Ngenxa ye-ACA, iningi lama-nsurers alinakusetshenziswa isikhathi eside sokusebenzisa izikhathi zokungabikho
Ngaphambi koMthetho Wokunakekelwa Okunakekelwayo ongenakunakekelwa umshwalense wezempilo e-US, izimo ezandulele zihlale zidlala indima ebalulekile ekuhlinzekeni komshuwalense wezempilo abantu abakwazi ukuthola.
Kuwo wonke ama-6 kodwa athi , umshuwalense wezempilo othengiswa emakethe ngayinye kungabandakanyi izimo ezikhona ngaphambili, eze nama-premiums aphakeme ngokusekelwe emlandweni wezokwelapha, noma ukuthi awutholakali nganoma yikuphi izindleko uma izimo ezandulele zikhona ngokwanele.
Emakethe exhaswe ngumqashi, abasebenzi ngabanye ababengafanelekile ukuthola ukuqashwa komqashi abakwazi ukwehla noma bakhokhiswa amaphrimiyamu engeziwe ngokusekelwe emlandweni wabo wezokwelapha (nakuba ama-premium amaqembu angase asekelwe emlandweni wezokwelapha jikelele weqembu ezindaweni eziningi) , kodwa abasebenzi abangenakufakazela ukuthi bazobe nokuthunyelwa okuqhubekayo babhekene nezinkathi zokukhishwa kwezimo ezikhona ngaphambili ezahluka ngobude kuye ngokuthi umsebenzi ungakaze uqinisekiswe kanjani ngaphambili.
Njengoba manje i-ACA isetshenzisiwe, iningi labantu alisekho ngaphansi kwezikhathi zokukhishwa kwezimo zangaphambili. Nakuba kukhulunywe ngezansi, izinhlelo ezinkulu nezinkulu zinemithetho ehlukene.
Indlela Isimo Esandulela Ngaphambi Kokusebenza Esenziwe Ngaphambi Kokubekwa I-ACA
Ngaphambi kuka-2014, lapho i-ACA ihlukumeza kakhulu imboni yomshuwalense wezempilo, izinhlelo ezithile zezempilo zizokwamukela ababhalisile abasha kodwa ngezikhathi zokubanjwa kwangaphambi kwesikhathi (isib. Isikhathi sokulinda).
Lokhu kwakuvame ngokwengeziwe izinhlelo ezixhaswe ngumqashi kunamapulani omakethe ngamunye, njengoba izinhlelo zomakethe zomuntu ngamunye zazithatha ukwelashwa okuqhubekayo kwezimo ezikhona ngaphambili (ngaphandle kwazo kuze kube nini nanini, ukushaja amaphrimiyamu aphezulu, noma ukuncipha isicelo ngokuphelele). Kodwa ezinye izinhlelo zamakethe zafika ngezimo zangaphambili ezikhona ngaphandle kwezikhathi ezithile.
Uma ngabe unesimo sokukhishwa kwesimo esandulela isikhathi, awuzange ube nokukhokhelwa kwanoma yikuphi ukunakekelwa noma amasevisi ahlobene nesimo sakho esandulele isikhathi esithile esinqunyiwe, naphezu kokukhokha imali yakho yenyanga . Lokhu kusho ukuthi noma yiziphi izinkinga ezintsha ezingezona ezihlobene nezempilo ezavela ngaleso sikhathi zahlanganiswa nenkampani yomshuwalense wezempilo, kodwa noma yiziphi izinkinga zempilo ezihlobene nesimo esandulele azizange zihlanganiswe kuze kube sekupheleni kokukhishwa kwesimo esandulele isikhathi.
Ngaphansi kwe-HIPAA (uMthetho Wokubheka Umshwalense WezeMpilo Nokuziphendulela Kwezempilo ka-1996 ), izinhlelo ezixhaswe ngumqashi (iqembu) zavunyelwa ukuba ziphoqe isikhathi sokukhishwa kwesimo sokuqala sokubekwa yisikhathi uma obhalisile abasha engenawo okungenani izinyanga ezingu-12 zokukhokhelwa okukweleta (okungukuthi, bekungakaqinisekiswa ngaphambi kokubhalisa ohlelweni lweqembu) ngaphandle kwezikhala ezinsukwini ezingama-63 noma ngaphezulu (izinyanga ezingu-18 zokukhokhelwa okukhokhwayo kungadingeka uma umuntu ebhalisela uhlelo lweqembu ngemuva kwesikhathi, ngemuva kokuthi ifasitela lakhe lokubhalisa lokuqala lidlulile).
Loluhlelo lwavunyelwa ukubukeka emuva ezinyangeni eziyisithupha ezedlule zomlando wezokwelapha lomuntu, futhi kungabandakanyi izimo ezikhona ngaphambili ezalashwa ngalezi zinyanga eziyisithupha, ngesikhathi sokuqedwa esingapheli izinyanga ezingu-12.
Ubude bokuthi isikhathi sokukhishwa kwesimo esandulele senziwe sinciphise inani lezinyanga umuntu ayenakho ukukhokhelwa kwezikweletu ezinyangeni ezingu-12 ezedlule. Ngakho-ke obhalisile owayengakaqinisekiswa izinyanga ezine angaba nezinyanga ezine zokuhlala ekukhungweni kwesimo se-plan esisha, ecabanga ukuthi uphethwe isimo sesimo esandulele kulezi zinyanga eziyisithupha zokugcina.
Abanye bathi izimo ezingakapheli ezikhona ngaphambi kwemikhawulo ye-HIPAA, kodwa ngokuvamile kwakukhona into abantu abazobhekana nayo uma bebona igebe ekufundeni ngaphambi kokubhalisa kuhlelo olusha ngaphambi kuka-2014.
Emakethe ngayinye, izivimbelo ze-HIPAA ngokuvamile azisebenzi. Ababheki bamasheya emazweni amaningi bavame ukubheka eminyakeni eyishumi noma ngaphezulu yomlando wezokwelapha, futhi bangabandakanyeka izimo zangaphambili ezikhona ezingenakubalwa.
Isimo esandulele
Isimo esandulele sikhona inkinga yezempilo ekhona ngaphambi kokuba ufake isicelo senqubomgomo yomshuwalense wezempilo noma ubhalise ohlelweni olusha lwezempilo.
Ngokuyinhloko noma yikuphi ukukhathazeka kwezokwelapha kungawela ngaphansi kwesambulela sempilo ekhona ngaphambili ezinsukwini zangaphambi kwe-ACA. Izimo ezikhona ngaphambili zingahle zivele ezintweni ezivamile njenge-asthma into enjenge-heart disease, umdlavuza, nesifo sikashukela. Izinkinga zempilo ezingapheli ezithinta ingxenye enkulu yabantu zazibhekwa njengezimo ezikhona ngaphambili.
Umthetho Wokunakekelwa Onganakekeli
I-Care Affordable Act yashintsha indlela izimo zangaphambili ezikhona ezisingathwa ngayo e-United States. Emakethe ngayinye, kusukela ngo-2014, umshuwalense wezezempilo akakwazanga ukuthatha umlando wakho wezempilo uma ekhetha noma ngabe akuthengise inqubomgomo yomshuwalense wezempilo noma cha. Awukwazi ukubeka eceleni isimo esivele sikhona kusukela ekubhaliseni, futhi angeke akhokhe ngaphezulu ngoba unesimo esandulele.
Kunjalo nakwezimakethe ezixhaswe ngumqashi, futhi izinhlelo zezempilo zeqembu azisekho isikhathi sokukhishwa kwezimo zangaphambi kwesikhathi, kungakhathaliseki ukuthi ukubhalisa kunomlando wokuqhubeka nokuhlinzekwa okuqhubekayo. Ngokushesha lapho ukubhalisa kubhalisa kusebenza kahle, uhlanganiswe ngokugcwele ngaphansi kwemigomo yepulani lezempilo, ngaphandle kokungaphandle kwemibandela ekhona ngaphambili.
Amapulani amakhulu futhi amakhulu ahlukile. Akudingeki ukuba banamathele emithethweni ye-ACA mayelana nokufaka izimo zangaphambili, futhi bangaqhubeka nokukhipha izimo zangaphambili ezikhona zamalungu.
Emakethe ngayinye, abantu abakwazi ukubhalisa ezinhlelweni ezinkulu kusukela ngo-Mashi 2010, futhi kuzinhlelo eziyinhloko kusukela ekupheleni kuka-2013.
Kodwa ezimakethe ezixhaswe ngumqashi, abasebenzi abasanda kufaneleka (nalabo ababhalisa ngesikhathi sokubhalisa ngonyaka ovulekile umqashi wabo) bangakwazi ukubhalisa ezinhlelweni ezixhaswe ngabakwa-grandmothered nabazali abaningi, okusho ukuthi kunabantu abathile abasanda kuncike kuya ezikhathini zangaphambili zokukhishwa kwezimo ezikhona. Uma unemibuzo mayelana nemithetho yepulani yakho kulokhu, xhumana nomnyango wakho we-HR noma uhlelo lomshuwalense.
Ulwazi oluningi oluvela kuDkt Mike
ยท Izimo zangaphambili ezikhona - Ukungaziqondi nokuqonda okuKhokhwayo
> Imithombo:
> Amasevisi e-Medicare naseMedicaid Services. Umthetho we-Health Insurance Portability and Accountability Act (HIPAA) ka-1996 . Izeluleko eziwusizo .
> Kaiser Family Foundation. Ukuguqulwa Kwemakethe Yempilo Yomshwalense Wezempilo: I-Issue Eqinisekisiwe . Juni 2012.