Dziko lirilonse liri ndi kusintha kwake ndipo ndilosiyana
https: // www. / actuarial-value-your-health-inshuwalansi-4147819 Chifukwa cha Affordable Care Act, yomwe inasaina lamulo mu March 2010 ndi Purezidenti Obama, boma lililonse liri ndi inshuwalansi ya thanzi. Msonkhanowo unayamba kupezeka kuti ugwiritsidwe ntchito mu Oktoba 2013, ndipo wakhala akutumikira kuyambira pakhomo kuti anthu adzigulitse chinsinsi cha inshuwalansi yaumsika pamsika (pamsika pawokha umathandiza anthu omwe akufunikira kugula inshuwalansi yawo chifukwa alibe Kufotokozera kuchokera kwa abwana kapena pulogalamu ya boma monga Medicare).
Anthu ena omwe ali ovomerezeka ku Medicaid amatha kulembetsanso kudzera mu mgwirizano, ngakhale izi zimadalira chifukwa chake munthuyo ali woyenera, ngati kulembedwa kwasinthidwa mosiyana ndi anthu omwe ali oyenerera pokhapokha pa ndalama, potsutsana ndi omwe omwe akuyenerera amadalira ena zinthu, monga mimba kapena kulemala.
Ndipo magulu ang'onoang'ono omwe amapanga makampani ang'onoang'ono amapezeka kudzera mu mgwirizano, ngakhale kuti gawoli la msika wawo lakopa anthu owerengeka, ndipo boma la federal linalengeza mu May 2017 kuti sichidzagwiritsanso ntchito kayendetsedwe kakang'ono ka kulembetsa bizinesi (ntchito 33 kuyambira mu 2017) kumapeto kwa 2017. M'malo mwake, kuyambira mu 2018, malonda ang'onoang'ono omwe amalembedwa mwachindunji kupyolera mu makampani a inshuwalansi kapena mothandizidwa ndi wogulitsa broker, ndi kulipira malipiro kwa inshuwalansi mmalo mopanga malipiro apamwamba kudzera mwa kusinthana.
Kusinthanitsa ndi Kulembetsa Maofesi
Ndikofunika kumvetsetsa kuti kusinthanitsa kuli chabe nsanja yogula kufalitsa.
Ngati mumagula inshuwalansi yapamwamba kudzera ku Covered California, mwachitsanzo (kuthamanga kwa boma ku California), Covered California si kampani yanu ya inshuwaransi. M'malo mwake, kampani yanu ya inshuwalansi idzakhala Health Net kapena Blue Shield, kapena Anthem kapena ena onse omwe ali ndi inshuwalansi omwe amapereka chithandizo kudzera pa Covered California.
Ngakhale inshuwalansi ya umoyo ndi yovuta kwambiri kuposa matikiti a ndege, ganizirani za kusinthanitsa ngati nsanja monga Travelocity kapena Expedia. Zimakuwonetsani zosankha za inshuwalansi m'deralo ndipo zimakulolani kugula zomwe mukufuna. Koma monga momwe ndege yanu idzaperekere ndi ndege yomwe mumasankha-osati ndi Travelocity kapena Expedia-inshuwalansi ya thanzi yanu idzaperekedwa ndi a inshuwalansi, osati mwachindunji.
Mayiko anali ndi mwayi wosankha kusinthana kwawo kapena kudalira boma la federal kuti liwathandize. Maiko ena ali ndi kusakanikirana kwabwinja kumene kumakhala mgwirizano pakati pa boma ndi boma, kapena kusintha kwa boma komwe kumagwiritsa ntchito gawo lolembetsa la federal (HealthCare.gov). Mu 2018, pali makampani khumi ndi awiri omwe akutsutsana, omwe amagwiritsa ntchito HealthCare.gov kuti ayambe kulembetsa chiwerengero, mayiko asanu ndi limodzi, komanso mayiko okwana 28.
Ndipo kufotokoza mfundo ina yomwe nthawi zina imabweretsa chisokonezo, mawu akuti "kusinthanitsa" ndi "msika" amagwiritsidwa ntchito mosiyana. Koma mawu oti "msika" amagwiritsidwa ntchito mobwerezabwereza. Kotero, ngakhale inshuwalansi ya zaumoyo kapena msika imatchulidwa mwachindunji ku portal mu dera lirilonse limene anthu angagwiritse ntchito poyerekeza zosankha zosiyanasiyana ndi kulembetsa, mawu akuti "malonda a inshuwalansi ya umoyo" amatanthauza zambiri, ndondomeko zothandizidwa komanso ndondomeko zazikulu zomwe zidakalipo.
Cholinga cha kusinthanitsa kwa inshuwalansi ya umoyo ndikuti inshuwalansi ya umoyo ikhale yogula komanso yosavuta kugula.
Thandizo Loyamba ndi Zothandizira Kugawana Ndalama: Zokha Zimapezeka Mukusintha
ACA imaphatikizapo ndalama zothandizira ndalama zowonjezera ( zopereka za msonkho wapamwamba) komanso ndalama zopatsana ndalama zomwe zimapereka ndalama zochepa (kupereka malipiro okhudzidwa) kuti apereke ndalama zowonjezereka komanso kuchepetsa ndalama zomwe anthu ena amalembetsa. Zothandizira izi ndizopindulitsa ndalama ndipo zimapezeka kwa olembetsa omwe amapeza ndalama zochepa.
Mitundu yonse ya chithandizo ilipo pokhapokha mutagula zolemba zanu pogwiritsa ntchito ndalama. Ngakhale ngati ndondomeko yomweyi ikupezeka-kusinthana (mwachindunji kuchokera ku kampani ya inshuwalansi), mudzayenera kulipira mtengo wathunthu ngati mumagula malo alionse kusiyana ndi kusinthanitsa.
Ndipo ngakhale kuti federal ndalama zothandizira kuchepetsa ndalama zinathetsedwa mu kugwa kwa 2017, kupindula kwa ndalama zogawanika kukupitirira kupezeka kwa anthu olembetsa omwe akugula malingaliro a siliva mwa kusinthanitsa ndipo omwe malipiro awo ali m'zigawo zogwirizana ndi kugawa malipiro olipira mtengo (mwachitsanzo, osachepera 250 peresenti ya umphaŵi, ndipo osachepera 100 peresenti ya umphaŵi m'mayiko omwe sanawonjezere Medicaid, kapena 139 peresenti ya umphaŵi muzinthu zomwe zawonjezera Medicaid).
Ndani Angagwiritse Ntchito Kusinthanitsa?
Nzika zonse za ku United States komanso okhalamo mwalamulo omwe sali m'ndende komanso osayenera kulandira malipiro a premium Gawo A Medicare ali oyenerera kugula ndondomeko yaumoyo mu kusinthanitsa ndi dziko limene akukhala. Anthu osamukira kudziko lina sangathe kulembetsa mauthenga awo, ngakhale popanda kupereka ndalama zothandizira .
Mabizinesi ang'onoang'ono angathenso kugula chithandizo mu kusinthanitsa; m'mayiko ambiri, izi ndi zochepa kwa makampani omwe ali ndi antchito okwana 50 , ngakhale pali mayiko ena (California, Colorado, New York, ndi Vermont) kumene malonda omwe ali ndi antchito 100 angathe kugwiritsira ntchito kusinthanitsa. Onani kuti m'mayiko omwe amagwiritsa ntchito malonda ang'onoang'ono a HealthCare.gov, kusinthanitsa sikungathenso kulembetsa, ndipo m'malo mwake malonda amalembetsa mwachindunji ndi a inshuwalansi.
Chifukwa cha Grassley Amendment ku ACA, Congress ndi ogwira ntchito awo amafunika kupeza chithunzi pa kusinthanitsa. Kuti akwaniritse zofunikirazi ndikuonetsetsa kuti Congress ndi ogwira ntchito sizinatayire zopereka zawo zaboma, boma limapanga ntchito zomwe zimapangitsa Congress ndi ogwira ntchito kuti azilembera ndondomeko ya magulu ang'onoang'ono kupyolera mu kayendetsedwe ka boma mu District of Columbia (DC Health Link) . DC Health Link inafotokoza mu April 2017 kuti pafupi 11,000 mwa olemba anzawo ochepa anali mamembala a Congress ndi ogwira ntchito zawo.
Njira Yogulitsa Imodzi ndi Zambiri
Phindu lapadera la kusinthanitsa kwa inshuwalansi ya umoyo ndikupanga zosavuta kuti muyereze zosankha ndi kulembetsa ndondomeko yaumoyo. Zina mwa njira zomwe kusinthana kumalimbikitsa kusankha ndi mpikisano ndi:
- Zokonzekera zaumoyo mu zip code zanu zalembedwa pa webusaiti yoyendetsedwa ndi boma lanu kapena boma la federal. Pa tsamba ili, mukhoza kuphunzira za mapulani azachuma ndi ndalama, ndikulembetsa.
- Ngati muli ndi mwayi wopita ku intaneti, kusinthanitsa kungakupatseni chuma kuti mudziwe zambiri ndi zida zolembetsa kudzera mwa makalata komanso pamalo omwe anthu adasankha kumalo anu; pali anthu omwe akuthandizira kuti azipezeka pa dziko lonse panthawi yolembetsa chaka chilichonse kuti athe kulembetsa anthu omwe amasankha kuthandizana ndi maso ndi maso.
- Kuti mulole kuti kuphatikiza kwake kukhale kosavuta, kusinthanitsa kumagwiritsa ntchito mawonekedwe, mafotokozedwe, ndi zipangizo zamalonda. Mungathe kulembetsa pa intaneti, pamtundu, pamakalata kapena pafoni.
- Malo osungirako mafoni kuti atsimikizire ntchito yabwino ya makasitomala
Phindu la Umoyo
Ngati mutagula inshuwalansi mwa kusinthanitsa, mudzatha kusankha chithandizo chaumoyo chomwe chili chabwino kwa inu ndi banja lanu. Ndondomeko iliyonse yaumoyo yomwe ilipo ikuphatikizapo phindu lofunikira lomwe limapereka chithandizo chamankhwala chokwanira ndi magawo osiyanasiyana ogawana mtengo.
Komanso, ndalama zomwe mumagwiritsa ntchito pachaka zomwe mumagwiritsa ntchito (ndalama zowonongeka, mapepala, ndalama zothandizira ndalama) zimangopeza malipiro omwe boma la federal limachita chaka chilichonse. Mu 2018, chiwerengero chachikulu cha munthu mmodzi yekha ndi $ 7,350 kwa munthu mmodzi, ndi $ 14,700 kwa banja. Ndondomeko zikhoza kukhala ndi malire a kunja kwa pansi pano , koma osati pamwamba pawo.
Zolinga zonse zomwe zinagulitsidwa kusinthana zikugwirizana ndi chimodzi mwa magawo asanu otsatirawa :
- Ndondomeko ya Bronze: Amawononga pafupifupi 60 peresenti ya mtengo wamtengo wapatali wathanzi kwa anthu owerengeka.
- Ndondomeko ya Siliva: Amawononga pafupifupi 70 peresenti ya mtengo wamtengo wapatali wathanzi kwa anthu owerengeka.
- Ndondomeko ya Golidi: Amawononga pafupifupi 80 peresenti ya mtengo wamtengo wapatali wathanzi kwa anthu owerengeka.
- Ndondomeko ya Platinum: Amawononga pafupifupi 90 peresenti ya mtengo wa zofunika zofunika zaumoyo pa chiwerengero cha anthu onse.
- Ndondomeko Yowopsya: Amawononga pafupifupi 60 peresenti ya mtengo wa zofunika zofunika zaumoyo pa chiwerengero cha anthu onse, ndipo akuphatikizapo chisamaliro choyang'anira ofesi ndi chisamaliro chisanafike. Zina zonse zimagwiritsidwa ntchito ku deductible, ndipo zimangotsekedwa zitatha. Malingaliro odetsa nkhaŵa amapezeka kwa anthu omwe ali ndi zaka makumi atatu zokha kapena kwa iwo omwe ali oyenerera kuthandizidwa ndi zovuta za udindo wakugula
Onani kuti m'mayiko ambiri, pali -4 / + 2 de minimis mtundu womwe umaloledwa kupanga zasiliva, golide, ndi platinum, ndi -4 / + 5 de minimis mtundu womwe umaloledwa kupanga mapulani a bronze. Choncho ndondomeko ya golide ikhoza kufikitsa pakati pa 76 peresenti ndi 82 peresenti ya ndalama zowonjezera, ndipo ndondomeko ya mkuwa imatha pakati pa 56 ndi 65 peresenti ya ndalama.
> Zotsatira:
> Magulu a Medicare ndi Medicaid Services. Tsogolo la a SHOP: CMS imapereka kulola malonda ang'onoang'ono ku SHOPs pogwiritsa ntchito HealthCare.gov Zowonjezereka kwambiri polembetsa ku Healthcare Coverage. May 15, 2017.
> Magulu a Medicare ndi Medicaid Services. Pulogalamu ya Odziwitsa Anthu ndi Kuyang'anira Inshuwalansi. Zolemba Zenizeni Zomwe Mayiko Amasiyana. June 2, 2017.
> Dipatimenti ya zaumoyo ndi zithandizo zaumunthu, Chitetezo cha odwala komanso chithandizo chamankhwala chamtengo wapatali, Msika Wolimbitsa . April 13, 2017.
> Federal Register, Wodwala Chitetezo ndi Affordable Care Act; Chidziwitso cha HHS cha Kupindula ndi Kulipira Malipiro a 2018; Kusinthidwa kwa Nthawi Zowonjezera Zapadera ndi Ogulitsa Ogwira Ntchito ndi Okhazikitsa Mapulani Pulogalamu. December 22, 2016.