Isicwangciso se-inshorensi yezempilo yongezelelo yiprogram yokunakekelwa kwempilo ejongene nantoni na ngasentla kwaye ngaphaya komncinci kubandakanya unyango lwezempilo.
Izicwangciso zezempilo ezongezelelweyo zingabonelela ngeenkonzo zonyango ezongeziweyo, okanye zingathengwa ukuba zenze igalelo ekuhlawuleni iindleko ezingagqityiweyo kwisicwangciso se-inshurensi yezempilo, njengentengiso yomshuwalense, ukuhlawula kunye kunye neentlawulo . Konke kuxhomekeke kulolu hlobo lwesicwangciso se-inshurensi yempilo oyifunayo.
Nazi izibonelo ezimbalwa zeeNtsholongwane zeeNtsholongwane zempilo yomshuwalense:
- Intshurensi yamazinyo kubantu abadala
- Intsholongwane yokugula
- Plans Insurance Plans
- Intshuwalense yokukhubazeka
- I- inshurensi yokuThutyana yokuThuthukiswa kwenkxaso yezempilo xa ungaphandle kwenethiwekhi ye-inshurensi yempilo
- Inshorensi yesikhatho eside
- I-inshorensi yempilo yexesha elifutshane
- Izicwangciso zeMedare okanye iMedicaid Supplemental Plans
I-inshurensi yeeNtsholongwane yezeMpilo isebenza njani?
I-inshorensi eyongezelelweyo ihlawula inzuzo kumntu okhuselekile. Isixa sokuhlawula kunye nendlela esihlawulwa ngayo kuxhomekeke kwisicwangciso se- inshorensi yempilo okanye ipolisi. Ezinye iinkcukacha zonyango zonyango zonyango ezongezelelekileyo ziyimpilo yomshuwalense ethile njengale:
- ngomhlaza
- ukufa kwengozi kunye ne-inshuwalense yomshuwalense
- yomshuwalense wezempilo yengozi, kunye ne- inshorensi yokuhlawulela esibhedlele
- I-Medigap (i-Medicare eyongezelelweyo inshorensi yezempilo)
Ngubani o fanele athathe iSicwangciso seNtshumo yeeNtsholongwane yeMpilo?
Ngaba ufuna iimfuno zonyhorensi zempilo xa unesifo se-inshorensi yempilo?
Oku kuxhomekeke kwimingcipheko yakho kunye nokuba uninzi lwe-inshurensi oyifunayo, okanye into ofuna ukuyifumana.
Izicwangciso ezongezelelweyo zikhethiweyo. Kuphelele kuwe ukuba uthathe isigqibo sokuba ngaba izibonelelo ezibonelelwe ngesicwangciso zifanele ukutyalomali kwi-premium oza kuhlawula.
Ngomzekelo: Ukuba uyazi ukuba abantwana bakho baya kufuna i- inshorensi ukukhawuleza ukunakekelwa kwe-orthodontic kwiminyaka ezayo, kwaye ukuthenga isicwangciso esingcono sezinyo zokuncedisa izibonelelo zakho kuya kukuvumela ukuba ufumane ama-braces, ngoko unako ukugqiba isicwangciso se-inshurensi yamazinyo. ikufanele oko.
Omnye umzekelo uya kuba ngaba uyazi ukuba awukwazi ukufumana iindleko zokunyamekelwa kwexesha elide, okanye ukulahleka kwengeniso xa ufumene unomdlavuza, ngoko ukunyamekelwa kwexesha elide okanye ugula olubi kunokuba lutyalo oluhle ukuba uqwalasele.
Ukufumana iMigaqo-nkqubo ye-Intshumo Enempilo
Ngaphambi kokuba utyalomali kwi-inshurensi yempilo, qiniseka ukuba uyaziqonda iinkcazo ezikhoyo kwiiprogram ze-inshorensi zempilo ezahlukeneyo okanye ukuba unomlingane, qiniseka ukuba uyaziqonda ukuba unako ukulungelelaniswa kwezibonelelo kwizicwangciso zakho ezikhoyo .
Awufuni ukuphinda uhlawule okanye uhlawule i- inshurensi engaphezulu kunokuba uyifunayo .
Imigaqo-nkqubo ye-inshorensi yempilo yohluke ngoko ke, yintoni na kwaye baya kuhlawula njani. Khangela ukuqinisekisa ukuba unomgaqo-nkqubo we-inshorensi yempilo ehlawulela inzuzo ephezulu kwixabiso elifanelekileyo .
I-inshurensi yezempilo iyongezelela ukunceda ukuhlawula oko i-inshorensi yakho yempilo ayihlawuli okanye ezinye iindleko. Izicwangciso zezempilo ezongezelelweyo ezifana nokugula okanye ukukhubazeka kunokukunokukhusela nezindleko ongeke uzihlawule ukuba kwenzeka ntoni apho okwethutyana okanye ngokusisigxina akunakwenza inzuzo ukuze uhlawule iibhokhwe zakho.
Oko Kufuneka Uyiqwalasele Xa Ukhetha Inkonzo Yomshuwalense Wezempilo
Ezinye izinto oza kuziqwalasela xa usenza isigqibo sokuba ufuna i-inshorensi ye-inshorensi yezempilo yile:
- izizathu zempilo yakho yengozi
- lwakho lokulondoloza
- ingakanani inshuwalense onokuyenza
Ukugcina kwakho kufuneka kuthathe indima ebalulekileyo kwisigqibo sakho sokuthenga umgaqo-nkqubo we- inshorensi yempilo . Ukuba ubesibhedlele kwiiveki ezimbalwa okanye ngaphezulu, ngaba unako ukukhawulela ezinye iindleko ukuba i-inshurensi yakho ayifuni? Ingaba unayo imali onokufikelela kuyo nge- HSA okanye kwi-FSA ? Xa usenza isigqibo malunga nokuthenga umgaqo-nkqubo, kufuneka uqwalaselwe ukuba unako ukuwufumana okanye awukwazi.
Kuphi ukufumana iSicwangciso seMpilo esongezelelweyo?
Izicwangciso zezempilo ezongezelelweyo zithengiswa ngabanini-mshishino bangegunyeni, abazithengiswa ngokubanzi kwi-ACA indawo yokuthengisa.
- Hlola nomqeshi wakho ukuba ufumane ukuba kukho naziphi na iinkonzo ezongezelelweyo kwisicwangciso sakho sempilo esisebenza emsebenzini esibandakanya izicwangciso zezempilo. Ngemizekelo, ngabaqeshi bangabandakanya umboniso owandisiweyo, amazinyo okanye ukukhubazeka kwexesha elifutshane. Ukuba i-inshurensi yakho ayinikeli le nto, jonga kwakhona i-inshurensi eyinikwe ngumlingane wakho okanye umlingane wakho wasekhaya, kungengqiqo ukuhamba kunye ne-inshurensi yabo ukuba ezi zibonelelo ezifumanekayo zikhoyo. Kuya kuba nzima ukuba abaqeshi banikele ngeenzuzo ezingongeziweyo njengenxalenye yesicwangciso sokugcina abasebenzi, ngoko kuyafaneleka ukubuza malunga.
- Unokuqhagamshelana nomshuwalense wabucala okanye uthintane nomthengisi we- inshurensi yempilo ukukhangela abaqinisekisi bamashishini abucala kuwe xa ufuna iinjongo ze-inshorensi zempilo zonyango .
- Kwi-Medicare, ungasebenzisa i-medicare.gov ukufumana isicwangciso.
Imizekelo eyongeziweyo yeZicwangciso zoMpilo ezongezelelweyo
- Ubulwelwe obunzima okanye izifo I-inshurensi ekhethekileyo ngumhlobo we-inshorensi yempilo eyongezelelweyo inikeza inzuzo yemali ehlawulwa ngqo kuwe ukuba ufuna unyango kwisifo esithile njengesifo somhlaza. Ngokuqhelekileyo, imali ingasetyenziswa nganoma yiphi indlela oya kukhetha ngayo kwaye ukufumana inzuzo yakho ayinakuyenza nayiphi inshuwalense yakho ehlawulwa kwiindleko zakho zonyango.
Intshurensi yezeMpilo yengozi okanye iNtsholongwane yokuPhelelwa kweNgcaciso yeNgcaciso kunye neNkxaso yokuNqanda. Olu hlobo lwe-inshorensi eyongezelelweyo ngokuqhelekileyo luza kuhlawula iindleko zonyango ngenxa yeengozi. Iinzuzo zihlawulwa xa usweleka (kubaxhamli bakho) okanye ukhubazekile ngenxa yengozi ethile echazwe kumgaqo-nkqubo. Iimali-ntlawulo zihlala ziphantsi kwaye akukho mvavanyo yezokwelapha efunekayo. Izingozi zingabandakanya izingozi zemoto kunye neengozi ekhaya okanye emsebenzini wakho. Kwakhona, ukuba ulahlekelwa yimilenze, iminwe, iinzwane, okanye umbono wakho ngenxa yengozi efihliweyo, unokukwazi ukuqokelela ipesenti yokufumana inzuzo yokufa.
- Inkonzo Yomshuwalense Wemali Yobhedlele: Olu hlobo lomshuwalense wezempilo olongezelelweyo lunikeza inzuzo yansuku zonke, ngeveki, okanye ngeenyanga xa uvalelwe kwisibhedlele. Ngokuqhelekileyo kukho ubuncinane bhedlele ukuhlala ngaphambi kokuba iinzuzo zihlawulwe. Inzuzo yemali ihlawulwa ukongeza kwiphina inshurensi onokuyenza. Izinzuzo ziyancitshiswa xa uvalelwe esibhedlele sengqondo kwaye kaninzi unokufumana izicwangciso ngomqeshi ongenakufuna ukuhlolwa kwempilo.