kanye nezinhlelo ze-Obamacare oziqhathanisa nazo, usuphelile. Uma uhlelo olulodwa lungabizi kakhulu kunabanye, ngoba zonke izindinganiso ezifanayo ze-actuarial, uhlelo oluphansi kakhulu lukunika i-bang best for buck yakho. Khetha leyo plan yomshuwalense wezempilo uma ufuna ukuthengiswa okuhle.
Uma i-Obamacare ne-Job Based Based Insurance Insurance Yizo Iziphesheli Ezinhle
Uma izindleko zakho kuzo zonke izinhlelo zifana nalokho, ungabeka isinqumo sakho kwisakhiwo sezempilo esikuthandayo. Hlola ukufaneleka okuphelele kwezidingo zakho ngokubuka
- Uhlobo lwepulani lezempilo.
- Indlela ukwabiwa kwezindleko kuhlelwe ngayo.
- Inethiwekhi yomhlinzeki wezempilo .
- I-formula yezempilo ye- drug plan.
- Ukuhlelwa kwekhwalithi yezempilo nokulinganisa ukwaneliseka.
Uma uthanda inkululeko yokuphuma ngaphandle kwenethiwekhi futhi uzimisele ukukhokha kancane uma wenza, cabanga nge-PPO noma uhlelo lwe-POS. Uma ungakhathazeki ukuhlala kwinethiwekhi ukugcina izindleko zakho ziphansi, i-HMO noma i-EPO ingase ikusebenze kahle. I-HMO, i-PPO, i-EPO & i-POS-Uyini umehluko nokuthi yikuphi okungcono kakhulu?
Uma ungenalo imali noma ungakwazi ukukhokha imali enkulu, i-plan yezempilo ene-deductible ephansi kepha ngaphezulu kwamazinga okukhokha noma ama-coinsurance angenza uzizwe ukhululekile.
Uma unenhliziyo yakho isethi ukugcina udokotela wakho oyinhloko wokunakekelwa oyinhloko noma isazi, hlola inethiwekhi yomhlinzeki ngamunye wezinhlelo zezempilo. Ngaphambi kokuya ohlelweni lwezempilo i-PCP yakho in-inethiwekhi , shayela ihhovisi likadokotela ukuqinisekisa ukuthi namanje in-inethiwekhi nalohlelo lwezempilo nokuthi abahlezi ukuyeka inethiwekhi yayo noma nini ngokushesha.
Uma uthatha imithi kadokotela, hlola imithi ngayinye yezidakamizwa zezempilo ukuze uqiniseke ukuthi izidakamizwa zakho zemithi ekhethekile zihlanganisiwe. Imithi Yezidakamizwa Yami Akuyona Impilo Yami Yokuhlela I-Formule Yezidakamizwa. Yini Manje?
Okokugcina, hlola izilinganiso zekhwalithi nokwaneliseka zezinhlelo zezempilo ozicabangayo. Ungakwenza lokhu ngamakhadi wombiko wezinhlelo zezempilo ezitholakalayo kwiKomidi likaZwelonke lewebhusayithi ye-Quality Assurance. Zonke ezinye izinto zilingana, uma umuntu enokulinganisa okuhle ngenkathi omunye enokulinganisa, isinqumo siyoba lula.