Ukulinganisa Okuncane Okubalulekile: I-ACA Terminology Evame Ukudideka
Kungenzeka ukuthi uzwile igama eliphansi lokubaluleka okubalulekile, futhi kungenzeka wazi ukuthi livela kuMthetho Wokunakekelwa Onganakekelwayo (ACA). Kodwa uma ufana nabantu abaningi, ungase uzibuze ukuthi ihluke kanjani eminye imigomo evamile, njengokuthi "i-ACA-coverage" futhi "inani eliphansi." Ngakho ake sibambe ukuthi kusho ukuthini ukutholakala okungenani okubalulekile, futhi kungani kubalulekile.
Kuyini Okushiwo "Ukusetshenziswa Okuncane Okubalulekile"?
Ukubambisana okungenani okubalulekile kubhekiswa nje ngokuthi ukuhlanganisa okubonwe ukuthi kuyamukeleka ekufezeni ukuhlinzekwa komuntu ngamunye okwabelwana ngakho- yi-ACA. Ngamanye amazwi, uma nje unesibalo esincane esibalulekile esifundweni, awukho ngaphansi kwesigwebo somuntu ngamunye we-ACA (ngisho noma ungenayo insizakalo encane ebalulekile, ngeke ube ngaphansi kwesigwebo uma ufaneleka ukuze kukhululwe , kodwa lokho akufani nokuthi kunesidingo esincane esibalulekile).
Kubalulekile ukuqonda ukuthi ukuthunyelwa akudingeki ukuthi kube yi-ACA ehambisanayo ukuze kubhekwe njengokubambisana okubalulekile.
Yini Ebalinganisa Ukulinganisa Okuncane Okubalulekile?
Kunezinhlelo ezihlukahlukene ezibalwe njengendlela yokubambisana ebalulekile, futhi ngaleyo ndlela anelise igunya lomuntu ngamunye we-ACA. Uma unomunye walezi zinhlobo zomshuwalense, ubhekwe njengesiboshwa futhi ngeke ube ngaphansi kwesigwebo sentela sokungaqinisekisiwe:
- Ukuhlinzekwa okuhlinzekwa ngumqashi, kubandakanya ukutholakala kwe-COBRA kanye nezinhlelo zezempilo ezishiya umhlalaphansi
- Ukuthenga uthola nge- ACA exchange embusweni wakho
- Ukuhlinzekwa ngaphansi kohlelo lwezempilo lwe-ACA Basic (kuphela iMinnesota neNew York ezinamapulani anjalo)
- Ukufakwa kwe-ACA-okuvumelanisiwe oyitholile ngaphandle kokushintshaniswa (ngqo kusuka kumshuwalense, noma nge-agent noma umthengisi)
- Amalungiselelo ezempilo amakhulu (amapulani aqala ukusebenza ngemuva kokuthi i-ACA isayinwe ngomthetho ngo-Mashi 2010, kodwa ngaphambi kokuba izinhlinzeko ze-ACA ziqale ukusebenza ngo-2014). Lezi zinhlelo azihambisani ngokugcwele ne-ACA, kodwa ziye zavunyelwa ukuba zihlale ezindaweni eziningi.
- Izinhlelo zezempilo ezindala (izinhlelo zaqala ukusebenza lapho i-ACA ingene ngemvume emthethweni ngo-Mashi 2010 futhi ayishintshiwe kakhulu kusukela ngaleso sikhathi). Lezi zinhlelo azihambisani ngokugcwele ne-ACA, kodwa zivunyelwe ukuba zihlale phakade, kuzo zonke izimo.
- Umshuwalense wezempilo we-Student oye wamukelwa njengobuncane bokubaluleka okubalulekile
- I-Medicare Part A noma i- Medicare Advantage (ungase ube ne- Medicare Part B , i- Medicare Part D , noma uhlelo lwe- Medigap , kodwa lezo azizona izingxenye ezibhekwa njengezingqinamba zokubaluleka okubalulekile)
- Uhlelo lwe-Health Insurance Program (I-CHIP) lwezingane
- Iningi le- Medicaid
- I-TRICARE (ezempi), ukuthunyelwa kohlelo lweNzuzo yezeMpilo yeSikhwama esingasetshenziswanga, kanye nokuhlanganisa okuphelele kwe-Veterans Administration (VA)
- Usizo Lwezokwelapha Ababaleki
- Bika ukusabalala kwezinga lokubeka amanzi engozini (kulesisimo esasasebenza ngamachibi aphezulu)
Ezinye izinhlobo zokubambisana okungenani okubalulekile zihambisana ne-ACA, kufaka phakathi izinhlelo ezixhaswe ngumqashi (nakuba imithetho ye-ACA ihlukile kunezinhlelo ezinkulu nezincane zamacembu), kanye nezinhlelo zamakethe zodwa ezaqala ukusebenza ngoJanuwari 2014 noma kamuva.
Kodwa ezinye izinhlobo zokubambisana okubalulekile azihambisani ne-ACA, noma azilawulwa kakhulu yi-ACA. Lokhu kufaka amapulani amakhulu kanye nezinhlelo eziningi, amachibi aphezulu, kanye neMediare and Medicaid (kunezinye izinhlinzeko ze-ACA ezisebenza kwezinye zalezi zinhlobo zokufakaza, kodwa hhayi ngezinga lokuthi izinhlelo zomuntu ngamunye noma ezincane zilawulwa).
Ngakho iqiniso lokuthi uhlelo lwakho aluhambisani nemikhombandlela yokuhambisana kwe-ACA, noma i-pre-dates ye-ACA, akusho ukuthi akuyona mininingwane ebalulekile yokubambisana. Uma ungabaza, hlola nomqondisi wakho wezinhlelo ukuze uthole ngokuqinisekile.
Yini Engayibali Njengesivinini Esincane Esisimqoka?
Ngokuvamile, ukuhlanganisa okungavamile akubhekwa njengokubambisana okubalulekile. Ngakho-ke izinhlelo ezihloswe ukufaka ezinye ukufakwa, noma ukuhlinzeka ngezinzuzo ezilinganiselwe kuphela, azibhekwa njengokubambisana okubalulekile okubalulekile. Uma uthembele kwenye yalezi zinhlelo njengendlela yokuthunyelwa kwakho kuphela, uzobe uhambisana nesigwebo somuntu ngamunye we-ACA ngaphandle uma ukhululekile.
Izibonelo zezinhlelo ezingezona zokubambisana okubalulekile zibandakanya:
- Noma yikuphi okubhekwa njengento "ngaphandle kokuzuzwa" ngaphansi kwe-ACA, okusho ukuthi ayilawulwa umthetho wokuguqulwa kwezempilo. Lokhu kufaka hlangana ukusabalalisa kwamazinyo nokuma kombono, amahlelo wokuhlawulela ama-indemnity, ama-added supplements, amahlelo wokugula okubaluleko, ukuhlanganiswa kwabasebenzi, njll. Ngokuvamile, iinzuzo ezingenalo azange zenzelwe ukukhonza njengomthombo womuntu owodwa wokubambisana-bona kufanele ukuba wengeze uhlelo lwe-"real" lomshuwalense wezempilo.
- Izinhlelo zomshuwalense wezempilo wesikhathi esifushane , kufaka phakathi ukufinyelelwa kwesikhashana okuhlinzekwa kumavolontiya aKwaZulu-Natali abuyele emuva.
- Izinzuzo ezilinganiselwe izinhlelo zeMedicaid (ukufakwa komkhawulo kunqunyelwe ukuhlela komndeni kuphela, noma ukunakekelwa okuhlobene nokukhulelwa kuphela, noma ukunakekelwa okuphuthumayo kuphela, njll). Ungakhetha isimo sakho kuleli khasi futhi sizokukhombisa ukuthi ukuhlinzekwa kwe-Medicaid kubalwa njengobunikazi obuncane obunikazi, futhi okungenjalo.
- Ukuthunyelwa kwe-AmeriCorps (uhlelo luyethemba lokuthi ekugcineni luzothuthukisa ukufakwa kwalo ukuze kungabhekwa njengokubambisana okubalulekile)
Ingabe Inani Eliphansi Lingasho Into Efanayo Njengomsebenzi Omncane Obalulekile?
Inani elincane kanye nokubambisana okungenani okubalulekile yizimbili zomthetho ezaziswa nge-ACA. Futhi nakuba bezwakala okufanayo, banezincazelo ezahlukene.
Njengoba kuchaziwe ngenhla, ukufakwa okubalulekile okubalulekile kuhlanganisa ukugcwalisa igunya le-ACA ngabanye. Inani elincane, noma kunjalo, lihlobene nokugunyazwa komqashi womthetho.
Ngaphansi kwe-ACA, abaqashi abanabasebenzi abalingana nesikhathi esigcwele abangu-50 noma ngaphezulu kudingeka banikeze umshuwalense wezempilo ngesikhathi sabo esigcwele (abasebenzi base-30 + amahora ngeviki). Ukuze uthobele igunya lomqashi futhi ugweme izinhlawulo zentela ezikhona, kunezimiso ezimbili eziyisisekelo ezisebenza ngokuphathelene nokuzihlanganisa ngokwazo:
- Amaphrimiyamu kufanele afike angabizi (okusho ukuthi kubiza umsebenzi ngaphandle kwezingamaphesenti angama-9.56 emali engenayo yomndeni ngo-2018, ngenxa yokuqashwa kwabasebenzi kuphela ).
- Lokhu kuhlinzekwa kufanele kuhlinzekwe inani eliphansi , okusho ukuthi lizohlanganisa okungenani amaphesenti angu-60 ezindleko zezokwelapha kubantu abaphakathi, futhi inikeze "ukutholakala" okukhulu kwezinsizakalo zesiguli kanye nodokotela.
Abaqashi ngokuvamile banikeza izinhlelo ezihlinzeka ngenani eliphansi, kokubili ngoba izinhlelo ezixhaswe ngumqashi zivame ukuba ziqinile, futhi ngoba abaqashi bafuna ukugwema isigwebo somqashi. Ukuqashwa okuxhaswe ngumqashi kubhekwa njengokubambisana okubalulekile, kodwa kucacile ukuthi le mibandela emibili inezincazelo ezahlukene.
> Imithombo:
> Amasevisi we-Medicare ne-Medicaid Servies. Isikhungo Sokwaziswa Komthengi kanye Nokuqapha Umshuwalense. Abafakizicelo Basemqoka Abayisisekelo Abamukela Ukwamukelwa , ngo-Okthoba 12, 2017.
> Amasevisi e-Medicare naseMedicaid Services. Isikhungo Sokwaziswa Komthengi kanye Nokuqapha Umshuwalense. Imikhakha encane yokusikisela ebalulekile.
> HealthCare.gov. Funda uMthetho Wokunakekelwa Onganakekelwa (Umbhalo Ophelele Womthetho Wokunakekelwa Onganakekelwayo noMthetho Wokubuyisana).
> Isevisi yangaphakathi yeNgeniso. Imithwalo Yemfanelo Yomuntu Ngamunye Ukuhlinzekwa-Okuncane Okubalulekile Okubalulekile.
> Isevisi yangaphakathi yeNgeniso. Inqubo Yokuthola Imali 2017-36 .