Ngilahlekelwe ngumshwalense wami wezempilo — manje kwenzenjani?

Inkampani

Ukuyekiswa noma ukuxoshwa emsebenzini akusho nje ukukhokha okulahlekile — kwabaningi baseMelika, kusho nokuthi ulahlekelwe ngumshuwalense wezempilo. Kusukela ngo-2018, cishe uhhafu wabantu base-U.S. Bathola umshuwalense wezempilo oxhaswe umqashi, ngokusho kocwaningo olwenziwe yi IKaiser Family Foundation . Kuyinkinga eyaba yinto ebaluleke kakhulu ngesikhathi sobhadane lwenoveli i-coronavirus (COVID-19) lapho izinombolo ezirekhodiwe zabantu base-U.S. Belahlekelwa yimisebenzi kanye nokutholakala kwabo ngasikhathi sinye ingozi yokugula yanda kakhulu.

Futhi ngaphandle kokutholakala komshuwalense wezempilo, ungahle uzibuze ukuthi uzokhokha kanjani izindleko ezibalulekile zokwelashwa njengokuvakasha kodokotela, imishanguzo kadokotela, nokunakekelwa kwezimo eziphuthumayo. Kepha kunezinketho-izinhlelo ezixhaswe umqashi akuyona ukuphela kwendlela yokutholakala kwezempilo.

OKUSHIWO: Ungawuthola kanjani umshuwalense wezempilo

Ulahlekelwe umshuwalense wezempilo? Qhathanisa izinketho zakho
Izinketho	Buhle	Nebubi	Izinsizakusebenza
I-COBRA noma izinhlelo zeMarketing federal	Inikeza ukumbozwa okuqhubekayo ngemuva kokulahleka komsebenzi	Lezi zinhlelo zivame ukubiza kakhulu kunezinhlelo zomshwalense wezempilo womqashi	Funda kabanzi nge-COBRA
I-Medicaid noma i-CHIP	Izinketho zomshuwalense wezempilo ezingabizi kakhulu	Kufanele uhlangabezane nezidingo zokufaneleka zokuthola imali	Funda kabanzi mayelana neMedicaid
Umshuwalense wesikhashana esifushane noma wegebe	Ungabhalisa noma kunini	Hhayi njengophelele njengomshuwalense wezempilo wesikhathi eside	Funda kabanzi mayelana nomshuwalense wezempilo wesikhashana
Okufanayo	Amakhuphoni akhululekile ayi-100%, ayasebenza kabusha kukho konke ukugcwaliswa, futhi akudingeki ukuthi kube nomshuwalense	I-SingleCare ikhona hhayi uhlobo lomshuwalense wezempilo	Funda kabanzi nge-SingleCare

Ngaphelelwa umsebenzi. Yini engiyenzayo ngomshuwalense wezempilo?

Uma usanda kulahlekelwa noma ushiye umsebenzi wakho, ungahle ufaneleke ukunweba ukumbozwa kwakho kwamanje ngaphansi I-COBRA (Umthetho Wokubuyisana Wesabelomali se-Omnibus). Lo mthetho ubeka ukuthi - uma kuhlangatshezwa imibandela ethile — umqashi kufanele anwebe uhlelo lwempilo lweqembu lakho kuze kube izinyanga eziyi-18 ngemuva kokushintsha kwakho emsebenzini. Kwezinye izimo ezilinganiselwe, ukumbozwa kungahlala kuze kube yiminyaka emithathu.

Kunezinqubo ezintathu eziyinhloko okufanele kuhlangatshezwane nazo ukuze umuntu afanelekele ukuthola umshuwalense wezempilo we-COBRA, ngokusho koMnyango Wezabasebenzi wase-US, Employee Benefits Security Administration:

• Uhlelo lwakho lwempilo lweqembu kufanele luhlanganiswe yi-COBRA
• Umcimbi ofanelekile kufanele wenzeke (ukunqanyulwa nganoma yisiphi isizathu ngaphandle kokungaziphathi kahle, ukushiya isikhundla, noma ukunciphisa amahora)
• Kufanele ube ngumhlomuli ofanelekayo walowo mcimbi

Abashadikazi kanye nezingane ezincikene nabo bangafanelekela i-COBRA, noma uhlu lwama-criteria luyehluka. (Ungabona uhlu olugcwele lapha .)

Uma ufanelekela ukumbozwa okunwetshiwe ngaphansi kwe-COBRA, uzonikezwa isikhathi esithile (ngokuvamile izinsuku ezingama-60) lapho ungakhetha khona ukumbozwa, ukubuyisela emuva kuze kube usuku lwakho ukumbozwa ngalo ngabe ngabe luphelile. Uma uhluleka ukukhetha ukumbozwa kwe-COBRA ngalesi sikhathi, ngeke ukwazi ukukwenza kamuva.

Ukutholakala ngaphansi kwe-COBRA kuvame ukubiza kakhulu kunomshuwalense ngomsebenzi wakho ngoba umqashi wakho kungenzeka ukuthi usiza ukukhokhela amaprimiyamu akho wanyanga zonke. Akudingeki ukuthi benze kanjalo ngaphansi kwe-COBRA. Ubude besilinganiso buyehluka-izinyanga eziyi-18 ubuncane, noma bungangeza ubude obufinyelela ezinyangeni ezingama-36, kuya ngemicimbi efanelekayo.

Imininingwane yokuthi ungasifaka kanjani isicelo se-COBRA kufanele ifakwe kwimininingwane yohlelo oyitholile ngenkathi ukumbozwa kwakho kuqala. Uzophinda uthole izincwadi ezivela kuhlelo lwakho lomshuwalense noma kumqashi mayelana nezinyathelo ezilandelayo ze-COBRA uma isimo sakho sokuqashwa sishintshile.

Uma uthatha isinqumo sokungakhethi ukumbozwa kwe-COBRA noma kungatholakali kuwe ngoba awuhlangabezani nayo yonke imigomo, ungahle uthande ukubheka Indawo Yemakethe Yomshwalense Wezempilo (noma umane, iMakethe), lapho ungaqhathanisa amanani ezempilo yangasese izinhlelo zomshuwalense. Futhi, uzofuna ukwazi imikhawulo ethile yesikhathi lapho uphenya izinketho zakho. A Isikhathi Esikhethekile Sokubhalisa ivamise ukunwetshwa kumuntu osanda kushiya noma ophelelwe umsebenzi, kepha kufanele ukhethe uhlelo ezinsukwini ezingama-60 ngaphambi noma ezinsukwini ezingama-60 ngemuva kokulahlekelwa ukumbozwa kwakho ngomsebenzi. Uma kungenjalo, kuzodingeka ulinde isikhathi sokubhalisa esivulekile ukuze uthole ukumbozwa. Futhi qaphela ukuthi izikhathi zokubhalisa ezivulekile zingahluka, kuya ngokuthi izwe lakho linokushintshisana kwalo noma lithembele kwi-Federal exchange. Ungathola eminye imininingwane ku- ezempilo.gov .

OKUSHIWO: Ungawuthola kanjani umshuwalense wezempilo ngemuva kokuphela kokubhalisa okuvulekile

Ngidinga umshuwalense wezempilo, kodwa anginayo imali engenayo

Uma ungakwazi ukukhokhela umshuwalense wezempilo, hlola ukuthi ingabe ukulungele yini ukutholakala ngaphansi kohlelo lwelungu lomndeni. Okwalabo ngaphansi kweminyaka engama-26 , ungakwazi ukujoyina uhlelo lwabazali — kuya ngohlelo lwabo — noma ngabe ungahlali nabo noma awuthembele kubo ngokwezimali. Ngakolunye uhlangothi, uma ushadile noma ubambiswano lwesikhathi eside, ungakwazi ukujoyina uhlelo lomlingani wakho noma lomlingani oxhaswe umqashi wakho. Umshado ubalwa njenge- umcimbi wempilo ofanelekile , okusho ukuthi ungangezwa ohlelweni lomuntu oshade naye zingakapheli izinsuku ezingama-30 (noma ngaphezulu) usushadile. Uma ungahlangabezani nalo umnqamulajuqu, kuzodingeka ulinde kuze kufike isikhathi sokubhalisa esivulekile esilandelayo ukuze ujoyine.

Uma uhlelo lwelungu lomndeni lungeyona inketho, ungakufanelekela ukutholakala ngaphansi kweMedicaid noma i-Children's Health Insurance Program (CHIP), izinhlelo ezimbili zomshuwalense wezempilo nezikahulumeni ezisiza abantu baseMelika abahola kancane ngezindleko zezokwelapha (kungaba ngokunikeza umshuwalense ngqo noma ngohlelo lwangasese). Kusukela ngoFebhuwari 2020, AmaMelika aseMelika angama-63.8 zahlanganiswa ngaphansi kweMedicaid. Izindleko nokutholakala kwehlukahluka kuye ngesifundazwe (ezinye izifundazwe, ngokwesibonelo, zinikeza ukumbozwa kwanoma imuphi umuntu omdala umholo wakhe owela ngaphansi kombundu othile inyanga ngayinye), ngakho-ke kuzodingeka ucwaninge izidingo zombuso wakho. Bangu izindlela ezimbili zokufaka isicelo seMedicaid uma ungafaneleki ngokuzenzakalela:

• Ngokusebenzisa Indawo Yemakethe Yomshwalense Wezempilo: Uma ngemuva kokugcwalisa isicelo, kubonakala sengathi wena noma omunye umuntu wasendlini yakho angafanelekela ukuthola iMedicaid, iMakethe izothumela imininingwane yakho kwi-ejensi yombuso ephethe iMedicaid. Phakathi nale nqubo, ungahle futhi ufanelekele ukonga (okufana noxhaso lwe-Affordable Care Act) kuhlelo lwangasese olususelwa kumholo wakho, okungenza uhlelo lwangasese lufinyeleleke ngokwezezimali.
• Ngqo ngokusebenzisa i-ejensi yakho yezokwelapha: Thola ukuthi ungaxhumana kanjani neyakho lapha .

OKUSHIWO: Izinguquko zeMedicaid zango-2020

Ungawuthola kanjani umshuwalense wezempilo emuva

Uma udinga ngokushesha ukumbozwa kepha isikhathi sokubhalisa esivulekile sisekude nezinyanga, ungahle uthande ukubheka i- uhlelo lomshuwalense wezempilo wesikhashana njenge-stopgap. Imihlahlandlela yoqobo eyadluliselwa ngo-2016 yayibeka ukuthi umshwalense wesikhathi esifushane ungahlala izinyanga ezintathu kuphela. Noma kunjalo, imithetho emisha ngaphansi kokuphathwa kukaTrump ukunweba leso sikhathi sibe yizinsuku ezingama-364, lapho kungenzeka khona ukuthi kunwetshwe isikhathi esifinyelela ezinyangeni ezingama-36.

Ukucaca, umshwalense wesikhathi esifushane awunikeli ukumbozwa okuphelele okufana necebo lezempilo leqembu noma uhlelo olufanelekile ngaphansi kwe-ACA. Isibonelo, izinhlelo zesikhashana esifushane azidingi ukumboza izindleko zemithi kadokotela, izindleko zokubeletha, noma abantu abanezimo esezivele zikhona. Okuphambili ukuthi awudingi ukulinda isikhathi sokubhalisa esivulekile, futhi ukumbozwa ngokuvamile kuqala ezinsukwini ezimbalwa isicelo sakho samukelwe.

Omunye umthombo womshuwalense wokungezelela umshuwalense we-gap (umshuwalense we-AKA womshuwalense wakho). Yize kungahloselwe ukusetshenziswa njengokufakwa komuntu kuphela, abanye abantu bakusebenzisa ngaleyo ndlela ngenkathi bengaqinisekisiwe. Lolu hlobo lwenqubomgomo luvamise ukusebenza ngokubambisana nomshuwalense wakho oyinhloko wezempilo (uhlelo lwempilo lweqembu noma uhlelo lwe-ACA) ukuhlinzeka ngembozo eyengeziwe. Isibonelo, uma uhlelo lwakho oluxhaswe umqashi lungabandakanyi umsebenzi wamazinyo, ungakwazi ukuthola umshuwalense wegebe owenzayo.

Ukutholakala komshuwalense wegebe kucace kakhulu futhi kungaqala ukusebenza ezimweni ezithile, njengokuhlaselwa yisifo senhliziyo noma isifo sohlangothi. Izinkampani ezidumile zomshuwalense zifaka phakathi i-AIG, i-Aetna, ne-Aflac, kanye nama-premium aphakathi kuka- $ 30- $ 40 ngenyanga.

Okufanelekile, umshuwalense wesikhashana esifushane (kanye nomshuwalense wegebe njengezindlela zakho kuphela zokuhlanganisa) kuzosetshenziswa uze ukwazi ukuthola ukutholakala kwesikhathi eside ngesikhathi sokubhalisa esivulekile. Ngenkathi ukubhaliswa okuvulekile kwe-2020 kudlulile, Izinsuku ezingama-2021 ziyeza : Maka ikhalenda yakho ngoNovemba 1, 2020 kuya kuDisemba 15, 2020. Ngenkathi izifundazwe eziningi zinamathela kulezo zinsuku, hhayi zonke, ngakho-ke uzofuna ukuhlola izinsuku zesimo ohlala kuso. Ngaphezu kwalokho, eCalifornia, eColorado, naseWashington, DC, banwebe amafasitela abo okubhalisa avulekile unomphela. Ukubhaliswa kweMedicaid nakho kuvulekile unyaka wonke.

Kungakhathaliseki ukuthi awuqinisekisiwe noma awuqinisekisiwe, i-SingleCare ingakusiza wonge imali ngemithi yakho kadokotela. I-SingleCare iyisevisi yokonga kadokotela yamahhala engasiza ekwehliseni isikweletu sakho ezinkulungwaneni zamakhemisi ase-U.S. Ungasebenzisa ikhadi lethu ngaphandle komshwalense ukukusiza wonge intengo yemali yomuthi.

Isibonelo, ngo-2019, intengo yemali emaphakathi ye- I-Oseltamivir phosphate (i-antiviral eyaziwa ngegama layo ngegama elithi Tamiflu) yayingu- $ 136.30. Ngekhadi le-SingleCare, intengo emaphakathi yehlele ku- $ 52.51. Landa ikhadi lakho lamahhala le-SingleCare lapha .

FUNDA OKULANDELAYO: Izindlela ezi-5 zokuthola usizo ngezindleko zezokwelapha uma ungenawo umshwalense