Ukulinda uze ugula kungabi kubiza
Umshuwalense wezempilo uyabiza, ngakho kungani ungalindeli futhi uthenge umshuwalense wezempilo uma udinga? Kungani ukhokhela izinyanga zama- premium uma kungadingeki uyisebenzise?
Njengoba imithetho ye- Care Affordable Act Act idinga ukuthi uthenge umshuwalense wezempilo ovela kwinhlangano, kunokuba uhlelo olusekelwe ohulumeni abakhokhelwayo olutholakala emazweni amaningi athuthukile, kungase kubonakale kungabizi futhi kuphephile ukulibala ukulithenga uze ulidinge.
Kodwa, kunezizathu eziphoqelekile zokungalindeli.
Ukubhalisa Okuvulekile Akuvuliwe-Kuvaliwe
Ungathenga kuphela umshuwalense wezempilo emakethe ngayinye (okufaka phakathi kokuhwebelana kwemishwalense yempilo kanye nokungaphandle kokungena ) ngesikhathi sokubhalisa okuvulekile , isikhathi lapho wonke umuntu angathenga umshuwalense wezempilo.
Uma ungathengi umshuwalense wakho wezempilo ngesikhathi sokubhalisa okuvulekile, kuzodingeka ulinde kuze kube nokubhaliswa okulandelayo okuvulekele elinye ithuba. Uma ugula okwamanje, cishe uzophuma enhlanhleni.
Isikhathi sokubhalisa okuvulekile sesifushane. Kusukela ngo-2018 ukufakwa kokubhalisa, ukubhaliswa okuvulekile kuzoba ngamasonto ayisithupha kuphela, kusukela ngoNovemba 1 kuya kuDisemba 15 unyaka ngamunye, ngokubandakanya ukusebenza ngoJanuwari 1 wonyaka ozayo ( ngo-2018 , kuphela ukuthengiselana okukhona, kunamathuba ayisishiyagalolunye okushintshaniswa kwamanye amazwe asele ukubhaliswa okudlule kuDisemba 15).
Ngo-2014, lapho izinhlelo ze-ACA ezivumelanisiwe zisanda kuqalwa, ukubhaliswa okuvulekile kwahlala ezinyangeni eziyisithupha.
Kusukela ngo-2015 kuya ku-2017, ukubhaliswa okuvulekile kwakuyizinyanga ezintathu ngonyaka.
Ngaphandle kokuvula ukubhalisa
Izinguquko zesimo empilweni yakho (kodwa hhayi izinguquko esimweni sakho sezempilo) zizokwenza isikhathi sokubhalisa esikhethekile lapho ungathenga umshuwalense wezempilo noma ushintshe uhlelo lwakho lwezempilo. Lezi zenzakalo ezifanelekayo zihlanganisa:
- Ukulahlekelwa ukufinyelela ohlelweni lwakho lomshuwalense wezempilo ngenxa yezizathu ngaphandle kokukhokhwa kwe-premium noma ukukhwabanisa (isibonelo, ushiya umsebenzi wakho futhi ulahlekelwa ukufinyelela kumshuwalense oxhaswe ngumqashi).
- Ukuthola umuntu othembekile noma othembekile. Ukushada, ukuba nomntwana, noma ukwamukela ingane yizibonelo.
- Ukuthutha unomphela kungakha isikhathi sokubhalisa esikhethekile. Lokhu kusebenza nakakhulu kubantu abakhululwa ejele. kodwa kusukela phakathi no-2016, lokhu sekusetshenziselwe kuphela uma usuvele unesiqiniseko endaweni yakho yangaphambilini-uzothola ithuba lokushintsha umshuwalense uma uhamba, kodwa ungakutholi ukutholakala kokuqala okokuqala.
Izinkathi zokubhalisa ezikhethekile zikhawulelwe isikhathi, futhi usuvele uthola izinsuku ezingu-60 kusukela ngosuku lomcimbi ofanelekayo wokubhalisa kuhlelo olusha.
Izikhathi Zokulinda Umshuwalense Wezempilo
Ukutholakala komshuwalense wezempilo akusebenzi ukusebenza ngosuku owuthengayo. Kungakhathaliseki ukuthi u-insured ngomsebenzi noma ngokusebenzisa inkampani oyitholile ekushintsheni kwezempilo, ngokuvamile kuvame isikhathi sokulinda ngaphambi kokufakwa kwakho kokungena. Ngokwesibonelo:
- Uma ubhalisa ngesikhathi sokubhalisa okuvulekile ekwindla kuzoqala ngoJanuwari 1st (inothi ukuthi kulaba abayisishiyagalolunye abathi baye bawandisa ukubhaliswa okuvulekile kokubhalwa kwe-2018 kuphela, kukhona okunye okuhlukile kulokhu )
- Uma ubhalisa ngaphandle kokubhalisa okuvulekile (usebenzisa isikhathi sokubhalisa esikhethekile) futhi ubhalisa ngaphambi kwenyanga yesi-15, ukufakwa kwakho kuzoqala ekuqaleni kwenyanga ezayo
- Uma ubhalisa ngemuva kwe-15 yenyanga, ukufakwa kwakho ngeke kuqale kuze kube sekuqaleni kwenyanga yesibili elandelayo. Isibonelo, uma uhlangabezana nesenzakalo esifanelekayo bese ubhalisa ngomhla ka-Mashi 25, 2018, ukufakwa kwakho ngeke kusebenze kuze kufike ku-Meyi 1, 2018 (ngaphandle uma umcimbi wakho ofanelekile ulahlekelwa ezinye izinto noma umshado, lapho kwenzeka khona imithetho ekhethekile usuku olusebenzayo, futhi ukufakwa kwakho kungasebenza ngo-Ephreli 1, 2018; inothi ukuthi kuzo zonke izimo, ungathola ukubhekela okuphumelelayo kwengane entsha noma ingane eyamukelwayo ivuselela usuku lokuzalwa noma lokutholwa uma nje ubhalisa ngaphambi kokubhaliswa okukhethekile isikhathi siphela).
Umshwalense wezeMpilo ngezimo ezingalindelekile
Luhlelo olubi ukulinda ukuthenga umshuwalense wezempilo uze udinga ukuyisebenzisa. Ngisho noma usencane futhi unempilo, izinto ezimbi zingenzeka.
Kuthiwani uma uhlile isandla sakho lapho ingilazi yewayini iphuka lapho uhlamba? Ukugxila ekamelweni eliphuthumayo kungabiza kakhulu. Kuthiwani uma uhlasele ikati ngenkathi uhamba phansi ezitebhisini? I-ankle ephukile ayikwazi ukulinda ukwelashwa futhi ingase idinge nokuhlinzwa.
Ngisho noma into enjengale iyenzeka uma ukwazi ukubhalisa ekubhaliseni ngokushesha (ngesikhathi sokubhalisa okuvulekile noma ngesikhathi sokubhalisa esikhethekile), ukufakwa kwakho ngeke kusebenze ngokushesha. Akungabazeki ukuthi ungathanda ukulinda amaviki ukuya ekamelweni eliphuthumayo. Udinga ukulinda izinyanga nje ukuze ubhalise.
Imali Yomshuwalense Wezempilo
Isizathu esivame kakhulu abantu abanikeza ngenxa yokungenawo umshuwalense wezempilo ukuthi kubiza kakhulu. Kodwa i-ACA iye yasiza ekwenzeni ukuthengwa okungabizi kakhulu kubantu abanemali ephansi nephakathi kwebanga.
Uma imali yakho engenayo ingaphansi kuka-$ 16,642 ngo-2017 (kumuntu oyedwa), ungase ufanelekele i-Medicaid. Kuxhomeke ukuthi ngabe isimo sakho sandise iMedicaid, kodwa-ke izifunda ezingu-31 kanye ne-DC ziye zakhetha ukukhulisa iMedicaid ngaphansi kwe-ACA.
Uma imali yakho engenayo iphezulu kakhulu ku-Medicaid kepha kuze kube kasikhombisa izinga lobuphofu, ungase uvumeleke ukuthola izinsizakalo zokufaka ingxenye ye-premium yakho ekushintsheni. Umkhawulo ongenayo engenayo ngo-2017 ukuze uthole izinsizakalo zokubambisana ngo-2018 zomuntu oyedwa kwakungaba ngu-$ 48,240-ngokuqinisekile eqenjini eliphakathi komuntu oyedwa (umndeni wesine, umkhawulo wemali engenayo uhamba yonke indlela eya ku-$ 98,400).
Ukuze ufanelekele ukuthola izinsizakalo, kufanele uthenge umshuwalense wakho wezempilo ngokusebenzisa ukushintshaniswa. Ungase uthathe izinsizakalo eziphezulu, ukhokhe ngqo kumphathi wakho womshuwalense unyaka wonke, noma ungakhokha inani eliphelele lokwaziswa kwakho bese ucela imali yakho yokubuyisela intela yakho .
Izinhlelo ezimbi
Uma uneminyaka engaphansi kwengu-30 ubudala, noma uma unenkinga yezezimali, ungase ulungele uhlelo lwezempilo oluyingozi . Nakuba lezi zinhlelo zinezindleko ezidonswe kakhulu kakhulu nezindleko ezingaphandle kwe-ACA, ama-premium awo aphansi kunezinye izinketho ezitholakalayo, futhi okungenani uzothola ukufaka.
Amaphuzu amabi angeke athengwe ngabantu abangaphezu kuka-30 ngaphandle kokuthi banelungelo lokukhululwa kanzima. Futhi kubalulekile ukuqaphela ukuthi izinsizakalo ezingasetshenziselwa ukusiza ukukhokhela izinhlelo ezimbi, ngakho-ke ngokuvamile akuyona into enhle kunoma ubani ofanelekayo ukuthola izinsizakalo ezisekelwe kwinzuzo.
> Imithombo:
> Izinsuku nezinsuku zokugcina zonyaka we-2018 Umshwalense Wezempilo. HealthCare.gov. https://www.healthcare.gov/quick-guide/dates-and-deadlines/.
> I- PPACA, Ukuchitshiyelwa Kwezikhathi Ezibalulekile ZokuBhaliswa kanye nohlelo lwaBathengi oluSebenza kanye nohlelo oluhlelekile . UMnyango wezeMpilo kanye nezinsizakalo zabasebenzi. https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-11017.pdf.
> Isikhathi Esibalulekile Sokubhalisa (SEP). HealthCare.gov. https://www.healthcare.gov/glossary/special-enrollment-period/.