Ngati mukuyesera kusankha ndondomeko yanu ya thanzi kapena kuyerekezera mapulani a inshuwalansi ku United States, muyenera kumvetsa dongosolo lachitsulo. The Affordable Care Act imayimiritsa momwe dongosolo la thanzi likuyendera. Kuyambira chaka cha 2014, mipangidwe yatsopano yathanzi komanso yachinyamata yatsopano imayenera kukhala imodzi mwazinthu zinayi: bronze, siliva, golide kapena platinamu (paliponse pazinthu zoopsa zomwe zimagulitsidwa pamsika ).
Chitsulo chitsulo chimakuuzani kufunika kwa dongosolo la thanzi. Ndi njira yophweka yoyerekeza phindu la dongosolo limodzi la thanzi labwino kuti muwone kuti ndondomeko yomwe imakupatsani ndiyambiri ya buck wanu. Zolinga zonse zaumoyo pazitsulo zofanana zitsulo zili ndi mtengo wofanana wa actuarial, ngakhale iwo akhoza kukhala osiyana ndi zochepa peresenti.
Kodi Chowonadi Chofunika Chikutanthauza Chiyani?
Kufunika kwa dongosololi kumakuuzani kuchuluka kwa ndalama za chithandizo cha zaumoyo zomwe ndondomeko ya inshuwalansi ya umoyo imayenera kulipiritsa oyenerera. Ndondomeko yokhala ndi ndalama zokwanira 60 peresenti ikuyembekezeredwa kulipira pafupifupi 60 peresenti ya ndalama zomwe anthu ogwira ntchitoyo amapeza. Olemba mapulaniwa amapereka ndalama zina 40 peresenti ya ndalama zawo zothandizira zaumoyo pogwiritsa ntchito ndalama zowonongeka , zothandizira ndalama , ndi zolipilira .
Phindu lenileni likuwerengedwa pa dongosolo la thanzi lonse (malinga ndi "chiŵerengero cha anthu") osati kwa munthu aliyense.
Choncho, pafupipafupi kudutsa onse olemba mapulogalamu a zaumoyo, mtengo wamtengo wapatali umalongosola kuchuluka kwa ndalama zothandizira zaumoyo zomwe zidzaperekedwa ndi dongosolo. Komabe, chiwerengero cha ndalama zomwe mukugwiritsira ntchito pazondomeko zomwe mukulipira zidzasiyana malinga ndi momwe mumagwiritsira ntchito inshuwalansi yanu ya umoyo.
Zitsanzo
Mwachitsanzo, tiyeni tinene kuti mapulani anu azaumoyo ali ndi chiwerengero cha 80 peresenti, zomwe zikutanthauza kuti ndi ndondomeko ya golide.
Ngati mutagwiritsa ntchito inshuwaransi yanu pachaka chaka chonse, mwinamwake mukayendera kachipatala mwamsanga kuti mukakumane ndi matenda a chimfine, mungapeze kuti ndondomeko yanu ya thanzi sililipira kalikonse pa ndalama zomwe mumagula pa chaka. Ngati simunakumanepo ndi chaka chomwe mudapatsidwa, mutha kumaliza kulipira ngongole yachangu mwamsanga. Ndalama zomwe mudalipira zidzatchulidwa kwa deductible yanu. Pachifukwa ichi, ndondomeko yanu yathanzi siinalipire ndalama zokwana 80 peresenti ya ndalama zanu zothandizira. Munalipira 100 peresenti ya ndalama zanu zothandizira.
Komabe, ponseponse mndandanda wamakonzedwe, ndondomeko yaumwini monga chitsanzo pamwambayi iyenera kukhala yoyenerera ndi zochitika zomwe ndondomeko yaumoyo imapereka ndalama zambiri za membala. Mwachitsanzo, munthu amene amapezeka ndi khansa ndipo amatha kukhala ndi madola 400,000 pamalipiro azachipatala chaka chonse amangopereka ndalama zokwana madola 7,350 pa chithandizo cha mu-network mu 2018 . Ndondomeko ya inshuwalansi ya zaumoyo idzabwezera ena onse, omwe angakhale oposa 98 peresenti ya ndalamazo.
Ndipo mamembala ena omwe samadwala nthawi zonse pachaka adzapindula chifukwa chakuti mapulani a ACA amapereka ndalama zokwana 100 peresenti ya ndalama zothandizira kuti azisamalidwa ngati chaka ndi chaka.
Anthu amenewo sanapereke kalikonse pa ndalama zawo zothandizira pa chaka chomwecho.
Ndalama zomwe zimagwiritsidwa ntchito kwa anthu onse olemba mapulaniwa zikufika kumapeto kwa chaka, ndondomeko yokhala ndi ndalama zokwanira 80 peresenti idzapindula pafupifupi 80 peresenti ya ndalama zothandizira odwala onse pamodzi.
Zowerengera zamtengo wapatali sizinaphatikizepo malipiro a inshuwalansi ya zaumoyo kapena zinthu zomwe ndondomeko ya thanzi silikuphimba. Mwachitsanzo, ngati inshuwalansi ya umoyo sichikuthandizani kuchitidwa opaleshoni, kuwonongeka kwa kulemera kwake sikungaphatikizidwe pamene mukubwera ndi mtengo wapulani.
Kodi Tiers Tikulumikizana Bwanji ndi Mtengo?
- Mapulani a zitsulo zamkuwa ndi ofunika pafupifupi 60 peresenti
- Ndondomeko zamagetsi zokhudzana ndi siliva zimakhala pafupifupi 70 peresenti
- Ndondomeko zamagetsi za golide zimakhala pafupifupi 80 peresenti
- Mapulani othandizira a Platinum-tier amakhala ofunika pafupifupi 90 peresenti
Pogwiritsira ntchito zitsulo, anthu omwe sadziwa bwino momwe ntchito yamagwiritsidwe ntchito ikudziwikiratu kuti intuitively ndi ndondomeko ya golide imapindulitsa kwambiri kusiyana ndi ndondomeko yamkuwa (koma monga momwe tafotokozera m'munsiyi, anthu omwe ali ndi ndalama zochepa omwe amasankha Ndondomeko ya siliva ikhoza kuthetsa kupeza golide kapena platinum mlingo wopindulitsa, chifukwa cha ndalama za ACA zomwe zimachepetsa ndalama zowonongeka ).
Kodi Ndiyenera Kusankha Bronze, Siliva, Gold kapena Platinum?
Gwiritsani ntchito chitsulo chosungiramo zitsulo poyerekezera ndi kuchuluka kwa momwe mukufunira kulipira malipiro ndi kuchuluka kwa momwe mukufunira. Mapulani apamwamba ali ndi mapepala apamwamba, koma amalipira kuchuluka kwa ndalama zanu zothandizira zaumoyo kuposa ndondomeko zotsika mtengo, zapansi.
Zigawo zili m'munsizi zikuphatikizapo magawo omwe ayenera kulingalira komanso omwe ayenera kupewa pepala lachitsulo. Ngati mukusankha ndondomeko yaumoyo, mukangomaliza kupanga ndondomeko yachitsulo, onetsetsani kuti simuli pa mndandanda wa anthu omwe ayenera kupewa njirayo.
- Ndondomeko Yamkuwa-Ndi Chiyani?
- Ndondomeko ya Siliva-Ndi Chiyani?
- Mapulani a Golide-Ndi Chiyani?
- Mapulani a Platinum-Ndi Chiyani? (onani kuti malo ambiri alibe mapulani a platinamu)
Kuyenerera kwanu kwa thandizo la boma kungakhudze kusankha kwanu kwazitsulo. Ngati muli oyenera kulandira ndalama zothandizira ndalama (aka, kuchepetsa kugawanitsa ndalama, kapena CSR) kukuthandizani kulipira ndalama zanu zotsalira, mapepala, ndi ndalama zothandizira ndalama, simungapeze chithandizo ngati simugula Ndondomeko ya thanzi la ndalama zogwiritsira ntchito inshuwalansi ya umoyo wanu . Kuti mudziwe zambiri za chithandizo, werengani, " Kodi Ndingapeze Thandizo Kulipira Thandizo la Inshuwalansi? "
Ngati muli oyenera kulandira ndalama zothandizira ndalama komanso mutagula ndondomeko ya siliva, mukhoza kumaliza kufotokozera zomwe zili zofanana ndi ndondomeko ya golide kapena platinamu, pa mtengo wa ndondomeko ya siliva. Ndikofunika kumvetsera mwatsatanetsatane za dongosolo lililonse limene liripo, mmalo mongoganizira kuti imodzi yazitsulo idzakhala yabwino kuposa ena.
Ndipo muzinthu zina zowonongeka, zopangira za golide m'madera ena, kwa ena olembetsa, kwenikweni ndi ochepa kusiyana ndi malipiro a ndalama zasiliva, za 2018. Izi ndi chifukwa Boma la Trump linasiya kubwezeretsa makampani a inshuwalansi pa mtengo wa CSR mochedwa 2017, ndi mabungwe a inshuwalansi m'mayiko ambiri adawonjezera mtengo wa CSR ku malipiro a ndalama. Izi zinapangitsa kuti ndalama zowonjezera zazikulu zithandizidwe kumadera ena, komanso mitengo yachitsulo yomwe sichikutsatira ndondomeko yomwe amayembekezera (ie, kuphimba bwino kukhala okwera mtengo). Mukhoza kuwerenga zambiri za momwe izi zikugwirira ntchito pano , koma mfundo yomwe mungatenge ndi yakuti ngati mutalandira ndalama zowonjezera, mungapeze kuti ndondomeko ya golide ndi yokwera mtengo kuposa ndalama, ndipo mukhoza kupeza kuti ndondomeko yamkuwa ndi yotsika mtengo kwambiri.
Ngati Zonse Zopangidwa Zomwe Zapatsidwa Ndizofunika Kwambiri, Bwanji Osangokhalira Kunyamula Wopanda Pakati?
Ngakhale kuti mapulani onse opangidwa ndi gawo limodzi ali ndi mtengo womwewo, iwo amasiyana mosiyana. Tengani kusiyana kumeneku mukusankha mapulani; sankhani ndondomeko yomwe imagwira bwino ntchito yanu.
Mwachitsanzo, ndondomeko imodzi ya golide ikhoza kukhala ndi deductible ya $ 1,500 ndi ndalama zothandizira ndalama zokwana 15 peresenti. Ndondomeko ina ya golidi ikhoza kukhala ndi ndalama zochepa zomwe zimagwiritsidwa ntchito ndi ndalama zowonjezereka komanso zolembera za mankhwala. Ngati simungakwanitse kulipira deductible yaikulu isanafike inshuwalansi yanu itatha, mungasankhe ndondomekoyi ndi ndalama zotsika pansi ngakhale mutakhala ndi ndalama zapamwamba. Mukudziwa kuti mapulani onse a golide ali ofunika kwambiri, choncho kusankha kwanu kumapangidwa malinga ndi momwe mungakonde kugwiritsira ntchito inshuwalansi mmalo momwe mukufunira.
Mfundo zina zowonetsera zikuphatikizapo intaneti . Kodi dokotala wanu mu-intaneti ali ndi zolinga zamankhwala zomwe mukuziyerekezera? Kodi magulu onse a mapulani a operekera aakulu akukupatsani mwayi wosankha operekera ngati mutasankha kuti simukukonda dokotala kapena chipatala ndikufuna kusintha wina?
Mndandanda wa mankhwala ovomerezeka ndi mankhwala (mankhwala okhudzidwa ndi mankhwala) adzasinthasintha kuchokera kwa inshuwalansi kupita kwina. Kotero inu mukhoza kuyang'ana pa ndondomeko zitatu zasiliva zosiyana, koma imodzi yokha imakhudza mankhwala ena omwe mukuwatenga.
Kodi ndondomeko imodzi imakupatsani ufulu wochuluka kuposa wina? HMO kawirikawiri sangathe kulipira kuti mutuluke. Komabe, PPOs idzaperekera chisamaliro cha kunja kwa-network, koma pa mlingo wotsika kusiyana ngati mutakhala mu-network. PPOs sichipezeka m'madera onse, koma zikapezeka, zimakhala zofunikira kwambiri. Kodi ndinu wokonzeka kupereka malipiro apamwamba pa ndondomeko yomwe imakulolani kuti mukhale osamala ngati mukufuna? Kapena kodi mungakane ufulu umenewu wosankha, koma mumapereka malipiro apamwamba?
Kodi khalidwe lamtengo wapatali la dongosolo limodzi ndilopambana ndondomeko yotsutsana? Kodi malipiro a mapulani amodzi omwe ndi otsika kwambiri kusiyana ndi mapulani opikisana nawo omwe ali ndi khalidwe lofanana?
Ngati mukufuna kugwiritsa ntchito inshuwaransi yanu yambiri, yerekezerani kuti miyandamiyanda ya ndondomekoyi ndi yotani. Ngati ndondomeko imodzi ili ndipamwamba kwambiri kusiyana ndi mapulani enawo, mukhoza kusunga ndalama posankha ndondomekoyi ndizomwe zili pansipa. Mudzapeza zambiri za momwe njirayi ikugwiritsira ntchito " Momwe Mungapulumutsire pa Inshuwalansi ya Umoyo Ngati Mufikira Pakati Pazokha ."
> Zotsatira:
> Federal Register, Centers for Medicaid ndi Medicaid Services, Dipatimenti ya Zaumoyo ndi Zaumunthu. Chitetezo cha Odwala ndi Zopanda Thandizo Labwino; 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.