Uma umshuwalense wakho wezempilo efika ne-deductibles eyodwa noma ngaphezulu, uzophela ukukhokha ama-dollar angamakhulu angama-dollar ayizinkulungwane ezimbalwa. Ukuqonda ukuthi lokhu kudonswa yikuphi, ukuthi kusebenza kanjani, uma kufanele ukhokhe, futhi uma kungadingeki ukhokhe lokhu kuyingxenye yokusebenzisa umshuwalense wakho wezempilo ngokuhlakanipha.
Uphi Umshwalense Wezempilo Owenziwe Deductible?
I-deductible yakho iyinani elilinganiselwe okufanele ukhokhe unyaka ngamunye ngokubheka izindleko zemali yakho yokukhokhelwa kwempilo ngaphambi kokuba umshwalense wakho wezempilo ukhahle ngokugcwele futhi uqala ukukhokha (uma ubhalisile ku-Medicare, i- Part A deductible isekelwe ngezikhathi zokuzuza kunokuba unyaka wekhalenda ).
Indlela Imisebenzi EyiDeductible-Isibonelo
Ake sithi umshuwalense wakho wezempilo udinga i-deductible ye-$ 1000 yaminyaka yonke, futhi zonke izinsizakalo ezingekho zokuvimbela zibalwa ekudonseni.
- NgoJanuwari, uthola i-bronchitis.
- Inkokhelo yonke = $ 200. (Udokotela, odokotela.)
- Ukhokha u- $ 200.
- Umshwalense wakho wezempilo ukhokhela u- $ 0.
- I-$ 200 idalwe ku-deductible yakho.
- U-$ 800 osele ngaphambi kokukhipha imali.
- Ngomhla ka-Ephreli, uthola isifuba esiswini sakho. Isibungu siphenduka sibe sinobuhle; uphile.
- Inkokhelo yonke = $ 4,000. (Odokotela, ukuhlolwa, i-biopsy.)
- Ukhokha u- $ 800. (Manje uhlangabezane ne-$ 1000 yakho enikezwe imali.)
- Ukhokha noma yimaphi ama- copayments noma u- coinsurance uhlelo lwakho lwezempilo oludinga.
- Umshwalense wakho wezempilo ukhokhela konke okusemthethweni.
- Ngo-Septhemba, uphula ingalo yakho.
- Inkokhelo yonke = $ 2,500. (Igumbi eliphuthumayo, udokotela, i-X-ray, iphonswe.)
- Ukhokha ama-copayments no-coinsurance, kodwa akukho deductible.
- Umshuwalense wezeMpilo ukhokhela wonke umthethosivivinywa ngaphandle kokukhokhwa kwemali yakho kanye ne-coinsurance.
- NgoJanuwari olandelayo, uzoqala uhlelo lonke futhi.
Ezenzweni eziningi zempilo, uma usukhokhele imali ekhishwayo ngonyaka, usuqedile ngokukhokha imali enqunyiwe kuze kube ngonyaka ozayo. Unyaka ngamunye, uhlelo lwezempilo lubeka imali entsha. Ngezinye izikhathi kunesilinganiso esifanayo nonyaka ngaphambili; ngezinye izikhathi liyakhuphuka.
Izinhlobo ezahlukene zeDeductible
Ezinye izinhlelo zezempilo zinezinhlobo ezingaphezu kweyodwa ze-deductible.
- Deductible yonyaka
Lona uhlobo oluvame kakhulu lwe-deductible futhi yilokho okuchazwe kusibonelo ngenhla.
- I-Per-Episode Deductible
Ngokungafani ne-deductible yonyaka, i-episode episode deductible kwenzeka njalo lapho uthola uhlobo oluthile lwenkonzo. Isibonelo, umshuwalense wakho wezempilo ungadinga imali engama-dollar engu-R1 000 uma uhlala esibhedlela (ezinye izinhlelo zizobhekisela kulokhu njenge-copay esikhundleni, kodwa ubukhulu becala bubiza ukuthi kusukela kumbono wabathengi, kufana ne-deductible). Ama-deductibles ama-per-epidemic awavamile kakhulu kunamaducucbles waminyaka yonke, nakuba kuphawuliwe ngenhla, i-Medicare Part A ihlola ama-deductibles ngokusekelwe esikhathini esizuzayo kunokuba iminyaka ikhalenda.
- I-Out-of-Network Ideductible
Ezinye izinhlelo zezempilo, i- PPOs ikakhulukazi, inokukhishwa konyaka owodwa kunakekelo oyitholayo kusuka odokotela be -in-network kanye nokukhishwa konyaka okungaphezulu kokunakekelwa okutholakala kubahlinzeki be- out-of-network .
Isibonelo, uma uhlelo lwakho lwezempilo lunemali engama-dollar eyi-$ 1,000 in-net deductible ngonyaka kanye ne $ 2,000 ngaphandle kwe-deductible yenethiwekhi, uhlelo lwakho lwezempilo luzoqala ukukhokhela ukunakekelwa kwezempilo kwe-in-network emva kokukhokha imali engu- $ 1,000 kumabhilidi akho oku-inethiwekhi . Uma ngabe uqale ukubuka ochwepheshe be-out-of-network, kuzodingeka ukhokhe imali engu-$ 2,000 kulokhu okunakekelwa ngaphandle kwenethiwekhi ngaphambi kokuthi uhlelo lwakho lwezempilo luqale ukukhokha noma yini ekunakekelweni kwakho ngaphandle kwenethiwekhi.
I-$ 1,000 oyikhokhelwe kakade njenge-in-network deductible ayibalo ngokubhekiselele ekuphumeni kwakho kwenethiwekhi.
Kwezinye izinhlelo zezempilo, noma yiliphi inani okhokhayo ngaphandle kwe-out-of-network deductible lakho libuye libheke nakuyo in-network deductible. Kwamanye amahlelo ezempilo, ama-deductibles amabili ahluke ngokuphelele (phawula ukuthi amanye amaphuzu awamane ahlinzekele ukunakekelwa kwe-inthanethi, okusho ukuthi uzobe unomthwalo wemali yonke ye-bill-ngaphandle kwekhanda ekuphumeni ukukhokhiswa kwamacala-ngaphandle uma isimo esiphuthumayo).
- I-Deductible yomndeni
Uma inqubomgomo yomshuwalense wezempilo ihlanganisa yonke imindeni yakho, kungenzeka ukuthi ifika nomndeni owenziwe.
Ukudonswa kwemindeni kusebenza ngokuhlukile kunezinkampani ezidonswa ngabanye futhi ziza ngezinhlobo ezahlukene ezifana ne- deductible embedded kanye ne- aggregate deductible . Funda kabanzi ku- " Indlela Imisebenzi Yakho Yomndeni Okuqediwe Ngayo ." Qaphela ukuthi uMthetho Wokunakekelwa Onganakekelwayo udinga ukuthi izinhlelo zempilo zikhawulele imali yokuchitha imali yomuntu oyedwa (ekunakekelweni kwenethiwekhi) ngonyaka onikeziwe, ngisho noma lowo muntu ehlanganiswa uhlelo lomndeni oludonswa ngumndeni.
Ngo-2017, umkhawulo ongaphezulu ngu-$ 7,150 ezindleko ezingaphandle kwe-pocket yomuntu oyedwa, kuhlanganise neductible, copays, kanye ne-coinsurance. Ngo-2018, kuyoba ngu- $ 7,350. I-deductible yokuthi umuntu oyedwa angadingeka ukukhokha ingaba phezulu njengaleyo mali, kodwa ayikho ephakeme.
Uma Ungakhokhi I-Deductible?
E-United States, ngenxa ye- Care Affordable Care Act , akudingeki ukhokhe imali ekhishwayo uma uthola izinsizakalo zokunakekela ezikhungweni ezivela kudokotela onenethiwekhi. Izinto ezinjengokubukeka kwakho kwenyanga yonke, i-colonoscopy oyithola uma uvula iminyaka engu-50 ubudala, futhi ukudubula komkhuhlane wakho wonyaka akuhambisani ne-deductible. Uhlelo lwakho lwezempilo luzokhokhela lezo zinsizakalo zokuvimbela ngisho noma ungahlangabezane ne-deductible yakho okwamanje.
Ezinye izinhlelo zezempilo, ikakhulukazi amanye ama- HMO , azidingi ukuba zithathwe kalula. Noma kunjalo, lezi zinhlelo ngokuvamile zikhokhisa ama-copay for izinto ezifana nokuvakashelwa odokotela, imiyalelo, ukuvakashelwa kwamagumbi okuphuthumayo, nokuvakasha.
Yini Engayifuni KuDeductible?
Izindleko zokunakekelwa kwezempilo ezingesizo inzuzo ye-plan yakho yezempilo azibhekiseli kumshwalense wakho wezempilo onqunywe yize ungazikhokhela. Isibonelo, uma umshuwalense wakho wezempilo ungafihli ukufakwa kwezicathulo ze-orthotic, imali engu-$ 400 oyikhokhelwe i-pair of orthotics enqunywe yisiphathamandla sakho ayifuni ekubhekisweni kwakho. Ngokufanayo, uma uhlelo lwakho lwezempilo lungabheki ukunakekelwa kwe-out-of-network, noma yiliphi inani olikhokhela ukunakekelwa kwe-out-of-network ngeke libalwe ngokudonswa kwakho.
Uma umshuwalense wakho wezempilo udinga isahlulelo esinqunyiwe ngasinye kanye ne-deductible yaminyaka yonke, imali oyikhokhayo kwi-episode episode deductible kungenzeka ukuthi ayikho ekubhekisweni kwonyaka wakho.
Uma unezinzuzo ezihlukene zokunakekelwa kwe-in-network kanye nokunakekelwa kwe-in-out, inkokhelo oyikhokhelwe kakade ku-in-network deductible ayifuni ekubhekaneni ne-out-of-network deductible yakho. Kuye ngemithetho yakho yezempilo, inani okhokhelwe ekuphumeni kwakho kwenethiwekhi okungenakulinganiselwa kungabonakali ku-in-network deductible, noma.
Ezenzweni eziningi zempilo, ama-copayments awaqhathanisi nalokho okwenziwe minyaka yonke, nakuba zibalwa ngokuqondene nezindleko zakho eziphelele zokuphuma ngonyaka. Funda kabanzi ku- "Ingabe I-Copayments Bala Ku-Inshuwalense Yempilo Yakho? "
> Imithombo:
> UMnyango wezeMpilo kanye nezinsizakalo zabasebenzi , ukuvikelwa kwabagulayo kanye nomthetho wokunakekelwa okwethenjelwa; Isaziso se-HHS Isaziso seNzuzo kanye neMigomo yokukhokha ka-2018; Ukuchitshiyelwa kwezikhathi ezikhethekile zokubhalisa kanye nohlelo lwabathengi olusetshenzisiwe futhi oluhlelekile . NgoDisemba 22, 2016.
> Medicare.gov. I-glossary. Isikhathi Sokuzuzisa.
Medicare.gov. I-Medicare 2016 no-2017 ibiza nge-shazi.