Chimwe chakabatanidzwa chakabatanidzwa inzira inobatanidza vanhu vanozvigadzirisa uye vemhuri muhutano hwehutano hwehutano. Zvikwereti zvakakosha zvehutano zvinowanzoshandisa zvikwereti zvakakwana pane zvishoma asi zvakabatanidzwa zvakabatanidzwa zvinowanzoonekwa kune zvimwe zvirongwa apo vazhinji vemhuri vakanyoreswa muurongwa pamwechete.
Apo chirongwa chehutano chakaiswa mumabhadharo, zvinongoreva kuti imwe nhengo yemhuri haifaniri kusangana nemhuri yakazara inokwaniswa nokuda kwekugadziriswa kwekugadziriswa kwekutsvaga.
Panzvimbo pacho, munhu anenge apedza kubvisa zvinyorwa zvake achabviswa munguva pfupi kana achinge awana munhu wacho akadzikinurwa, kunyange kana kugoverwa kuri kuburikidza neurongwa hwemhuri.
Kubva muna 2016, pane mitemo mitsva inoshanda kune yose yekuti-ye-podha mari yekuti chero munhu mumwe chete pane chirongwa anogona kudiwa kubhadhara kunze kweiyo-muhomwe mari mukati megore. Zvikwereti zvakagadziriswa zvichiri kubvumidzwa, asi zvirongwa zvemhuri zvose zvinofanira kunge zvakasungirirwa pamagariro evanhu vari kunze. Izvi zvinoreva kuti muna 2017, hapana nhengo yemhuri inogona kudiwa kubhadhara mari inodarika madhora 7,150 mune zvekunze kwemahomwe mukati megore (in-network). Iyo yepamusoro inopera inowedzera madhora 7,350 muna 2018, kunyange zvazvo zvirongwa zvizhinji zvicharamba zvichiine mitemo yekunze-in-pocket iyo yakaderera kupfuura yakanyanya kubvumirwa nemutemo.
Basa Rakavharirwa Rakabviswa Sei?
Nokudhakwa kwakabatanidzwa, chirongwa chako chehutano chichachengetedza mhando mbiri dzakasiyana-siyana dzehutano hwehutano huchigadziriswa kune umwe neumwe wemhuri: mumwe munhu anotsvaga uye mhuri inodzingwa.
Mhuri inodonhwa kazhinji inowanikwa kaviri kana yakakwirira sezvo munhu akadzikinurwa. Apo nhengo yemhuri ine mari yekuchengetedza utano, mari yaanobhadhara kune mumwe munhu akazvitsaurira inoratidzwawo kumhuri inobviswa.
Kune nzira mbiri dzekugoverana dzichapinza-mukati, uye chirongwa chehutano chichatanga kubhadhara mari yekuchengetwa kwehutano kune umwe munhu wemhuri:
- Nhengo yemhuri yakange iine hutano hwakakwana hwehutano hwemari iyo yaakambosangana nayo munhu akadzikinurwa. Munyaya iyi, hurongwa hwehutano hunotanga kubhadhara mari yemunhu uyu, asi kwete mari yekuchengetedza utano hwevamwe vemhuri (kunze kwekunge ichitarisirwa iyo yakavharwa isati yabviswa, sezvinongoita kuchengetedzwa , kana kurapwa kwakafukidzwa ne copay pane kuverengwa kusvika kune yakabviswa).
- Nhengo dzinoverengeka dzakasiyana dzemhuri imwe neimwe yakabhadhara zvakakwana mumadhorobha ega ega, akawedzerwa pamwe, mhuri yakabviswa inosangana. Munyaya iyi, hurongwa hwehutano hunotanga kubhadhara mari yekuchengetedza hutano hwemhuri yose, kunyange nhengo dzemhuri dzisina kubhadhara chero chinhu chakanaka kumunhu mumwe nomumwe anotsvaga.
Pros uye Cons weDhipatimendi Yakabudiswa Deductible
Dambudziko nemhuri yakabatanidzwa yakagadzirirwa ndeyokuti nzira chete iwe unogona kusangana nayo nemhuri yakabviswa uye kugoverwa kwemhuri yose ndeyokubatanidza mumwe munhu anodha mari yevabereki vakawanda. (Izvi hazvisi zvechokwadi nokuda kwechikwata chinokonzerwa.)
Nekuvharwa kwakabatanidzwa, kunyange kana mumwe wemhuri ari oga ane hutano hwepamusoro hwekutarisira mari, izvo zvinodhura zvese hazvikwanisi kuonana nemhuri inobviswa.
Sei? Nokuti pakarepo kana munhu wacho akasangana nomunhu wake wepasi ari kubviswa, inshuwarano yehutano inobatsira inotanga uye inotanga kuripa. Anogona kuve achida kubhadhara mamwe maitiro ekugovana-kugovana semari kana mapepa ekubhadhara mari , asi izvo zvisiri izvo zvekutora mari hazviwanikwi kune mhuri inodzingwa. Mari chete yaaibhadhara kune mumwe munhu akadzikinurwa inowana chikwereti kumhuri inobviswa. Sezvo munhu akaderedzwa akadukusa kudarika mhuri yakabviswa, mumwe munhu mumhuri haakwanisi kugutsa mhuri yose inotsvaga iye pachake.
Izvozvo zvinoreva kuti imwe imwe nhengo yemhuri inofanirawo kusangana nemumwe munhu anotsvaga pamusoro pemakore egore rekuti mhuri inobviswa kuti inogadziriswe uye inobviswa-inobviswa zvidzidzo kutambirwa kune vose vanobatanidzwa mumhuri.
Kubatsirwa kwemhuri yakabatanidzwa yakabviswa ndeyekuti shure kwekudzikinurwa kwehutano yehutano inshumo inotambira kune avo vanorwara zvikuru vemhuri nokukurumidza kupfuura kune dzimwe nhengo dzemhuri. Nemhaka yokuti avo vanorwara nemhuri vane nhepfenyuro yepamusoro yehutano, vanosvika kumunhu wavo akakurumidza kukurumidza kudarika zvavanoda kana chirongwa chacho chaiva nechikwereti chakaderedzwa, uye inshuwarisi yehutano inotanga kuripa kune vose kana akawanda emishonga yehutano hwavo. Ndiko kubhadharo yakagadziridzwa yakagadzirirwa iyo inshuwarheni yavo inobhadhara mukati uye inotanga kubhadhara mhuri isati yabviswa.
Kuchinja kwakaitwa muna 2016
Zvose zviri pamusoro apa zvichiri kushanda, asi mukati mechiratidzo chekutsvaga kuti hapana munhu mumwechete anogona kudiwa kubhadhara mari yakawanda mu-ye-pocket mari (in-network) kupfuura yepamusoro yakagamuchirwa kunze kwehomwe yegore iroro. Yakanga iri $ 6 850 nokuda kwegore ra2016, $ 7150 yegore ra2017, uye $ 7 350 nokuda kwe 2018.
Saka semuenzaniso, gore ra2016 risati rapera, zvaive zvichikwanisa kuva nechirongwa chehutano chakanga chisina kubhadharwa zvakabatanidzwa kana kuti chakaiswa kunze kwe-pocket maximums. Ngatiti chirongwa chacho chaiva ne $ 10 000 yemhuri yakabviswa, uye zvekare chikamu chezana chekugoverwa pashure pacho ( urongwa hwekugadzirisa urongwa hwaive hwakawanda pane HDHPs ). Kana chete nhengo imwe chete yemhuri yaibhadhara mari yekurapa mukati megore, ingadai yakatobhadhara $ 10 000 mushure mekuvharwa kwechikwata. Icho chigadziro chekugadzira hachigoni kubvumirwa nokuti mari yake kunze kwehomwe yaizofanira kutorwa pa $ 7,150 muna 2017. Urongwa hwacho hwakanga huchiri kuve nemhuri inodzingwa madhora gumi nemakumi maviri, asi vanhu vanopfuura mumwe chete vaifanira kutora mari yezvechiremba kuti vasvike iyo yakabviswa.
> Sources:
> Dhipatimendi reZvipatano uye Humana Services. Murwere Anodzivirirwa uye Anogadziriswa Kuchengetedza Mutemo, HHS Chinyorwa Chekubatsira uye Kubhadhara Zvikamu zve 2015. February 2015.
> Dhipatimendi Rezvoutano uye Human Services. Mucherechedzo Kuchengetedzwa uye Kutengeswa Kwezvokuchengetedza Mutemo, HHS Chinyorwa Chekubatsira uye Kubhadhara Zvikamu zve 2018, Kuvandudzwa kweZuva Rokunyoresa Zvikwereti uye Mutengi Anoshandiswa uye Akarongeka Purogiramu . December 2016.