Umshuwalense wezempilo obhekene nenhlekelele uthathwa njengenetha lokuphepha kwezimali uma unenkinga yempilo. Ngeke ukhokhele izinkinga zezempilo zansuku zonke, kodwa uzokhokha uma unesidingo sokunakekelwa kwezempilo esibi kakhulu. Ngenxa yalokhu, izinhlelo ezinhle zempilo ngokuvamile zibiza kancane kunezinye izinhlelo zezempilo.
Uma ufuna umshuwalense wezempilo ozokhokha izidingo zokunakekelwa kwezempilo njengama-ankles abhekwayo kanye nomkhuhlane, uhlelo oluyingozi alukho kuwe.
Uma ungakwazi ukukhokhela izidingo zakho zokunakekelwa kwezempilo njalo futhi ufuna kuphela umshuwalense wakho wezempilo ukukufihla lapho kwenzeka inhlekelele yempilo efana nokudinga ukuhlinzekwa okuphuthumayo, ukubekwa okubi kungase kube yilokho okufunayo.
I- deductible yaminyaka yonke yomshuwalense wempilo enhle kakhulu kangangokuthi abantu abaningi abanempilo ngeke baphinde bakhokhe; unyaka uzobe usuphelile ngaphambi kokuthi bachithe okuningi kulokhu kunakekelwa kwezempilo. Kodwa-ke, uma unesidingo sokunakekelwa kwempilo ebiza kakhulu, uhlelo oluyingozi luzokhahlela bese uqala ukukhokha ngemuva kokukhokha imali enkulu.
Igama elithi "inhlekelele" livame ukusetshenziselwa ukuchaza noma yiliphi uhlelo lwezempilo elinokukhishwa okuphezulu. Kodwa ngaphansi kwe-Care Affordable Act, uhlobo oluthile lwepulani, lwahlukaniswa kwezinye izinketho eziphezulu ezikhishwe.
Yini Echaza Uhlelo Lwezempilo Lwezinhlekelele?
Umshuwalense wezempilo oyingozi onikezwa ngemali yomshuwalense wezempilo (Affordable Care Act), futhi ngaphandle kwezingxoxo.
- Une-deductible ephezulu kakhulu.
- Ihlanganisa zonke izinzuzo ezibalulekile zezempilo.
- Imingcele engabhalisa. Akuwona wonke umuntu ofanele ukuthenga uhlelo oluyingozi.
- Ngeke isetshenziswe ngemali yesibonelelo somshuwalense wezempilo ukuze usize ukukhokha amaprimiyamu wenyanga.
Izinhlelo ezimbi ezihlinzekwe emibhakisheni yomshuwalense wezempilo kanye nesifundazwe zine-deductible ephezulu kakhulu uma kuqhathaniswa nezinye izinhlobo zezinhlelo.
Isibonelo, izinhlelo ezimbi ezinikezwa ngo-2017 zine-deductible ye-$ 7,150 yomuntu ngamunye. Eqinisweni, i-deductible yezinhlelo eziyingozi iyalingana nokukhululeka kwepokhethi. I-deductible yecebo lakho lempilo eliyingozi liyokhula minyaka yonke njengoba uhulumeni evumela ukukhuphuka ekuphumeni kwe-pocket (ngonyaka ka-2014, bekuyizigidi ezingama-6,350, futhi sekukhulile minyaka yonke kusukela ngaleso sikhathi).
Uma usukhokhele ngokwanele ephaketheni lakho ukuze uhlangabezane ne-deductible, uhlelo lwezempilo oluyingozi luzoqala ukukhokhela izindleko zakho zokunakekelwa kwezempilo. Ezimweni eziningi, uma uhlala ku-inethiwekhi , uhlelo lwakho oluyingozi luzokhokhela izindleko zokunakekelwa kwempilo zakho eziyi-100% uma ukhokhele imali ekhishiwe.
Iyini izindleko zokunakekelwa kwempilo? Uhlelo oluyingozi kufanele luhlanganise izinzuzo ezifanayo ezibalulekile zezempilo ukuthi zonke ezinye izinhlelo zezempilo ze- Obamacare kufanele zimboze. Isibonelo, kumele ukhokhele izinto ezifana nokuvakasha kukadokotela, ukuhlolwa kwegazi, ukunakekelwa kokubeletha, ukunakekelwa kwezempilo yengqondo kanye nokwelapha izidakamizwa. Noma kunjalo, ngeke iqale ukukhokhela lezo zinzuzo kuze kube yilapho ukhokha imali yakho enkulu.
Kunezinto ezimbili ezihlukile kulowo mthetho:
- Umshwalense wempilo oyingozi kumele ukhokhele ukunakekelwa kwezempilo okuvimbela noma ngabe awuzange ukhokhe imali yakho. Lokhu kufaka phakathi izinto ezifana nomkhuhlane wakho wesifo sonyaka, ukuhlola i-mammogram , ukuvakashelwa kahle kwabesifazane, nokukhulelwa .
- Izinhlelo zezempilo ezimbi kufanele zikhokhele wena ukubona umhlinzeki wakho oyinhloko ngokunakekela izikhathi ezintathu ngonyaka ngaphandle kokukhokha kuqala.
Abantu abathile kuphela abanelungelo lokuthenga umshuwalense wezempilo obhekene nokuthengiswa komshuwalense wezempilo okhokhelwayo. Kufanele ube ngaphansi kweminyaka engama-30, noma ube nokukhululeka kokukhululeka noma ukukhokhelwa okungenakho ukukhokhelwa ku-ACA's penalty. Thola ukuthi ufanelekile ku-"Ingabe Ufanelekela Umshwalense Wezempilo Obuhlungu? "
Uma ufanelekile ukuthola usizo lwemali yomshuwalense wezempilo ukuze kukusize ukhokhele amaphrimiyamu akho yomshuwalense wenyanga, awukwazi ukusebenzisa leyo nsizakalo ngecebo lempilo eliyingozi .
Kumele ukhethe ithusi, isiliva, igolide, noma iplatinum uhlelo lokusebenzisa insizakalo. Funda kabanzi mayelana nokuthi ubani ofanelekile kumxhaso womshuwalense wezempilo nokuthi yiziphi izinhlobo zenkxaso ezitholakala ku-" Ngingayithola Usizo Lokukhokhela Umshwalense Wezempilo? "
Ezinye izinhlelo ze-bronze zinezinhlelo eziyingozi kakhulu (kanye nezindleko ezingaphandle kwe-pocket ezilingana nalabo asezinhlelweni eziyingozi), kodwa akukho ukufakwa kokuvakashelwa okuyinhloko ngaphambi kokudonswa. Usizo lwe-Althouh premium alukwazi ukusetshenziselwa izinhlelo eziyingozi, umuntu osemusha onempilo ongafanelanga ukusizwa ngezimali ze-premium angathola uhlelo oluyingozi lokusebenzisana okungcono kunecebo le-bronze.
Inzuzo Efihliwe Yomshuwalense Wezempilo Oyinhlekelele
Ngisho noma ungasisebenzisi okwanele ekunakekelweni kwezempilo ukuze uhlangabezane ne-deductible plan yakho yezempilo emangalisa, uzobe ukhokhela kancane izindleko zezokwelapha ngaphandle kwepulani kunokuba ungenayo inkokhelo yomshuwalense wezempilo nhlobo. Izinhlelo eziningi ezimbi ziyi- HMO, PPO, EPO, noma i-POS plan. Lezi zinhlelo zonke zixoxisana ngamanani asehlisiwe kanye nodokotela, izibhedlela, ama-laboratory kanye nama-pharmacy asezinkundleni zabo zabahlinzeki. Njengobhalisile ohlelweni lwezempilo oluyingozi, uthola inzuzo yalezi zindleko ezishintshiwe ngisho nangaphambi kokuba ukhokhe imali yakho.
Nasi isibonelo. Ake sithi awuzange uhlangabezane necebo lakho elibi lika- $ 7,150 okwenziwe ngokukodwa. Ulimaza isifuba sakho futhi udinga i-X-ray ye-ankle. Isilinganiso sokuqhafaza se-X ray yakho ngu-$ 200. Ngaphandle komshuwalense wakho wezempilo oyingozi, kuzomele ukhokhe imali engu-$ 200 ngaphandle kwepokhethi. Izinga lokusaphulelo lokungena kwenethiwekhi lamalungu ehlelo lwezempilo liyi $ 98. Njengoba uyingxenye yepulani yezempilo usebenzisa insiza ye-X-in-inethiwekhi, kuzodingeka ukhokhe inani elilinganiselwa ku-$ 98. Uzokhokha u- $ 102 ngaphansi kunalokho ozokhokha uma ungaqinisekisiwe.
Qaphela Lapho Uthenga Ngomshwalense Wezempilo Obuhlungu
Kulula ukwenza iphutha lokucabanga ukuthi uhlelo lomshuwalense wezempilo oluyingozi luyinto efanayo necebo eliphezulu lokudonswa kwezempilo, noma i-HDHP. Emva kwakho konke, uhlelo oluyingozi ludedelwe kakhulu, ngakho kufanele lube uhlelo oluhle lokunakekelwa kwempilo, akunjalo?
Akulungile.
I-HDHP eqeqeshiwe iyinhlobo ekhethekile kakhulu yomshwalense wezempilo oklanyelwe ukusetshenziswa nge-akhawunti yokulondoloza impilo. Funda umehluko phakathi kwe-HDHP necebo eliyingozi, futhi yini engenzeka uma uthengisa uhlelo oluyingozi lapho ucabanga ukuthi uthenga i-HDHP.
> Imithombo:
> HealthCare.gov, Izinhlelo Zempilo Ezimbi.