Ukudonswa komndeni kwaklanyelwe ukuze imindeni emikhulu ingeke ihambe ihlukane nokukhokha imali yomshuwalense wezempilo ngamunye kulungu lomndeni. Udinga ukuqonda ukuthi umndeni usebenza kanjani ukuze uhlele isabelomali izindleko zempilo yomndeni wakho.
Okokuqala, uma ungajwayele izinto ezisisekelo ze-deductible, funda " Umshuwalense Wezempilo Owusizo Nalokho Okusebenzayo " ngaphambi kokuba uhambe phambili.
Uzodinga ukuqonda okuyisisekelo kwama-deductibles ngaphambi kokuthi ukwazi ukuqonda ukuthi umndeni usebenza kanjani.
Indlela uMndeni Owenziwe Ngayo Imisebenzi Yomshwalense Wempilo Eningi
Iningi lemishwalense yomshuwalense wempilo yomndeni inezinkampani ezidonswayo zombili kanye namadoksibles omndeni. Ngaso sonke isikhathi umuntu ngaphakathi komndeni akhokhela lowo muntu ngamunye, lowo mali uyabhekiselwa emndenini okhishiwe. Ukuqala kuqala kunoma yimuphi umuntu ngokushesha lapho ehlangene nomuntu ngamunye. Ukuqala kuqala kuwo wonke umndeni, ngisho nalawo malungu omndeni angakaze ahlangabezane namaducucbles abo ngabanye, ngokushesha nje lapho umndeni ususwe.
Kunezindlela ezimbili umgomo womshuwalense wempilo yomndeni uzoqala ukukhokhela izinzuzo zomuntu othile ngaphakathi komndeni.
- Uma umuntu ehlangana nomuntu ngamunye, i-plan plan yezempilo izokhahlela bese iqala ukukhokhela izindleko zokunakekelwa kwezempilo kulowo muntu kuphela , kodwa hhayi kwamanye amalungu omndeni.
- Uma kutholakala umndeni, izinzuzo zezempilo zempilo zikhahlelwa wonke amalungu omndeni ukuthi ngabe ahlangabezane namadokodo.
Lolu hlobo lwesistimu yokudonswa kwemindeni luyaziwa ngokuthi i- deductible embedded ngoba i-deductibles ngayinye ingene ngaphakathi futhi ibheke emndenini omkhulu.
Isibonelo Sokuthi Imisebenzi Yomndeni Yayisuswa Kanjani
Ake sithi umndeni wamahlanu unomuntu ngamunye okhishwe imali engu-$ 500 kanye nomndeni okhishwa ngamadola angu-1,500:
- Januwari:
Ubaba ukhokhela amaRandi ayizigidi ezingu-500 ngezindleko zokudonsa.
Ubaba uhlangane nomuntu ngamunye.
Umndeni okhishiwe unama $ 500 odunywe, $ 1,000 ukuze ahambe ngaphambi kokuba ahlangane.
Uhlelo lwezempilo manje lukhokhela ukunakekelwa kwezempilo kukababa.
Uhlelo lwezempilo alukhokheli umama nezingane okwamanje. - Febhuwari:
Ingane ikhokhela u- $ 500 ngezinkokhelo ezithathwe.
Ingane eyodwa ihlangabezane nomuntu ngamunye.
Umndeni osuswe manje unama $ 1,000 odalwe, $ 500 ukuya ngaphambi kokuba uhlangane.
Uhlelo lwezempilo manje lukhokhela ukunakekelwa kwezempilo kwabazali nezingane.
Uhlelo lwezempilo alukhokheli umama, ingane ezimbili noma ingane kathathu okwamanje. - Mashi:
Umama ukhokha imali engu- $ 200 ngemali etholakalayo.
Umama akazange ahlangane nomuntu wakhe ngamunye, kodwa u-$ 300 ukuya.
Umndeni osuswe manje unama $ 1,200 odalwe, u-$ 300 ukuze uhambe ngaphambi kokuba uhlangane.
Uhlelo lwezempilo lukhokhela kuphela ukunakekelwa kwezempilo kwabazali nezingane.
Isicwangciso sempilo namanje asikhokheli umama, ingane ezimbili noma ingane ezintathu. - Ephreli:
Izingane ezimbili zikhokha u-$ 300 ezizindeni ezithintekayo.
Izingane ezimbili azihlangabezane ne-individuuc deductible yakhe okwamanje, $ 200 ukuya.
Umndeni osuswe ngu- $ 1,500 usuhlangene manje.
Uhlelo lwezempilo luqala ukukhokhela izinzuzo kuwo wonke amalungu omndeni.
Njengoba lo mndeni uhlangene nomndeni wakhe udonswe, uhlelo lwezempilo lwaqala ukukhokhela izinzuzo kubo bonke amalungu omndeni, nakuba abathathu babo bengakafiki ukuxhaswa ngabanye.
Umndeni ususeka kanjani imali yakho ngaphezu kwezidakamizwa ngabanye?
Izinqubomgomo eziningi zomshuwalense wezempilo zinemali ehlukaniswayo emkhatsini wezikhathi ezimbili neziphindwe kane. Ngaphandle kokuba umndeni uncane, umndeni owehliswayo uvame ukwedlula inani lazo zonke izinkampani ezidonswayo.
Isibonelo, asitshele ukuthi unamalungu omndeni amahlanu, imali ekhishwa ngamadola angu-R1 000 kanye nomndeni okhishwa ngamadola ayizinkulungwane ezingu-2,000, izikhathi ezimbili ezilinganiselwe imali. Uma bekungekho umndeni owehliswayo futhi ilungu ngalinye lomndeni ladingeka lihlangabezane nomuntu ngamunye owadonswa ngaphambi kokuba uhlelo lwezempilo luqale ukukhokha izinzuzo, umndeni wakho oneminyaka emihlanu uzokhokha u-$ 5,000 ngaphambi kokukhishwa kwezempilo kuwo wonke amalungu omndeni.
Kodwa-ke, njengoba izinzuzo zokukhokhela zikhawulela wonke umndeni uma umndeni ususwe imali engama-$ 2,000, umndeni usindisa kuze kufike ku-$ 3,000 ngezindleko ezidonswayo.
Yini Engekho KuDeductible?
Izinto ezingagciniwe ngumshuwalense wakho wezempilo ngeke zibheke ekubhekisweni kwakho noma ngabe uzikhokhela ephaketheni lakho. Isibonelo, i-liposuction ngokuvamile ayihlanganiswa nomshuwalense wezempilo. Uma ukhokha u-$ 1,500 we-liposuction, leyo $ 1,500 ngeke ihlonishwe ngokuqondene nomuntu ngamunye noma umndeni wakhohliswa ngoba awuzuzisi inzuzo yecebo lakho lempilo.
Izinsizakalo zokunakekelwa okuvimbelayo azidingi ukukhipha imali, ukukhokha imali , noma ukukhokhelwa kwemali e-United States ngenxa yoMthetho Wokunakekelwa Ongabizi . Lokhu kusho ukuthi umshuwalense wakho wezempilo uzokhokhela izinto ezifana nomzimba wakho wenyama, umkhuhlane wesifo , nomswakama wezimbuzi ngisho noma ungahlangabezane ne-deductible yakho okwamanje.
Ama-Copay ekuvakasheni kwamahhovisi kanye nemigomo ngokuvamile ayifuni ku-deductible yakho, kodwa imininingwane ingashintsha ngecebo. Funda kabanzi lapha: Ingabe I-Copays Bala Ku-Umshwalense Wezempilo Yakho Deductible?
Izinhlelo Zempilo Eziphakeme Zedeductible Akuyona Imvelaphi, kodwa imithetho emisha iyasebenza
Uma unesiphakamiso sempilo ephakeme esinqunyiwe, umndeni wakho owehliswayo ungasebenza ngokuhlukile. Iningi le-HDHPs lisetshenziselwa ukuxoshwa ngokugcwele kunalokho uhlelo oluxhunyiwe lwe-deductible oluchazwe ngenhla. Ungafunda kabanzi ngalokhu ku- " Indlela Umndeni Oqedile Ukusebenza Ngayo HDHP ."
Qaphela ukuthi uhlelo lwakho lungase lungabi yi-HDHP nje ngoba i-deductible yakho ibonakala ikhulu kakhulu. I-HDHP uhlobo olukhethekile lwezempilo, hhayi nje igama elichazayo. Ngenxa yokuthi i-HDHP ngokuvamile ihlotshaniswa nama- Akhawunti Wokulondoloza Impilo Ehlelwe intela, inemithetho ekhethekile eyahlukanisa nezinhlelo zezempilo ezingezona i-HDHP.
Kodwa-ke, kusukela ngo-2016 , izinhlelo zezempilo ezingezona ezithandwa kakhulu kumele zisebenzise ama-maximum e-ACA-avumelana nomuntu ngamunye ohlelweni lwezempilo lomndeni, noma ngabe i-HDHP enomndeni ophelele. Ngonyaka we-2018, ukukhishwa kwepokhethi okuvunyelwe yi-$ 7,350 kumuntu oyedwa, futhi u-$ 14,700 umndeni. Ngakho i-HDHP yomndeni ingaba nomndeni ohlangene owadonswa u-$ 7,000 njengesibonelo, kodwa angeke ube nomndeni ophelele owehliswa u-R10 000, ngoba lokho kungadinga ilungu lomndeni elilodwa ukuba likhokhe imali engu-R10 000 ngaphambi kokuthola izinzuzo ngaphansi kwepulani, futhi akuvumelekile .
Ngo-2019, i-HHS ihlongoze ukuqoqa izindleko ezingaphandle kwe-pocket ngo-$ 7,900. Imithethonqubo ekhawulela izindleko zamalunga omndeni womuntu ngamunye ngaphandle kokuthi leyo mali izoqhubeka nokusebenza.
Ingabe Imithetho Iyashintsha Ngaphansi KweRepublican Health Care Reform?
Abameli beRiphabhliki basebenzisa isikhathi esiningi sika-2017 besenza imizamo yokuphinda futhi bachithe i-ACA. Leyo mizamo ayiphumelelanga, ngaphandle kwe-BOP yentela yentela ezosusa igunya le-ACA ngabanye kusukela ngo-2019 .
Izindleko ezazisungulwa ngo-2017 ngokuvamile azizange zibize noma yiziphi izinguquko emthethweni obudinga ukufaka ama-maximums angaphandle e-pocket ngamapulani omndeni. Ngokuvamile futhi abengeke ashintshe imikhawulo engaphandle kwe-pocket ukuthi i-ACA ibeka izinhlelo zezempilo.
Noma kunjalo, kubalulekile ukuqaphela ukuthi i-ACA's cap on out-of-pocket izindleko kuphela isebenza ezinsizakalo ezibhekwa izinzuzo zezempilo ezibalulekile . Iziphakamiso zokuguqulwa kwezempilo kwe-GOP ziye zafaka ngokugcizelela ekunikeni ukuthi ikhono lokuhlenga izinzuzo ezibalulekile zezempilo. Uma ngabe umthethosivivinywa onjengawo ungasungulwa, ungabangela izinhlelo zomshuwalense kwezinye izifundazwe ezingahlanganisi izinto okwamanje ezidingekayo ukuba zihlanganiswe ngaphansi kwe-ACA (ukunakekelwa kokubeletha, noma ukunakekelwa kwempilo yengqondo, isibonelo).
Uma lokho kwenzeka, izinhlelo zezempilo zingahle zibe namandla kakhulu, futhi imindeni ingase ikwazi ukumboza ngokugcwele izindleko zokwelapha okwamanje ezihlanganiswe ngaphansi kwama-ACA-amapolisi ahambisanayo. Kulokho, izindleko ezingaphandle kwe-pocket ezenzelwe izinto ezingagciniwe yilolu hlelo ngeke zibalekele ekudonseni noma ekuphumeni kwepokhethi. Esikhundleni salokho, zizoholela ezindleko eziphezulu kakhulu ezingaphandle kwamapokhethi kumalungu adinga amasevisi angasaphathwa ngenxa yemithetho encane eqinile mayelana nezinzuzo ezibalulekile zezempilo.
> Imithombo:
> I-Federal Register (uMnyango WezeMpilo kanye Nezinsizakalo Zabantu), > Isiguli > Ukuvikelwa kanye noMthetho Wokunakekelwa Okunganakwa; Isaziso se-HHS Isaziso seNzuzo kanye neMigomo yokukhokha ka-2018; Ukuchitshiyelwa kwezikhathi ezikhethekile zokubhalisa kanye nohlelo lwabathengi olusetshenzisiwe futhi oluhlelekile. NgoDisemba 22, 2016.
> I-Federal Register (uMnyango WezeMpilo Nemisebenzi Yabantu). Ukuvikelwa kwesineke kanye noMthetho Wokunakekelwa Kwezinkinga; Isaziso se-HHS Isaziso seNzuzo kanye neMigomo yokukhokha ka-2019. Novemba 2, 2017.
> HealthCare.gov, Imisebenzi Yempilo Yokuvikela.
> Kaiser Family Foundation. Isifinyezo somthetho we-American Health Care Act, ngoMeyi 2017.