Indlela umxhaso we-ACA Umshuwalense wezeMpilo osebenza ngayo

Ukuqonda uxhasomali lwe-Assurance ye-Premium yesikweletu se-ACA

Umthetho Wokunakekelwa Onganakekelwayo uhlanganisa ukuxhaswa kukahulumeni ukusiza abantu bakhokhele izindleko zomshuwalense wezempilo. Enye yalezi zinshuwalense zempilo yomshuwalense yikhokhwa yentela ye-premium esiza ukukhokhela izinkokhelo zomshuwalense wenyanga yomshuwalense wezempilo

Ngaphansi kwezokuPhatha kweTrump, abameli beRiphablikhi bachitha isikhathi esingaphezu kuka-2017 bezama ukuwuqeda i-ACA bese beyifaka esikhundleni sezinye iziphakamiso ezihlukahlukene, kodwa abaphumelelanga.

Umthetho we-Tax Cuts and Jobs (HR1), owasungulwa ngoDisemba 2017, uzogcina ekugcineni isigwebo somuntu ngamunye we-ACA, kodwa lokho ngeke kusebenze kuze kufike ngo-2019 ( kusekhona isigwebo sokungaqinisekiswa ngo-2018 ). Futhi ukulungiswa kwesabelomali okuqhubekayo kukaJanuwari kubambezele izintela ezimbalwa ze-ACA, kuhlanganise ne- Cadillac Tax .

Kodwa ngenye indlela, akukho lutho olushintshile mayelana ne-ACA. Ukunciphisa ukwabelana ngezindleko kusatholakala kuma-enrollees afanelekayo, naphezu kokuthi i-Trump Administration yabhidliza imali kubo ekupheleni kuka-2017 (ababheki bomshuwalense bamane nje bangeze izindleko zama-premium esikhundleni, okuyinhloko ekhokhwa yizinkokhelo eziphezulu ezihambelana ne-premium). Futhi isikweletu sentela ye-premium, i-aka premium subsidy, ihlala isebenza, futhi isatholakala kubantu abathenga ukuthengiswa nge -exchange .

I-credit premium yesikweletu / insizakalo yinkimbinkimbi. Ukuze uthole usizo lwezezimali futhi ulisebenzise ngendlela efanele, kufanele uqonde ukuthi insizakalo yomshuwalense wezempilo isebenza kanjani.

Uma ungayisebenzisi kahle, ungaphelela ekucwilweni kwezezimali. Nakhu okudingeka ukwazi ukuthi uthole usizo olufanelekile futhi ulisebenzise ngokuhlakanipha.

Ngifake kanjani isicelo seNkxaso Yomshuwalense Wezempilo Yesikweletu Sokukhokhelwa Kwemali Yesikweletu?

Faka isicelo sekhredithi yentela ye-premium ngokusebenzisa ukushintshwa komshuwalense wezempilo .

Uma uthola umshuwalense wakho wezempilo kwenye indawo, awukwazi ukuthola isikweletu somklomelo wesikhokhelo (amaSenenari uLamar Alexander noBob Corker, bobabili amaRiphabhuliki abamelela iTennessee, bathula uMthetho we-American Health Care Act ka-2017, okwakungavumela ababhalisile ukuba bathole i-premium ikhredithi yentela yezinhlelo ezithengwa ngaphandle kokushintshaniswa, uma kwenzeka ukuthi akukho bhukhisense abahlinzeka ngamalungiselelo ekushintshiseni endaweni ethile; umthetho awuzange uthuthuke esimisweni sonyaka ka-2017, futhi zonke izindawo zezwe zaphela lapho kunezinhlelo ezitholakala ngokushintshaniswa ngo-2018).

Uma ungahambi kahle ngokwakho umshuwalense wezempilo ngokusebenzisa ukushintshaniswa kombuso wakho, ungathola usizo kumthengisi wempilo yomshwalense onelayisense oqinisekisiwe ngu-exchange, noma ovela kumuntu obhalisiwe / umgibeli wemoto. Laba bantu bangakusiza ukuthi ubhalise ohlelweni bese uqedela inqubo yokuqinisekisa ukufaneleka kwezimali ukuze unqume ukuthi ufanelekile yini insizakalo (kungekho sikweletu ngosizo lwabo).

Ngingayifanelekela Imali Esizayo?

Abantu abenza amaphesenti angama-100 no-400 wezinga lobuphofu lombuso bangakwazi ukuthola umxhaso wesikhwama semali yesikhwama semali yentela yemali yentela yemali yentengo yemali yentengo yemali (umthamo ophansi ungama-139% wezinga lobuphofu uma usesimweni esandise iMedicaid, njengoba kutholakala ukuhlinzekwa kwe-Medicaid ngezansi lelozinga).

Izinga lobuphofu laseSweden lishintsha njalo ngonyaka, futhi lusekelwe esilinganisweni sakho somholo kanye nomndeni wakho. Ungabheka i-FPL yonyaka lapha.

Uzosebenzisa izibalo ze-FPL zonyaka ukwenza isicelo somxhaso womshuwalense wezempilo wonyaka olandelayo. Isibonelo, uma ufake isicelo se-2018 Plan Obamacare ngesikhathi sokubhalisa okuvulekile ekupheleni kuka-2017, noma uma ufaka isicelo sokuhlinzeka ngo-2018 phakathi nonyaka ka-2018 usebenzisa isikhathi sokubhalisa esikhethekile (okubangelwa umcimbi ofanelekayo), uzosebenzisa izibalo ze-FPL kusukela ngo-2017. Kungenxa yokuthi ukubhaliswa okuvulekile kokuhlinzeka ngo-2018 kwaqhutshwa ngasekupheleni kuka-2017, ngaphambi kokuba izinombolo ze-2018 FPL zifinyeleleke. Ukuze kuhambisane, izinombolo ezifanayo zeFPL zisetshenziselwa unyaka ogcwele wokuhlanganisa.

Izinombolo ezintsha ze-FPL ziphuma ngonyaka ngasekupheleni kukaJanuwari, kodwa azisetshenziselwa ukukhokhelwa kwemali ekhokhelwa izinsizakalo kuze kufike ukubhaliswa okuvulekile ngoNovemba, ukuze kutholakale umsebenzi osebenzayo ngonyaka olandelayo.

Ukuze usebenze ngokuphumelelayo ngo-2018, usebenzisa amazinga e-2017 FPL, e-Continental yase-US (i-FPL iphakeme e-Alaska naseHawaii), uzokwazi ukuthola usizo lwemali yomshuwalense wezempilo njengomuntu onobuhle bokuthola imali:

• $ 12,060 kuya ku-$ 48,240 kumuntu oyedwa (umngcele ongaphansi u $ 16,763 uma usesesimweni esandise iMedicaid)
• $ 16,240 kuya ku-64,960 kumbhangqwana (umngcele ongaphansi u $ 22,823 uma usesesimweni esandise iMedicaid
• $ 24,600 kuya ku-$ 98,400 emndenini wezine (umngcele ophansi u-$ 33,194 uma usesesimweni esandise iMedicaid).

Uma uhlangabezana neziqu zemali engenayo, ungase ungabi namalungelo ensizakalo. Kungaba njalo uma:

• Uhlelo lwesibili lwezindleko zesiliva endaweni yakho lucatshangwa ukuthi lungabizi ezingeni lakho lokuhola, ngisho nangaphandle kwezimali.
• Uyakufanelekela uhlelo olungabizi, lokunciphisa inani eliphansi kumqashi (owakho noma oshade naye). Qaphela ukuthi ukukhokhelwa kwezinhlelo ezixhaswe ngumqashi kubalwa ngokusekelwe ezindlekweni zomsebenzi, kungakhathaliseki ukuthi kudingekile ukwengeza oshade naye nabancike kulo. Kodwa oshade naye nabaxhomekile abafanelekile ukusizwa ngemali ekushintsheni uma umsebenzi wokubheka umsebenzi uthathwa njengakhokhwa ngumsebenzi futhi unikezwa amalungu omndeni. Lokhu kubizwa ngokuthi i- glitch yomndeni .

Ngingakanani Imali?

Ukuze uthole ukuthi ingakanani isikweletu sakho sokukhokha intela, kufanele wazi izinto ezimbili:

1. Umnikelo wakho kulindeleke ukuthi ubhekane nezindleko zemshuwalense wakho wezempilo
   Ungabheka lokhu etafuleni phansi kwekhasi. Qaphela ukuthi lishintsha njalo ngonyaka. Amaphesenti omnikelo we-2018 ayingqikithi enkambisweni ye-IRS Revenue 2017-36 , kanti empeleni ukwehla kwamaphesenti omnikelo ka-2017 (lena kwakuyiyokuqala ukuthi amaphesenti anciphile kusukela ngonyaka owodwa kuya olandelayo, esikhundleni sokwandisa).
   
2. Izindleko zepulani lakho lokuhlola uphawu lokuhlola
   Uhlelo lwakho lokubheka uphawu luhlelo lwezempilo lwe - silver-tiered kanye nama-premium aphansi kakhulu ngenyanga. Ukushintshaniswa komshwalense wakho wezempilo kungakutshela ukuthi yiliphi uhlelo nokuthi libiza kangakanani. Ungawuthola ngokwakho ngokumane uthola izingcaphuno zakho ekushintsheni, uzihlukanise ngamanani (lokho ngokuvamile okuzenzakalelayo), bese ubheka uhlelo lwesiliva eliphansi kakhulu lokubiza imali.

Imali yakho yenkxaso yohlu umehluko phakathi komnikelo wakho okulindelekile kanye nezindleko zesicwangciso sokubheka endaweni yakho. Bheka isibonelo sokubala izindleko zakho zenyanga kanye nemali yakho yesibonelelo ngezansi kwekhasi (kodwa wazi ukuthi ukushintshanisa kuzokwenza konke lokhu kubalo-isibonelo sizokusiza ukuthi uqonde ukuthi konke kusebenza kanjani, kodwa wena akudingeki wenze lezi zibalo ukuze uthole isikweletu sakho sentela ye-premium!).

Ngingayithola I-Plan Engabizi Ukugcina Imali, Noma Kufanele Ngithenge I-Benchmark Plan?

Ngenxa yokuthi uhlelo lokulinganisa lisetshenziselwa ukubala isibonelelo sakho akusho ukuthi kufanele uthenge uhlelo lokukhomba. Ungathenga noma yiluphi uhlamvu lwezethusi, isiliva, igolide, noma iplatinum ebhalwe ku-inshuwalense yakho yezempilo. Ungase ungasebenzisi isibonelelo sakho ukuthenga uhlelo oluyingozi , noma kunjalo.

Uma ukhetha uhlelo olubiza okungaphezu kwecebo lokubheka, ngaphezu kwemali yakho ekulindelekile, uzokhokha umehluko phakathi kwezindleko ze-benchmark plan kanye nezindleko zecebo lakho elibiza kakhulu. Uma ukhetha uhlelo olungabizi kunaloluhlelo lwesibonakaliso, uzokhokha kancane ngoba imali yesibonelelo izofaka ingxenye enkulu yenkokhelo yenyanga. Uma ukhetha uhlelo olubi kakhulu kangangokuthi lubiza imali engaphansi kwesibonelelo sakho, akudingeki ukhokhe noma yini umshwalense wezempilo. Kodwa-ke, ngeke uthole emuva imali eyengeziwe (inothi ukuthi abantu ezindaweni eziningi banokuthola izinhlelo ze-bronze ngaphandle kwama-premium ka-2018-ngemva kokusetshenziswa kwezikweletu zabo zentela-ngenxa yezindleko zokunciphisa izindleko wengezwe ezinkampanini zesiliva zesiliva ngo-2018).

Uma uzama ukulondoloza imali ngokukhetha uhlelo nge- value actuarial ephansi, (njengohlelo lwebhedu esikhundleni secebo lesiliva), qaphela ukuthi uzoba nokuqinisekiswa okuphezulu nakwe- copay uma usebenzisa umshwalense wakho wezempilo. Kodwa eminye imingcele yokuhlinzeka ngo-2018, izinhlelo zegolide kwezinye izindawo zingabizi kakhulu kunamapulani esiliva (njengoba izindleko zokunciphisa izindleko zengezwe ezinkampanini zezimali zesiliva), naphezu kokuthi izinhlelo zegolide zinenani eliphakeme le- actuarial .

Kodwa-ke, uma unayo engenayo engaphansi kwamaphesenti angama-250 e-FPL-ikakhulukazi uma ingaphansi kuka-200 amaphesenti e-FPL-cabanga ngokukhetha uhlelo lwe-silver-tier, njengoba inani lamanje lalo hlelo lizoba ngcono kunecebo legolide, noma kwezinye amacala, ngisho nangcono kunecebo leplatinum. Kungenxa yokuthi kunomxhaso ohlukile owehlisa ama-copays, u-coinsurance, nama-deductibles kubantu abanemali engaphansi kuka-250% wezinga lobuphofu. Abantu abamukelekayo bangayisebenzisa ngaphezu kwezimali ezikhokhelwa ngesikweletu sentela yesikweletu. Noma kunjalo, itholakala kuphela kubantu abakhetha uhlelo lwe-silver-tier.

Ingabe Kufanele Ngilinde Kuze Ngifake Iimali Zami Ukuze Ngithole Insizakalo Njengoba I-Tax Credit?

Akudingeki ulinde uze ufake i-intela yakho. Ungathola isikweletu sentela ye-premium kusengaphambili. Kodwa-ke, uma ngabe ungathanda, ungakhetha ukuthola isikweletu sakho sokukhokhwa intela njengembuyiselo yentela uma ufaka izintela zakho esikhundleni sokuthi ukhokhwe kusengaphambili. Lolu khetho lutholakala kuphela uma ubhalisile ohlelweni ngokusebenzisa ukushintshaniswa. Uma uthenga uhlelo lwakho ngqo kusuka enkampanini yomshuwalense, ngeke ukwazi ukuthola usizo oluphezulu lwe-premium, futhi ngeke ukwazi ukufaka isicelo somxhaso kumbuyiselo wakho wentela.

Uma imali yakho engenayo iphansi kakhulu ukuthi awudingi ukukhokhisa intela, usengathola insizakalo, nakuba ungayikufanelekela umxhaso uma imali yakho engenayo ingaphansi kwezinga lobuphofu (noma ngaphansi kwamaphesenti angu-139 wezinga lobuphofu) emazweni athi akhulise iMedicaid).

Kungakhathaliseki ukuthi uthatha isibonelelo sakho phezulu ngonyaka noma ngesamba semali yentela yakho, kuzodingeka ufake iFomu 8962 ngokubuyisela intela yakho. Yilelo ifomu lokubuyisana (noma ukubiza ngokugcwele) isikweletu sakho sentela ye-premium.

Ngithola Kanjani Imali?

Uma ukhetha ukuthola isikweletu sentela yesikhokhelo kusengaphambili, uhulumeni uthumela imali ngqo kwinkampani yakho yomshuwalense wezempilo. Izimali zakho zomshuwalense wezempilo ukuthi imali ehambelana nezindleko zemishanguzo yomshuwalense wezempilo, ukunciphisa ukuthi uzokhokha malini ngenyanga.

Uma ukhetha ukuthola i-credit premium yentela njengembuyiselo yentela, imali izofakwa ekubuyiselweni kwakho imali uma ufaka intela yakho. Lokhu kungase kusho ukubuyisela intela enkulu. Kodwa, uzokhokha ngaphezulu umshuwalense wezempilo inyanga ngayinye kusukela uzobe ukhokhela kokubili isabelo sakho se-premium kanye nesabelo esasizohlanganiswa nesekelo uma ngabe ukhethe inketho yokukhokha ephakeme. Kuzophuma ngisho nasekupheleni, kodwa uma usuphansi ekukhokheni-ngakwesokunene, ungathola inketho yokukhokha kusengaphambili ngaphezulu komsebenzisi-friendly.

Kungani Kufanele Ulinde Ngifake Ikhokhwa Yami Imali Ukuze Ngithole Insizakalo?

Iningi labantu alifuni ukulinda; bakhetha ukukhetha inketho yokukhokha kusengaphambili. Noma kunjalo, cabanga ukukhetha ukuthola insizakalo kanye nembuyiselo yakho yentela uma:

• Ingeniso yakho iseduze kakhulu namaphesenti angama-400 e-FPL.
• Imali engenayo yakho iyahlukahluka unyaka nonyaka ngakho awuqiniseki ukuthi uzokwenzani okuningi.

Lapho insizakalo isakhokhiswa kusengaphambili, inani le-subsidy isekelwe ekulinganisweni kwemali engenayo yonyaka ozayo. Uma ukulinganisa kungalungile, inani lemali yesibonelelo ngeke lilungile.

Uma uhola kancane kunokulinganiselwa, uxhasomali oluthuthukile luzobe luphansi kunalokho okufanele lube khona. Uzothola konke njengembuyiselo yentela.

Uma uhola okungaphezu kokulinganiselwa, uhulumeni uzothumela imali eningi kakhulu kunkampani yakho yomshuwalense wezempilo. Kuzodingeka ukhokhe ingxenye noma yonke imali eyengeziwe ngokwezimali uma ushiya intela yakho. Okubi nakakhulu, uma imali yakho engenayo iphela ngaphezu kwamaphesenti angama-400 e-FPL, kuzodingeka ukhokhe yonke imali ye-subsidy . Lokhu kungaba izinkulungwane zamadola.

Uma uthola isibonelelo sakho uma ufaka intela yakho yentela kunokuba kusengaphambili, uzothola imali eyisibonelelo esilungile ngoba uzokwazi kahle ukuthi uzuze kangakanani kulo nyaka. Ngeke udingeke ukhokhe noma iyiphi yayo .

Yikuphi Okunye Okudingeka Ngikukwazi Ngendlela Imali Yomxhaso Yomshwalense Wezempilo Esebenza Ngayo?

Uma uxhasomali lwakho lukhokhiswa kusengaphambili, sazise inguquko yakho yomshuwalense wezempilo uma usayizi wakho noma usayizi womndeni uguquka phakathi nonyaka. Ukushintshaniswa kungabuye kubalwe isibonelelo sakho kulo lonke unyaka ngokusekelwe kolwazi lwakho olusha. Ukwehluleka ukwenza lokhu kungaholela ekutholeni usizo olukhulu noma oluncane kakhulu, futhi kufanele wenze ushintsho olubalulekile kumali yesibonelelo ngesikhathi sentela.

Isibonelo Sendlela Yokubala Insizakalo Yomshuwalense Wezempilo

Khumbula ukuthi ukushintshaniswa kuzokwenza zonke lezi zibalo kuwe. Kodwa uma unesifiso sokuthi zivela kanjani ngemali yakho yenkxaso, noma uma ufuna ukuphindaphinda kabili ukuthi umxhaso wakho ulungile, nansi okudingeka ukwazi:

1. Bonisa indlela imali engenayo ngayo eqhathaniswa neFPL.
2. Thola izinga lakho lomnikelo elilindelekile etafuleni elingezansi.
3. Bala inani le-dollar oyilindeleke ukuba linikele.
4. Thola imali yakho yesibonelelo ngokususa umnikelo wakho olindelekile kusuka ezindlekweni zezinhlelo zokubheka.

UTom ungashadile onomholo we $ 23,000 ngonyaka. I-FPL ye-2017 (esetshenziselwa ukuhanjiswa kuka-2018) ingu- $ 12,060 kubantu abangashadile.

1. Ukuze ubone ukuthi imali kaTom ifanisa kanjani neFPL, sebenzisa:
   imali engenayo ÷ FPL x 100.
   $ 23,000 ÷ $ 12,060 x 100 = 191.
   Imali kaTom ingamaphesenti angu-191 we-FPL.
2. Ukusebenzisa ithebula elingezansi, uTom kulindeleke ukuthi abe nomthelela phakathi kuka-4.03 kuya ku-6.34 wamaphesenti akhe. Kufanele sithole ukuthi yiyiphi iphesenti yendlela ehamba ngayo leyo ngqikithi enenzuzo yephesenti lika-191 ye-FPL. Lokhu sithatha ngokuthatha u-191-150 = 41, bese sihlukanisa lokho ngo-50 (umehluko ophelele phakathi kwamaphesenti angu-150 no-200 we-FPL. 41/50 = 0.82, noma amaphesenti angu-82.
3. Okulandelayo, sinquma ukuthi yimaphi amaphesenti angu-82 endleleni phakathi kuka-4.03 no-6.34. Sisebenzisa 6.34-4.03 = 2.31, futhi sithatha amaphesenti angu-82 alokho. 2.31 yanda ngo-0.82 = 1.89. Ngakho-ke siqala nge-4.03 futhi sengeza okungu-1.89, futhi lokho kusihola amaphesenti angu-82 endleleni ngaleyo ndlela. 4.03 + 1.89 = 5.92
4. UTom kulindeleke ukuthi akhokhe amaphesenti angu-5,92 wemali engenayo ngenhloso yesiliva yesiliva.
5. Ukubala ukuthi uTom kulindeleke ukuthi anikele, sebenzisa lesi sivumelwano:
   5.92 ÷ 100 x engenayo = okumele kulindeleke uTom.
   5.92 ÷ 100 x $ 23,000 = $ 1,361.60.
   UTom kulindeleke ukuba anikeze imali engu-$ 1,361.60 ngonyaka, noma u-$ 113.47 ngenyanga, ngokuqondene nezindleko zemshuwalense wakhe wezempilo. Insizakalo yekhredithi yemali yentela ye-premium ikhokhela ezinye izindleko zepulani lempilo yokuhlola.
6. Uhlelo lwezempilo lwe-benchmark ku-inshuwalense yezempilo kaTom lubiza u-$ 3,900 ngonyaka noma i-$ 325 ngenyanga. Sebenzisa lesi silinganiso ukuze uthole isibalo senkxaso:
   Izindleko zepulani lokulinganisa - umnikelo olindelekile = inani lomxhaso.
   $ 3,900 - $ 1,361.60 = $ 2,538.40.
   Insizakalo yekhredithi yemali yentela ye-premium izoba ngu- $ 2,538.40 ngonyaka noma i-$ 211.53 ngenyanga.

Uma uTom ekhetha uhlelo lokukhomba, noma olunye uhlelo lwe-$ 325 ngenyanga, uzokhokha u-$ 113.47 ngenyanga ngomshwalense wakhe wezempilo. Uma ekhetha uhlelo olubiza u-$ 425 ngenyanga, uzokhokha u- $ 213.47 njalo ngenyanga ngomshuwalense wakhe wezempilo. Uma ekhetha uhlelo olubiza u-$ 225 ngenyanga, uzokhokha u-$ 13.47 ngenyanga ngomshwalense wakhe wezempilo.

Iminikelo Yakho Ekulindelwe Yakho Emakhokhwalini Yomshuwalense Wezempilo Wama-2018

> Imithombo:

> Congress.gov, S.761, uMthetho Wokukhethwa KwezeMpilo ka-2017.

> UMnyango WezeMpilo Nezinsizakalo Zabantu, Ukuvikelwa Kweziguli Nokunakekelwa Kwezinkinga Ezihambelanayo: Ukuqiniswa Kwemakethe . Ngo-Ephreli 13, 2017.

> Insizakalo yangaphakathi yeNgeniso, Inqubo Yokuthola Imali Yonyaka 2016-24 .

> Insizakalo yangaphakathi yeNgeniso, Inqubo Yokuthola Imali Yenzuzo 2017-36 .