Kugovana-kubhadhara mari yekubhadhara kunosanganiswa pamaronga esirivha kana iwe uchikodzera
Kutenga utano hwehutano inodhura, uye kubhadhara mari yepamwedzi yemwedzi haisi iyo chete mari inobatanidzwa nehutano inshuwarisi. Iwewo unofanirwa kubhadhara doroti , zvinyorwa, uye coinsurance kana ukashandisa utano hwako hwehutano. Izvi zvinowanikwa kunze kwehomwe mari, inozivikanwa semari yekugovana, inogona kuwedzera kusvika kumazana emadhora pagore.
Iyo Inogadziriswa Care Care Act yakagadzira inshuwalhu yehutano yehutano yekutenga nekushandisa utano hwehutano inonyanya kukosha kune vanhu vane mari shoma uye ine mwero.
Kune marudzi maviri:
- Inotsigira iyo inoderedza mapeimisi emishonga yemishonga yemishonga yemishonga yemwedzi wepamusoro kuitira kuti kutenga inshuwarano yehutano isingakwanisi. Dzidza zvakawanda pamusoro peizvi mune, " Inhu Inoshuwarenzi Inobatsira Sei-Kunzwisisa Mutero Wekutanga Mutero ."
- Kunotsigira kunobatsira kubhadhara mari-ye-podha mari zvakadai sokuderedza, zvinyorwa, uye coinsurance. Idzi dzinozivikanwa sekugoverana mari dzekubhadhara mari, kana kuderedza kugovana-mari. Vanouya muzvikamu zviviri, kunyange zvazvo zvikamu zvose zviri zviviri zvinongowanikwa zviri muchirongwa chesirivha kune vakakodzera kunyora:
- Chikamu chimwe chinoderedza chikwereti chaunobhadhara nokuda kwekubvisa kwako, makopiko, uye kubhadhara mari imwe neimwe paunoshandisa inshuwarisi yehutano. Dzidza zvakawanda pamusoro pemubatsiro uyu, " Maitiro ekugoverwa kweAinishuwarenzi yehutano Inobatsira ."
- Chikamu chechipiri chinoderedza purogiramu yako yepamusoro-ye-pocket kuitira kuti iwe ubhadharwe zvishoma apo utano hwako hwekutarisira huri pamusoro.
Chii Chinonzi kunze kwe-Pocket Maximum?
Iko -in-pocket yepamusoro , kana kuti kunze kwe-pocket muganhu, ndiyo yakaipisisa-case-scenario yakawandisa yemari yaunofanira kubhadhara kune mari yekugovana-mari dzinoshandiswa sekutengeswa kwako, makopiko, uye kubhadhara gore negore.
Kana uchinge wakabhadhara zvakakwana mu deductible, makopiko uye coinsurance kuti wakasvika kune imwe nzvimbo yepamusoro-soro, inshuwarisi yehutano inopa zvikwereti zvako zvose zvehutano zvakachengetwa kwegore rose.
Kana iwe usingashandisi utano hwako hwehutano huzhinji, mari yako yekugoverana mari haigoni kusvika kumiganhu yekunze-ye-pocket.
Zvisinei, kana iwe une dambudziko risingakoshi rehutano kana kuti chirwere chimwe chinotyisa kana kukuvadzwa, iwe unogona kuripa zviri nyore mu coinsurance uye inodhadharwa mari kuti usvike kunze kwehomwe.
Semuenzaniso, kana iwe ukawa kubva pamatanho uye ukaputsa chiuno chako paunenge uchichera muti, chikamu chako chemukana wekukurumidzira, chirwere chekuvhiya uye chipatara mari inogona kudarika $ 10 000 kana utano hwako hwehutano hwehutano husina chikamu chekunze.
Zvisinei, kana hutano hwako hwehutano inshuwarisi ine chikamu chekunze kwema $ 6,000, iwe unobva urega kubhadhara kana wakabhadhara $ 6,000 kune hutano hwako hwehutano. Mushure meizvozvo, inshuwarisi yako yehutano inopa 100 muzana yemishonga yako yehutano yehutano kwegore rose. Iwe waizobhadhara $ 6000 panzvimbo ye $ 10,000. Kana iwe uchida kutarisirwa zvakare gare gare mugore, hurongwa hwako hwehutano huchabhadhara mari yose.
Musati gore ra2014, hurongwa hwehutano hwakanga husingadiwi kuti hubatanidze zvikwereti zvisingabatsiri. Zvizhinji zvirongwa zvakaitwa, kunyange zvazvo pakanga pane kuchinja kwakakura maererano nekukwirira kwemiganhu kwakabva kune rimwe zano kune rimwe. Uye zvimwe zvirongwa zvakangoita kuti zvisave zvisingatauri pachena.
Icho hachisi ichocho nekuda kweAACA. Kunze kwemagadzirirwo makuru uye ane zvizvarwa zvakawanda, zvirongwa zvose zvinoda kubhadhara mari inodarika madhora 6,850 kune mumwe munhu muna 2016 (mhuri yemiganhu inopetwa kaviri kupfuura yakakosheswa), kunyange iri kuwedzera zvakare nokuda kwe 2017 (izvo ACA's inoda hazvirevi kuMedare; vanhu vane Vekutanga Medicare kugoverwa havana muganhu pane zvavanenge vasingakwanisi kuita mari, ndizvo zvinoreva kuti vazhinji veMedarere vanozvinyora vanowedzera kubhadhara, zvichida nekunyora muMedare Advantage pane Pakutanga Medicare, kana nokutenga chirongwa cheMedigap).
Ndezvipi Zvisina Kubatanidzwa MuZvinyorwa-Mukati-Mahombe?
Iko-kunze kwehomwe yepamusoro haisanganidzi mishonga yako yemainishuwarensi yehutano yepamwedzi. Iyo haina kusanganisira mari yezvinhu zvisingafukidzwi nehutano inshuwarisi kana kuti hazvisi hutano hunobatsira. Somuenzaniso, kana inshuwarhu yehutano yehutano isingabatanidzi maitiro ekugadzirisa maitiro, kubhadhara mari yako hazvirevi kutarisa kwako kunze kwehomwe. Iyo haisanganisi chikamu-chikwereti chikamu chekuchengetwa kwawakawana kubva kune -kunze-network- utano hwekupa mupiro. Dzidza zvakawanda mu " Chii Chisingagoni Kuverengera Kumutsetse Wako Wechipfuva? "
Ndezvipi Zvakawanda Zviri kunze kwePocket Maximum Pamberi Patsigiro?
Zvose zvehutano inshuwalhu yehutano hutengo inotengwa kuburikidza neChipatara Chine Utano hweHutano hweInishuwarenzi yehutano inofanirwa kunge iine chikamu chekunze kwehomwe.
Hurumende yehurumende inotarisa kuti kukwirira kwakadini kunogona kuva, uye mari yakabvumidzwa inoshandurwa gore negore.
Kwegore ra2016, humwe huwandu hwemapurisa hahukwanisi kuva ma $ 6 850 kune mumwe munhu kana $ 13,700 pamhuri. Utano hwehutano inshuwarheni hunogona, kunyange zvakadaro, hune mutezo wekunze uri kunze kweiyo.
Inishuwarenzi yehutano Inobatsira Zvakadini Kuderedza Iko-Kwe-Pocket Maximum?
Kunyanya mari inobhadhara mari yako inogadzirisa chikamu chako chekunze chekugadzirisa zvinoenderana nemari yako. Izvo zvaunowedzera mari yako ndeye federal poverty level (FPL), kana uwandu hwekubuda kwehomwe yako huchaderedzwa. FPL inochinja gore roga roga uye inosiyana zvichienderana nehukuru hwemhuri uye kwaunogara (Alaska naHawaii vane FPLs dzakasiyana).
IFPL yakashandiswa kugadzirisa mari yako ye 2016 inobhadharwa $ 11,770 kune mumwe munhu, $ 15,930 kune vaviri, uye $ 20,090 yemhuri yevatatu. Iwe unogona kuwana FPL kune mamwe makore uye mhuri dzakakura pano.
Sezvo zvose FPL uye muganhu wehurumende pa-kunze kwehomwe mari yakawanda inoshanduka gore roga roga, dhora racho rekuderedza kwako richachinja gore negore.
Kuti uwane rubatsiro kubva kune rubatsiro iyo inoderedza kusununguka kwako kwekunze kwemahombe, unofanirwa kunyoresa muchirongwa chesirivha kuburikidza nekutsinhana. Tichifunga kuti iwe unosarudza chirongwa chesirivha, yekubatsira kwe 2016, kana iwe uchiwana:
- 100-200 muzana yeFPL,
- muganhu wako wekunze-we-pocket hausi wepamusoro $ 2 250 kune mumwe munhu.
- muganhu wako wekunze-muhomwe hausi kuzove inopfuura $ 4,500 yemhuri.
- 200-250 muzana yeFPL,
- muganhu wako wekunze-muhomwe haufaniri kuva mari inodarika $ 5,450 kune mumwe munhu.
- muganhu wako wekunze-we-pocket hauzove uri kupfuura $ 10,900 yemhuri.
Kubva muna 2017, muganhu wekunze kwemapurisa kune avo vakakumbira mari inosvika pakati pe100 ne200% muzana yeFPL ichawedzera zvishoma, kusvika pamadhora mazana maviri nemakumi mashanu, asi mamiriyoni ekubuda kwevanhu vane mari iri pakati pe2002 ne250 muzana yeFPL ichawedzera kusvika $ 5 700 (mumatambudziko acho maviri, iyo inowanikwa mumhuri yemiganhu inopetwa kaviri pamuganhu mumwechete).
Kurapa kwakakosha kunowanikwa kuNative America maIndia ane miriyoni inopfuura 300 muzana yeFPL. Mumamiriro avo ezvinhu, inshurensi yehutano ichabvisa mari yose yekugoverana chero ipi zvayo inobatsira yehutano.
Kana Icho Chitsigiro, Unowana Mari Here?
Iko-ye-pocket maxim subsidy haisi kukupa mari. Pane kudaro, inogona kukuchengetedza mari sezvo iwe uchibhadhara zvishomanana usati wasvika pakudarika kwako kwepamusoro pehomwe.
Kana iwe ukasvika kune iyo yakaderedzwa kunze kwehomwe yepamusoro uye unoramba uchishandisa masangano ekuchengetwa kwehutano, kambani yako yehutano inshuwarheni ichagumisa kubhadhara zvimwe zvekutarisira kwako kudarika kana iwe usina kugamuchira rubatsiro. Mukudaro, hurumende yehurumende ichadzorera kambani yehutano yehutano yehutano nokuda kwemari yakawedzerwa yakashandiswa nekuda kwekubatsira kwako.
Ndiani Anokodzera Kubhadhara Kwemahombekiti Ehutano?
Kuti ave akakodzera kubhadhara iyi:
- Mari yako inofanira kunge iri 100-250 muzana yeFPL.
- Unofanirwa kuwana inshuwarhu yako yehutano kuburikidza nehutano hwehutano inshuwarheni .
- Iwe unofanirwa kusarudza chirongwa chechirwere-tier yehutano (zvisingaenzaniswi rubatsiro rwekutanga, izvo zvinoverengerwa zvichienderana nemararamiro esirivha-tier, asi anowanikwa kuti ashandiswe pane zvese zveurongwa hwematanda)
- Kana iwe wakaroora, nzvimbo yako yekutsvaga mutero inofanira kuva yakaroora kuisa pamwe chete. Chimiro chekuroora kana kuchinyorera zvakasiyana pachako chichakusiya iwe. (Pane chimwe chinhu chakasiyana kana iwe usingakwanisi kuisa pamwe chete nekuda kwekunyadzisa mamiriro ezvinhu.)
- Iwe unofanira kugara muUnited States zviri pamutemo.
- Iwe haugoni kuiswa mutirongo.
- Iwe haufaniri kukodzera kubhadharwa kubva kune waunoshandira unofungidzirwa kutenga uye unopa huwandu hunokosha .
Iwe Unoshandisa Sei Iri Rubatsiro?
Iwe haufaniri kuita chimwe chinhu chinowedzera kuti uwane mari yekugovera mari. Kana iwe uchikwanisa kuzviita zvichienderana nemari yako, inenge ichinyatsoiswa mumaronga esirivha ayo anowanikwa kwauri kuburikidza nekutsinhanisa.
Kufanirwa kwako kwekubhadharwa kwepayimusi uye kugoverana kwezvikwereti kunotarisirwa nekutsinhanisa paunopinza ruzivo rwako pachako mumagadziriro avo. Iva wakagadzirira kupa utano hwehutano inshuwarano ruzivo pamusoro pemari yako, mhuri yako, uye mushandirwi kana iwe uine basa. Tsvaga hutano hwehutano hwehutano hwako.
Kunze kwemamiriro ezvinhu chaiwo , unogona kungotenga inshuwarhu yehutano kuburikidza nehutano hwehutano hwehutano panguva yekunyora kwegore rose . Vhura kusungirirwa kuti uwane inshuwarano yehutano ye 2017 inotangira kubva munaNovember 1, 2016 kusvika munaJanuary 31, 2017 (izvi zvinoshanda kune inshuwarisi yehutano yaunotenga iwe pachako, kusiyana neshoko raunowana kubva kumushandi).
Kana iwe ukawana iyo yakaderedzwa-ye-pocket masimba ekubhadhara, ita nechokwadi kuti iwe ugozivisa hutano hwehutano inshuwarano kana mari yako inoshandurwa mukati megore. Kana mari yako inopera, iwe unogona kukodzera kubhadhara rubatsiro rwako kuti uwedzere kuderedza huwandu hwemapurisa ako.
Maitiro api kunze kwePasidhi-Mhemberero Mitemo uye Zvikamu Zvakachinja
Inotengeswa Care Care Act pakutanga yakaratidza kuti mirefu yekunze-ye-pocket inoderedzwa ne
- 2/3 kuvanhu vane mari kubva ku100-200 muzana yeFPL.
- 1/2 yevanhu vane mari kubva ku 200-300 muzana yeFPL.
- 1/3 yevanhu vane mari kubva ku300-400 muzana yeFPL.
Zvisinei, iyo haisi iyo yakaguma ichishanda. Dhipatimendi reZvipatano neHuman Services rakagadza kuti hazvingakwanisi kubvisa chikamu chepamusoro-chepamusoro chekuti vanhu vakawanda vanoita zvinopfuura 250 muzana zveFPL pasina kuputsa dzimwe nhengo dzomutemo kana kuita kuti kuwedzerwa kwevamwe vanobhadhara mari . Saka, mumutemo wokupedzisira unobudisa nzira iyo rubatsiro runoshandisa, HHS yakashandura zviyero izvi kuti zvideredze huwandu hwehupfumi hunoti:
- 2/3 kuvanhu vane mari kubva ku100-200 muzana yeFPL
- 1/5 yevanhu vane mari kubva ku200-250 muzana yeFPL
- Hapana kuderedzwa kwevanhu vane mari inopfuura 250 muzana yeFPL.
HHS inogona kugadzirisa kune zviyero izvi gore roga roga kana richibudisa "Chinyorwa chebatsiro uye zvikamu zvekubhadhara" kwegore rinotevera.
Sources:
Dhipatimendi reZvipatano neHuman Services, The Notice of Benefit and Payment Parameters for 2016, Yakasvika muna June 6, 2016.
Dhipatimendi Rezve Utano neHuman Services, The Notice of Benefit and Payment Parameters for 2017. Yakasvika muna June 6, 2016.
The Notice of Benefit and Payment Parameters for 2014, Dhip Health and Human Services, http://www.gpo.gov/fdsys/pkg/FR-2013-03-11/html/2013-04902.htm. Yakasvika musi waSeptember 10, 2013.
Actuarial Kukosha uye Kukosha-Kugoverana Kuderedzwa Bulletin, Dhipatimendi reZvipatano neHuman Services, http://www.cms.gov/CCIIO/Resources/Files/Downloads/Av-csr-bulletin.pdf
Murwere Anodzivirira & Affordable Care Act , chikamu 1402 (c). Yakasvika musi waSeptember 9, 2013.
Jost, Timothy, "Kuita Kubudirira Kwehutano Hwenyika: Kubatsira uye Kubhadhara Zvikamu Zvokupedzisira Murairo" wakawanikwa paHealthAffairs.org, Svondo 9, 2013.