Uhlelo lweplatinum luhlobo olumisiwe lomshuwalense wezempilo okhokhela, ngokwesilinganiso, cishe amaphesenti angu-90 ezindleko zezempilo. Amalungu akhokhela amanye amaphesenti angu-10 ezindleko zabo zokunakekelwa kwezempilo ngendlela yokukhokha imali , ukuqinisekiswa kwezimali kanye nokudonswa kwemali .
Ingemuva
Ukwenza kube lula kuwe ukuqhathanisa ukubaluleka okuthola imali oyisebenzisayo kwimishanguzo yomshuwalense wezempilo, i- Affordable Care Act eqinisekisiwe amazinga we- actuarial value kumahlelo ezempilo emakethe yeqembu ngalinye namancane .
Lawa mazinga, noma amathayi amathathu, ayi-bronze, isiliva, igolide ne-platinum. Zonke izinhlelo zezempilo ezingeni elinikeziwe kulindeleke ukuthi zinikeze cishe inani elifanayo eliphelele.
Kuzinhlelo ze-platinum-tier, inani lamaphesenti angama-90 (ngebanga elincane elingu-+/- 2, elizokhula kuze kube ngu-2 / -4 ngo-2018, okusho ukuthi uhlelo lweplatinum ngo-2018 luyoba nenani le-actuarial ebangeni ngamaphesenti angu-86 kuya kwangu-92 amaphesenti). Izinhlelo ze-bronze, zesiliva negolide zinikela ngamanani angama-60, 70 no-80 ngokulandelana.
Kuyini Okubalulekile Ngokuphathelene Nomshuwalense Wezempilo?
Inani, noma inani le-actuarial , likutshela ukuthi yiliphi iphesenti lezindleko zokunakekelwa kwempilo elihlelwe uhlelo olulindeleke ukuthi lukhokhele ubulungu balo lonke. Lokhu akusho ukuthi wena, ngokwakho, uzoba namaphesenti angu-90 enkambiso yokunakekelwa kwezempilo akhokhelwa yi-platinum plan. Kuyinto inani elilinganiselwe elisabalalisa kuwo wonke umuntu ojwayelekile. Kuye ngokuthi usebenzisa kanjani umshuwalense wakho wezempilo, ungase ube nezindleko zakho ezikhokhelwayo ezingaphansi kwezingu-90.
Izindleko zokunakekelwa kwezempilo ezingekho emthethweni azibala uma kunquma inani lezempilo. Isibonelo, uma uhlelo lwakho lwezempilo lwe-platinum-tier lungahlinzeki ngokuthola imithi engaphezu kwemithi, izindleko zalezo zinto azifakiwe uma kubalwa inani lepulani yakho. Izindleko ezingaphandle kwe-network azihlanganisiwe ekunqumeni ukubaluleka kokuhlelwa kwepulani, kanti futhi akuzona izinzuzo ezingangeni ngaphansi kwezigaba ezibalulekile zokuhlomula ezempilo (cishe konke ukunakekelwa okudingekayo ngokwezempilo kuncatshangelwa ukuthi kuyisibonelelo sempilo esibalulekile, noma kunjalo)
Izinkokhelo
Kuzodingeka ukhokhe izinkokhelo zenyanga zonke ukuze uthole ukuhlinzekwa kohlelo lwezempilo. Amaprimiyamu amapulani asePlatinum ayabiza kakhulu kunamapulani aphansi aphansi ngoba amapulani e-platinum akhokhela imali eningi emithwalweni yakho yokunakekelwa kwezempilo.
Njalo uma usebenzisa umshuwalense wakho wezempilo, kuzodingeka ukhokhe ukwabelana ngezindleko ezifana nokudonswa kwezimali, ukuqinisekiswa kwezimali , kanye nama-copays . Indlela iplatinum ngayinye eyenza ngayo ukuthi ukhokhele isabelo sakho samaphesenti angu-10 kuzohluka. Isibonelo, uhlelo olulodwa lweplatinum lungase lube ne-$ 1000 ephezulu ekhishwe ngokubambisana ne-coinsurance ephansi ye-5%. Uhlelo lweplatinum olunomncintiswano lungase lube ne-$ 400 engezansi ehlanganiswa ne-coinsurance ephezulu kanye ne-$ 10 ye-copay yemigomo.
Izinzuzo
Khetha uhlelo lwezempilo lwe-platinum uma isici esibaluleke kunazo zonke kuwe yizindleko eziphansi ezingaphandle kwe-pocket uma usebenzisa umshwalense wakho wezempilo. Uma ulindele ukusebenzisa umshwalense wakho wezempilo kakhulu, noma ungakhathazeki ngamaprimiyamu aphezulu ngenyanga ngenyanga, uhlelo lwezempilo lweplatinum lungase lube yisinqumo esihle kuwe.
Uma usebenzisa umshuwalense wakho wezempilo okuningi, mhlawumbe ngenxa yokuthi unesimo esibi kakhulu esingapheli, qaphela ngokucophelela iplanium platinium ngaphandle kwepokhethi . Uma wazi kusengaphambili ukuthi izindleko zakho ezingaphandle kwezezimali zizodlulela lokhu okungaphezulu kwe-pocket esiphezulu, ungase ukwazi ukugcina imali ngokukhetha uhlelo oluphansi oluhambisana ne-po-out efanayo ephezulu kodwa amaphesenti aphansi.
Izindleko zakho eziphuma ngonyaka zezindleko zizofana, kodwa uzokhokha ama-premium amancane .
I-Cons
Ungakhethi uhlelo lwezempilo lwe-platinum-tier uma ungakwazi ukukhokhela amaprimiyamu aphezulu ngenyanga. Uma ulahlekelwa ngumshwalense wakho wezempilo ngenxa yokuthi awukwazi ukukhokha ama-premium, ungazithola usendaweni enzima.
Uma uvumelekile ukuthola izinsizakalo zokwabelana ngezindleko ngoba imali yakho engenayo ingaphansi kwamaphesenti angama-250 wezinga lobuphofu lombuso, kufanele ukhethe uhlelo lwe-silver-tier ekushintsheni ukuze uthole izinsizakalo. Ngeke uthole izinsizakalo zokwabelana ngezindleko uma ukhetha uhlelo lwezempilo kusuka kunoma iyiphi enye ingxenye, noma uma uthenga ngaphandle kwe-exchange ( izinsizakalo ze-premium nazo zitholakala kuphela ekushintsheni, kodwa zingasetshenziselwa izinhlelo noma kunoma iyiphi insimbi izinga).
Izinsizakalo zokwabelana ngezindleko zinciphisa imali enikezwayo, ama-copays, kanye ne-coinsurance ukuze ukhokhe kancane uma usebenzisa umshuwalense wakho wezempilo. Empeleni, isabelo semali yokwabelana ngezindleko sandisa inani le-actuarial yecebo lakho lempilo ngaphandle kokuphakamisa i-premium. Kunjengokuthola ukuthuthukiswa mahhala kumshuwalense wezempilo. Ngeke uthole ukuthuthukiswa kwamahhala uma ukhetha uhlelo lwe-platinum-tier.
Ukutholakala
Ngaphansi kwe-ACA, ama-inshuwalense athengisa amapulani ngokushintshaniswa kuphela adingekayo ukuze anikele ngokubheka emazingeni esiliva negolide. Izinhlelo zePlatinum zithandwa kakhulu kunamanye amazinga ezensimbi (amapulani e-platinum ayengaphansi kwamaphesenti angama-1 okubhalisa inani lokubhalisa ngesikhathi sokubhalisa okuvulekile ngonyaka ka-2017), futhi avame ukuba nezindleko eziphezulu zababheki besikhwama somshwalense, njengoba abantu abakukhethayo bathambekele kube labo abanezimo zempilo ababheke ukusetshenziswa okuphawulekayo kokunakekelwa kwezempilo phakathi nonyaka.
Ngenxa yokubhalisa okuphansi kanye nezindleko eziphakeme, ababhalisi kwezinye izindawo bayeke ukunikeza izinhlelo ze-platinum. Lokhu kusho ukuthi ngeke ukwazi ukuthenga uhlelo lweplatinum nhlobo, nakuba izinhlelo zegolide zizoqhubeka zikhona.
> Imithombo:
> UMnyango wezeMpilo kanye nezinsizakalo zabasebenzi. Ukuvikelwa kwesineke nomthetho wokunakekelwa okunganakekelwayo: Ukuqiniswa kwemakethe . April 2017.
> Kaiser Family Foundation. 2017 Ukukhethwa Kwemakethe Yemakethe Yezinga LeMakethe (Level 1, > 2016, > kuya kuJanuwari 31, 2017) >.