Yintoni i-inshurensi yezempilo yexesha elifutshane?

Inkampani

Kulabo bathenga i-inshurensi yezempilo epokothweni, i-inshurensi yexeshana izandi njengokhetho olunomtsalane. Emva kwayo yonke loo nto, kukho iindleko ezisezantsi kunye ne-inshurensi yezempilo eqala ngokukhawuleza. Kodwa xa usikhupha isiciko, uyakubona ukuba asiboneleli ngxelo ipheleleyo-ezinye izicwangciso zeinshurensi yezempilo yexesha elifutshane zisenokungagubungeli iimeko esele zikho, ukhathalelo lwempilo yengqondo, okanye amayeza kagqirha. Kwaye uhlala unolunye ukhetho, njenge-COBRA okanye ukugubungela phantsi kwesicwangciso selungu losapho. Ke nini i-inshurensi yezempilo yexesha elifutshane lukhetho olufanelekileyo?

I-inshurensi yezempilo yexesha elifutshane ekuqaleni yayenzelwe ukuba ibe yile nto ivakala ngathi-isisombululo sexesha elifutshane kubantu abafuna ukhathalelo lwempilo ngexesha lesithuba kwingqesho yeemeko ezintsha zonyango. Ekuqaleni, ubunokufumana i-inshurensi kuphela phantsi kwesicwangciso se-inshurensi yezempilo yexeshana ukuya kuthi ga kwiinyanga ezintathu. Ukusukela ngo-Okthobha u-2018, nangona kunjalo, oko kutshintshelwe kwiintsuku ezingama-364, kwaye izicwangciso zinokuhlaziywa ukuya kuthi ga kwiinyanga ezingama-36. Kwithiyori, umntu angabhalisa kwisicwangciso sethuba elinye elifutshane, athabathe indawo engaphantsi konyaka omnye, emva koko atshintshele komnye umphathi kwinkqubo efanayo yexesha elifutshane.

Nangona kunjalo, kubalulekile ukuba uqaphele ukuba ayingawo onke amazwe anikezela ngezicwangciso zexesha elifutshane zezempilo njengokhetho. Azifumaneki kumazwe ali-11, kubandakanya iCalifornia, iColorado, iNew York, iNew Jersey, neMassachusetts, nokuba kungenxa yokuba zingavunyelwa okanye ngenxa yokuba imithetho engqongqo ithetha ukuba iinkampani zeinshurensi zikhethe ukungaziniki. Kwamanye amazwe, banokubanomda kakhulu, kwaye imigaqo iyahluka ngokwendlela yokukhetha ubude kunye nokuhlaziya.

Oko i-inshurensi igubungeleyo iyahluka kakhulu phakathi kweinshurensi nakwimeko, kodwa inye into efanayo kukuba azizifihli iimeko zempilo esele zikho. Ukongeza, bahlala bengazibandakanyi zonke izibonelelo ezifanelekileyo zempilo ezifunekayo phantsi koMthetho woKhathalelo ongenakufikeleleka (i-ACA okanye i-Obamacare), ebandakanya ukhathalelo lothintelo njengotyelelo oluqhelekileyo loogqirha, ukhathalelo lokuya kubeleka, kunye neziyobisi.

Ngaba kufanelekile ukuba ndifumane i-inshurensi yezempilo yexesha elifutshane?

Izibonelelo zezicwangciso zexeshana zempilo

Ngaphantsi kweemeko ezithile, i-inshurensi yempilo yexeshana inokunceda ngokwenene. Olona ncedo lukhulu linqaku lamaxabiso; Iipremiyamu zanyanga zonke zinokuba sezantsi kancinci kunezicwangciso zomgangatho wezempilo. Ukuba usempilweni, sukujonga kwangaphambili naluphi na utshintsho olwenziwayo kwindlela yokuphila (njengokukhulelwa), kwixa elizayo, kwaye zilungile ngokugubungela umda, i-inshurensi yexesha elifutshane inokuba ngumnatha wokhuseleko olomeleleyo kwaye inokubandakanya amanye amalungu akho usapho.

Kuyanceda kwiimeko ezithile, ezinje phakathi kwengqesho, ngelixa ulinde ukhuselo lweMedare ukuze ungene ngaphakathi, okanye ukuba wena uphose ubhaliso oluvulekileyo ngomqeshi wakho okanye kumaqonga,utsho IYuna Rapoport , MD, MPH, ugqirha wamehlo eManhattan Eye kwisiXeko saseNew York.Izinto eziluncedo zibandakanya ukuba kulula ukufumana kwaye ukugubungela kunokukhaba ngokukhawuleza okukhulu. Zihlala zibiza ixabiso eliphantsi kwaye zinika ingxelo ephantsi.

I-inshurensi yexeshana ikwanika ubhetyebhetye-amaxesha amaninzi okuqala kokugubungela ukuqala kwiiyure nje ezingama-24 kwaye ungarhoxisa ngokuthanda. Kungaba nzima ukubhalisela imigaqo-nkqubo yeinshurensi yezempilo, kodwa nge-inshurensi yexesha elifutshane, ukubhalisa kuhlala kuyinkqubo elula, ewe, okanye hayi kwimibuzo.

Ezinxulumene: Utshintsho kwingqesho? Funda malunga nokugubungela i-COBRA

Ukungancedi kwezicwangciso zexeshana zezempilo

Ngelixa i-inshurensi yezempilo yexesha elifutshane inokunceda ngexabiso eliphantsi ukuvala umsantsa phakathi kweziganeko zobomi ezinje ngomsebenzi omtsha okanye ukuya ekholejini, ineengxaki ezithile njengesisombululo sexesha elide.

Imeko yakho yezempilo iya kuthi igqibe ukuba ngaba i-inshurensi yempilo yexesha elifutshane unokukhetha yona. Ukuba unayo nayiphi na imeko esele ikho njenge-asthma okanye isifo seswekile, ngekhe ulungelwe ukukhutshwa phantsi kwesicwangciso seinshurensi yezempilo yexesha elifutshane. Kuyafana nakwiimeko zempilo yengqondo kunye nonyango lwengqondo. Kwaye ukuba kuyenzeka ukuba ubukhe wanayo imeko ongayazi ngaphambili okanye ukhawule kwibhokisi engeyiyo kulowo ubhalisileyo ngokukhawuleza? Unokuba uphumile kwithamsanqa. Izicwangciso zonyango zexesha elifutshane azihambelani ne-ACA, ngoko ke i-inshurensi inokuthi ikwazi ukuphonononga amabango akho onyango angaphambili-kubandakanywa ngaphambi kokuba bakugubungele- ukumisela ukuba ubusele unemeko esele ikhona.

Ukongeza, impilo eninzi esisiseko efunwa ngabantu kwi-inshurensi yabo yezonyango. Iinkonzo zokhathalelo lwempilo njengokundwendwelwa ngugqirha kwesiqhelo kunye nokugubungela amayeza amayeza zihlala zikhutshelwa ngaphandle kwizicwangciso zexesha elifutshane. Unokulinganiselwa ukuba isicwangciso sakho sigubungela kangakanani, nokuba kungangonyaka okanye ngosuku, okt ukukhwela i-ambulensi kuxabisa i-500 yeedola, kodwa i-inshurensi yexesha elifutshane inokuba ne-300 yeenkonzo zexakeka. Ngelixa iipremiyamu zakho zenyanga zinokuba zitshiphu, usenokugqibela ukuchitha imali eninzi epokothweni ngaphandle kohlahlo-lwabiwo mali ukuba kufuneka ufune unonophelo okanye unongxamiseko.

Kuxhomekeka ekubeni isicwangciso sakho siphelelwa nini, unokuzifumana ngaphandle kwezinye iindlela zokugubungela. Ukuba isicwangciso sakho sexesha elifutshane sigqiba ngaphandle kwexesha lokubhalisa elivulekileyo le-ACA, usenokungafaneleki de kube lilandelayo, njengoko ukuphela kwexesha elifutshane lokuphela kungathathelwa ngqalelo umsitho ofanelekileyo ovumela ixesha lokuBhalisa eliKhethekileyo . Oko kunokuthetha ixesha elibalulekileyo apho ungenayo i-inshurensi yezempilo konke konke.

Ngaba i-inshurensi yexesha elifutshane ngumbono olungileyo? Isishwankathelo seenzuzo kunye neengxaki
Iinkonzo	Bendlela
Iipremiyamu ezingamaxabiso aphantsi kunezicwangciso eziqhelekileyo	Iindleko zokuphuma epokothweni zinokuba phezulu ngenxa yokugubungela umda
Ukugubungela kwangoko onokurhoxisa ngalo naliphi na ixesha	Umngcipheko owandileyo wokulahleka kobhaliso
Izicwangciso zomntu ngamnye kunye neentsapho ziyafumaneka	Ayigubungeli iimeko esele zikho, ukugula ngengqondo, ukhathalelo lokuthintela, okanye imigqaliselo

Ungasifumana njani isicwangciso seinshurensi yezempilo yexesha elifutshane

Ukuba ucinga ukuba isicwangciso seinshurensi yezempilo yexesha elifutshane kunye nobuncinci bokugubungela eyona nto ifanelekileyo yeyakho, into yokuqala kukufumanisa ukuba ziyafumaneka na kwilizwe lakho. Ukuba uhlala kula mazwe alandelayo, ixesha elifutshane aliyi kuba lukhetho:

• California
• IColorado
• IHawaii
• EMassachusetts
• Inew York
• Enew Jersey
• IRhode Island
• IVermont
• Unxibelelwano
• ENew Mexico

Ukuba izicwangciso are iyafumaneka kwindawo yakho, licebo elihle ukuqaphela izinto ezimbalwa: ixesha lokugubungela, njengoko amanye amazwe enemida emifutshane kunamanye; ziya kuba yintoni iipremiyamu zakho zenyanga; kunye neenkcukacha zesicwangciso sokuprinta.

Iindleko zeinshurensi yezempilo yexesha elifutshane

Ngelixa ngokomndilili, izicwangciso zeinshurensi yezempilo yexesha elifutshane ziphantse Ixabiso eliphantsi ngama-224% Ngaphandle kwezicwangciso ze-ACA, licebo elilungileyo ukuthatha isitokhwe sokuba yeyiphi na indawo yokuqeshwa okanye ukuvuselelwa komyalelo onokubakho nawo. Umzekelo, ukuba unonyango lonyaka okanye ugcwalisa amayeza rhoqo, uyakufuna ukubandakanya ezo ndleko zokhathalelo lwempilo njengoko ubala iindleko eziphuma epokothweni.

Kwaye kunjalo, ukusebenzisa i-SingleCare, nokuba ukwisicwangciso seinshurensi yexesha elifutshane okanye i-ACA efanelekileyo, inokukunceda ugcine kwimigqaliselo.

FUNDA OKULANDELAYO: Uyifumana njani i-inshurensi yezempilo