Uyini umcimbi wempilo ofanelekayo womshuwalense wezempilo?

Inkampani

Uma usanda kushada noma unengane, mhlawumbe uyazibuza ukuthi wenzeni ngokushintsha uhlelo lwakho lomshuwalense wezempilo. Izinguquko eziphawulekayo ezinjengalezi zingathinta ukufaneleka kwakho komshuwalense wezempilo. Ake sibheke imicimbi yokuphila efanelekile yezinhlelo ze-Affordable Care Act (ACA) nokuthi zithinta kanjani lapho ukwazi ukufaka isicelo somshuwalense wezempilo.

Uyini umcimbi wempilo ofanelekayo womshuwalense wezempilo?

Imicimbi yokuphila efanelekile (ama-QLEs) yizinguquko ezimeni zakho ezikuvumela ukuthi ubhalise kumshwalense wezempilo ngaphandle kwezikhathi zokubhaliswa ezivulekile zonyaka. I-ACA ichaza imicimbi efanelekile njengezinguquko ezibalulekile empilweni ezinikeza umuntu isidingo esisheshayo somshuwalense wezempilo, ezibavumela ukuthi babhalise noma benze ezinye izinguquko kumshuwalense wabo esikhathini esikhethekile sokubhalisa. Nayi eminye imicimbi yokuphila efaneleke kakhulu enikeza umuntu amandla okukhetha uhlelo olusha lomshuwalense wezempilo noma enze olunye ushintsho kuhlelo lwabo ngaphandle isikhathi sokubhalisa esivulekile s .

Qaphela: Imithi futhi ukumbozwa kwabaqashi kunemithetho eyingqayizivele, imicimbi yokuphila efanelekile, izikhathi zabo zokubhalisa ezivulekile. Okulandelayo yimicimbi yokuphila efanelekayo yezinhlelo ze-ACA.

Izinguquko emakhaya

Izinguquko ezinkulu emndenini wakho zingakufanelekela ukuthola i- Isikhathi Esikhethekile Sokubhalisa lapho uvunyelwe ukubhalisa ekunakekelweni kwezempilo ngaphandle kwesikhathi esibekiwe sokubhalisa. Uma wena noma othile ekhaya lakho ushadile, unengane, uthole ingane, noma ubeke ingane ekunakekelweni ngabazali ezinsukwini ezingama-60 ezedlule, uzofanelekela ukubhaliswa okuvulekile.

Uma ngabe uhlukanisile noma uhlukaniswe ngokomthetho ezinsukwini ezingama-60 ezedlule futhi ulahlekelwe ngumshwalense wezempilo, uzofanelekela Isikhathi Esikhethekile Sokubhalisa. Kuyafana futhi uma wena noma omunye umuntu ekhaya lakho elahlekelwa ngumshuwalense wezempilo ezinsukwini ezingama-60 ezedlule, noma ulindele ukulahlekelwa ngumshuwalense wezempilo ezinsukwini ezingama-60 ezizayo. Esimweni esibi lapho othile ohlelo lwakho lokunakekelwa kwezempilo efa futhi ukufaneleka kwakho kwalolo hlelo kuguquka, uzofanelekela Isikhathi Esikhethekile Sokubhalisa esikuvumela ukuthi uthole ukunakekelwa kwezempilo okusha.

Izinguquko zokuhlala kabusha

Izinguquko zokuhlala zihlala zivumela abantu ukuthi balungele Isikhathi Esikhethekile Sokubhalisa. Uma uthuthela kukhodi entsha ye-zip noma esifundeni; singene e-U.S. sisuka kwelinye izwe; abafundi bathuthela noma bahambe esikoleni; Abasebenza ngezikhathi ezithile bathuthela noma bahambe emsebenzini; noma uye endaweni yokukhosela noma yezindlu zesikhashana, uzokwazi ukuthola Isikhathi Esikhethekile Sokubhalisa. Ukuthuthela kwenye indawo ukuze uthole ukwelashwa noma iholide akufaneleki.

Kufanele ube nomshwalense ofanelekile wezempilo okungenani usuku olulodwa ezinsukwini ezingama-60 ngaphambi kokuhamba kwakho ukuze ufanelekele Isikhathi Esibalulekile Sokubhalisa. Kodwa-ke, awudingi ukunikeza isiqinisekiso uma uthuthela ezweni langaphandle noma insimu yase-U.S.

Ukulahlekelwa ngumshuwalense wezempilo

Uma wena noma omunye womndeni wakho elahlekelwa noma elindele ukulahlekelwa ukumbozwa kwezempilo ezinsukwini ezingama-60 ezizayo, ungafaneleka Isikhathi Esikhethekile Sokubhalisa. Inqubomgomo yomshuwalense wezempilo osuzolahlekelwa yiyo kufanele ihlolisise ibhokisi elilodwa noma amaningi kulawa alandelayo ukuze ufanelekele Isikhathi Esikhethekile Sokubhalisa:

• Awusafaneleki njengothembekile ngaphansi kohlelo lomshuwalense wezempilo womzali noma womnakekeli wakho.
• Wena noma ilungu lomndeni, oshade naye, noma umzali uyekile, wadilizwa, noma waxoshwa emsebenzini, okuholela ekulahlekelweni kokutholakala kwezempilo ngomqashi wakho noma umqashi welungu lomndeni wakho, oshade naye noma umzali. Uma wena noma oshade naye uqala umsebenzi omusha, uzokwazi ukuthola Isikhathi Esikhethekile Sokubhalisa.
• Ulahlekelwa ukufakwa kweMedicaid noma i-Children's Health Insurance Program (CHIP) ngenxa yento efana noshintsho kumholo wakho wekhaya.
• Awusafanelekele uhlelo lwezempilo lwabafundi.
• Uhlelo lwakho lwamanje luyanqanyulwa.

Qaphela: Ukulahleka kokuzithandela kokutholakala kungukuthi hhayi kubhekwe njengomcimbi ofanele wokuphila.

Izincwajana zemininingwane izimo ezehlukile

Ungahle ufanelekele Isikhathi Esikhethekile Sokubhalisa uma:

• Ukuqala noma ukuqeda insizakalo njengelungu le-AmeriCorps
• Ukuba yisakhamuzi saseU.S
• Ukushiya ukuboshwa
• Ukuba yilungu loMdabu lase-Alaska noma ilungu lesizwe esaziwa njenge-federally

Uma wena noma abantu obethembele kubo niyizisulu zokuhlukunyezwa emndenini noma ukulahlwa ngumlingani, ungafaneleka Isikhathi Esikhethekile Sokubhalisa. Udlame Lwasekhaya Lukazwelonke Inombolo yocingo ye-hotline ngu-1-800-799-7233. Bangakunikela ngezinsizakusebenza zokukusiza futhi bangakunikeza nezeluleko zokuthi ungawuthola kanjani umshuwalense wezempilo omusha. Ungabheka futhi ku-carecare.gov noma esigcawini sakho sombuso, noma ucabangele ukufaka isicelo kuMedicaid.

Ngokuya nge-COVID-19, akusiwo umcimbi wokuphila ofanelekile ngokwawo. Izizwe eziyishumi nanye, kufaka phakathi i-D.C kuvulwe Izikhathi Zokungena Okukhethekile , kodwa ezinye izifundazwe ezingama-38 azikaze. Uma uhlala kwesinye salezi zifundazwe ezingama-38, kuzofanele ubheke ukuthi unawo yini umcimbi wokuphila ofanelekile, kusho uSusan Lyon, iMenenja yeMedia kanye nePartnerships e-Health Sherpa.

Bheka uhlu olugcwele lwemicimbi yokuphila efanelekile ku- lolu hlu lwe-SEP .

Yini eyenza hhayi ufaneleke?

Kwesinye isikhathi kuba nzima ukuthola ukuthi yimiphi imicimbi yokuphila ezokufanelekela Isikhathi Esikhethekile Sokubhalisa. Wena ungenzi ufaneleke ukuthola Isikhathi Esikhethekile Sokubhalisa uma:

• Kuhanjiswe kwenye indawo kuphelaukwelashwa.
• Bahlala ndawana-thile eholidini elide.
• Lahla ukumbozwa kwakho kwezempilo ngoba awuyikhokanga i-premium yakho.
• Uncike ohlelweni lokunakekelwa kwezempilo lomzali noma umnakekeli futhi uyeke ngokuzithandela ukwehliswa. Kufanele ube neminyaka yobudala engama-26 ukuze ufanelekele Isikhathi Esikhethekile Sokubhalisa. Ngaphandle kwalokho, kuzofanela ulinde kuze kufike isikhathi sokubhalisa esivulekile.
• Sizohlala sikufanelekela ukunakekelwa kwezempilo nezinzuzo zakho zamanje, noma ngabe uhlukanisile noma ulahlekelwe yilungu lomndeni.

Yinde kangakanani Isikhathi Sokubhalisa Esikhethekile?

Uzoba nezinsuku ezingama-60 ukulandela umcimbi wakho wempilo ofanelekile ukubhalisela uhlelo lokunakekelwa kwezempilo. Uma ungabhalisi ngalesi sikhathi sesikhathi, kungadingeka ukuthi ulinde kuze kufike isikhathi sokubhalisa esivulekile esilandelayo.

Ukubhaliswa okuvulekile kwe-ACA yisikhathi esibekiwe sezinsuku ezingama-45 lapho ungashintsha khona umshwalense wakho wezempilo noma ubhalisele uhlelo olusha. Ngokuhlukile okuningana, okuhluka ngombuso, ukubhaliswa okuvulekile kuhlala kusuka ngoNovemba 1 kuze kube maphakathi noDisemba unyaka ngamunye.

Ngakho-ke uma unomcimbi wokuphila ofanelekile ngoMashi, ngokwesibonelo, futhi ungasebenzisi Isikhathi Sakho Sokubhalisa Esikhethekile ukuthola umshuwalense wezempilo, kuzodingeka ulinde kuze kube nguNovemba ukuze ubhalise ekusetshenzisweni, okungaqali ukukumboza kuze kube nguJanuwari 1. Ukugcina ithrekhi yokuthi umcimbi ofanelekile wenzeka nini kuqinisekisa ukuthi uthola ukunakekelwa okwanele kwezempilo ngaso sonke isikhathi.

Izinyathelo ezilandelayo

Ngemuva komcimbi wokuphila ofanelekile nangesikhathi sokubhaliswa okukhethekile, isinyathelo esilandelayo ukukhetha uhlelo olusha olungakusebenzela kangcono. Ungadinga amadokhumenti athile ukusiza ngenqubo yokufaka isicelo, efana nale:

• Ilayisensi yomshado
• Isehlukaniso, ukwesulwa, noma amaphepha okuhlukanisa ngokomthetho
• Isitifiketi sokuzalwa, amaphepha okutholwa, noma ubufakazi bamaphepha okugcinwa ngokusemthethweni
• Ubufakazi bomshuwalense wezempilo ofanelekile ngaphambili
• Ukuguqulwa kokuqinisekiswa kwekheli

Lolu hlu lwemibhalo alunabunzulu. Imibhalo oyodinga ukuyibhalisela umshwalense wezempilo ngeSikhathi Esikhethekile Sokubhalisa incike ezimweni zakho ezihlukile. Inqubo yokufaka isicelo izokutshela ukuthi yini okudingeka uyisebenzise.

Ezinye izinqubo zohlelo lokusebenza sikunikeze izinsuku ezingama-30 ngemuva kokufaka isicelo sokuthumela noma imiphi imibhalo edingekayo ezofakazela ukufaneleka kwakho Isikhathi Esikhethekile Sokubhalisa. Ukumbozwa okusha kuqala usuku ofaka ngalo uhlelo. Kodwa-ke, ngeke ukwazi ukusebenzisa izinzuzo zezempilo kuze kuqinisekiswe ukufaneleka kwakho futhi ukhokhe i-premium yakho. Usengagcina amarisidi wezindleko ezingaphandle kwesikhwama ukufaka isicelo sokubuyiselwa imali emuva uma ukumbozwa kwakho kusebenza.

Kuthiwani uma ngingafanelekiIsikhathi Esikhethekile Sokubhalisa? Yiziphi izinketho zami?

Uma ungafanelekeli Isikhathi Esikhethekile Sokubhalisa futhi kufanele ulinde ukubhaliswa okuvulekile okukude kakhulu, ungakwazi ukuthola umshuwalense wezempilo wesikhashana . Izinhlelo zomshuwalense wezempilo wesikhashana esifushane zihlinzeka ngokumbozwa izinsuku ezingama-364. Lokhu kusiza kakhulu kubantu abadinga ukumbozwa ngesikhathi sezikhala emsebenzini.

Ungafaka isicelo seMedicaid noma uHlelo Lomshwalense Wezempilo Wezingane (CHIP). Ungafaka isicelo kunoma iyiphi ye- lezi zinhlelo nganoma yisiphi isikhathi. I-COBRA futhi kungenzeka. Kunezinketho eziningi zokuthola ukunakekelwa kwezempilo lapho ukudinga kakhulu.