Yini i- ‘copay’?

Inkampani

Ukunakekelwa kwezempilo kuyisihloko esiyinkimbinkimbi esinamagama angabonakala njengolimi oluhluke ngokuphelele kwesinye isikhathi. Elinye lala magama ngu ikhophi , noma eyaziwa kangcono ngokuthi ikopay . I-copay yinani elinqunyelwe elikhokhelwa imiyalelo noma izinsizakalo zokunakekelwa kwezempilo lapho uvakashela udokotela. Kepha njengezinto eziningi ezihlobene nomshuwalense wezempilo, ingabe lokho kulula ngempela?

Iyini icopay?

Ezinhlelweni eziningi zomshuwalense, njalo uma ubona udokotela ngemuva kokuhlangana nemali oyidonsayo ukhokha inani elibekiwe elibizwa ngokuthi yi-copay. I-copay isebenza njengemali ekhokhwa phansi udokotela wakho ojwayelekile noma uchwepheshe akukhokhisa ngokusebenzisa amasevisi abo. Inani elithile linqunywa uhlelo lwakho lomshuwalense wezempilo, ngakho-ke qiniseka ukuthi ufunda ukuphrinta okuhle. Izinhlelo ezinaphansi amaphrimiyamu nyangazonke angaba namakhophi aphezulu.

Kubalulekile ukuqaphela ukuthi ama-copays enzelwe umshwalense wezohwebo, womqashi, nowasemakethe. I-Medicare neMedicaid zizoba nemithetho nezincomo ezehlukile kunolwazi olulandelayo.

Ama-Copays ayindlela yokwabelana ngezindleko nenkampani yakho yomshuwalense wezempilo. Futhi zihloselwe ukusiza ukunqanda abathengi ekutholeni ukunakekelwa kwezempilo okungadingeki. Ama-Copays angaba nobudlelwano obuyinkimbinkimbi nezinye izingxenye zezakhiwo zakho zezindleko zomshuwalense wezempilo.

Ngaphambi kokufinyelela kufayela lakho le- minyaka yonkeebanjwayo - okuyinani lemali okufanele uyikhokhe ngaphambi kokuba inkampani yakho yomshuwalense izokusiza ukukhokhela izindleko zakho zokwelashwa — uzokhipha wonke umthethosivivinywa ngenqubo ehlanganisiwe noma incwadi kadokotela. Uma usufinyelele ekubanjweni kwakho, i ukuqinisekiswa kwemali ukungena, okusho ukuthi uhlelo lwakho luzoqala ukubhekela iphesenti elibekiwe lezindleko zezokwelapha. Yilapho izindleko zakho zezokwelapha ziba nzima, ikakhulukazi ngoba i-copay yakho ayibheki ekunciphiseni kwakho, kodwa kunalokho iya kumnyaka wakho okuphezulu ephaketheni .

Manje, nasi isibonelo sokusiza ukucacisa izinto: Ukhuze unyawo lwakho udlala ibhola futhi ucabanga, Mfana, nginenhlanhla kakhulu ngisanda kuhlangana ne-deductible yami, futhi umshwalense uzohlanganisa lolu hambo lokunakekelwa okuphuthumayo. Kepha ongakwazi ukuthi unesibopho se-copay yakho kanye ne-coinsurance yakho. Ngaphambi kokuba uphume ehhovisi likadokotela, owamukela izivakashi uyakucela ukuthi ukhokhe i-copay yakho engu- $ 20 ngaphambili. Emasontweni amabili kamuva, uthola isikweletu se- $ 80 eyengeziwe — lesi yisibambiso sakho semali, kulesi sibonelo okungu-20% wayo yonke imali ekhokhwayo (kanti kuwe bekuyibhili engu- $ 400). Ngakho-ke, ngalolu nyawo oluminyene, ugcine ukhokha u- $ 100. Izinhlelo zivame ukuxoxisana ngamanani, ngakho-ke bazokhokhela umhlinzeki wakho iphesenti lesilinganiso okuxoxiswene ngaso ngaphambi kokuthi ulindeleke ukuthi ukhokhe inani lakho le-coinsurance elifanele.

Abantu bathambekele ekucabangeni ukuthi uma sebefinyelele emalini ebanjwayo, bazokhululeka kwizikweletu zezokwelapha. Kodwa-ke, umshwalense uzokhokhela zonke izindleko zakho zokwelashwa uma usuhlangabezane nobukhulu bakho obuphuma ephaketheni, obuhlangatshezwa yinhlanganisela yokukhokha imali yakho ekhishwayo, i-coinsurance, nama-copay.

OKUSHIWO: Uyini umehluko phakathi kwe-copay vs. deductible?

Yini okumbozwa ikopayay?

I-copay ivame ukusiza ukukhokhela izindleko ekuvakasheni okuhlukahlukene kwamahhovisi. Kodwa-ke, izinsizakalo zezokwelapha ezidinga ama-copay ziyahlukahluka phakathi kwezinhlelo zomshwalense. Izinsizakalo ezidinga kakhulu i-copay zifaka:

• Ukunakekelwa okuyisisekelo nokuvakashelwa odokotela abangochwepheshe
• Izindlela zokwelapha zomzimba, zomsebenzi nezenkulumo
• Imithi kadokotela
• Izinsizakalo zezempilo yengqondo: okusho ukuvuselelwa kwezidakamizwa, ukwelashwa kwengqondo
• Kuyaphuthuma lokho
• Ukuvakashelwa kwamagumbi okuphuthumayo
• Ukugibela i-ambulensi

Izintengo zeCopay ngokuvamile ziyahlukahluka phakathi kwezinsizakalo futhi zingaphakama lapho kuvakashelwa ochwepheshe kunokuvakasha kukadokotela wokunakekelwa okuyisisekelo. Abahlinzeki be-Out-of-network nabo bazoba ne-copay ephakeme. Uma i-copay yakho ibiza kakhulu ebhodini, lokhu kungenxa yokuthi unohlelo lomshuwalense wezempilo ophansi kakhulu.

Kubalulekile futhi ukuqaphela ukuthi ngenxa ye- Umthetho Wokunakekelwa Ongabizi , ezinye izinsizakalo zokuvikela ezifana nokuhlolwa, ukuhlolwa komdlavuza, noma ukuvakashelwa kwabesifazane abafanele akufanele babe nokwabelana ngezindleko zabathengi.

Ngazi kanjani ukuthi ngizoba ne-copay?

Izinkampani eziningi zomshuwalense noma abahlinzeki bezempilo badinga ukuthi ama-copay akhokhwe ngesikhathi sokusebenza. Imvamisa, inani le-copay liphrintwa ngqo ekhadini lakho lomshuwalense wezempilo. Kungaba nemali efakwe kuhlu yezinsizakalo ezahlukahlukene njengokuvakashelwa kokunakekelwa okuyinhloko nezinsizakalo zokunakekelwa kochwepheshe. Bheka uhlelo lwakho lomshuwalense ukuthola uhlu oluningiliziwe lwawo wonke amasevisi ahlanganisiwe adinga i-copay kanye nezindleko zalowo nalowo.

Ezinye izinhlelo zomshuwalense azinayo i-copay. Kulokhu, mhlawumbe uhlelo olubiza kakhulu, ngakho-ke ngenkathi ingekho i-copay yezinsizakalo, usasebenzisa imali ethe xaxa ngamaphrimiyamu ohlelo.

Ungayinciphisa kanjani i-copay yakho

Izindleko eziphuma ephaketheni akudingeki ukuthi zishaye i-akhawunti yakho yasebhange ngaso sonke isikhathi. Uma ufaka isandla kwi-akhawunti yokonga yezempilo (i-HSA), i-akhawunti yokonga eguquguqukayo, noma i-akhawunti yokubuyisela imali yezempilo (i-HRA), ungazisebenzisa izimali zangaphambi kwentela ukumboza i-copay yakho. Ngemuva kwakho konke, lena yimali osuyibekele eceleni yezinzuzo zezempilo. Kodwa-ke, ukuphela kwendlela yokwehlisa i-copay yakho kungaba ngokushintsha izinhlelo zomshuwalense, okungeyona inketho ngaso sonke isikhathi.

Noma kunjalo, I-SingleCare ilapha ukuzosiza . Kwesinye isikhathi ama-copay yemibhalo angaba ngaphezu kwesilinganiso esinephulelo ongasithola ngekhadi le-SingleCare. Sesha incwadi kadokotela wakho ku-singlecare.com ukuze ubone ukuthi intengo yakho engcono kangakanani.