Ndiphulukene neinshurensi yam yezempilo — ngoku kuza kuthini?
InkampaniUkuyekiswa umsebenzi okanye ukugxothwa emsebenzini akuthethi nje ukuba ulahlekelwe ngumvuzo — kubantu abaninzi baseMelika, kukwathetha nokuba ulahlekelwe yinshurensi yezempilo. Ukusukela ngo-2018, phantse isiqingatha sabantu baseMelika bafumana i-inshurensi yezempilo exhaswa ngumqeshi, ngokophando olwenziwe yi Isiseko soSapho seKaiser . Ingxaki eyaba yinto ebaluleke kakhulu ngexesha lesifo se-coronavirus bhubhane (i-COVID-19) xa inani lerekhodi labantu base-US baphulukana nemisebenzi kunye nokugubungela kwabo kwangaxeshanye umngcipheko wokugula wanyuka.
Kwaye ngaphandle kwe-inshurensi yezempilo, usenokuzibuza ukuba uza kuzihlawula njani iindleko zonyango ezibalulekileyo njengokundwendwela ugqirha, amayeza amiselweyo, kunye nokhathalelo olungxamisekileyo. Kodwa kukho iindlela zokukhetha-izicwangciso ezixhaswe ngumqeshi ayisiyiyo kuphela indlela yokugubungela impilo.
Ezinxulumene: Uyifumana njani i-inshurensi yezempilo
| Ulahlekile i-inshurensi yezempilo? Thelekisa ukhetho lwakho | |||
|---|---|---|---|
| Khetha | Iinkonzo | Bendlela | Izixhobo |
| I-COBRA okanye izicwangciso zeNdawo yeNtengiso | Ukubonelela ngokugubungela okuqhubekayo emva kokuphulukana nomsebenzi | Ezi zicwangciso zihlala zibiza kakhulu kunezicwangciso zeinshurensi yezempilo yomqeshi | Funda ngakumbi malunga neCOBRA |
| Medicaid okanye i-CHIP | Ixabiso eliphantsi kwi-inshurensi yezempilo | Kuya kufuneka uhlangabeze iimfuno zokufumana umvuzo | Funda kabanzi malunga neMedicaid |
| I-inshurensi yexesha elifutshane okanye umsantsa | Ungabhalisa nanini na | Hayi njengebanzi njenge-inshurensi yezempilo yexesha elide | Funda ngakumbi malunga ne-inshurensi yezempilo yexesha elifutshane |
| Ukhathalelo | Iibhondi ziyi-100% yasimahla, ezinokuphinda zisebenze kuyo yonke into yokugcwalisa, kwaye akukho inshurensi iyafuneka | Ukhathalelo olulodwa hayi uhlobo lweinshurensi yezempilo | Funda ngakumbi ngeSingleCare |
Ndiphelelwe ngumsebenzi. Ndenza ntoni nge-inshurensi yezempilo?
Ukuba kutshanje uphulukene okanye ushiye umsebenzi wakho, unokulungela ukwandisa ingxelo yakho yangoku phantsi I-COBRA (Umthetho woDityaniso loHlahlo-lwabiwo mali lwe-Omnibus). Lo mthetho ucacisa ukuba — ukuba ngaba kufikelelwe kwiikhrayitheriya ezithile-umqeshi kufuneka andise isicwangciso sempilo seqela lakho ukuya kwiinyanga ezili-18 emva kotshintsho lwakho kwingqesho. Kwezinye iimeko ezinqunyelweyo, ukugubungela kunokuhlala ukuya kwiminyaka emithathu.
Zintathu izinto ekufuneka zifezekisiwe ukuze umntu afaneleke ukufumana i-inshurensi yezempilo ye-COBRA, ngokweSebe Lezabasebenzi lase-US, uLawulo lweZibonelelo zaBasebenzi.
- Isicwangciso sempilo seqela lakho kufuneka sigutyungelwe yi-COBRA
- Umnyhadala ofanelekileyo kufuneka wenziwe (ukupheliswa nangasiphi na isizathu ngaphandle kokuziphatha gwenxa, ukushiya isikhundla, okanye ukunciphisa iiyure)
- Kuya kufuneka ube ngumxhamli ofanelekileyo kulo msitho
Amaqabane nabantwana abaxhomekeke kubo banokufumana i-COBRA, nangona uluhlu lweekhrayitheriya lwahlukile. (Ungabona uluhlu olupheleleyo Apha .)
Ukuba ulungele ukufumana ukwanda okwandisiweyo phantsi kwe-COBRA, uya kunikwa ixesha elithile (ngesiqhelo kwiintsuku ezingama-60) apho unokukhetha khona ukhuseleko, ukubuyela kumhla wokugubungelwa kwakho ngewayengazange aphele. Ukuba uyasilela ukukhetha i-COBRA yokugubungela ngeli xesha, ngekhe ukwazi ukwenza njalo kamva.
Umyinge ophantsi kwe-COBRA uhlala ubiza kakhulu kune-inshurensi ngomsebenzi wakho kuba umqeshi wakho wayenokunceda ukuhlawulela iipremiyamu zakho zenyanga. Akukho mfuneko yokuba benze njalo phantsi kwe-COBRA. Umyinge wobude uyahluka-iinyanga ezili-18 ubuncinci, nangona inokwandiswa ukuya kuthi ga kwiinyanga ezingama-36, kuxhomekeke kwimisitho efanelekileyo.
Ulwazi malunga nendlela yokwenza isicelo se-COBRA kufuneka ibandakanywe kwisicwangciso solwazi osifumeneyo xa i-inshurensi yakho yaqala. Uyakufumana kwakhona imbalelwano evela kwisicwangciso sakho seinshurensi okanye kumqeshi malunga namanyathelo alandelayo e-COBRA nje ukuba imeko yengqesho yakho itshintshile.
Ukuba uthatha isigqibo sokungakhethi i-COBRA okanye ayifumaneki kuwe ngenxa yokuba ungazifezekisi zonke iikhrayitheriya, unokufuna ukuqaphela indawo yentengiso yeinshurensi yezempilo (okanye ngokulula, indawo yentengiso), apho unokuthelekisa amaxabiso ezempilo yabucala izicwangciso zeinshurensi. Kwakhona, uya kufuna ukuba wazi izithintelo ezithile zexesha xa uphanda ukhetho lwakho. A Ixesha elithile loBhaliso Ngokwesiqhelo inikwa umntu osandula ukushiya okanye uphulukene nomsebenzi, kodwa kufuneka ukhethe isicwangciso kwithuba leentsuku ezingama-60 ngaphambili okanye kwiintsuku ezingama-60 emva kokuphulukana nesimbozo sakho ngomsebenzi. Ukuba akunjalo, kuya kufuneka ulinde de kube lixesha lokubhalisa elivulekileyo ukuze ufumane ingxelo. Qaphela ukuba amaxesha obhaliso avulekileyo anokuhluka, kuxhomekeka ekubeni ilizwe lakho linotshintshiselwano okanye lixhomekeke kutshintshiselwano lwaseburhulumenteni. Unokufumana ulwazi ngakumbi ku kwezempilo.gov .
Ezinxulumene: Uyifumana njani i-inshurensi yezempilo emva kokuphela kobhaliso
Ndidinga i-inshurensi yezempilo, kodwa andinamvuzo
Ukuba awukwazi ukufumana i-inshurensi yezempilo, jonga ukuba ukulungele na ukufumana ingxelo phantsi kwelungu losapho. Okwezo Ngaphantsi kweminyaka engama-26 , unokwazi ukujoyina icebo labazali-kuxhomekeke kwisicwangciso sabo-nokuba awuhlali nabo okanye awuxhomekekanga kubo ngokwasemalini. Ngokuchaseneyo, ukuba utshatile okanye kubambiswano lwexesha elide, unokukwazi ukujoyina iqabane lakho okanye isicwangciso esixhaswe ngumqeshi wakho. Umtshato ubalwa njenge isiganeko sobomi esifanelekileyo , Oko kuthetha ukuba unokongezwa kwisicwangciso seqabane lakho ngaphakathi kweentsuku ezingama-30 (okanye ngaphezulu) kokuba utshatile. Ukuba awuhlangabezani nalo mhla wokugqibela, kuya kufuneka ulinde de kufike ixesha lokubhalisa elivulekileyo elilandelayo ukuze ujoyine.
Ukuba isicwangciso selungu lentsapho asiyiyo inketho, unokufanelekela ukukhutshwa phantsi kweMedicaid okanye iNkqubo ye-Inshurensi yezeMpilo yabantwana (CHIP), iinkqubo ezimbini ze-inshurensi yezempilo nezombuso ezinceda abantu baseMelika abanengeniso ephantsi ngeendleko zonyango (nokuba kungokubonelela nge-inshurensi ngokuthe ngqo okanye ngesicwangciso sabucala). Ukusukela ngoFebruwari 2020, Izigidi ezingama-63.8 zaseMelika zagutyungelwa phantsi kweMedicaid. Iindleko kunye nokugubungela kuyahluka kurhulumente ukuya kurhulumente (amanye amazwe, umzekelo, abonelela ngomntu omdala onomvuzo uwela ngaphantsi komyinge othile kwinyanga nganye), ke kuyakufuneka uphande iimfuno zikarhulumente wakho. Nazi iindlela ezimbini zokufaka isicelo seMedicaid ukuba awufanelanga ngokuzenzekelayo:
- NgeNdawo yeNtengiso ye-Inshurensi yezeMpilo: Ukuba emva kokugcwalisa isicelo, kubonakala ngathi wena okanye umntu othile kwikhaya lakho unokufanelekela iMedicaid, indawo yentengiso iya kuthumela ulwazi lwakho kwiarhente yaseburhulumenteni elawula iMedicaid. Ngexesha lale nkqubo, unokufumana ulondolozo (olufana nenkxaso yoKhathalelo efikelelekayo) kwisicwangciso sabucala esisekwe kwingeniso yakho, enokuthi yenze ukuba isicwangciso sabucala sifikeleleke ngokwezemali.
- Ngokuthe ngqo kwiarhente yakho yonyango yeMedicaid: Fumanisa ukuba ungaqhagamshelana njani neyakho Apha .
Ezinxulumene: Utshintsho lweMedicaid ngo-2020
Uyifumana njani i-inshurensi yezempilo
Ukuba ufuna ngokukhawuleza ukugubungela kodwa ixesha lokubhalisa elivulekileyo lisekhona iinyanga, ungafuna ukuqaphela a isicwangciso seinshurensi yezempilo yexeshana elifutshane njengendawo yokumisa. Izikhokelo zoqobo ezapasiswa ngo-2016 zichaza ukuba i-inshurensi yexesha elifutshane inokuhlala kuphela iinyanga ezintathu. Nangona kunjalo, imithetho emitsha phantsi kolawulo lukaTrump wandise elo xesha ukuya kwiintsuku ezingama-364, ngokunokwenzeka ukongezwa ukuya kuthi ga kwiinyanga ezingama-36.
Ukucaca, i-inshurensi yexesha elifutshane ayinikezeli ngxelo efanayo efanayo njengesicwangciso sezempilo seqela okanye isicwangciso esifanelekileyo phantsi kwe-ACA. Umzekelo, izicwangciso zexesha elifutshane akufuneki zigubungele iindleko zonyango, iindleko zokubeleka, okanye abantu abaneemeko esele zikho. Icala elisezantsi kukuba awunyanzelekanga ukuba ulinde ixesha lokubhalisa elivulekileyo, kwaye ukogquma kuqala ngaphakathi kweentsuku zokuvunywa kwesicelo sakho.
Omnye umthombo weinshurensi eyongezelelekileyo yi-inshurensi ye-gap (i-inshurensi ye-AKA yeinshurensi yakho). Ngelixa kungenzelwanga ukuba kusetyenziswe njengokugubungela umntu kuphela, abanye abantu bayayisebenzisa ngaloo ndlela ngelixa bengaqinisekiswanga. Olu hlobo lomgaqo-nkqubo luhlala lusebenza ngokudibeneyo ne-inshurensi yakho yezempilo (isicwangciso sempilo seqela okanye isicwangciso se-ACA) ukubonelela ngenkxaso eyongezelelweyo. Umzekelo, ukuba isicwangciso sakho esixhaswe ngumqeshi asihlanganisi umsebenzi wamazinyo, unokufumana i-inshurensi yesikhewu eyenzayo.
Ukuvalwa kwe-inshurensi yomsantsa kubaluleke kakhulu kwaye kunokusebenza kuphela kwiimeko ezithile, njengokuhlaselwa sisifo sentliziyo okanye ukubetha. Iinkampani zeinshurensi ezidumileyo zibandakanya i-AIG, i-Aetna, kunye ne-Aflac, kunye neeprimiyamu eziphakathi kwe- $ 30- $ 40 ngenyanga.
Ngokufanelekileyo, i-inshurensi yexesha elifutshane (kunye ne-inshurensi yomsantsa njengeyona ndlela yokugubungela) iya kusetyenziswa de ube ukulungele ukufumana ingxelo yexesha elide ngexesha lokubhalisa. Ngelixa ukubhaliswa okuvulekileyo kwe-2020 kudlulile, Imihla engama-2021 iyeza : Phawula ikhalenda yakho ngoNovemba 1, 2020 ukuya kuDisemba 15, 2020. Ngelixa uninzi lwamazwe luhambelana nale mihla, ayizizo zonke ezenzayo, ke uya kufuna ukujonga imihla yobume ohlala kubo. Ukongeza, eCalifornia, eColorado, kunye neWashington, DC, bandise ubhaliso oluvulekileyo windows ngokusisigxina. Ubhaliso lweMedicaid luvulekile unyaka wonke.
Nokuba awuqinisekiswanga okanye awuqinisekiswanga, i-SingleCare inokukunceda ugcine imali kumayeza akho amiselweyo. I-SingleCare yinkonzo yasimahla yokonga amayeza enokunceda ukunciphisa ityala lakho kumawakawaka ee-pharmacy ezise-U.S. Ungasebenzisa ikhadi lethu ngaphandle kwe-inshurensi ukukunceda ugcine kwixabiso lemali lonyango.
Umzekelo, kwi-2019, ixabiso lentengo eliphakathi I-Oseltamivir phosphate (i-antiviral eyaziwa ngegama layo linguTamiflu) yayiyi- $ 136.30. Ngekhadi le-SingleCare, ixabiso eliphakathi lihle lafika kwi- $ 52.51. Khuphela ikhadi lakho lasimahla elinye Apha .
FUNDA OKULANDELAYO: Iindlela ezi-5 zokufumana uncedo ngeendleko zonyango xa ungenayo i-inshurensi
