Umshuwalense wezempilo owehliswayo ezinkulungwaneni zamaRandi wenza ama-copayments, izinkokhelo ezikhokhwa ngu- $ 25 kuya ku-$ 75 ozikweleta ngaso sonke isikhathi uma uya kudokotela noma ugcwalisa imithi kadokotela, kubonakala sengathi i-chump ishintshe. Kodwa ama-copay afaka ngempela uma unezinkinga zempilo. Ingabe i-copays ibalwa nomshwalense wakho wezempilo owehlisiwe? Ingabe usuke ususa imali yakho enkulu ngesikhathi uhlawula i-copay ye-$ 30 ye-thyroid noma ye-cholesterol kadokotela?
Kuyinto engokwemvelo ukuphoqa uma ucabanga ngemshwalense wakho wezempilo okudonswe, ngokuvamile uyingxenye yamaRandi ayizinkulungwane ezimbalwa. Ukubhajethi kwemali yomshuwalense wakho wezempilo owenziwe ngemali kuye kwaba yinto edingekayo kubantu abasebenzisa imali abacebile. Kodwa, kunzima ukulandelela inqubekelaphambili yakho ekuhlangabezaneni ne-deductible yakho uma ungaqondi ukuthi yini, ngokuqondile, ibala kulo .
Kungakhathaliseki ukuthi amakhophi wakho we-copay abalwa kanjani ekunqunyiwe kwakho kuncike ekutheni uhlelo lwakho lwezempilo luhlele kanjani izidingo zalo zokwabelana ngezindleko . Ekuhlangenwe nakho kwami, izinhlelo eziningi azikho amakhophi wakho we-copays kumshwalense wakho wezempilo owenziwe. Noma kunjalo, uhlelo lwakho lungenzeka. Izidingo zezokwelapha zokwabelana ngezindleko zishintsha njalo ngonyaka njengoba izinhlelo zezempilo zibheke izindlela ezintsha, ezisebenzisekayo nezomthengi zokwakha izidingo zokwabelana ngezindleko.
Uyazi kanjani ngokuqinisekile? Okokuqala, hlola isifinyezo sakho sezinzuzo nokuphepha. Qaphela ngokucophelela izibalo kulezi zibonelo. Uma kusengacacile, kungadingeka ubize inombolo yelungu ekhadini lakho lomshuwalense wezempilo bese ucela.
Kodwa ngokujwayelekile, kufanele ulindele ukuthi ama-copay wakho ngeke abaleke ekudonseni kwakho. Kodwa-ke, bazobe bebalwe ekuphumeni kwakho kwepokhethi (ngaphandle uma unomgomo omkhulu noma omkhulu osebenzisa imithetho ehlukene yezindleko ezingaphandle kwe-pocket).
Lapho i-Health Plan Credits Cayits Copays Towed the Deductible
Amakhophi ayihlanganisa.
Uma ubona udokotela njalo noma ugcwalisa imithethonqubo njalo, ukukhokhwa okukhokhwayo okudalwe ku-deductible yakho kuzosiza.
Ake sithi umshuwalense wakho wezempilo uhlelwe kanje:
- $ 1,000 deductible,
- I-$ 30 ye-copay yokubona udokotela wakho wokunakekela oyinhloko ,
- I-$ 60 copay ngokubona udokotela ochwepheshe,
- Ama-copay angu-$ 25 okugcwalisa imithi yesidakamizwa esijwayelekile ,
- I-$ 45 copay yokugcwalisa imithi kadakamizwa egameni lomuthi.
Manje, qhathanisa impembelelo yezezimali usebenzisa isimo esifanayo sokunakekelwa kwezempilo nomshuwalense wezempilo okhokha imali yakho yokukhokhela imali yakho, futhi umshuwalense wezempilo ongawubhalisi ama-copayments akho ku-deductible yakho.
NgoJanuwari, uthola ukuthi unesifo sikashukela . Ubona i-PCP yakho kathathu futhi kunqunywe umuthi owodwa we-generic kanye negciwane elilodwa lomuthi. Ukukhokhwa kwakho kwe-Januwari wakho kungu- $ 30 + $ 30 + $ 30 + $ 25 + $ 45 = $ 160.
I-PCP yakho ayijabuli nokulawulwa kwesifo sikashukela, ngakho ngoFebruwari, ikuthumela ukuba ubone i- endocrinologist , udokotela ogxile kwisifo sikashukela nezinkinga ze-hormone. Ubona ochwepheshe futhi ugcwalise kokubili imiyalelo yakho. Amakhophi akho e-Februwari angu-$ 60 + $ 25 + $ 45 = $ 130.
Ngo-Mashi, ubona i-endocrinologist kabili. Uyashintsha imiyalelo yakho; manje usuphethe izidakamizwa ezimbili zegama lomkhiqizo.
Ukukhokhwa kwakho kwe-Mashi ku-$ 60 + $ 60 + $ 45 + $ 45 = $ 210.
Ekupheleni kukaMashi, ukhokhe inani lama- $ 500 emakhokheni. Uma uhlelo lwakho lwezempilo lubala ama-copay akho ku-deductible yakho, uyingxenye ekuhlanganiseni imali yakho engama-$ 1,000. Uma uhlelo lwakho lwezempilo lungabalandeli ama-copay akho ku-deductible yakho, uzobe usukhokhela yonke imali engu-$ 1,000 ekhishwayo noma ngabe usuvele ukhokhele ama-$ 500 ngezinkokhelo zezempilo ephaketheni lakho.
Izinhlelo ze-ACA-ezihambisanayo I-Copays ye-Count Ku-Out-of-Pocket yakho enkulu
Nakuba kungavamile ukuhlangabezana necebo elibalula ama-copay ekudonsheni, zonke izinhlelo ze-ACA-ezihambisanayo zibala ama-copays (ngezinsizakalo ezibhekwa njengezinzuzo zezempilo ezidingekayo ) ekubhekaneni nonyaka wakho ongaphandle we-pocket , futhi kunomkhawulo ongaphezulu ngokwemigomo ukuphakama kwakho okungaphezulu kwe-pocket kungaba ( $ 7,150 kumuntu oyedwa ngo-2017 ).
Iningi labantu alipheli ukuhlangabezana nokukhishwa kwe-pocket okungaphezulu konyaka. Kodwa uma wenza kanjalo, kungaba yinoma iyiphi inhlanganisela yamakhophi, i-deductible, kanye ne-coinsurance eyenza ube ngumkhawulo. Uma unamasevisi amaningi okusebenza ngawo i-copay, ungase ugcine ukuhlangabezana nomkhawulo wakho wokuphuma ngaphandle kwekhophi kuphela, ngaphandle kokuthi uhlangabezane ne-deductible yakho nhlobo (kuleso simo, ngeke kudingeke uhlangabezane ne-deductible yakho ngonyaka, noma ngabe udinga ukunakekelwa ukuthi i-deductible ingasetshenziswa kanjani ngokuvamile).
Kubuyekezwe nguLouise Norris.
> Imithombo:
> Amasevisi e-Medicare naseMedicaid Services, Isikhungo Sokwaziswa Komthengi kanye Nokuqapha Umshwalense. Imibuzo Yokunakekelwa Kwemisebenzi Yokunakekelwa Engenakusiza - Setha 18.