Umshuwalense wezempilo ngumgomo womshuwalense ozokhokha imali ecacisiwe ukuze kubhekwe izindleko zezokwelapha noma ukwelashwa. Izinqubomgomo zomshuwalense wezempilo ezihlinzekwa ngumqashi, owaziwa nangokuthi izinqubomgomo zomshuwalense wezempilo, zinikeze abasebenzi izinketho eziningi ezihlukahlukene zokufaka umshwalense.
Izinqubomgomo ezihlinzekwa ngumqashi ziyahlukahluka ezindleleni zabo zokusabalala
Ngokusho kwe-Healthinsurance.org, yabaseMelika abanempilo, cishe u-60% bathola ukufakwa kwabo ngokusebenzisa uhlelo oluxhaswe ngumqashi. Kuleli qembu uhlelo lwezempilo, umqashi ukhokhela i-premium, noma ingxenye yezingonyama ze-premium, ehlanganisa izindleko ezahlukene zokunakekelwa kwezempilo ezihluka ngenqubomgomo.
Ngokuvamile, izinhlelo zomshuwalense wezempilo zeqembu zihlanganisa izindleko zokuvakashelwa kwehhovisi lezokwelapha ngenxa yokugula nokuhlolwa, izibhedlela, izinsizakalo zamagumbi okuphuthumayo, ukuhamba kwe-ambulensi, imisebenzi, ukwelashwa ngokomzimba, kanye nemithi yokwelashwa, ukuhlinzeka ngezibonelo ezimbalwa zezinsizakalo zokunakekelwa kwezempilo ezikhona. Kodwa, zonke izinhlelo zihlukile futhi kufanele ukuba isisebenzi sijwayele imininingwane yomsebenzi womqashi wakhe ngaphambi kokuba kudingeke inzuzo.
Eminyakeni yamuva, ngenxa yokwenyuka kwezindleko zezempilo, abasebenzi bakhokhela amaphesenti okwandisiwe wezindleko zemishwalense yabo yomshuwalense wezempilo, ngokuvamile ngokudonswa kwemali.
Ezinye izinhlelo zimboza umsebenzi okufanele akhokhe izindleko zokuqinisekisa amalungu omndeni. Ngaphezu kwalokho, cishe zonke izinhlelo zinezinkokhelo zokukhokha (co-pay) umthwalo lapho abasebenzi bekhokhisa khona imali yokufaka isicelo sokunakekelwa kwempilo enikeziwe, ngokuvamile kusuka ku-$ 10-40.00.
Ngaphezu kokunciphisa izindleko zokunakekelwa kwezempilo kwabasebenzi, inzuzo yesibili yeluhlelo oluxhaswe ngumqashi ukuthi lihlinzeka ngokuqinisekiswa okuqinisekisiwe; inkampani yomshuwalense kumele ihlanganise bonke abafake izicelo ababafanelekela ukuqashwa .
Ngokuvamile, izinhlelo ezixhaswe ngumqashi zingabandakanya izinketho eziningi zezinhlelo. Kusuka ezinhlanganweni zezokugcinwa kwezempilo (izinhlangano ze-HMO) kanye nezinhlangano ezihlinzekwayo zokuhlinzeka ngezempilo (ama-PPOs) kumacebo anikezela ukuhlinzekwa okungeziwe njengomshuwalense wamazinyo, umshuwalense wokuphila , umshuwalense wokukhubazeka okwesikhashana , nomshuwalense wokukhubazeka isikhathi eside , izinhlelo zempilo ezixhaswe ngumqashi zingaba ziphelele ukuhlangabezana nezidingo zomshuwalense zabasebenzi.
Izinguquko Ezizayo Ezokuphepha Kwezempilo
Ngo-2010, uMengameli uBarack Obama usayine umthetho oMvikeli Wezokwelapha kanye noMthetho Wokunakekelwa Kwezinkinga. Kulindeleke ukuthi izinguquko eziphawulekayo ezinhlelweni zomshuwalense wezempilo, imikhuba, nezindleko zizokwenzeka njengomphumela walo mthetho.
Izinhlinzeko ezihlukahlukene zomthetho womshuwalense wokuqapha umshuwalense waqala ukuqala ngo-2010 phakathi neminyaka eyishumi. Izinguquko ezithile eziphathelene nokusakazwa kwezingane ezineminyaka engama-26 kanye nabantu abanemibandela ekhona ngaphambili nokunye okwenzekile kakade. Okuningi kubikezelwe.
Abaningi abaqashi balindela izindleko zomshuwalense wezempilo kanye nezithinta ekuhlinzekeni kwezempilo kwesisebenzi. Lezi zimthelela, okungcono kakhulu, zishintsha futhi zandise ukuhlinzekwa kanye nezinzuzo ezikhona, futhi nakakhulu, kungabangela ukuthi abaqashi bangakwazi ukunikeza inketho yomshuwalense wezempilo ohlinzekwa ngumqashi.
Akekho okwamanje owazi izidingo eziphelele noma umthelela walezi zinguquko ezifinyelela kude empilweni yomshuwalense wezempilo kanye nokunakekelwa kwezempilo e-US.
Umshwalense wezempilo ngumhlomulo wesisebenzi ohlonishwayo. Ukufuna emva kwabasebenzi ngeke bacabange ukwamukela umsebenzi ongahlinzeki ngemali yomshwalense wempilo njengenzuzo yomsebenzi.
Ukuziphendulela - Sicela uqaphele:
USusan Heathfield wenza konke okusemandleni ukuhlinzekela okunembile, umqondo ovamile, ukuphathwa kweMithombo yezabasebenzi, umqashi, kanye nezeluleko zomsebenzi kokubili kule webhusayithi, futhi uxhumeke kule webhusayithi, kodwa akayena ummeli, nokuqukethwe kusayithi, ngenkathi okugunyazayo, akuqinisekisiwe ngokuchaneka nangokusemthethweni, futhi akufanele kuthathwe njengeseluleko sezomthetho.
Isayithi inezilaleli zomhlaba jikelele kanye nomthetho wemisebenzi kanye nemithethonqubo yemisebenzi ihlukahluka kusuka emazweni kuya emazweni nakwamanye amazwe, ngakho-ke isayithi ayikwazi ukucaca kubo bonke emsebenzini wakho.
Uma ungabaza, njalo ufune iseluleko sezomthetho noma usizo oluvela kuhulumeni, uHulumeni, noma izinsiza zikaHulumeni zomhlaba wonke, ukuze wenze ukuthi incazelo yakho yezomthetho kanye nezinqumo zakho zilungile. Ulwazi olukuleli sayithi luyisiqondiso, imibono, kanye nosizo kuphela.