Bhizimisi yehutano yehutano inowanikwa pamwedzi wepainishuwarenzi kana chirongwa chehutano kuti upe hutano hwehutano. Kuvhara kwehutano hwezvehutano kunowanzobatanidza zvose kana chikamu chemari yehutano-yakabatanidzwa nheyo dzakadai sechiremba anoshanyira, hospitalizations, zvinyorwa, nemishonga.
Muchidimbu, mubayiro wekubhadhara iwe ndiyo inowanikwa kune imwe yekambani yehutano inshuwarisi inochengetedza chinyorwa zvizere.
Premium kubhadhara ine zuva rakakodzera pamwe chete nenguva yenyasha. Kana purogiramu isingabhadharwi zvakakwana pamagumo enyasha, kambani ye inshuwarisi yehutano inogona kumisa kana kubvisa kugoverwa.
Zvimwe zvehutano hwehutano inshuwarheni dzinogona kusanganisira kubhadhara , kubhadhara , uye kubhadharwa . Izvi ndizvo zvaunobhadhara kana uchida kurapwa. Kana iwe usingadi chero kurapwa, haugoni kuripa deductible, copays, kana coinsurance. Asi iwe unofanirwa kubhadhara mubayiro wako mwedzi mumwe nomumwe, pasinei nokuti unoshandisa utano hwako hwehutano kana kwete.
Ndiani anoronga Health Insurance Premium?
Kana ukawana kurapwa kwehutano kuburikidza nebasa rako, wako waunoshandira achawanzobhadhara zvimwe kana kuti mwedzi wekutanga wepurogiramu yemwedzi. Kakawanda, kambani yako inoda kuti iwe ubhadhe chikamu chemari yemwedzi, iyo ichaderedzwa kubva pamari yako. Vachazovhara zororo rose.
Maererano neongororo yekubatsira yevashandi veKaiser Family Foundation ye 2016, vashandi vakabhadhara muvhareji ye 82 kubva muzana yevashandi vasina kubhadhara vashandi, uye avhareji ye 71 muzana yemakambani ekutanga emhuri, kune vashandi vanowedzera nhengo dzemhuri muchirongwa.
Kana iwe uri kuzvipira iwe pachako kana kutenga yako yehutano inshuwarisi, iwe somunhu wega unotarisirwa kubhadhara premium yemwedzi mumwe nomumwe mwedzi. Zvisinei, kubva muna 2014, Affordable Care Act yakapa mari yepamusoro yekutora zvikwereti (rubatsiro) iyo inowanikwa kune vanhu vanotenga zvakapambwa kuburikidza nekutsinhanisa .
Kuti uwane chikwereti chekubhadhara mari yepamusoro, mari yako haigone kudarika 400 muzana ye federal poverty level, uye iwe haugone kuwana kukwanisika, kubhadharwa zvakakwana kubva kumushandi wako kana kumushandi wako.
Zvipo zvekutsvaga kushandiswa kubva muna 2014 zvinowirirana neAACA, asi rubatsiro rwema premium harungashandisi kukanganisa mari yavo. Izvozvo zvinogona kuchinja, zvakadaro, kana America Health Care Act inogadziriswa .
Muenzaniso wePaulumu
Ngatitii makanga mutsvaga nezvehutano hwehutano uye zvirongwa kuitira kuti muwane chirongwa chinogona kutenga uye chakakodzera iwe nevanoda. Mushure mekutsvakurudza kwakawanda, iwe pakupedzisira unopedzisa kusarudza hurongwa humwe hunodhura madhora 200 pamwedzi. Mari iyo yemwedzi 200 yemwedzi ndeyehutano wehutano premium yako. Kuti hutano hwako hwose hubatsire kuramba uchingoshanda, premium yehutano yehutano inofanira kubhadharwa zvakakwana mwedzi wose.
Kana iwe uri kubhadhara mubayiro wako uri wega, bhadharo yako yemwedzi nevhiki ichauya kwauri zvakananga kwauri. Kana mushandirwi wako achipa urongwa hwehutano hwehutano hwehutano, iyo miriyamu ichabhadharwa kurongwa hwe inshuwarisi nemushandi wako (kana mushandirwi ari oga-inshuwarisi, iyo inowanzova iyo yevashandi vakawanda kwazvo), kunyange zvazvo chikamu chekambani yepamusoro zvichida kuunganidzwa kubva kune umwe neumwe mushandi kuburikidza nemubhadharo wokubhadhara.
Kana iwe uine chirongwa chehutano hwezvehutano kuburikidza nekushandura uye uri kugamuchira purogiramu yekubhadhara, rubatsiro runobhadharwa nehurumende, zvakananga kune yako inshuwarisi yekambani. Chikamu chinosara chekutanga chichaendeswa kune iwe, uye iwe unofanira kubhadhara chikamu chako kuitira kuti uchengetedze kugovera kwako kushanda. Zvimwewo, iwe unogona kusarudza kubhadhara mari yakazara ye premium iwe mwedzi woga woga ugoti yako premium rubatsiro pamutero wako kudzorera gore rinotevera (iyi haisi yowanzosarudzwa, asi iripo uye inosarudzwa ndeyako).
Deductibles, Copays, uye Coinsurance
Zvikwereti zvinotarirwa mari inofanira kubhadharwa pamwedzi.
Kana ma-premium enyu akwana kusvika, iwe uri inshuwarisi. Ichokwadi kuti iwe uri bhizimisi, zvisinei, hazvireve kuti zvinoreva kuti mari yako yese yehutano inobhadharwa.
Deductibles . Deductibles, maererano neHealthcare.gov, ndiyo "mari yaunobhadharwa nokuda kwehutano hwehutano husati wasvika purogiramu yako yehushuwarisi inotanga kuripa." Ne $ 2,000 inodhakwa, somuenzaniso, iwe unobhadhara $ 2,000 yekutanga yehupfumi iwe pachako. , iwe unowanzobhadhara chete mari yekubhadharwa kana kuti mari yekubhadhara kwemabasa akavharwa. " Mari yebhadharo inowanzosungwa zvakanyanya kune vanobviswa: iwe uchabhadharira mari yakawanda yeinishuwarenzi iyo inoderedza zvishoma, uye zvakasiyana-siyana (cherechedza kuti zvirongwa zveAACA-zvinogamuchirika, kusanganisira zvirongwa zvinotsigirwa nevanoshandira uye zvirongwa zvemisika, pane zvimwe zvinodzivirira pa hapana mari kune vanobhadhara, kunyange kana iyo yakabviswa isati yasangana).
Co-kubhadhara . Kunyange kana hutano hwehutano inshuwarisi uine zvishoma kana zvisingabhadharwi, iwe ungangodaro unobvunzwa kubhadhara mari shoma yekurapa. Iyi mari inonzi "co-kubhadhara." Zvizhinji zvezvirongwa zvinosanganisira zvose zvakabhadharwa uye kubhadhara pamwe chete, pamwe nemari yekubhadhara inoshandiswa kune zvinhu zvakadai sekushanyira mahofisi nemitemo, asi iyo inobviswa inoshandiswa kumakamuri ekurapa, basa rebasa, kuvhiyiwa, nezvimwewo. Kubhadhara kunogona kuwedzera kana mwedzi miviri inenge iri pasi .
Coinsurance. Healthcare.gov inotsanangura kuburitswa kwehutano sezvinotevera: "kuwandisa kwemari yehutano hwehutano hwakabhadhara iwe unobhadhara (20%, somuenzaniso) mushure mekunge iwe wakabhadhara mari yako yakabviswa. yako coinsurance ndeye 20 %.Kana iwe wakabhadhara yako yakabviswa: Unobhadhara 20% ye $ 100, kana $ 20. "
Deductibles, co-payments, uye coinsurance zvinoshandiswa kune murwere wegore negore. Gore roga roga-kunze kwehomwe yepamusoro ndiyo yepamusoro-soro kana yehuwandu huwandu huwandu hwehutano hwekambani yehutano inshuwarano inoda murwere kuzvibhadhara ivo pachavo kumutengo wose wehutano hwavo.
Kana imwe nguva kugadziriswa kwechiremba, kubhadharwa kwemari, uye kubhadhara mari yakabhadhara kwegore rimwe chete kunowedzera kusvika kune imwe yepamusoro-pfupa, zvido zvekugoverana kwezviremba zvino zvakapedzerwa gore iroro. Kutevera kuzadzika kwehuwandu hwepasipo, purogiramu yehutano inotora zvose zvinokonzerwa nekuchengetedzwa kwe-network kusara kwegore. Kunyange zvakadaro, miriyamu inofanira kuramba ichibhadharwa, mwedzi woga woga, kuitira kuti ichengetedze kuparidzirwa.
> Sources:
> Kaiser Family Foundation, 2016 Employer Health Benefits Survey. Svondo 14, 2016.