Kungani ukubhaliswa kwezempilo kulinganiselwe isikhathi sokubhalisa esivulekile
Uke wazama ukubhalisela umshuwalense wezempilo kuphela ukuthi utshelwe ukuthi awuvunyelwe ukuthenga umshuwalense wezempilo kuze kube sekubhaleni okuvulekile ? Uma uya kumthengisi wemoto ukuthenga imoto, umdayisi akawenqabe ukukuthengisa imoto kuze kube nguNovemba ozayo. Kodwa izinkampani zomshuwalense wezempilo ngeke zikuvumele ukuba ubhalisele umshuwalense wezempilo noma kunini lapho ufuna, kungakhathaliseki ukuthi uzama ukuthenga uhlelo lwezempilo ku- Care Affordable Act , ukushintshanisa umshwalense wempilo, ubhalisele kumqashi wakho, noma ngisho ubhalisele i- Medicare .
Izinhlelo zezempilo zinciphisa ukubhalisa isikhathi sokubhalisa okuvulekile ukuze kudambise ukukhethwa okubi . Ukukhetha okubi kwenzeka lapho abantu abagulayo bebhalela umshuwalense wezempilo, kodwa abantu abanempilo abayitholi. Ihlaziya ingozi yengozi yezempilo lapho iqinisekisa umuntu, ngakho yonke imboni yomshuwalense wezempilo uzama ukuyivimbela.
Ukukhethwa Okubi Okusebenzayo
Ikhamphani yomshuwalense wezempilo ingabikho kuphela uma kuthatha imali eyengeziwe emahoyisimini unyaka ngamunye kunalokho okukhokhwa kwezicelo . Ukuze lokhu kwenzeke, kudinga amalungu amaningi anempilo kunamalungu agulayo.
Nasi isibonelo esenziwe lula. Ake sithi ilungu ngalinye lezempilo likhokhela u- $ 6,000 ngonyaka ngomshwalense wezempilo. Ngelungu ngalinye elidinga ukukhishwa komnkantsha wama-bone angu-$ 400,000 ngalowo nyaka, kumele kube namalunga angama-67 akhokhela ama-premium awo unyaka wonke ngaphandle kokufaka isicelo esisodwa. (67 X $ 6,000 = $ 402,000.) Inkampani yomshuwalense wezempilo isebenzisa amaphrimiyamu avela kumalungu angama-67 angadingi ukunakekelwa ukukhokhela izikweletu zezokwelapha ilungu elilodwa elidinga ukunakwa okuningi.
Okwenza ukhetho olubi lubi kumuntu wonke
Uhlelo lonke lwaluzohlukana uma bonke abantu abaphilile bezicabangela bona, "Kungani kufanele ngikhokhe imali engu-6,000 ngonyaka ngonyaka ngomshwalense wezempilo? Nginempilo. Ngizogcina imali engu-6,000 kuphela futhi ngilinde kuze ngigule ukuthenga umshuwalense wezempilo. "Khona-ke, kuphela abantu abagulayo, abantu abathi izimali zabo ezingaphezu kwama-premiums abo, babhalise umshuwalense wezempilo.
Uhlelo lwezempilo lungeke luthathe imali eyanele kuma-premium ukukhokha zonke izimangalo. Uma lokhu kwenzeka, uhlelo lwezempilo luyoba nezinketho ezimbili: hamba ngaphandle kwebhizinisi noma uphakamise ama-premium.
Uma kuphuma ebhizinisini, lokho kubi kuwo wonke umuntu. Sonke singaba nezinketho ezimbalwa ezitholakalayo lapho uthengisa umshuwalense wezempilo, futhi kuyoba nomncintiswano omncane. Izinkampani zomshuwalense ezimbalwa ezincintisana nebhizinisi kusho ukuthi kunezincishwana ezincane ezinhlelweni zezempilo zokuhlinzeka ngemisebenzi yamakhasimende enhle futhi zingabakhuthazi kakhulu ukuba zigcine phansi izinkampani eziphansi ukuze zikhange amakhasimende.
Uma iphakamisa amaphrimiyamu, lokho kubi nakumuntu wonke. Sonke kufanele sikhokhele ngaphezulu umshuwalense wezempilo. Njengoba ama-premium ayenyuka, abantu abanempilo babeyokwazi ngisho nokuzicabangela bona, "Kungani kufanele ukhokhele kangaka umshuwalense wezempilo? Ngizovele ngilinde ngize ngigule bese ngibhalisa ohlelweni lwezempilo. "Lokhu kungabangela amanani e-premium ukuba aqhubekele phezulu kuze kube yilapho umuntu engakwazi ukukhokhela umshuwalense wezempilo.
Indlela Ababheki Bempilo Abavimbela Ukukhethwa Okubi
Abaqinisekisi bezeMpilo abakwazi ukuvimbela ngokuphelele ukhetho olubi, kodwa bangenza kube lula ngokunciphisa uma ungabhalisela umshwalense wezempilo kanye kanye ngonyaka. Isikhathi sokubhalisa esivulekile sivumela wonke umuntu ofuna ukubhalisa ohlelweni lwezempilo ukwenza kanjalo, kodwa futhi kuvimbela abantu abanempilo ukuthi bangacabangi, "Ngizolinda kuze kube yilapho ngigula ukuthenga umshuwalense wezempilo." Ngaphandle kokuba nje bevele bezothola abagulayo ngesikhathi sokubhalisa ngonyaka ovulekile, ngeke baphume ngenhlanhla futhi bangakwazi ukubhalisela umshuwalense wezempilo uma begula.
Enye inqubo edikiba ukukhethwa okubi yisikhathi esifushane sokulinda phakathi kokubhalisa okuvulekile nosuku lokuqala umshuwalense wezempilo. Isibonelo, uma ubhalisela umshuwalense wezempilo ngesikhathi sokubhalisa okuvulekile okuvaliwe, ukufakwa kwakho okuvame ukuqala ngoJanuwari 1. Lokhu kuvimbela abantu ukuba bangene emshuwalense wezempilo endleleni eya esibhedlela, benethemba lokuthi uhlelo lwabo olusha lwezempilo luzohamba ngesibhawuni sokuthola esibhedlela.
Ngaphezu kwalokho, uMnakekeli Wezinsizakalo ongenakusiza uhlose ukunciphisa ukhetho olubi ngokugunyaza ukuthi wonke umuntu unomshwalense wezempilo noma ukhokhele .
Ngaphandle kokuvula ukubhalisa
Kunemibandela embalwa evumela abantu ukuba babhalise umshuwalense wezempilo ngaphandle kokubhalisa okuvulekile.
- Isikhathi sokuqala sokufaneleka.
- Isikhathi sokubhalisa esikhethekile .
- I-Medicaid ne-CHIP.
- AmaMelika aseMelika .
Isikhathi sokuqala sokufaneleka senzeke uma uqala ukuthola umshwalense wezempilo emsebenzini, ngokuvamile ngenyanga noma emibili emva kokuqashwa kwakho. Lesi sikhathi sokuqala sokufaneleka cishe asihambisani nokubhaliswa okuvulekile ngoba abantu baqashiwe unyaka wonke. Noma kunjalo, isikhathi sokuqala sokufaneleka sinqunyelwe; uma ungabhalisi ngesikhathi samafasitela athile lapho uqala ukufaneleka, kufanele ulinde kuze kube yisikhathi sokubhalisa esilandelayo.
Uyothola futhi isikhathi sezinyanga eziyisikhombisa sokufaneleka kokuqala kwe-Medicare uma uvula iminyaka engama-65. Uma ungabhalisi ngesikhathi sokuqala sokufaneleka, akudingeki ukuthi ulinde kuze kufike esikhathini esizayo sokubhalisa ngonyaka, nazo zizohlawuliswa ngamaprimiyamu aphakeme.
Isikhathi sokubhalisa esikhethekile sibangelwa izenzakalo ezithile zokuphila ezifana nokushada noma ukuhlukaniswa, nokuba nosana, ukulahlekelwa umshwalense wempilo esekelwe emsebenzini, noma ukuphuma endaweni yesevisi yezempilo. Uma ukubhaliswa okukhethekile kubangelwa, unamawindi, ngokuvamile izinsuku ezingu- 30-60, ukushintsha uhlelo lwakho lwezempilo lwamanje noma ukubhalisela uhlelo olusha. Uma ungaphuthelwa lelo festile, uzodingeka ulinde kuze kufike isikhathi sokubhalisa esilandelayo.
Qaphela ukuthi imakethe ngayinye yayingenayo izikhathi zokubhalisa ezikhethekile ngaphambi kuka-2014, kodwa manje inezinsuku ezikhethekile zokubhalisa ngokuvamile ezifana nalabo abasebenza kumshuwalense wezempilo oxhaswe ngumqashi. Imakethe ngayinye ayizange isebenzise izikhathi zokubhalisa ezikhethekile (noma izinkathi zokubhalisa ezivulekile) ngaphambi kuka-2014 ngoba abantu bangabhalisa noma kunini lapho befuna ... kodwa ukuhweba kwakungukuthi kubo bonke kodwa kubambalwa abathile, ukufaneleka kokuthola emakethe ngayinye kuxhomeke emlandweni wakho wezokwelapha. Ababambisene nabo bazokwehlisa izicelo ngokuphelele (noma bafake izimo zangaphambili) uma abantu bezama ukubhalisa noma ukushintsha izinhlelo ngemuva kokuthola isimo sezokwelapha.
Manje lokhu kuhlanganiswa kuqinisekisiwe-emakethe ngayinye (njengendlela efanele kubasebenzi abafanelekele uhlelo lwempilo yomqashi wabo), imakethe ngayinye isebenzisa ukubhaliswa okuvulekile nezinkathi ezibhalisiwe ezikhethekile njengomshuwalense wezempilo oxhaswe ngumqashi.
I-Medicaid, uhlelo lwezenhlalakahle olusekelwe emphakathini oluhlinzeka ngempilo yezakhamuzi ezihola kancane, luhlukile kunezinye izinhlobo zomshuwalense wezempilo ngoba alinganiselwe ukubhaliswa ezikhathini ezithile zonyaka. Esikhundleni salokho, kunqanda ukubhaliswa kubantu abahlangabezana nemali engenayo eqondile kanye nezinye izindlela zokufaneleka. Uma ufaneleka ukuthola i-Medicaid, ungabhalisa noma nini unyaka. Kunjalo nange-CHIP ( Uhlelo Lwezempilo Lomntwana Wezempilo ).
I-Medicaid ayitholi imali yayo ukushaja abamukeli be-Medicaid amaprimiyamu wenyanga. Esikhundleni salokho, ixhaswa ngemali yentela kahulumeni kanye nesifundazwe. Njengoba abamukeli abaningi baseMedicaid bengakhokhi ama-premium, kunobungozi obuncane bokukhethwa okubi ngenxa yabantu abaphilile abazama ukulondoloza ama-premium.
> Imithombo:
> I-Cornell Law School. I-Legal Information Institute. 45 CFR 155.420 Izikhathi Ezibhalisiwe Ezikhethekile.
> Kaiser Family Foundation. Ukuguqulwa Kwemakethe Yempilo Yomshwalense Wezempilo: I-Issue Eqinisekisiwe . Juni 2012.
> Norris, uLouise. Isiqondiso Sezikhathi Ezibhalisiwe Ezikhethekile Emakethe Yomuntu ngamunye. February 2017.