Umshwalense omkhulu wezempilo wezokwelapha uhlobo lomshuwalense wezempilo oluhlanganisa izindleko ezihambisana nokugula okujulile noma ukugula esibhedlela.
Umshuwalense wezempilo omkhulu wezokwelapha igama elisetshenziselwa ngokomlando ukuchaza izinhlelo eziphelele zezempilo ezihlanganisa ukunakekela okudingekayo. Lapho uMnyango Wokunakekelwa Ongenakunakekelwa usuqalisiwe, igama elithi "ukubhekwa okungenani okubalulekile" lalivame ukusetshenziswa.
Ukuhlinzekwa okungenani okubalulekile yilokho okumele ube nakho ukuze ugweme isijeziso se - ACA sokungaqinisekisiwe , futhi zonke izinhlelo ezinkulu zomshuwalense wezezempilo zempilo zibalwa njengendlela yokubambisana okubalulekile.
"Umshwalense Wezempilo" wangempela
Umshuwalense wezempilo omkhulu wezokwelapha ngokwemibandela yomuntu yilokho abantu ngokuvamile abakubheka umshwalense wezempilo "wangempela". Akubandakanyi izinhlelo ezilinganiselwe zokuhlomula, amacebo wamazinyo / umbono, izongezo zengozi, umshuwalense wezempilo wesikhathi esifushane , noma izinhlelo zokugula ezibucayi, okungekho kuwo okulawulwa yi-Care Affordable Act.
Izinhlelo ezinkulu zezokwelapha ngokuvamile ziba nesamba esinqunyiwe, noma i- deductible , isiguli esiphethe ukuyikhokhela. Uma lelo deductible likhokhwa, uhlelo luhlanganisa kakhulu izindleko ezisele zokunakekelwa, ngokuhambisana nomshwalense okhokhelwa yisiguli. Amanye amahlelo abuye akhokhele ezinye izinsizakalo.
Amapulani amakhulu wezokwelapha azophinda athole ukuvezwa kwe-out-of-pocket kwemisebenzi ye-in-network.
Ngo-2018, zonke izinhlelo ze-ACA ezivumelanisiwe kufanele zifake izindleko ze-pocket ngaphandle kwe -inthanethi (izinzuzo zezempilo ezidingekayo) ezingekho kuka $ 7,350 umuntu ngamunye kanye no-$ 14,700 emndenini.
Izinhlelo ezinkulu zezokwelapha ezingekho ezihambisana ne-ACA (okungukuthi, izinhlelo ezinamakhulu amakhulu) zingaba nemingcele ephakeme kakhulu, kodwa kungaba yinto engavamile kakhulu ngisho nalezi zinhlelo ukuba zibe nezindleko ezingenamkhawulo ezingekho emphakathini (inothi yendabuko I-Medicare , ngaphandle komfelandawonye we- Medigap , ayinayo i-cap kwizindleko ezingaphandle kwe-pocket, kodwa lokhu akuyona imodeli yokuthi umshuwalense wangasese ulandela).
Izinhlelo ezinkulu zezokwelapha zingaba namandla kakhulu, kodwa zibandakanya izinhlelo eziphezulu zokunakekelwa kwempilo ezihambisana ne- HSA- kanye nezinhlelo eziyingozi njengoba kuchaziwe yi-ACA.
Ungayitholaphi Ukuhlinzeka Okukhulu Kwezempilo?
Ukuthola okuvela kumqashi wakho cishe umshwalense wezempilo wezempilo omkhulu. Uma usebenzela umqashi omkhulu, kufanele anikele ngokubambisana okunikeza inani elincane ukuze kuhambisane nomsebenzi weqashi lomqashi ka-ACA. Uhlelo oluhlinzeka ngenani elincane lizobhekwa njengento enkulu yokwelashwa, njengoba kuzoba kuhle kakhulu.
Noma yiluphi uhlelo owalutholayo ekushintsheni kuhulumeni wakho luzocatshangelwa ukukhishwa okukhulu kwezokwelapha. Izinhlelo zokungaxhunywanga nazo ziyizinhlelo ezinkulu zezokwelapha, uma nje zivumelana ngokugcwele ne-ACA (zonke izinhlelo ezintsha zokwelapha ezidingekayo kufanele zibe yi-ACA-ehambisanayo kusukela ngo-2014, kuhlanganise nalabo abathengiswa ngaphandle kwezingxoxo. , kanye nezinhlelo zesikhathi esifushane zisengathengiswa ngaphandle kwezingxoxo; lezi zinhlelo azilawulwa yi-ACA futhi azibhekwa njengezokwelapha ezinkulu).
Uma uthenga ukuthengiswa ekushintsheni kuhulumeni wakho, ungase ufanelekele izinsizakalo ze- premium ukuze ususe izindleko zokuthenga ukuhlinzeka okukhulu kwezokwelapha.
Ngo-2018, ukufaneleka koxhaso lomndeni wezingane ezine kufinyelele emindenini yasemakhaya ephakeme kakhulu njengamaRandi ayi-98,400 (ukufaneleka kukhishwa ngamaphesenti angama-400 ezinga lobuphofu; leli shidi libonisa lokho okulingana namadola ezinkampanini ezihlukahlukene zomndeni; ekugcineni okuphansi, izinsizakalo ayitholakali uma imali yakho engenayo ingaphansi kwezinga lobuphofu, noma uma ufanelekile ku-Medicaid).
I-Medicare kanye nezinhlelo eziningi ze-Medicaid nazo zibheka njengento encane ebaluleke kakhulu, futhi ngaleyo ndlela ingabhekwa njengezinhlelo ezinkulu zezokwelapha (abanye abantu abafanelekele ukuhlinzekwa okulinganiselwe-okuzuzwa nge-Medicaid-Medicaid okufaka kuphela amasevisi ahlobene nokukhulelwa, isibonelo-futhi lokhu ngeke kuthathwe njengokungenani ukubaluleka okubalulekile noma ukutholakala kwezokwelapha okukhulu).
Izinhlelo zezempilo ezizukulu nezikhulu zibalwa njengezokwelapha ezinkulu, nakuba zingasakwazi ukuthengwa. Kodwa uma usenayo i-cover ngaphansi kwalezi zinhlelo, unesibalo esincane esibalulekile (kanye nokwaziswa okukhulu kwezokwelapha), futhi akuhambisani nesigwebo se-ACA. Amacebo amakhulu agcina esebenza njalo, uma nje bengashintshi kakhulu. Amacebo omkhulu angahlala endaweni kuze kube sekupheleni kukaDisemba 31, 2018, ngokuqonda kwamazwe kanye nabashuwalense.
> Imithombo:
Amasevisi e-Medicare neMediicaid Services; Isikhungo Sokwaziswa Komthengi kanye Nokuqapha Umshuwalense. Uchungechunge Lwemigomo Yomshuwalense - Ukwaziswa - Ukwandiswa Kwemigomo Yesigodi Ngonyaka KaKhalenda 2018 . Ngo-February 23, 2017.
> HealthCare.gov. Ukulinganisa Okuncane Okuncane (uMEC).