Kuti chirongwa chehutano chako chinotarisira sei zvakasiyana-siyana zvinoenderana neurongwa hwekugadzira
Zvinorevei kana hutano hwehutano huri "husina kubva kune iyo yakabviswa" kana "kwete pasi pekudhara"? Uyu mubvunzo vamwe vaverengi vakave nawo mukupindura kwezvinobudiswa neCommunitywealth Fund yekuongorora zvirongwa zvehutano zvinotengeswa muhurumende dzinoshandisa Healthcare.gov.
Zviri nyore kuona kuti izvi zvingave zvakavhiringidza sei sezvo "kusabviswa" ishoko rinoshandiswa kurondedzera mabasa asina kuvharwa zvachose nehutano hwehutano (taura, somuenzaniso, kushandiswa kwekushaya rubatsiro muhurumende isingadi) .
"Kwete pasi pehurukuro" = iwe unobhadhara zvishomanana
Asi kana basa risina kuiswa kune rakabviswa, zvinoreva kuti iwe wakanyatsogadzirisa zviri nani zvebasa iroro. Izvo zvinoshandiswa ndezvokuti kushanda kunenge kuri pasi pekubviswa, izvo zvinoreva kuti iwe unobhadhara mutengo wakakwana kunze kwekuti waive watoona zvawakabvisa zvegore.
Kuti ujekese, "mutengo wakakwana" zvinoreva mushure mokutengeswa kwe-network-negotiated discount inoshandiswa. Saka kana muongorori wenguva dzose ari $ 250, asi kambani yenyu yehutano inshuwarheni yakataurirana chiyero che $ 150, "mutengo wakakwana" zvinoreva kuti iwe unogona kubhadhara $ 150.
Kuve nemanzwisisiro aya ose, zvakakosha kunzwisisa izwi rinoshandiswa kurondedzera zvirongwa zvehutano . Copay haisi chinhu chakafanana ne coinsurance. Deductible haisi chinhu chakafanana nechokunze kwehomwe yepamusoro (iyo inogona kunge yakadarika $ 6 850 kune munhu mumwechete muna 2016, uye yakakwirira se $ 7150 muna 2017 ). Zvikomborero hazvina kuverengwa mumari yako yekunze-ye-muhomwe (kunyange iwe uchifanira kuisanganisira iyo uri kuita masvomhu kuenzanisa zvirongwa).
Zvakakoshawo kunzwisisa zvakakosha zveMutano Care Act zvakakosha zvehutano, izvo zvinofukidzwa nezvirongwa zvehutano zveboka rimwe nerimwe uye zviduku pamwe nemazuva anobatsira aJanuary 2014 kana kuti gare gare. Kana iwe uine ruzivo pasi peboka duku kana chirongwa cheumwe munhu chisina kuberekwa kana kuti chizukuru , kurapwa kunowira pasi pemaambura eimwe yezvinokosha zvehutano hunofukidzwa neurongwa hwako.
Asi "akafukidzirwa" zvinongoreva kuti zvirongwa zvako zvehutano zvinoshanda. Maitiro aya anobatsira sei zvinoenderana neurongwa hwekugadzirira kwako:
- Iwe ungasafanira kubhadhara chero zvachose (ichi chichava chiitiko chekuchengetedza kudzivirira).
- Kana iwe unofanirwa kubhadhara copay (mari yakadzika iyo inotanga kugadzirirwa neurongwa hwako - zvichida $ 25 kana $ 50 kana $ 100, zvichienderana nemutano uri mubvunzo).
- Kana iwe unogona kubhadhara mutengo wakakwana wekurapa (kana iwe usati wakwanisa kuwana yako deductible zvakadaro).
- Kana iwe unogona kubhadhara chikamu chemari (coinsurance).
Zvose zvezviisarudzo zvinotora se "yakavharwa." Zvimwe zvirongwa zvehutano zvakasikwa uye kuti dzinogadzira sei kugoverwa kwavo (semuenzaniso, chirongwa chisina deductible, asi $ 5,000 copay yekurapwa). Asi pasinei nokuti zvirongwa zvako zvakagadzirirwa sei, mari yaunenge uchibhadhara nokuda kwebasa rakaputika mugore rose ichaverenga kune yako yepamusoro-yepamusoro pehomwe. Inogona kuva chero kusanganiswa kwemakambani, kubviswa, uye kubhadhara mari, asi kana wapedza kugadzirisa gore rose re-pocket, chirongwa chehutano chako chichabhadhara 100% chero ipi zvayo yakavharidzirwa yezvisikwa zvegore (cherechedza kuti kana iwe shandura kune imwe sarudzo pakati pemakore, kubuda kwako kwemahombekombe kunotanga kupfuura neyo chirongwa).
Copays = mari shoma panguva yebasa
Kana hurongwa hwako hwehutano huri nehutano hwakasiyana-siyana hunofukidzirwa asi husingatungamiri kune zvakabviswa, zvinoreva kuti iwe uchabhadharira zvishoma kune izvozvo zvakanyanya kupfuura iwe ungadai dai basa racho richikwaniswa kune rakabviswa.
Kana zvaive pasi pekubviswa, iwe unogona kubhadhara mutengo wakakwana webasa racho, uchifunga kuti iwe wakange usati wambosangana nemari yako yakabviswa (kana waive watoona zvawakabvisa, iwe unogona kubhadhara chikamu chemari - coinsurance - kana kuti hapana zvachose, kana iwe waive watoona huwandu hwenyu hwepamusoro).
Asi kana basa racho risina kuiswa kune rakabviswa, iwe pachako uchava nemhosva yepayipi yakagadzirirwa pane nzvimbo yakakwana. Cherechedza kuti mamwe mabasa - sekuchengetedza, uye pane zvimwe zvirongwa, zvinodhaka zvinodhaka - hazvisi pasi pezvakabviswa kana kuti ikopi, izvo zvinoreva kuti haufaniri kubhadhara chero chinhu chekuchengetedza (zvese zvisati zvarairwa zvinoda rinovhara kuchengetedza kuchengetedza pasina kubhadhara mari, izvo zvinoreva kuti murwere haabhadhara chero chinhu chekutarisira kwakadaro - yakafukidzwa nemishandirapamu inobhadharwa kutenga iyo chirongwa).
Muenzaniso unobatsira mazwi 1 000
Saka ngatiti chirongwa chako chehutano chinokwana $ 35 copays kuona chiremba wekutarisira asi iwe unoyera unyanzvi hwokushanyira kune ductible. Iwe unowana $ 3,000 deductible uye $ 4,000 kubva kunze kwehomwe. Uye muongorori wehutano-hutano hwakananga nekambani yehutano inshuwarisi ye $ 165.
Ngatiti iwe unoshanyira katatu kuPPP yako mugore, uye maviri anoshanya kune imwe nyanzvi. Mari yako yakakwana yekushanyira PCP iri $ 105, uye mari yako yose yekushanyira nyanzvi inosvika $ 330 sezvo iwe uchibhadhara mutengo wakakwana.
Parizvino, iwe wakabhadhara $ 330 kune yako yakabviswa, uye iwe wakabhadhara $ 435 kune yako yepamusoro yepamusoro. ($ 330 pamwe ne $ 105).
Iye zvino ngatitii uri mungozi musati rapera gore, uye kuguma muchipatara kwevhiki. Inpatient mashandiro anoshanda kune iyo yakabviswa, uye urongwa hwako huripa 80% mushure mekunge iwe wakabhadhara iyo yakabviswa kusvikira wapedza huwandu hwako huri kunze.
Nokuda kwekugara muchipatara, iwe unofanirwa kubhadhara $ 2 670 mu deductible mashandiro ($ 3,000 kudarika $ 330 kuti iwe wakatove wakabhadhara kune unyanzvi hwokushanyira). Zvino iwe unofanirwa kubhadhara 20% yezvimiti zvakasara kusvikira mari yose yawakabhadhara gore yakasvika $ 4,000. Sezvo iwe wakabhadhara iyo mapepa matatu eCPP anokwana $ 105, iwe unofanira kungobhadhara $ 895 mubhadharo yekubhadhara kwechipatara ichigara kuti uende kumahombekombe akabuda kunze.
Hezvino iyo mathematiro aizotarisa apo zvose zvataurwa uye zvaitwa:
- $ 330 + $ 2,670 = $ 3,000 akawanikwa
- $ 105 (copays) + $ 895 (coinsurance) = imwe $ 1,000 muzviitiko zvegore
- $ 3,000 + $ 1,000 (deductible plus mamwe ose kunze kwemari) = $ 4,000
- $ 4,000 ihwo huwandu hwehupfumi huripo pahutano hwako, zvinoreva kuti chero humwe hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hwehutano hwegore huchazadzirwa zvizere nehutano hwehutano hwehutano, uchifunga kuti iwe ugare nehumwe urongwa hwegore rose.
Kana hurongwa hwako hwehutano hwakanga hwaiswa pasi pePPP kushanyira kune yakabviswa, iwe ungadai wakabhadhara mutengo wakakwana kune avo pamwe (ngatiti $ 115 mumwe nomumwe). Muchiitiko ichocho, ungadai wakasvika kusvika ku $ 675 pamhosva dzinoshandiswa kune iyo yakabviswa kare usati wagara muchipatara ($ 345 nokuda kwekushanyira PCP, pamwe ne $ 330 nokuda kwekushanyira mazamu). Iwe unenge uchingopedzisira uine $ 4,000 imwe chete mumutengo wekubuda kwehomwe mushure mokunge chipatara chigara.
Asi kana njodzi yacho isati yaitika uye iwe usati wapera muchipatara, mari yako yose yegore ingadai yave yakakwirira pane chirongwa neCPP kushanyira zvichienderana nehurukuro ($ 675, pane $ 435). Kana iwe ukapedzisa kusangana nehuwandu hwako hwekubuda kwehomwe yegore, haisi kuzova nenyaya imwe neimwe kana imwe. Asi kana iwe usingapedzisi kusangana nekunze kwako kwepamusoro, iwe unowanzobhadhara zvishoma apo iwe unoronga ine mabasa asina pasi pekutengesa.
Summary
Usatya kana iwe ukaona kuti mazano haasi pasi pekudhakwa. Chero bedzi ivo vakafukidzwa nepurogiramu yenyu, izvi zvinongoreva kuti iwe uchabhadhara zvishomanana zvemashumiro aya kupfuura iwe waizoita kana akaiswa pasi pezvakabviswa.
Kana iwe uine chirwere chisingaperi, chirwere chakakomba chinoda kurapwa kwakakura, pane mukanano wakanaka wekuti uchasangana nehuwandu hwemapurisa ako kwegore pasinei neurongwa hwekugadzirira, uye iwe uchaona kuti urongwa nekunze kwekunze kwehomwe yepamusoro kuchakubatsira kwauri, pasinei nokuti ichauya nepamusoro-soro.
Asi kana iwe uine hutano uye usati wapedzisa kusangana nemagadziro ako kunze kwe-pocket akakwirira - kana kunyange iyo deductible - ine zvikwereti zvisiri pasi pehurukuro inongoreva chete kuti kambani yako yehutano yehutano ichatanga kutora chikamu zvekutarisira kwako nokukurumidza kudarika zvaizoita kana zvibvumirano zvose zvaive pasi pezvakabviswa (nokuti izvi zvinoreva kuti iwe unofanira kubhadhara mutengo wakakwana kusvikira kubviswa kwacho kwasangana - izvo zvingasazoitika zvachose mugore rakapiwa).
Izvozvo zvakati, kana humwe hutano husingawanikwi kubva kune iyo yakabviswa, inowedzera mapeamisi anowanzove.