Ukuqonda Idiza Eliphezulu Lengozi Yombuso
Abaningi baseMelika bathola umshwalense wabo wezempilo ngomqashi wabo kanye nabanye abaningi ababhalisile ezinhlelweni zikahulumeni ezifana neMedicaid , Medicare , CHIP, kanye nezinhlelo zezempilo ezihambisana namabutho ahlomile. Futhi, abantu abaningi abazisebenzisayo bazithengela uhlelo lwabo lwezempilo ngqo kusuka enkampanini yomshuwalense wezempilo.
Ukwengeza, abangaphezu kwezigidi ezingama-40 baseMelika abanayo yomshuwalense wezempilo ngoba basebenze isikhathi esithile, umqashi wabo akahlinzeki umshuwalense wezempilo, noma abakwazi ukukhokhela izinkokhelo zomshuwalense wezempilo kepha benza imali eningi ukuze bakwazi ukuthola iMedicaid.
Kukhona nezinombolo ezibalulekile zabantu abangakwazi ukukhokhela umshuwalense kodwa behlaselwa yizinkampani zomshuwalense ngoba banesimo esibucayi esandulele esinjengomdlavuza, isifo sikashukela noma ukutheleleka nge-HIV. Ezingxenyeni eziningi, awekho imithetho edinga inkampani yomshuwalense wezempilo ukuze inikeze ukufakazela umuntu ngamunye.
Amachibi Aphezulu Amathuba
Kodwa-ke, izifunda ezingu-35 zenze izinhlelo ezikhethekile kubahlali abaphikisana nokuhlinzekwa ngabashuwalense abazimele ngenxa yezindaba ezihlobene nempilo. Ngokuyinhloko, lezi zinhlelo, ezibizwa ngamachibi aphezulu, ziqinisekisa ukuthi abantu bangathenga futhi babhalise ohlelweni lwezempilo kungakhathaliseki isimo sabo sempilo.
UDkt. Mike's Bottom Line
Uma usemncane futhi unempilo futhi ungenayo izici ezingozini zempilo (njengokubhema), cishe uzoba nesikhathi esilula ukuthola umshuwalense wezempilo ongabizi futhi izinhlelo zezempilo ezikulangazelela ukuthi ube ngumthengi. Kodwa-ke, uma uphethwe isimo sempilo esingapheli noma unezici eziphathelene nempilo, izici eziphezulu zokubeka ubungozi (njengokungaphezu komzimba noma ukuhlafuna ugwayi), ungase ungakwazi ukuthola umshuwalense wezempilo nganoma iyiphi intengo.
Izinhlelo eziningi zempilo zisebhizinisi ukwenza imali futhi azifuni ukubhalisa abantu "abagulayo" abazosebenzisa izinsizakalo eziningi .
Kwenzekani Emachibini Aphakeme Kungozi Ngaphansi Kokuguqulwa Kwezempilo?
Enye yezinhlinzeko ezinkulu ze- bill yokulungiswa kwempilo (Isiguli Sokuvikela kanye Nokwelashwa Okungathintekiyo) esasayinwe ngomthetho ngo-Mashi 2010 ukuqeda imithetho yangaphambili ekhona futhi inikeze ukufinyelela kumahlelo ezempilo angabizi angakwazi ukuphika ukuxhaswa okusekelwe esimeni sezempilo.
Umbuso ngamunye unomshwalense wempilo yomshuwalense ohlinzeka okungenani izinketho ezimbili zokuhlela ezempilo namazinga ahlukene ama-premium kanye nezindleko zangaphandle. Ukuhwebelana kungase kube ukushintshwa, noma ukungezwa, echibini lakho lamanje eliphakeme eliyingozi.
Ingakanani Imali Yomshuwalense Wensiza Ephezulu Yengozi?
Izinhlelo zezempilo ezinengozi kakhulu ziyabiza kakhulu ukuze umbuso wakho usebenze. Ngenxa yalokho, ichibi eliphakeme kakhulu engozini yakho cishe lizokukhokhela ngaphezu kwezindleko zokuthenga umshuwalense wezempilo wendabuko. Ngokuvamile, amachibi aphezulu ahlinzeka ngezinhlelo zempilo ezine eziyisishiyagalombili ngenkontileka phakathi kwezwe lakho kanye nezinkampani eziningi zomshuwalense wezempilo yangasese.
Ngokuya ngohulumeni, i- premium yakho yenyanga yengozi yezempilo ephezulu izoba yi-125% kuya ku-200% ye-premium yepulani elizimele elifanayo - elifana nehlelo lempilo elikuphikisayo. Isibonelo, uma uhlelo lendabuko lomuntu lubiza izindleko zamaRandi ayizigidi ezingama-500 ngenyanga, eCalifornia ungase ukhokhele u-R6 625 ohlelweni oluphezulu lokubeka ingozi (125% isilinganiso), e-West Virginia $ 750 for the plan high risk (150% rate) , nakuMadrid $ 1000 yecebo eliphakeme kakhulu ($ 1000).
Ezingxenyeni eziningi ezinamachibi aphezulu, inkampani yomshuwalense nayo ingashintsha izindleko ze-premium yakho ngokusekelwe kwezici zakho siqu, ezifana nobudala, ubulili, isimo sokubhema, lapho uhlala khona, kanye nesimo sakho sezempilo.
Awukwazi ukukuphika uma unenkinga yezempilo, kodwa angakukhokhisa i-premium ephakeme!
Ngaphandle kwe-premium yakho yenyanga, uzophinde ube nesibopho sezindleko zangaphandle, njengama-deductibles waminyaka yonke, ama-copayments, kanye ne-co-inshurensi. Ungalindela ukuthi ube ne-deductible yonyaka okungenani engu-$ 500, kodwa kuningi uthi i-deductible ingaba phakathi kuka-$ 1000 no-$ 3000.
Ingabe Amachibi Aphezulu Ayisimo Esihle?
I-pool enkulu engozini ingaba usizo kakhulu uma unesimo esandulele, senqatshelwe ikhono lokubhalisa ohlelweni lwezempilo, futhi singakwazi ukukhokhela izinkokhelo zenyanga. Njengoba ezinye izifunda zinikeza usizo lwezezimali ngama-premium, i-pool ephakeme kakhulu ingaba njengethente lokuphepha uma ungeke ukwazi ukuthenga uhlelo lwempilo yangasese.
Kodwa-ke, kunezinye izinkinga ezibalulekile ezinamachibi aphezulu. Nakuba abantu abayizigidi eziningana kulaba abangu-35 abashoyo ngamachibi aphezulu bangase bakwazi ukuhlanganyela, ukubhaliswa kwangempela - cishe ngo-190,000 - sekuphansi kakhulu. Lokhu kubangelwe ngenxa yezindleko eziphezulu zama-premium kanye nezindleko ezingaphandle kwe-pocket ngonyaka - abantu abaningi abakwazi ukukwazi ukuthenga ngokufihla endaweni ephezulu.
Njengoba amachibi angenengozi ebiza kakhulu ukusebenza, izifunda eziningi ziye zalinganiselwe noma zayeka ukubhalisa abantu emachibini.
Izinsiza
Njengoba wonke ama-35 athiwa ngamachibi aphezulu anemithetho ehlukile, kubalulekile ukuba uqonde izidingo zokufaneleka kobuso bakho, izinhlelo ezikhona ezinikeza umshuwalense echibini eliyingozi kakhulu, izindleko zonyaka, nokuthi kungenzeka ukuthi izinhlelo zikhona manje ivaliwe.
Amaphakheji aphezulu kaHulumeni: Ngokuningiliziwe - idokhumenti enhle kakhulu evela kuKaiser Family Foundation efaka uhlu lwezifunda ngamachibi aphezulu kanye nolunye ulwazi oluyisisekelo mayelana nezinhlelo zikahulumeni.
Izinhlelo Zomshuwalense WezeMpilo Kazwelonke Zikazwelonke zihlinzeka uhlu lwalezi zindawo ngamachibi aphezulu okubandakanya ukuxhumana ngokuqondile ohlelweni ngalunye.