Banja loperewera linapangidwa kuti mabanja ambiri asapite kukaphwanya kulipira kwa inshuwalansi kwa aliyense m'banja. Muyenera kumvetsetsa momwe ntchito ya deductible yamagwirira ntchito ikuthandizira kuti musamalire ndalama zothandizira ana anu.
Choyamba, ngati simukudziwa zofunikira za deductible, werengani " Health Inshuwalansi Deductible-Kodi Ndiyo ndi Momwe Zimagwirira Ntchito " musanapite patsogolo.
Mudzasowa kumvetsetsa kwakukuluzikulu kotereku musanathe kumvetsetsa momwe banja limagwirira ntchito.
Momwe Banja Linasinthira Ntchito ya Inshuwalansi Yambiri ya Zaumoyo
Mabungwe ambiri a inshuwalansi a umoyo amakhudzidwa paokha ndi mabanja omwe akutsitsimula. Nthawi iliyonse munthu m'banjamo amalipira yekha ndalama zake, ndalamazo zimatchulidwanso kwa banja lochotsedwa. Choyamba chimayambira kwa munthu wina aliyense mwamsanga atangomaliza kukwaniritsa yekha. Chiwerengero chimayambira banja lonse, ngakhale achibale awo omwe sanakumanepo ndi ndalama zawo zokha, pokhapokha ngati banja likuchotsedwa.
Pali njira ziwiri zomwe inshuwalansi ya umoyo wa banja idzayamba kulipiritsa munthu wina m'banja.
- Ngati munthu akukumana ndi ndalama zake zokhazokha, ndondomeko zaumoyo zimayambira ndikuyamba kulipilira ndalama zothandizira anthu okhawo , koma osati kwa ena a m'banja.
- Ngati banja likugonjetsedwa, malingaliro azaumoyo amatha kutsogolo-kwa aliyense wa m'banja ngati ali ndi zofuna zawo zokha kapena ayi.
Mtundu woterewu wotchedwa deductible system umadziwika kuti ndi deductible yokha chifukwa munthu wogwira ntchitoyo amalowa mkati mwake ndipo amawerengera ku banja lalikulu lomwe limadulidwa.
Chitsanzo cha Mmene Banja Lomwe Sanagwiritsire Ntchito
Tiye tinene kuti banja la anthu asanu lili ndi ndalama zokwana madola 500 ndipo banja limaperekedwa $ 1,500:
- January:
Bambo amalipiritsa $ 500 mu ndalama zokwanira.
Adadi adakumana ndi ndalama zake zokha.
Banja lochotsedwa limakhala ndi $ 500 lovomerezedwa, $ 1,000 kuti liyambe lisanafike.
Ndondomeko yaumoyo tsopano ikulipira chisamaliro cha abambo .
Mapulani azaumoyo samapindulitsa amayi ndi ana panobe. - February:
Mwana amalipiritsa $ 500 mu ndalama zokwanira.
Mwana mmodzi wamupeza iye yekha wogwiritsidwa ntchito.
Banja likuchotsedwa tsopano lili ndi $ 1,000 yodalitsidwa, $ 500 kuti isadakumane.
Ndondomeko yaumoyo tsopano ikulipira chisamaliro cha abambo ndi mwana.
Ndondomeko ya thanzi siilipira amayi, ana awiri kapena ana atatu. - March:
Amayi amalipira madola 200 mu ndalama zokwanira.
Amayi sanayambe kukomana naye yekha deductible, $ 300 kuti apite.
Banja lopatulidwa tsopano lili ndi $ 1,200 yodalitsidwa, $ 300 kuti isadakumane.
Ndondomeko yaumoyo imabweza ngongole ya abambo ndi mwana.
Mapulani a zaumoyo samapindulitsa amayi, ana awiri kapena mwana atatu. - April:
Mwana awiri amalipira $ 300 mu deductible mtengo.
Mwana wamwamuna awiri sanakumanepo ndi munthu wake yekha wogwiritsidwa ntchito, $ 200 kuti apite.
Banja lopatulidwa la $ 1,500 lakwaniritsidwa tsopano.
Ndondomeko yaumoyo imayamba kulipira phindu kwa onse m'banja.
Popeza banjali linakumananso ndi banja lawo, ndondomeko yaumoyo inayamba kubweretsa phindu kwa onse a m'banja, ngakhale kuti atatu mwa iwo anali asanakumanepo ndi ndalama zawo zokha.
Kodi Banja Lingawonongeke Bwanji Kusunga Ndalama Pamodzi pa Zopindulitsa Payekha?
Ambiri inshuwalansi ya ndondomeko imakhala ndi deductible ya banja yomwe ili pakati pa ziwiri ndi zinayi zomwe munthu amadula. Pokhapokha ngati banja lili laling'ono, banja loperewera limakhala lochepera kusiyana ndi ndalama zonse zomwe zimaperekedwa.
Mwachitsanzo, tiyeni tinene kuti muli ndi mamembala asanu a banja, ndalama zokwana madola 1,000 komanso ndalama zokwana $ 2,000, kawirikawiri ndalama zomwe mumalandira. Ngati kulibe banja lopatsidwa ndalama ndipo aliyense m'banja adayenera kukomana ndi munthu yemwe amamuperekera chithandizocho chisanayambe kumupindulira, banja lanu la asanu lidzalipire ndalama zokwana madola 5,000 musanayambe kulandira chithandizo chamankhwala kwa aliyense m'banja.
Komabe, popeza kupindula kumawombera banja lonse pamene banja limaperekedwa pa $ 2,000, banja limasunga ndalama zokwana madola 3,000 mu ndalama zokwanira.
Zomwe Zilibe Pakati pa Deductible?
Zinthu zomwe sizikugwiritsidwa ntchito ndi inshuwalansi ya umoyo wanu sizikuwerengera za deductible yanu ngakhale mutalipira mthumba lanu. Mwachitsanzo, liposuction sichitikidwe ndi inshuwalansi. Ngati mumalipiritsa $ 1,500 kuti liposuction, ndalama zokwana madola 1,500 sizidzatchulidwira kwa munthu aliyense kapena banja lanu loperekedwa chifukwa sichikupindula ndi dongosolo lanu la thanzi.
Ntchito zothandizira anthu osamalidwa sizitanthauza deductible, copayment , kapena ndalama ku United States chifukwa cha Affordable Care Act . Izi zikutanthauza kuti inshuwalansi ya thanzi lanu ikhoza kulipira zinthu monga za thupi lanu, chimfine , ndi mammografia ngakhale mutakhala kuti simunakumanepo ndi ndalama zanu.
Makope a maofesi oyendera maofesi ndi maofesi nthawi zambiri samawerengera za deductible yanu, koma zenizeni zingasinthe mwa dongosolo. Phunzirani zambiri pano: Kodi Copays Count ku Inshuwalansi Yanu ya Umoyo Deductible?
Ndondomeko Zaumoyo Zapamwamba Zili Zokha, koma malamulo atsopano amagwiritsidwa ntchito
Ngati muli ndi ndondomeko yowonjezera yachipatala, banja lanu limagwiritsidwa ntchito mosiyana. Ambiri a HDHPs amagwiritsa ntchito gulu lonse la deductible mmalo mwake. Mukhoza kuphunzira zambiri za izi mu " Momwe Banja Lomwe Linawonongera Ntchito mu HDHP ."
Dziwani kuti mapulani anu sangakhale HDHP chifukwa chakuti ndalama zanu zikuwoneka ngati zazikulu. HDHP ndi dongosolo lapadera la thanzi labwino, osati nthawi yodziwika bwino. Chifukwa chakuti HDHPs nthawi zambiri zimagwirizanitsidwa ndi Mauthenga Okhudzana ndi Kukhudzidwa kwa Umoyo , ali ndi malamulo apadera omwe amawasiyanitsa ndi ndondomeko zaumoyo za HDHP.
Komabe, pofika mu 2016 , mapulani a zaumoyo omwe sali nawo abambo ayenera kugwiritsa ntchito maulamuliro a ACA-ovomerezeka omwe aliwonse omwe ali ndi ndondomeko ya thanzi la banja, ngakhale ali HDHP ndi banja lonse loperekedwa. Mu 2018, ndalama zambiri zomwe zimaloledwa ndi $ 7,350 kwa munthu mmodzi, ndi $ 14,700 kwa banja. Choncho banja la HDHP likhoza kukhala ndi ndalama zambiri za ndalama zokwana madola 7,000 mwachitsanzo, koma sizingakhale ndi ndalama zambiri za ndalama zokwana madola 10,000, chifukwa zingakhale zofunikira kuti munthu wina m'banja azilipilira $ 10,000 kuti asapindulepo pulogalamuyo, .
Kwa 2019, HHS yapempha kuti ndalama zokwana $ 7,900 zidzipire ndalama zokhazokha. Malamulo omwe amachepetsa munthu wa m'banja lake sagwiranso ntchito kuposa ndalamazo.
Kodi Malamulo Adzayamba Kusintha Padziko Lonse?
Oweruza a Republican akhala akuchita zambiri mu 2017 akuchita khama kuti abwezeretse m'malo mwa ACA. Khama lawo silinapambane, kupatulapo msonkho wa msonkho wa GOP womwe udzachotsa udindo wa ACA kuchokera mu 2019 .
Misonkho yomwe inakhazikitsidwa mu 2017 kawirikawiri siinaitanidwe kusintha kwa lamulo lomwe limafuna kuti pakhale ndondomeko zogwiritsidwa ntchito pazinthu za banja. Komanso kawirikawiri sakanasintha malire omwe amachokera ku ACA.
Komabe, m'pofunika kuzindikira kuti chikwama cha ACA chomwe chili kunja kwa ndalama chimagwiranso ntchito pazinthu zomwe zimaonedwa kuti ndizofunikira zathanzi . Zolinga zothandizira kusintha kwaumoyo za GOP zakhala zikuphatikizapo kugogomezera kupereka kupereka mphamvu yowonjezeretsa ubwino wathanzi. Ngati ndalama ngati izi ziyenera kukhazikitsidwa, zikhoza kuchititsa mapulani a inshuwalansi m'mayiko ena kuti asapangire zinthu zomwe zikufunika kuti zikhale pansi pa ACA (chithandizo chakumayi, kapena chisamaliro cha thanzi).
Ngati izi zichitika, ndondomeko zaumoyo zitha kukhala zochepa, ndipo mabanja angafunikire kukwaniritsa mtengo wa chithandizo chomwe panopa chikugwiritsidwa ntchito ndi ndondomeko za ACA-zovomerezeka. Zikatero, ndalama zogwiritsira ntchito ndalama zomwe zimakhala zosakonzedwe ndi ndondomekoyi sizikanatha kuwerengera ndalama zadothi kapena zopanda pake. M'malo mwake, zidzatengera ndalama zowonjezereka kwambiri kwa anthu omwe akusowa thandizo lomwe salikuphimbidwa chifukwa cha malamulo ochepa okhudzana ndi ubwino wathanzi.
> Zotsatira:
> Federal Register (Dipatimenti ya Zaumoyo ndi Zopereka Zaumunthu), > Wodwala > Chitetezo ndi Ntchito Yodalirika Yothandiza; 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.
> Federal Register (Dipatimenti ya Zaumoyo ndi Zopereka Zaumunthu). Chitetezo cha Odwala ndi Zopanda Thandizo Labwino; Chidziwitso cha HHS cha Kupindula ndi Kulipira Malipiro a 2019. November 2, 2017.
> HealthCare.gov, Ntchito Zothandizira Zaumoyo.
> Kaiser Family Foundation. Chidule cha American Health Care Act, May 2017.