I-upshot? Iningi le-punt. Abangu-4 kwabangu-5 bathi basebenzisa isikhathi esingaphansi kwehora ngezinqumo zabo zenzuzo, futhi ngisho nokunye nje bakhetha izinzuzo ezifanayo ngonyaka nonyaka.
I-Price of Inaction
Lokho kungabiza uma ukhetha okungalungile. Ngithi ukhetha uhlelo lapho udokotela obona khona ngonyaka ongekho kwinethiwekhi. Lokhu kungase kube izindleko ozilungele ukuthwala. Kodwa uma ugcina udinga izinsizakalo zodokotela ngenqubo eyengeziwe engalindelekile? Ungaphetha ukukhokhela u-300% walokho okuzobiza uma ngabe uthola i-in-network doc kusukela ekuhambeni, ngokusho ngocwaningo luka-2015 yi-AHIP Isikhungo seNqubomgomo nePhando. Ngokufanayo, uma ukhetha ukukhokha amaphrimiyamu aphezulu afika namapulani anezinzuzo ezingezansi, kodwa akavamile ukubona udokotela noma ugcwalise imiyalelo ngoba uphilile njengehhashi, ungaphetha ukukhokha ngaphezulu ezindleko ezingaphambili kunesidingo .
Futhi intengo yokunamathela ikhanda esihlabathini inikezela phezulu.
Izindleko eziphelele zokunakekelwa kwezempilo e-US cishe zingama $ 3 trillion ngonyaka, abathengi bakhokhela ephaketheni cishe ngo-$ 400 kuya ku-$ 500 billion-futhi isabelo sethu sikhula ngamaphesenti angu-10 ngonyaka.
"Ngizimisele ukubheja ukuthi isabelo sethu sizokhuphuka," kusho uThomas Torre waseCopatient, inkampani esisiza abathengi ukuthi baxoxisane nodokotela nezibhedlela zabo.
"Lo mkhuba awunakuphelelwa amandla."
Ukwenza izinqumo ezifanele izinzuzo, ngenxa yalokho, kuxhomeke ekuzibopheleleni ngokuqonda kwangempela kokuqala: ukuqonda okuyisisekelo kwemigomo oyibona lapho ufunda ngezinhlelo zezempilo zanamuhla. (I-Aflac ihlolwe lokhu futhi. Abantu abaningi abenzi.) Futhi okwesibili, ukwazi ukuphendula imibuzo embalwa ezokutshela ukuthi yiluhlobo luni lwepulani okungenzeka libe ngcono kakhulu esikhwameni sakho.
Ukwenza izinqumo ezifanele, ngakho-ke, kuxhomeke ekuzibopheleleni ngolwazi nokuqonda imiqondo esemqoka yomshuwalense emsebenzini.
Khuluma uLimi
Okokuqala, udinga ukuqonda ngokuqinile imigomo yomshuwalense wezempilo. Kuhlolo lwaso, i-AFLAC ithole abantu abaningi bengabambeli ngesilulumagama esiyisisekelo sezempilo. Kunzima ukwenza isinqumo uma ungazi amagama alandelayo:
I-PPO: Inhlangano ehlinzekwayo yokuhlinzeka. Lolu uhlelo lwezempilo olungakukhawuli ekuhlinzekeni kwabahlinzeki bezempilo be-in-network (noma bakwenze ukuthunyelwa kochwepheshe) kodwa kuzodinga ukuthi ukhokhe izindleko eziphezulu ezingaphandle kwezokuhlinzekwa kwezempilo
I-Plan High Deductible: Uhlelo olufuna ukuthi ukhokhele ukunakekelwa kwakho okuningi (odokotela nemigomo) uze uhlangabezane ne-deductible yakho.
Ikunelungelo lokuvula i-HSA noma i-Akhawunti Yokulondoloza Impilo.
I-HSA: Ukuze usize ukulahlekelwa izindleko zemali yakho ephezulu yokudonswa, uzoba ne- akhawunti yokulondoloza impilo lapho wena nomqashi wakho ningayifaka imali engaphambi kwentela engasetshala futhi ikhule intela. Uma usebenzisa imali ukukhokha izindleko zokunakekelwa kwempilo ezifanele, ngokuvamile ngeke ukhokhe noma yiziphi izintela lapho usebenzisa.
I-Premium: Inani okhokhayo-ngokuvamile ngenyanga-ukuthenga umshuwalense wezempilo.
I-Deductible: Inani olikhokhela ephaketheni lokunakekelwa kwezempilo ngaphambi kokuba umshwalense aqale ukukhokha isabelo salo.
Co-pay: Inani olikhokhela ukuvakashelwa ihhovisi noma umshwalense okufakazela lokho umgcinimafa akhokhela (uze uhlangabezane ne-out-of-pocket yakho esiphezulu).
I-Coinsurance: Iphesenti yenkonzo yokunakekelwa kwezempilo kudingeka ukhokhe uze uhlangabezane ne-out-of-pocket yakho esiphezulu.
Izinqumo Ezinkulu
Manje ungaqhubeka nokukhetha uhlelo olufanele. Nazi izinqumo ezinkulu ozodinga ukwenza.
I-PPO vs. plan high deductible nge-HSA. Uma uthola uhlelo ngomqashi wakho, kungenzeka ukuthi lokhu kukhetha. Ukuze wenze ucingo, ubuye emuva ekusebenziseni kwakho kwezokwelapha ngonyaka odlule. Ubonake kangaki udokotela? Zingaki imiyalelo oyigcwalisile? Uma unempilo futhi ungathathi imithi eningi, ngokuvamile ungcono kakhulu ngecebo eliphezulu lokudonswa. Uma unezindleko zempilo ezilindelekile eziphezulu, kufaka phakathi izidakamizwa, ngokuvamile ungcono nge-PPO.
Qhathanisa ama-deductibles nalawo ma-premium. Qaphela, ngithi "ngokujwayelekile kungcono." Kungenzeka ukulandela lezo ziqondiso bese wenza amaphutha. Khetha uhlelo lwezempilo olusekelwe kuma-premium kuphela, ngokusho kocwaningo lweCopatient. Amaphrimiyamu abalulekile, kodwa akuyona eyona kuphela into okufanele icatshangelwe, kusho u-Justin Sydnor, uMnuz Professor eWisconsin School of Business. Engeza ama-premium wakho waminyaka yonke bese uqhathanisa ukuthi ukhokhaphi inqubomgomo ephakeme-yentengo kulokho okulondolozayo ku-deductible. Uma umqashi wakho ekwenzeni umnikelo kwi-Akhawunti Yokulondoloza Impilo ukuze akhokhe imali ekhishiwe, qiniseka ukuthi uyayithatha.
Cabanga odokotela, amafomula kanye nezinye izindleko. Qinisekisa ukuthi ucabangela iziguquguquko ezingenawo amanani entengo enamathiselwe. Ingabe odokotela ofuna ukukubona kuhlelo lwakho? Ingabe izidakamizwa ongase uzithathe? Uzokhokha malini-ngesimo se-copay noma i-coinsurance-njalo lapho uya khona ukunakekelwa kwezempilo? Bheka umlando wezempilo wonyaka odlule, futhi uthathe ukuziphatha kwakho kuzoba okufanayo.
Futhi uma ungeke ukwazi ukukhokhela uhlelo lokuncenga? Khumbula: Isu eshibhile singcono kunekho plan.
With Kelly Hultgren