Utano Hunobatsira Mitemo Inopesana
Mandated benefits (inozivikanwawo se "yakagadziriswa yehutano inshuwalano" uye "mvumo") inobatsira inofanirwa kuvhara kurapwa kwehutano hwehutano hwakanaka, mamwe marudzi ehutano hwehutano, uye zvimwe zvikamu zvevanhu vanotarisira, zvakadai sevana vakagadzirirwa kutorwa. Zvimwe zvipo zvehutano zvinobatsira zvinotarisirwa nemutemo wehurumende, mutemo wehurumende - kana mune zvimwe zviitiko - zvose.
Pakati pehurumende yehurumende nehurumende, pane zviuru zvehutano hwehutano inshumo.
Kunyange zvazvo mirairo ichiri kuwedzera kuwedzerwa sehutano inshuwarisi inoda, inopesana. Vashandi vanotsigira vanoti mitemo inobatsira kutsigira hutano hwehutano hwehutano hwakakwana apo vamwe (zvikurukuru makambani ehutano hwehutano) vanonyunyuta kuti mvumo inowedzera mari yehutano nehutano inshuwarisi.
Mandated Health Insurance Inobatsira Mitemo
Inyanzvi yehutano inshuwarisi yemitemo yakapedzisira yava iyo federal kana hurumende yenyika inowanzowira mune chimwe chezvikamu zvitatu:
- Chinodiwa kuti zvirongwa zvehutano zvive nehutano hwakasiyana-siyana hwehutano hwehutano kana kurapwa, zvakadai senzira yekushandisa zvinodhaka, kubata pamuviri, in vitro fertilization, mazano ekuberekwa, kuberekwa kwemishonga, uye kusvuta kusvuta.
- Chinodiwa kuti zvirongwa zvehutano zvinosanganisira kugoverwa kwehutano nevanopa vamwe kunze kwevanachiremba, vakadai sevacupuncturists, chiropractors, vanamukoti vanamukoti, vezvemishonga, uye vashandi vomunharaunda.
- Chinodiwa kuti zvirongwa zvehutano zvifukidze vanovimba nevamwe vanhu vakadai, vakadai sekurerwa vana, vadzidzi vanovimba, vazukuru, uye vashandi vomumba.
Mitemo yebatsiro inogamuchirwa kazhinji inoshandisa kuhutano hwehutano hwehutano hunowanikwa nevashandirwi uye inshuwarisi yehutano yega yega inotengwa nevanhu, zvichida kuburikidza nehutano hwekushandiswa kweinishuwarenzi kana kusagadzikana .
Asi panewo magwaro anoshanda kune Medicare uye Medicaid / CHIP .
Mandated Inishuwarenzi Inobatsira uye Mari YeInishuwarenzi
Vanhu vazhinji - vangave vari kana vanopesana nemitemo - vanobvumirana kuti mitemo yehutano yakagadziriswa inowedzera zvikwereti zvemishonga yemishonga yehutano Zvichienderana nebasa rakabhadharwa uye kuti kubatsirwa kwacho kunotsanangurwa sei, mari inowedzera yemwedzi wepamwedzi inogona kuwedzera kubva pasi pe1% kusvika kune 5%.
Kuedza kuongorora kuti kubatsirwa kunogadziriswa kuchaita sei purogiramu yeInishuwarenzi yakaoma zvikuru. Mitemo yemitemo yakasiyana nehurumende kuenda kune imwe nyika uye kunyange iyo iyo mvumo imwe chete, mitemo nemirairo zvinogona kusiyana.
Semuenzaniso, vazhinji vanotumira mvumo yekuparidzirwa kwechiropractors, asi nhamba yekushanyira mvumo inogona kusiyana kubva kune imwe nyika kuenda kune imwe nyika. Imwe hurumende inogona kuderedza nhamba yechiropractor inoshanyira mana gore negore apo imwe hurumende inogona kubvumira chiropractor 12 kuenda kuno rumwe gore. Sezvo chiropractor zvese zvinogona kudhura, zvinokonzerwa nemishonga yehutano yemishuwarenzi inogona kunge yakakura muhurumende pamwe nehuwandu hunobatsira.
Imwe muenzaniso ndeyekudzivirira kusununguka, izvo zvisingadi pasi pemutemo wehurumende, asi zvinotarisirwa nedzimwe nyika. Munharaunda dzehurumende idzi, kune zvakawanda zvakasiyana-siyana maererano nezvinofanira kuiswa mumashoko ekushaya vana, izvo zvinoreva kuti zvinokonzerwa nepurayamisi zvakasiyana zvikuru kubva kune imwe nyika kuenda kune imwe nyika.
Uyezve, kusakwanisa kwemasimba kunogonawo kuwedzera mari yehutano hwehutano uye yemainishuwarenzi ehutano hwehutano. Kana mumwe munhu ane chirwere chekurapa asina kutarisirwa utano hwehutano nokuti hahufukidzwe nehushuwarisi yake, angave ari kurwara uye anoda zvimwe mari dzinodhura mune ramangwana. Muenzaniso weiyi ndeyekuti vanhu vakuru vemazino havakwanisi kubatsirwa nehutano pasi peAACA, uye kana munhu mukuru wezvemazino anofanira kuchengetwa pasi peMedicaid (dzimwe nyika dzinosanganisira kuvhara mazino mumitambo yavo yeMedicaid, asi vamwe vachipa 't). Izvo zvinokonzerwa nekushayikwa kwekuwana kukwanisa kutarisirwa kwemazino kunogona kukonzera kukanganisa kwakanyanya kwenguva refu.
Federal Mandated Health Benefits
Mutemo weBurumende unosanganisira mitemo yakawanda yechuwarisi:
ACA inobatsira hutano huripo (EHBs).
Iko kusingakwanisi Kuchengetedza Mutemo kwaive kuchinja kwemashoko muhutano hwehutano hwemagariro ehutano, kuumba pasi rose maererano nehutano hwakakosha hunofanirwa kuiswa pane imwe nhengo itsva uye yezvirongwa zvehutano hudiki munzvimbo dzose. Chinodiwa kuisa EHBs chinoshanda kune mapoka ega ega uye ediki mapoka nemazuva anobudirira aJanuary 1, 2014 kana kuti gare gare. Nhamba yeEHBs inosanganisira:
- Ambulatory services (kunze kwekuchengetedzwa)
- Emergency services
- Hospitalization (inpatient care)
- Maternity uye kuberekwa patsva
- Utano hwepfungwa uye kushandiswa kwemishonga kushungurudza mabasa
- Prescription drugs
- Mabasa ekugadzirisa uye anobatsira uye zvigadzirwa
- Mabasa ekurapa
- Kuchengetedza kwekuchengetedza uye kusagadzikana kwezvirwere zvehutano ( humwe humwe hutano hwekuchengetedza hunosununguka pane zvese zvirongwa zvitsva, pasinei nokuti nhengo yeurongwa yakagadziriswa sei).
- Zvirongwa zvehutano, zvinosanganisira muromo uye chiratidzo ( kutarisira mazino uye maonero ekuonekwa haafaniri kuvharwa , uye kune zvimwe zvinogadziriswa maererano nemitemo yevana vezvemazino).
Kunze kwekuchengetedzwa kwekuchengetedza uye kushandiswa kwezvipatara, EHBs haifaniri kuvharwa nezvirongwa zveboka guru ("boka guru" rinowanzoreva zvirongwa zvakapiwa nevashandi vane vashandi vanopfuura 50, kunyange zvazvo pane zvine zvayo apo "boka duku" rinosanganisira vashandi pamwe nevashandi vanosvika zana ).
Zvikwata zveboka rakakura zvinowanzove zvakasimba, zvisinei. Uye dzimwe mimwe mitemo (somuenzaniso, zvinodiwa-zvinotsanangurwa pasi apa-kuti zvirongwa zvose zvinopiwa nevashandi vane 15 kana kupfuura vashandi vanovhara kutarisira vana) kunoshanda kumusika mukuru weboka.
COBRA kuenderera mberi kugoverwa
COBRA inopa vamwe vekare vashandi uye vatsigiri vavo kodzero yekuenderera mberi kugoverwa kwemwedzi 18 kusvikira ku36.
Kubatanidzwa kwevana vanorera
Zvimwe zvirongwa zvehutano zvinofanira kupa kugoverwa kune vana vakaiswa nemhuri kuti vawane vana pasi pemamiriro ezvinhu akafanana anoshanda kune vana venyama, kana kubvumirwa kwave kwakaguma kana kwete.
Maitiro ehutano hwepfungwa
Kana chirongwa chehutano chinopa hutano hwehutano hwehutano, gore negore kana hupenyu hwemadhora mitsara inofanira kunge yakafanana kana yakakwirira kudarika muganhu wezvokurapa nguva dzose.
Chipatara chiduku chinogara kuvana vacheche uye vanaamai
Pasi peNewborns 'uye Amai' Health Protection Act ye 1996, zvirongwa zvehutano hazvirevi kubatsiririra chero zvipi zvese zvipatara zvekugara zvakabatana nekuberekwa kweamai kana mwana achangoberekwa.
Kuvandudzwa kwekuvandudza mushure mekuita mastectomy
Urongwa hwehutano hunofanirwa kupa mumwe munhu ari kuwana zvikomborero zvakabatana nemasipectomy nehuwandu hwekuvakazve kwezamu iyo mastectomy yakaitwa.
Vanhu veAmerica vane Dambudziko reDare (ADA)
Vanhu vakaremara uye vasina kudzivirirwa vanofanira kupiwa zviyano zvakafanana maererano nepayamu, kubhadhara, miganhu yekugoverwa, uye kusati kwavepo maitiro ekumirira nguva.
Family and Medical Medical Act (FMLA)
Zvinoda mushandi kuti arambe akachengetedza hutano kwehuwandu hwekuenda kweFMF.
Uniformed Services Employment and Employment Rights Act (USERRA)
Inopa mushandi kodzero yekuenderera mberi kwehutano hwehutano pasi pezvirongwa zvehutano hwevashandirwi paanenge asipo kubva kubasa nekuda kwekushanda muhupfeksi yemasaiti.
Mutemo Wechirwere Chokudzivirira
Zvirongwa zvehutano zvakachengetedzwa nevashandi vane vane 15 kana kupfuura vanoshanda vanofanira kupa huwandu hwakafanana hwekuvhara pamuviri kune mamwe mamiriro.
State Mandated Health Benefits
Izvo zvinyorwa zvakasiyana zvikuru nehuwandu uye rudzi rwezvakagadziriswa, asi kumativi ose enyika makumi mashanu, kune vanhu vanenge 2 000 vanobatsirwa masimba ayo ave akaiswa panzvimbo yemakore makumi matatu apfuura.
Iwe unogona kuwana ruzivo pamusoro pemitemo yehurumende yega yega kubva kune zvimwe zvinyorwa:
- Dhipatimendi renyika yako yveshuwarisi, iyo iwe unogona kuwana kubva pawebsite ye National Association of Insurance Commissioners
- Sangano reNational National State Legislatures (NCSL)
- Chikamu cheKaiser Family Foundation kuumbwa kweHurumende Health Facts
Pasi peAACA, zvose zvitsva (zvinobudirira kubvira muna 2014) boka rimwe nerimwe neboka duku riri kuronga munyika dzose rinofanira kusanganisira kugoverwa kweEHBs, rinofanira kuva nehutano hwemapepa ehutano, uye inofanirwa kuvhara mamiriro ezvinhu akambovapo uye inopiwa kunze kwekufunga nezvehutano hwehutano.
Ndiyo mitemo inoshandiswa iyo zvirongwa zvinofanira kuwirirana, asi zvinogona kudarika zvinodarika zvinodiwa neAACA. Mimwe mienzaniso yezvimwe zvemagariro ehurumende-zvakanakira kuvhara kwekushaya simba, kubhadhara autism, nekugadzirisa kunze kwemapokisi mari yezvinyorwa.
Asi pane mitemo inoda nyika-panzvimbo pane vatsigiri-kubhadhara mari yezvibvumirano zvinobatsira izvo zvinopfuura kudarika kweAACA, izvo zvinoreva kuti dzimwe nyika dzakasarudza kushandiswa mishonga mitsva chete kune zvirongwa zveboka guru, izvo zvisiri pasi pe ACA ndiyo inofanirwa nehutano hwezvoutano (nyora zvakadaro, kuti zvirongwa zvehurumende yega-inshuwaridhe zvinotungamirirwa pasi pemitemo yehurumende panzvimbo yekutarisira kutarisa, saka haisi pasi pezvinodiwa zvitsva izvo zvinoreva kuisa; vazhinji vesangano guru rezvirongwa vanozvimiririra).
> Sources:
> Kaiser Family Foundation. State Health Facts
> National Conference of State Legislatures. Autism uye Inishuwarenzi Inoshandiswa, Mitemo yehurumende. June 7, 2017.
> National Conference of State Legislatures. 2011-2014 Utano Hwoutano Inoshandiswa Kugadziriswa Yakagadziriswa Mitemo yeHurumende inobatanidza neChinakidza Care Act. June 17, 2014.
> National Conference of State Legislatures. Inyore Inishuwarenzi Mandates uye ACA Essential Benefits Provision. March 8, 2017.