Dziwani bwino zomwe mungasankhe
Ngati mumagula inshuwalansi ya umoyo wanu, mwina munamva za ndondomeko zovomerezeka, malingana ndi komwe mukukhala. Zambiri mwazitsulo za inshuwalansi za boma zikupereka kale ndondomeko zovomerezeka. Koma pamene kulembera kwa oyamba kumayamba pa November 1, mapulani ovomerezeka adzakhalapo nthawi yoyamba muzogwiritsira ntchito mgwirizano wa federally, ndi chiyambi cha "Chosankha Chokha".
Kodi Kuyimika Kumagwira Ntchito Bwanji?
Kukonza ndondomeko yokha ndikumangomveka. Malangizowo amafotokozedwa motsatira ndondomeko yeniyeni yowunikira, ndipo ndondomeko zonse zovomerezeka ziyenera kupereka kufotokoza komweko kwa magawo a ndondomekoyi.
Healthcare.gov ikukonzekera ndondomeko zofanana za 2017, ngakhale kuti kutenga nawo mbali kudzakhala koyenera, pachiyambi pomwe. Pamene Dipatimenti ya Zaumoyo ndi Zopereka zaumunthu inafalitsa Zopindulitsa ndi Zopereka Zomwe Zilipira Pakati pa 2017, iwo anafotokoza mwatsatanetsatane ndondomeko zisanu ndi chimodzi zomwe anthu ogwira ntchito angakwanitse kupereka (zomwe zili patsamba 309 la Phindu ndi Malipiro Parameters ). Zomwe zingatheke, HHS inagwiritsira ntchito kupanga ndondomeko yoyenerera yofananayo ndi mapulani omwe adaperekedwa kale mu 2015.
Kwa ogwira ntchito ogwiritsa ntchito federally-facilitated exchange exchange (ie, Healthcare.gov), padzakhala dongosolo lokhazikitsidwa mwachitsulo pazitsulo zonse zamkuwa, zasiliva, ndi golidi , kuphatikizapo mapulani atatu oyenerera omwe apangidwe pa ndalama za anthu omwe ziyeneretsani kuti mupatsane ndalama zothandizira ndalama .
Kusinthanitsa kwapadera sikudzakhalanso ndi dongosolo lokonzekera la HSA lokonzekera mu 2017, ngakhale kuti mapulani oyenerera a HSA adzakhala adakalipo kuti agulitsidwe pakati pa mapulani omwe sali ovomerezeka omwe adzakhalapo.
Pazokhazikitsidwa zosavuta Zosankha Zambiri, mbali zambiri za kufotokozera zidzakhala chimodzimodzi mosasamala kanthu komwe inshuwalansi ya chithandizo cha umoyo imapereka dongosolo.
Mwachitsanzo, zonse zogwirizana ndi ndalama zowonongeka zimakhala ndi madola 3,500, ndalama zokwana $ 30 zoyang'anira ofesi yoyendera maofesi, ndi $ 15 / $ 50 / $ 100 copays ya mankhwala ochiritsira / omwe amadziwika ndi dzina / mankhwala omwe sali odziwika ndi dzina la mankhwala. adzakhala 40 peresenti ya ndondomeko zenizeni za siliva).
Pamene ogula atsegula Healthcare.gov kugwa uku ( kutsegulidwa kutsegula kumayambira Nov. 1 ), iwo adzawona Zosankha Zowonongeka zikuwonetsedwa momveka pakati pa zosankha zomwe zilipo; kusinthanitsa kwadzipereka kuti zikhale zosavuta kuti anthu adziwe zolinga zomwe ziri zofanana ndi zomwe siziri.
Kodi Ndondomeko Zomwe Zikuyimira Zimasiyana Bwanji?
Ngakhale mapulani ovomerezeka amapanga maapulo ndi maapulo kufanana mosavuta, mumayenera kumvetsera mwatsatanetsatane. Ndondomeko zikhoza kukhala zosiyana pakati pazinthu zomwe sizikufotokozedwa mwachindunji ndi ndondomeko zoyenera kutsata ndondomeko. Mapulogalamu ogwiritsira ntchito komanso mapulasitiki (zowonjezera mankhwala okhudzana ndi mankhwala) zidzakhalanso zosiyana kwambiri kuchokera pa dongosolo lina kupita ku lina.
Choncho, ngakhale kuti mungathe kuyerekeza ndondomeko zitatu zasiliva zomwe onse ali ndi ndalama zofanana ndi mankhwala osokoneza bongo, muyenera kuyang'ana makampani omwe ali ndi mankhwalawa kuti muwone ngati akuphimba mankhwala omwe mukufunikira, ndipo ngati Choncho, ndi mankhwala ati omwe amagwiritsa ntchito mankhwala.
Pogwiritsa ntchito njira zosavuta kusankha kuti Healthcare.gov ikuyambira 2017, pulojekiti imodzi yokhayo imaloledwa mwa dongosolo, kotero sipadzakhalanso ndondomeko zogwirira ntchito pakati pazomwe mungasankhe. Koma mautumikiwo amasiyana ndi dongosolo limodzi.
Kodi Health Plans Ali Okhazikika?
The Affordable Care Act wakhala akubweretsa chiwerengero chokhazikika cha malonda ku inshuwalansi ya msika, ndi kukhazikitsa zitsulo zazitsulo zazinthu zaumoyo . Mapulani onse a inshuwalansi zaumoyo ndi masiku abwino a January 2014 kapena pambuyo pake-kuphatikizapo ndondomeko zogulitsidwa kunja kwa kusinthanitsa- zogwirizana ndi dongosolo lachitsulo kapena kukhala ndondomeko yowopsya .
Chifukwa chakuti ndondomeko zatsopano zokhudzana ndi thanzi ndizitsulo, siliva, golide, platinamu, kapena zoopsa, zimakhala zosavuta kuti ogula aziyerekezera maapulo ndi maapulo kuposa chaka cha 2014. Koma zigawo zachitsulo zimatsimikiziridwa pogwiritsa ntchito actuarial value (AV) za dongosolo . Ndipo izi sizomwe zimakhala zovuta kwa anthu ogula. Mapulani a zitsulo ali ndi magawo 60 peresenti (ndizosiyana kwambiri, kuyambira 58 peresenti mpaka 62 peresenti; +/- 2 peresenti yazomwe amagwiritsidwa ntchito pa magawo onse), mapulani a siliva ali ndi 70 peresenti, mapulani a golide ali ndi AV 80 peresenti, ndi mapulani a platinum ali ndi 90 peresenti ya AV.
Choncho, ndondomeko ya siliva iyenera kulipira pafupifupi 70 peresenti ya ndalama zonse zothandizira kuti anthu azikhala ndi moyo wamba. Koma izi ndizowerengeka, kuphatikizapo anthu omwe alibe ndalama zambiri zogwiritsira ntchito mankhwala, pamodzi ndi anthu omwe angafunike chisamaliro cha madola miliyoni pachaka.
Munthu yemwe ali ndi ndalama zochepa zothandizira zaumoyo angapereke ndalama zochuluka kapena zosamalila zake pachaka, malinga ndi dongosolo lake (ie, ngati ali ndi ndalama zokwana madola 3,000 ndipo amangogwiritsira ntchito ndalama zokwana madola 1,000 zokhazokha zomwe amagwiritsa ntchito, d kulipira ndalama zonse). Komabe, munthu yemwe ndalama zake zothandizira kupeza ndalama zimakwana madola milioni pachaka zimangopereka gawo laling'ono la ndalama zake, chifukwa dongosolo lake la thanzi lidzalipiritsa 100 peresenti ya ndalama zake atatha kugula mphotho yaikulu malingaliro ake.
Ngakhale kuti mapulani omwe ali mumtambo womwewo ali ndi AV yemweyo, kufotokozera kumeneku kungakhale kosiyana kwambiri kuchokera pa dongosolo lina kupita ku lina. Mwachitsanzo, zimakhala zachilendo kuona ndondomeko za siliva ndi zopereka zomwe zimachokera pa $ 1,500 kufika $ 4,500. Ena ali ndi copays ofesi kukayendera , pamene ena samatero. Ena ali ndi mawonekedwe apamwamba kwambiri omwe amaloledwa , pamene ena ali ndi makapu apansi. Mwachidule, pali njira zambiri zomwe dongosolo lingakwaniritsire AV mkati mwa mndandanda wa mapulani a zitsulo.
Kotero ngakhale ogula omwe amachepetsa kufufuza kwawo kumalo amodzi a zitsulo amatha kuyerekezera mapulani omwe onse amapereka ofanana kwambiri, akhoza kupeza kuti ndondomeko ya kulinganiratu mapulani ingawonongeke, makamaka mukuti ali ndi ambiri ogulitsa inshuwalansi zaumoyo akugulitsa nawo.
Kuyamba kwa ndondomeko yoyimira mapulani ndikuyesa kupanga ndondomeko yowonetsera mapulani mosavuta, komanso kuthandizira kuchepetsa kufalikira kwa mapulani.
Mayiko Amene Ali Ndi Mapulani Okhazikika
Mayiko angapo ali kale ndi ndondomeko zoyenerera pazochita zawo. Ndondomekoyi imasiyanasiyana kuchokera ku boma kupita kudziko, koma cholinga chachikulu ndicho kusunga ndalama zothandizira ndalama, ndalama zothandizira ndalama, ndalama zothandizira ndalama, komanso ndalama zomwe zili kunja kwa ndalama zomwe zimagwirizanitsa ponseponse pa ndondomeko yoyenera. Mwachitsanzo, zonse zowonongeka zasiliva ku Oregon zosinthanitsa zidzakhala ndi $ 2,500 zokwanira payekha mu 2017 ndi $ 35 ofesi yoyang'anira maofesi oyendera maofesi.
Ndondomeko yowonjezerayi imapanga chithandizo chamtundu wina wamtundu wina wamtunduwu, osati kuigwiritsa ntchito ku deductible. Ambiri omwe ali ndi mapangidwe apangidwe apangidwe amavomerezanso amathawa kupereka mapulani omwe sali oyeneranso:
- Ku California , kusinthanitsa kumapangitsa anthu ogwira ntchito kuti apereke ndondomeko zovomerezeka.Zopindulitsa ku California-kuthamangitsidwa kwa boma-sikulola malingaliro omwe sali oyenerera kugulitsidwa, ndipo amathandizira kwambiri kukhazikitsa ndondomeko zovomerezeka m'mayiko omwe amagwiritsa ntchito Healthcare .gov mmalo moyendetsa zokha zawo.
- New York imafuna a inshuwalansi a zaumoyo kuti apereke dongosolo limodzi lokhazikika pa mlingo uliwonse wazitsulo, ngakhale kuti a inshuwalansi amaloledwa kupereka zopanga zitatu zomwe sizinayenere. 61 peresenti ya anthu amene analembetsa ku New York State Health mu 2015 anasankha ndondomeko yoyenerera.
- Massachusetts inayambitsa inshuwalansi ya umoyo waumphawi mu 2010, ndipo ikupitiriza kupezeka mwachitsulo cha boma, Massachusetts Health Connector. Koma ogulitsa ogulitsa malingaliro a kuchangolana kwa Massachusetts ndiwonso ali ndi mwayi wopereka ndondomeko zosadziwika.
- Mu District of Columbia , kusinthanitsa-DC Health Link - inalongosola zolinga zowonongeka mu 2016 , koma ogwira ntchito zonyamula katundu ali ndi kusintha kochepa kuti apereke mapulani omwe sali ovomerezeka. Kusinthanitsa kumafuna kuti wothandizira apereke dongosolo lokhazikitsidwa pa mlingo uliwonse wa zitsulo zomwe wonyamulira akupereka mapulani.
- Mapulogalamu a Kupeza Zowunikira ku Connecticut -amafuna kuti ogwira ntchito azipereka ndondomeko imodzi ya golidi yokhazikika, osachepera imodzi yokha ya siliva (yomwe iyenera kukhala ndondomeko ya siliva ya mtengo wotsika kwambiri) wothandizirayo, komanso mapulani awiri a bronze oyenerera, imodzi zomwe ziyenera kukhala HSA-zogwirizana . Zinyamulo siziloledwa kuti zigwiritse ntchito zofunikira za mlonda wam'chipatala pa mapulani awo; olembetsa ayenera kuloledwa kukachezera akatswiri popanda kutumizidwa kuchokera kuchipatala choyamba. Pokhapokha ngati ogwira ntchito akutsatira ndondomekoyi, amatha kupereka zopanga ziwiri zopangidwa ndi platinum, komanso mapulani atatu omwe sali ovomerezeka m'zinthu zonse zamkuwa, zasiliva ndi golidi.
- Oregon poyamba anali ndi kusinthasintha kwathunthu, koma tsopano amagwiritsa ntchito Healthcare.gov ngati nsanja yake yolembera. Boma linapanga ndondomeko yoyenerera pamagulu a mkuwa, siliva, ndi golide, koma mabungwe a inshuwalansi omwe amapereka chithandizo pazotsinthasintha angaperekenso mapulani awiri omwe sali ovomerezeka ndi ndondomeko ziwiri "zatsopano" mu gawo lililonse.
- Vermont Health Transchang, Vermont Health Connect, ili ndi ndondomeko yeniyeni yamkuwa, siliva, golide, ndi platinamu , kuphatikizapo ndondomeko yowonjezerapo yazitsulo zamkuwa ndi zasiliva zomwe zimagwirizana ndi HSA. Otsatira awiri omwe akutsinthanitsa ndi boma amaperekanso zosankha zosagwirizana.
HHS ikupanga mapulani ovomerezeka kwambiri-omwe amanyamula ndi ogula-mu 2017. Malinga ndi momwe Mapulani a Simple Choice amalandirira bwino, akhoza kukhala ovomerezeka mu kusinthana kwa federally m'tsogolomu.
Ndipo ngakhale otsutsa ena akutsutsa kuti malingaliro oyenererawo amalepheretsa zatsopano mu malonda a inshuwalansi, ndibwino kuti tizindikire kuti pafupi mitundu yonse ya mayiko omwe ali kale ndi ndondomeko yovomerezeka yovomerezeka imathandizanso ogulitsa kuti agulitse mapulani omwe sali oyenerera.
> Zotsatira:
> Access Health CT, Kuchonderera ku Thandizo la Thanzi Labwino Kuchita nawo Pulogalamu Yamagulu Athu / Akuluakulu Amagulu Amankhwala Amakono (SHOP) Misika, Mpaka Chaka 2016 .
> Covered California, Health Inshuwalansi Companies ndi Mapulani a 2016 .
> Dipatimenti ya zaumoyo ndi zithandizo zaumunthu, Patient Protection and Affordable Care Act, Chidziwitso cha Kupindula ndi Kulipira Zowonjezera kwa 2017 https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-04439.pdf .
> State of Health ya New York, Kuitana ndi Zofunikira kwa Insurer Certification ndi Recertification for Participation mu 2016 .
> Oregon Division of Financial Regulation, Oregon Standardized Health Plans, Chidule cha Zolemba.