Uhlelo lweSiliva luhlinzeka ngama-70 Amaphesenti angu-Actualarial Value
Ezimakethe zempilo yomshuwalense wezempilo ngabanye nezincane , uhlelo lwezempilo lwesiliva lukhokha, ngokwesilinganiso, cishe amaphesenti angu-70 ezindleko zakho zokunakekelwa kwezempilo. Ukhokha amanye amaphesenti angu-30 ezindleko zakho zokunakekelwa kwezempilo ngendlela yokukhokha imali , ukuqinisekiswa kwezimali nokudonswa kwemali .
Lokhu kwaziwa nangokuthi kune-value ye-actuarial engu-70, noma i-AV. Lokhu akusho ukuthi wena, ngokwakho, uzothola amaphesenti angu-70 ezindleko zakho zokunakekelwa kwezempilo ezikhokhelwa uhlelo lwakho lwesiliva.
Esikhundleni salokho, uhlelo lukhokha amaphesenti angu-70 wezindleko ezijwayelekile zendawo ejwayelekile. Kodwa bazokhokha iphesenti elingaphansi kakhulu lezindleko eziphelele zokubhalisa okunempilo ngokusetshenziswa okuncane kakhulu kwezempilo, kuyilapho bezophela ukukhokha ngaphezulu kwamaphesenti angama-70 ezindleko eziphelele zombhalisi ogula kakhulu obamba ama-dollar ayizigidi ezinkampanini .
Qaphela ukuthi ngenkathi uhlelo lwesiliva luzoba ne-AV engamaphesenti angama-70, kunezinhlawulo ezingavumelekile ze-minimus, ngoba kungaba yinselele kakhulu kubaninikampani bomshuwalense ukuhlela izinhlelo ezishaya ngqo amaphesenti angu-70 AV. Ngonyaka we-2017, uhla lwe-minimus lwaluyi-+/- 2, ngakho-ke izinhlelo zesiliva zine-AV ezinamaphesenti angu-68 kuya ku-72. Kodwa ngo-Ephreli 2017, i-HHS yaqedela imithethonqubo yokuqiniswa kwemakethe eyenza ukuphela komkhawulo ophansi, uvumela izinhlelo zesiliva ukuba zibe ne-AV noma yikuphi ukusuka kumaphesenti angama-66 kuya ku-72.
Izindleko zokunakekelwa kwezempilo ezingekho emthethweni azibala uma kunquma inani lezempilo.
Isibonelo, uma uhlelo lwakho lwezempilo lwe-silver-tier lunganikezeli ukuxhaswa kwemithi engaphezu kwe-counter , izindleko zazo azifakiwe uma kubalwa inani lepulani yakho. Izinsizakalo ezingaphandle kwenethiwekhi nazo azibala, futhi azikhathaleli ukuthi aziwa ngaphansi kwencazelo ye-ACA yezinzuzo zezempilo ezibalulekile .
Izinga leNani eliQinisekile lokuNakekela likaNgcono
Ukwenza kube lula kuwe ukuqhathanisa ukubaluleka okuthola imali oyisebenzisayo kuma- premium yomshuwalense wezempilo, ama- Care Affordable Care amazinga amanani aqinisekisiwe amahlelo ezempilo ezimakethe zeqembu ngalinye namancane. Lawa mazinga, noma amathrekhi, a:
- ithusi
- isiliva
- igolide
- i-platinum
Zonke izinhlelo zezempilo ezingeni elinikeziwe zinikeza inani elifanayo eliphelele:
- Izinhlelo ze-Silver-tier zinikeza inani lama-actuarial angu-70 (uhla lwamaphesenti angu-68 kuya kwangu-72, olwandisa ngamaphesenti angu-66 kuya kwangu-72 ngo-2018).
- Izinhlelo ze-bronze zinikeza inani lama-actuarial angu-60 (uhla lwamaphesenti angu-58 kuya kwangu-62, olwandisa ngamaphesenti angu-56 kuya kwangu-65 ngo-2018; izinhlelo zethusi zine -4 / + 5 de minimus range kusukela ngo-2018 ).
- Izinhlelo zegolide zinikeza inani lama-actuarial angu-80 (uhla lwamaphesenti angu-78 kuya kwangu-82, olwandisa ngamaphesenti angama-76 kuya kwangu-82 ngo-2018).
- Izinhlelo zePlatinum zinikeza inani lama-actuarial angu-90 (uhla lwamaphesenti angu-88 kuya ku-92, olwandisa ngamaphesenti angu-86 kuya kwangu-92 ngo-2018)
Yini Okudingeka Ngiyikhokhe Ngenqubo Yesiliva?
Amaprimiyamu okuhlelwa kwe-Silver avame ukungabi abizayo kunegolide noma iplatinum-tier izinhlelo kusukela izinhlelo zesiliva zilindele ukukhokha kancane emithwalweni yakho yokunakekelwa kwempilo.
Ngaphandle kwama-premium wakho wenyanga, isikhathi ngasinye lapho usebenzisa umshuwalense wakho wezempilo, kuzodingeka ukhokhe ukwabelana ngezindleko ezifana ne-deductibles, u- coinsurance, nama-copays .
Indlela uhlelo lwesiliva ngalinye olwenza ngayo ukhokhe isabelo sakho sezindleko kuzohluka. Isibonelo, uhlelo olulodwa lwesiliva lungase lube ne $ 4000 deductible elihlangene ne-20% ye-coinsurance. Isu sesiliva esincintisanayo singase sibe ne-R2 000 ephansi, kodwa sibambisane nge- coinsurance ephakeme kanye ne-$ 40 copay yemigomo.
Kodwa kubantu abathengisa ukuthengiswa kwemakethe ngabanye ekushintsheni futhi banomholo phakathi kwamaphesenti angu-100 ebunini lobuphofu (amaphesenti ayisishiyagalolunye nesishiyagalolunye emazweni asandise iMedicaid) namaphesenti angama-250 ezinga lobuphofu, ukunciphisa izindleko zokwabelana (izinsizakalo zokwabelana ngemali) zitholakalayo ukwenza izinhlelo zesiliva-nezinhlelo zesiliva kuphela-zine-AV ephakeme kunezingamaphesenti angu-70.
Kubhalisa abancane abahola imali, i-AV ivunywe yaba ngamaphesenti angama-94, okwenza kube ngcono ngaphezu kwepulani ye-platinum, ngaphandle kwezindleko ezengeziwe kubhalisile (uhulumeni wesifundazwe ukhokha izinkampani zomshuwalense ukunikeza le nzuzo).
Kungani Kufanele Ngikhethe Ipulani Yesiliva?
Khetha uhlelo lwezempilo lwesiliva uma:
- bafuna ukulinganisela izindleko zama-premium akho ngenyanga ngenani lezindleko zakho ezingaphandle
- ufuna ukugwema izindleko eziphezulu ze-premium zegolide ne- platinum izinhlelo , kodwa futhi ufuna ukuzivikela ukuthi kungenzeka ukuthi ukhokhe ama-deductibles aphezulu ajwayele ukuhlela izinhlelo zethusi ,
- bayakufanelekela ngemali eyabelwe izindleko , ngoba kufanele ukhethe uhlelo lwe-silver-tier ukuthola izinsizakalo. Lesi esinye sezizathu ezibaluleke kakhulu zokukhetha uhlelo lwesiliva. Uma imali yakho engenayo ingadluli amaphesenti angama 250 ezinga lobuphofu (ikakhulukazi uma lingekho ngaphezu kwamaphesenti angu-200 ebunini bobuphofu), uhlelo lwesiliva ngemali yokwabelana ngezindleko cishe luyoba yinzuzo kakhulu kuwe.
Izinsizakalo zokwabelana ngezindleko zinciphisa imali yakho yokubambisana, i-copays, i-coinsurance, ne-out-of-pocket esiphezulu ukuze ukhokhe kancane uma usebenzisa umshuwalense wakho wezempilo . Bakhulisa ukubaluleka kwe-actuarial yepulani lakho lempilo ngaphandle kokuphakamisa i-premium.
Kungani Kufanele Ngigweme I-Silver Pan?
Akufanele ukhethe uhlelo lwezempilo lwesiliva uma:
- Uyazi ukuthi uzothola izindleko ezinkulu zezokwelapha phakathi nonyaka futhi unqume ukuthi igolide noma iplatinum plan nge-down-of-pocket esiphezulu esiphezulu izokulondoloza imali, ngisho nalapho uhlawula amaphrimiamu aphezulu.
- Uzama ukunciphisa izindleko zakho isikhathi ngasinye lapho usebenzisa umshuwalense wakho wezempilo - futhi, uhlelo lwegolide noma lweplatinum lungase libe yindlela engcono.
- Uma usebenzisa umshwalense wakho wezempilo kakhulu futhi wazi kusengaphambili izindleko zakho ezingaphandle kwezezimali zizodlula ukuphuma kwepokhethi, ungase ukwazi ukugcina imali ngokukhetha uhlelo lwe-bronze-tier nge- out-of- isikhwama esiphezulu kodwa ama-premium aphansi . Izindleko zakho eziphuma ngonyaka zezindleko zizofana, kodwa uzokhokha ama-premium amancane.
- Awunelungelo lokuthola izinsizakalo zokwabelana ngezimali futhi ulindele kancane kakhulu izindleko zokunakekelwa kwezempilo ngonyaka ozayo. Uhlelo lwe-bronze lungase libe yindlela enhle kakhulu, njengoba izoba nezinhlawulo ezincane kunecebo lesiliva, ekuhwebeni ngokubambisana okunamandla okuncane.
Ungafunda kabanzi mayelana nokuthi le nqubo isebenza kanjani, " Indlela Yokulondolozwa Ngomshwalense Wezempilo Uma Ufinyelela Ngaphandle Kokuphakama Kwesikhwama ."
> Imithombo:
> UMnyango wezeMpilo kanye nezinsizakalo zabasebenzi. Ukuvikelwa kwesineke nomthetho wokunakekelwa okunganakekelwayo: Ukuqiniswa kwemakethe . April 2017.
> HealthCare.gov. Funda uMthetho Wokunakekelwa Onganakekelwayo. Isigaba 1402.