Yini i-premium yomshuwalense wezempilo?

Ukuchazwa Kwezempilo Kenkampani

I-premium yomshuwalense wezempilo imali oyikhokhayo, imvamisa nyangazonke, ukuthola kwakho impilo. Ngokufana nokufanelekile kobulungu beklabhu, kufanele ukhokhe imali ekhokhelwa ukuthola umshuwalense wakho wezempilo, futhi usakhokhiswa noma ngabe awusebenzisi umshwalense. Kukhona ezinye izindleko ezihambisana nomshuwalense wakho wezempilo, futhi, kufaka phakathi i-coinsurance, i-copayment, futhi idonswa .

Uma uthenge umshwalense wakho wezempilo uwedwa (isibonelo, nge-Affordable Care Act, noma i-ACA, indawo yemakethe yomshuwalense wezempilo), ukhokha imali ekhokhelwa inkampani yakho yomshuwalense wezempilo. Uma uthola umshuwalense wezempilo kumqashi wakho, ungahle uthole ingxenye yakho ye-premium (isb., Noma yini umqashi wakho angayikhokhi) ekhishwe emholweni wakho.

Malini umshuwalense wezempilo?

Ngokuya ngeKaiser Family Foundation, izindleko ezijwayelekile zonyaka zamaphrimiyamu omshwalense wezempilo we- umuntu ongashadile ngo-2019 wayengu- $ 7,188 no- $ 20,576 womndeni . Lokho kukhuphuka okungu-4% no-5%, ngokulandelana, ngaphezu kwezibalo zango-2018.

Izindleko ze-premium yakho yomshuwalense wezempilo zizoncika ezintweni eziningi, kusho uhulumeni wesifundazwe ezempilo.gov . Kubandakanya:

1. Uhlala kuphi. Akumangazi kakhulu lapha, kepha labo abahlala ezindaweni zezwe lapho izindleko zokuphila ziphakeme bangalindela ukukhokha izindleko zokunakekelwa kwezempilo eziphakeme, kufaka phakathi nezindleko zomshuwalense wezempilo.
2. Ubudala. Ngenxa yokuthi bathambekele ekubeni nezinkinga ezimbalwa zezempilo kunabantu abadala, abantu abasha ngokuvamile abazisebenzisi kangako izinsizakalo zezokwelapha ngakho-ke ngokuvamile bakhokhiswa amaprimiyamu aphansi. (Akusebenzi ezinhlelweni ezixhaswe umqashi.)
3. Ukusetshenziswa kukagwayi. Abantu abasebenzisa imikhiqizo kagwayi bangakhokhiswa kuze kufike ku-50% ngaphezulu ngomshwalense wabo wezempilo kunalabo abangayisebenzisi. (Akusebenzi ezinhlelweni ezixhaswe umqashi.)
4. Uhlelo olungashadile uma kuqhathaniswa nomndeni. Uhlelo lomndeni lumboza amalungu omndeni amabili noma ngaphezulu. Ukungeza umlingani kanye / noma izingane ohlelweni lwezempilo kuzokwenyusa imali ekhokhwa njalo ngenyanga. Ababhalisile bakhokhiswa umuntu ngamunye embozwe ngohlelo.
5. Usayizi wenkampani. Kuzinhlelo ezixhaswe ngumqashi, ubukhulu benkampani oyisebenzelayo bungakhombisa ukuthi bane-premium ephezulu noma ephansi.
6. Uhlobo lwecebo. Ngokuvamile kunezinhlobo ezinhlanu zezinhlelo zomshuwalense wezempilo ngemakethe ye-ACA: ithusi, isiliva, igolide, i-platinum kanye nenhlekelele. Ezimweni eziningi, uma iphrimiyamu yakho iphakeme ngolunye lwalezi zinhlelo, kwehliswa imali yakho ekhokhwayo — futhi ngokufanayo.

Izinto ezimbili okungamele zikhuphule izindleko zakho ze-premium ubulili bakho nesimo sempilo esivele sikhona. Kuzinhlelo ezintsha, ezihambisana ne-ACA, akukho emthethweni ukuthi umhlinzeki womshuwalense akhokhise abesilisa nabesifazane amanani ahlukene ohlelo olufanayo. Futhi abakwazi ukukukhokhisa ngaphezulu ngohlelo ngoba unenkinga efana noma enesifo sikashukela noma umdlavuza. Okuwukuphela kokungafani nalokhu kungaba izinhlelo ezinhle kakhulu, ezandulela i-ACA.

Kwenzekani uma ngiyeka ukukhokha imali yami yomshwalense wezempilo?

Izindleko zomshuwalense wezempilo eziphakeme zinganikeza ngisho ikhefu elinemali eliningi. Futhi kwesinye isikhathi kunzima ukulinganisa isidingo sento ongayisebenzisa ngokomqondo (umshuwalense wezempilo) uma kuqhathaniswa nesidingo sento esheshayo — njengokudla nemali yokuqasha.

Kepha uma uyeka ukukhokha imali yakho yomshuwalense wezempilo, ukumbozwa kwakho kungaphela. Lokho kusho ukuthi awukwazi ukufinyelela ukunakekelwa kwakho kwezempilo ngezinto ezifana nokuvakashelwa odokotela noma ukwamukelwa esibhedlela. Uma uthola ukumbozwa kwakho kwezokunakekelwa kwezempilo ngemakethe yomshuwalense wezempilo, unganikezwa isikhathi somusa, ngokuvamile izinsuku ezingama-90, ngaphambi kokuthi ikhava yakho iphelelwe yisikhathi. Kubalulekile ukukhokha wonke amaprimiyamu owaphuthelwe phakathi naleso sikhathi somusa noma ukumbozwa kwakho komshuwalense wezempilo kunganqanyulwa futhi kungadingeka ukuthi ulinde okulandelayo isikhathi sokubhalisa esivulekile ukubhalisela ukubhalisa. (Kodwa-ke, kunezinqubo ezimbalwa zokubangela isikhathi sokubhalisa esikhethekile, njengokuthola umntwana noma ukushintsha imisebenzi.)

Uma unenkinga yokwenza izinkokhelo ze-premium, unezinketho — yize kungadingeka ukuthi ulinde kuze kufike isikhathi sokubhalisa esivulekile esilandelayo ukwenza noma yiziphi izinguquko. Eminye imibono okufanele uyicabangele?

• Ukushintsha izinhlelo. Uma une-PPO, okukuvumela kakhulu ukuthi ubone noma yimuphi udokotela noma yikuphi ngaphandle kokudluliselwa, uzokhokha imali ephakeme kakhulu uma une-HMO. Nge-HMO, udokotela wakho oyinhloko unakekela konke ukunakekelwa kwakho kwezokwelapha futhi ungabona kuphela omunye udokotela ngokudluliselwa noma uma unesimo esiphuthumayo.
• Ukuhamba ngecebo eliphakeme elidonswayo. Okudonswa imali inani okufanele ulikhokhe ephaketheni lezinsizakalo zezempilo ngaphambi kokuthi umshuwalense wakho wezempilo uqale ukuthatha ithebhu. Ngokuvamile, izinhlelo ezinokudonswa okuphezulu zivame ukukhokhisa amaprimiyamu aphansi.
• Ukuthola uxhaso lwentela. Uma uthenga umshwalense wakho endaweni yemakethe yomshuwalense wezempilo, ungahle ufanelekele uhulumeni wesifundazwe Isikweletu Esikhokhelwa Intela Esiphezulu . Kuzofanele uhlangabezane nenqubo ethile, noma kunjalo, kufaka phakathi ukungafaneleki kweMedicaid noma iMedicare.
• Uhlelo Lokulondolozwa Kwemithi. Uma une-Medicare futhi unenkinga yokukhokhela i-premium yakho yanyanga zonke, ungahle ufanelekele uhlelo lwe-Medicare Savings. Abazuzi beMedicare bangaxhumana nomnyango wabo wendawo wezinsizakalo zenhlalakahle (aka, ihhovisi leMedicaid) ukuze ufunde kabanzi.

OKUSHIWO: Ukudonswa kwezindleko zezokwelapha eziyi-11 ongazifuna

Ungayonga kanjani imiyalo enezinhlelo zezempilo ezisezingeni eliphakeme

Noma ngabe umshwalense wakho wezempilo uphethe imali ekhokhelwayo ephezulu noma iphrimiyamu ephezulu, mhlawumbe usebenzisa imali eningi ukumbozwa kwezokunakekelwa kwempilo.

Futhi-ke kukhona izindleko zemithi kadokotela.

Kwezinye izimo, uzokhokha i-copay yesidakamizwa. Kunezigaba eziningana ze-copay ngokuya ngomuthi. Kwezinye izimo, umuthi ngeke umbozwe umshwalense nhlobo (noma mhlawumbe awunawo umshwalense) futhi kuzofanele uzikhokhele wena izindleko eziphelele zomuthi.

Akunandaba, kuyakhokha (i-pun kuhloswe!) Ukuhlola amakhadi wesaphulelo sezidakamizwa njenge-SingleCare. Ungase ukwazi ukuthola umuthi ngemali encane kune-copay yakho noma ukwehliswa okukhulu uma ungenayo-noma umuthi ungamboziwe-ngumshwalense. I-SingleCare ingakongela kuze kufike ku-80% emiyalelweni yakho. Ukuphela kokufanele ukwenze:

1. Bheka udokotela wakho ku singlecare.com .
2. Landa (noma uthumele umbhalo noma uthumele i-imeyili) ikhadi lesaphulelo le-SingleCare.
3. Khombisa ikhadi lakho lekhuphoni kusokhemisi lapho ushiya incwadi kadokotela.

Kulula, mahhala, kanye namakhadi esaphulelo sezidakamizwa ze-SingleCare angasetshenziswa kuwo wonke umndeni emakhemisi angaphezu kwama-35,000 ezweni lonke.