Uyini umehluko phakathi kwe-copay vs. deductible?

Ukuchazwa Kwezempilo Kenkampani

Kwesinye isikhathi amagama wokunakekelwa kwezempilo angabonakala njengolimi oluhluke ngokuphelele. Ngamazwi afana nalawa ikopay , ebanjwayo , futhi okuphezulu ephaketheni uphonswa nxazonke, kufanele wazi kanjani ukuthi yini? Yilapho uchungechunge lwethu lwe-Healthcare Defined lungena khona. Siphula amagama ukuze uqonde-futhi ngokuqonda, kuza ukonga okungcono.

Ukukhetha uhlelo lokunakekelwa kwezempilo? Ngaphezu kwezindleko zanyanga zonke, noma i-premium, kubalulekile ukuqonda ukuthi yini enye ozoba nesibopho sayo ngezezimali. I-copay nosizo oludonswayo lunquma ukuthi uzokhokha malini ephaketheni; lezi zindleko zingaba nomthelela omkhulu ekutheni uhlelo oluthile lungenzeka kanjani ngokwezimali kubhajethi yakho. Awuwazi umehluko phakathi kwe-copay vs deductible okwamanje? Sikubambile.

Iyini icopay?

Ama-Copays nokudonswa kwemali zombili izinhlobo zokwabelana ngezindleko — uzokhokhela ingxenye ethile yezindleko zakho zokunakekelwa kwezempilo, futhi inkampani yakho yomshuwalense imboza igebe eliphakathi kwalokho okukhokhisiwe nalokho okukhokhile.

TO ikopay ingxenye yakho yemali yesibonelo esithile sokunakekelwa, noma ngabe ukuvakasha kukadokotela noma incwadi kadokotela. Ngokuvamile kuyimali ephathekayo futhi ingase ibhalwe ngisho nangemuva ekhadini lakho lomshuwalense, njenge- $ 20 yokuvakashelwa udokotela noma i- $ 10 yokugcwaliswa kabusha kadokotela. Imvamisa, ukuphakama kwephrimiyamu yanyanga zonke, noma inani olikhokhela uhlelo lwakho, kwehla i-copay. Ngokunakekelwa kokuvimbela, njenge-mammogram noma umzimba wonyaka, ungahle ungabi nayo i-copay nhlobo. Ama-Copays ajwayele ukwehluka ekunakekelweni okuyisisekelo kuqhathaniswa nokunakekelwa okukhethekile kunethiwekhi yohlelo lwakho lomshuwalense, negama lomkhiqizo uma kuqhathaniswa nemithi ejwayelekile.

Yini okudonswayo?

Okudonswayo , ngakolunye uhlangothi, yilokho obhekene nakho ukukhokha ephaketheni ngaphambi kokuba inkampani yakho yomshuwalense iqale ukumboza.

Lapho imali yakho ebanjwayo idonswa minyaka yonke, inkampani yakho yomshuwalense kufanele qala ukumboza iningi lezindleko zakho ezihlanganisiwe, kodwa izindleko ezibucayi okuhlobene ne-coinsurance noma izikhala zokuhlanganisa isengaqhubeka nokuvela (ngaphezulu kwalokho ngokuhamba kwesikhathi).

Njengama-copay, ama-premium akho aphakeme kakhulu, i-deductible yakho ivame ukwehla, njengoba ukhokha imali ethe xaxa enkampanini yakho yomshuwalense ngaphambili. Lapho ukhetha uhlelo lokunakekelwa kwezempilo, kubalulekile ukuthi uqaphele ukuthi kuzolindeleka ukuthi ukhiphe malini-ngaphezu kwezindleko zakho zenyanga-ngaphambi kokuthi umshwalense wakho uzothatha yonke ithebhu.

Abantu abaningi abazi nakancane ukuthi yiziphi izinzuzo abazidonsayo kuze kube yilapho benesimo esiphuthumayo, kusho uRachel Trippett, MD, ongudokotela womndeni wase-U.S. Public Health Service Indian Hospital eNew Mexico. Akusona isikhathi lapho ufuna ukuthola ukuthi unemali ebanjwayo ongakwazi ukuyikhokhela.

OKUSHIWO: Izinsizakalo zezempilo ezi-5 okufanele uzenze ngemuva kokuhlangabezana nokudonswa kwemali yakho

Ngabe ama-copay nama-deductibles asebenza kanjani ndawonye?

Kuzwakala kulula kumqondo, kepha lokhu kusebenza kanjani empilweni yangempela? Ake sihlukane.

Inyanga ngayinye, ukhokha imali ekhokhwa njalo ngenyanga; le yimali ekhokhwayo ukuze ube nomshuwalense wezempilo. Uma uthola umshuwalense wakho wezempilo kumqashi wakho, ingxenye ethile ye-premium yakho ingahle iphume kumholo wakho.

Manje ake sithi phakathi nonyaka, ugcine uphuka iqakala. Uvakashelwa igumbi eliphuthumayo, kanye nohambo oluya ezinhlotsheni ezahlukahlukene zodokotela, ukuze ubuyele ezinyaweni zakho.

Yilapho okudonswayo kwakho kubalulekile. Uzocelwa ukuthi ushaye imali yakho ekhishwayo yaminyaka yonke — inani olikhokhile ephaketheni nganoma yiziphi izinsizakalo zezokwelapha lokho akunjalo ama-copay — ngaphambi kokuba umhlinzeki wakho womshuwalense aqale ukukhokha amaphesenti aphezulu ezikweletu zakho zezokwelapha.

Kuyini ukuqinisekiswa kwemali?

Kepha ezinhlelweni eziningi zomshuwalense, ukufinyelela kudonsi yakho akusho ukuthi usekusobala ngokungafanele ukhokhe lutho. Esikhundleni salokho, ungahle ube nakho ukuqinisekiswa kwemali imali. Leli iphesenti lezindleko zakho zokunakekelwa kwezempilo okudingeka ukuthi unikele ngazo, uze ufinyelele ezingeni eliphakeme lonyaka wakho lokuphuma ephaketheni lomshwalense wakho. Yilokho okuphelele inani olikhokhile unyaka wonke ngazo zonke izindleko zakho zezokwelapha, kufaka phakathi ama-copayments (kodwa kungafaki i-premium yakho yanyanga zonke).

Kuphela kanye lapho ufinyelela kuleso silinganiso lapho umshwalense wakho edingeka ukuthi akhokhele u-100% wezindleko zakho zezempilo ezihlanganisiwe. Bheka ikhalenda, futhi; izinqubomgomo zivame ukuba unyaka wonke, ngakho-ke izibopho zakho ezingadonselwa imali zizosethwa kabusha onyakeni wakho womshuwalense waminyaka yonke noma ngoJanuwari 1 uma imali yakho ekhishwayo isetha kabusha unyaka ngamunye wekhalenda.

Kafushane nje, kudonswa imali ekhishwa ephaketheni okudingeka uyikhokhe ngaphambi kokuba umshwalense wakho uqale ukukhokha noma yini ngezindleko zakho zezempilo. Ama-Copays ahlukene, izimali ezingaguquki ngokuvamile ezingabhekeki ekudonselweni imali yakho okungadingeka ukuthi ukhokhe lapho ubona udokotela noma uthola incwadi kadokotela igcwele. Uma usuhlangabezane nemali yakho ebanjwayo, uzobe ukhokha imali encane ngokunakekelwa kwakho, kepha usengakwazi ukubophezeleka nge-coinsurance, kuze kube yilapho usufinyelele umkhawulo wakho wonyaka ophuma ephaketheni wonyaka.

Coinsurance vs copay vs.

Enye yezindlela ezinhle kakhulu zokugwema imali yomshwalense engalindelekile ukunamathela kodokotela nezibhedlela ngaphakathi kwenethiwekhi yohlelo lwakho. Umshuwalense wakho uxoxisane ngentengo ephansi yalaba bahlinzeki, okuvame ukuhumusha ekunciphiseni izikweletu nezindleko ezingaphandle kwe-pocket zakho.

Okunye ukusebenzisa ifayili le- Ikhadi lesaphulelo se-SingleCare ngemiyalo yakho. Vele ufune imishanguzo yakho bese ubona ukuthi ungonga malini. Kungasiza ngempela uma unecebo ngaphandle kwephoyinti kadokotela, kepha kwesinye isikhathi intengo yethu ingaze ishaye intengo ye-copay!