Ama-Deductibles Ahlangene Namanje Akhona, Kodwa NgeMithetho Emisha
I-deductible ehlanganisiwe ibhekisela ohlelweni lwezempilo oluphezulu kakhulu lokudonswa (HDHPs) lusetshenziselwa ukukhishwa kwama-deductibles emndenini . Isebenza ngendlela ehlukile kune- deductibles evamile ehlanganisiwe esetshenziselwa umshuwalense wezempilo engeyona i-HDHP.
Ukuze sikusize uqonde le plan, ake sibheke ukuthi isebenza kanjani kanye nezinguquko zamuva kulolu hlobo lwenqubomgomo.
Izinguquko ezathatha umphumela ngo-2016
Ama- deductibles ahlangene angasetshenziswa futhi achazwa ngokuningiliziwe ngezansi.
Kodwa kusukela ngo-2016, zonke izinhlelo zempilo yomndeni kumele zibe nemigomo yokuphuma ngaphandle kwe-pocket . Lezi azikwazi ukudlulela umuntu ongaphandle kwepokhethi kulowo nyaka. Lokhu kusebenza kuwo wonke amahlelo ezempilo ezingenakulinganiswa (nezinhlelo zezempilo ezingakahlelwa phansi); izinhlelo eziningi zempilo zikhona nakwamanye amazwe) ezimakethe zomshuwalense ngamunye.
Isibonelo, ngo-2017 lowo muntu ongaphandle kwepokhethi u-$ 7,150 . Kungakhathaliseki ukuthi i-plan isakhiwe kanjani, akukho ilungu elilodwa lomsebenzi womndeni ongabhekene namacala angaphezu kuka-$ 7,150 ngezinkokhelo ezithintekayo ngo-2017 (lokhu kuzokwenyuka ku-$ 7,350 ngo-2018, nakuba izinhlelo eziningi zizobe zinezinkampani ezingaphandle kwamanye amazwe, i-pocket limingcele ngaphansi kwalesi samba).
Lokhu kusho ukuthi izinsuku zamapulani ezinama-deductibles angu-$ 10,000 aphelele. Uhlelo lungasenayo imali engama-$ 6,000 ehlanganisiwe, isibonelo, ngoba lokho kuphansi kunomuntu ongaphandle kwepokhethi.
Ukwengeza, izinhlelo zingasenokudonswa komndeni eziphakeme kunomuntu ongaphandle kwepokhethi. Kodwa bekungagcinwa kuphela uma ilunga lomndeni elilodwa lingaba nezimangalo. Lokhu kungenxa yokuthi uhlelo alukwazi ukuthi ilungu elilodwa lomndeni likwazi ukuhlangabezana nomndeni ophelele owehlisiwe ongaphezu komuntu ongaphandle kwepokhethi (usethe ngonyaka kaHHS).
Ngalokho engqondweni, ake sibuke ukuthi ama-deductibles amaningi asebenza kanjani.
Ngabe Umsebenzi Omningi Owenziwe Ngama-Deductible?
Ngomndeni ohlangene owenziwe, uhlelo lwezempilo aluqali ukukhokhela izindleko zokunakekelwa kwempilo kwanoma ubani emndenini kuze kube yilapho umndeni wonke ususwe. Uma sekuqediwe umndeni ophelele, umshwalense wezempilo ukhahlela wonke umndeni.
Kunezindlela ezimbili okungahlanganiswa ngazo zonke izibalo:
- Njengoba ilungu ngalinye lomndeni lisebenzisa futhi likhokhela izinsizakalo zokunakekelwa kwezempilo, inani abakhokha ngaphandle kwe-pocket lalezo zinsizakalo libizwa ngokubanjwa komndeni wonke. Emva kwamalungu omndeni amaningana akhokhele izindleko ezidonswayo, inani elihlanganisiwe lalezi zindleko lifinyelela ku-deductible eliphelele. Uhlelo lwezempilo luqala ukukhokha izindleko zokunakekelwa kwempilo yomndeni wonke (noma ngokugcwele noma ngokuhlukaniswa kwezimali ezisebenzayo ohlelweni ngemuva kokudonswa kwezimali).
- Ilungu elilodwa lomndeni linemali ephakeme yokunakekelwa kwempilo. Inani elikhokhela ngaphandle kwe-pocket lalezo zindleko likhulu ngokwanele ukuhlangabezana nokuhlanganiswa komndeni wonke. Uhlelo lwezempilo luqala ukukhokha izindleko zokunakekelwa kwempilo yomndeni wonke, noma ngabe ilungu elilodwa lomndeni likhokhele noma yikuphi ukukhishwa okuphelele.
Yiziphi izindleko ezibalekela emndenini ohlangene ohlangene?
Izindleko kuphela ze-HDHP yakho ezizobala ngokubhekiselwe kuzo zonke izindleko zemali yakho. Isibonelo, ama-facelifts awavamile ukuzuza inzuzo yezempilo. Uma uthola ukuphakanyiswa ubuso, imali oyikhokhayo ngeke ibale ngokubhekiselwe ku-aggregate deductible yakho.
Ikhamphani yakho yomshuwalense wezempilo ayikwazi ukukweleta noma iyiphi yezindleko zakho zezokwelapha ngaphandle kwe-deductible uma ingazi ngabo. Qinisekisa ukuthi wena noma izicelo zefayili yakho yezindleko zezokwelapha ngayinye.
Izimangalo zefayili noma ngabe uyazi ukuthi kufanele uzikhokhele ngoba awukakutholi okwamanje.
Yile ndlela inkampani yakho yomshuwalense wezempilo eyazi ukuthi ukhokhele kangakanani imali yakho.
Yiziphi izindleko ezikhishwa kwi-Aggregate Deductible?
E-United States, uMthetho Wokunakekelwa Ongenakudingeka udinga ukuthi izinhlelo zezempilo zikhokhele izinsizakalo zokunakekelwa kwezempilo ngaphandle kokufuna noma yiluphi uhlobo lokubelana ngezindleko . Lokhu kusho ukuthi umshuwalense uzokhokhela izinto ezifana nomkhuhlane wakho wokugubha, ukugonywa kwezingane zakho, kanye nomzimba wakho wezimbuzi ngisho noma ungazange ukhokhele imali yakho okwehlisiwe (phawula ukuthi akuwona wonke ukunakekelwa kokuvikela okuhlanganiswa ngaphandle kwezindleko).
Yeka ukuthi i-Aggregate Deductible isebenza kanjani ngo-2016 nangaphezulu
Ngaphansi kwemithetho emisha eyaqala ukusebenza ngo-2016, uhlelo lwezempilo alukwazi ukufuna noma yikuphi umuntu akhokhe i-deductible ephakeme kunomkhawulo wesifundazwe wokukhishwa kwe-pocket okwenziwe ngabanye, ngisho noma lowo muntu eboshwe ngaphansi umndeni ohlangene udonswe. Ngo-2017, ukukhishwa kwe-pocket okungaphezulu komuntu kulinganiselwa ku-$ 7,150, futhi ngo-2018 kungu-$ 7,350.
Lokhu kulungiswa kwemithetho kwasebenza ngempumelelo njengoba nje uhlelo lwakho lomshuwalense wezempilo luvuselelwa ngo-2016. Luzoqhubeka luba khona ngaphandle uma imithetho ingashintsha futhi.
Isibonelo sibonisa ukuthi lokhu kusebenza kanjani:
Ake sithi inqwaba edalulwayo ohlelweni lwakho lomndeni we-2017 yi-$ 12,000. Uma ilungu lomndeni elilodwa likhokhile u-$ 7,150 ngokulinganisa inani lemali elidonswayo, ukukhokhelwa kwalowo muntu kufanele kukhishwe ngaphandle kokudinga ukwabiwa kwezindleko ezifana ne-copays noma i-coinsurance.
Ukukhishwa kwalowo muntu kukhahlelwa ngoba manje usefinyelele umkhawulo ongaphandle kwezomthetho womuntu ngamunye. Noma kunjalo, ukufakwa kwamanye amalungu emndenini wakho ngeke usabalale kuze kube yilapho kutholakala yonke imali yomndeni eseduzane.
Imithombo:
UMnyango wezeMpilo kanye nezinsizakalo zabasebenzi, ukuvikelwa kwabagulayo kanye nomthetho wokunakekelwa okwethenjelwa, isaziso esikhombisiwe sezinzuzo kanye nemikhawulo yokukhokha ka-2016.
UMnyango WezeMpilo Nezinsizakalo Zabantu, Isaziso Sokugcina Senzuzo Nezikhawulelo Zokukhokha Zonyaka ka-2016 (80 FR 10823). 2015.
UMnyango WezeMpilo Nezinsizakalo Zabantu, Isaziso Sokugcina Senzuzo Nezikhawulelo Zokukhokha Zonyaka ka-2018 . Ngo-Disemba 17, 2016.