Litokelo le litšireletso tsa bareki

The Affordable Care Act (ACA) e qalile ho sebetsa ka la 23 Loetse 2010. E ne e kenyelletsa litokelo le litšireletso tse itseng bakeng sa bareki Litokelo tsena le ts'ireletso li thusa ho etsa hore litaba tsa tlhokomelo ea bophelo bo botle li be bonolo hape li utloisisehe habonolo.

Litokelo tsena li tlameha ho fanoa ka meralo ea inshorense 'Marakeng oa Inshorense ea Bophelo hammoho le mefuta e meng e mengata ea inshorense ea bophelo bo botle.

Litokelo tse ling li kanna tsa se koaheloe ke merero e meng ea bophelo bo botle, joalo ka merero ea bophelo bo botle ea bo-ntate. Morero oa ntate-moholo ke leano la inshorense ea bophelo bo botle le rekiloeng ka la 23 Hlakubele 2010 kapa pele ho moo.

Kamehla hlahloba melemo ea moralo oa hau oa bophelo ho netefatsa hore na u na le tšireletso ea mofuta ofe.

LITOKELO LE TS'IRELETSO

Mona ke litsela tseo molao oa tlhokomelo ea bophelo o sirelletsang bareki.

O tlameha ho koaheloa, leha o na le boemo bo seng bo ntse bo le teng.

• Ha ho moralo oa inshorense o ka u hanang, oa u lefisa ho feta, kapa oa hana ho lefella melemo ea bohlokoa ea bophelo bo botle bakeng sa boemo bofe kapa bofe boo u neng u na le bona pele tšireletso ea hau e qala.
• Ha u se u ngolisitse, leano le ke ke la u hanela kapa la nyolla litefiso tsa hau ho ipapisitsoe le bophelo ba hau feela.
• Medicaid le Lenaneo la Inshorense ea Bophelo ba Bana (CHIP) le lona le ke ke la hana ho u koahela kapa ho u lefisa haholo ka lebaka la boemo ba hau ba pele.

U na le tokelo ea ho fumana tlhokomelo ea mahala ea thibelo.

• Merero ea bophelo bo botle e tlameha ho koahela mefuta e meng ea tlhokomelo ho batho ba baholo le bana ntle le ho u lefella tefo ea chelete ea chelete.
• Tlhokomelo e thibelang e kenyelletsa ho hlahlojoa ha khatello ea mali, ho hlahloba mahlo, liente le mefuta e meng ea tlhokomelo ea thibelo.
• Tlhokomelo ena e tlameha ho fanoa ke ngaka e nkang karolo morerong oa hau oa bophelo bo botle.

U na le tokelo ea ho lula morerong oa bophelo bo botle ba motsoali oa hau haeba u le ka tlase ho lilemo tse 26.

Ka kakaretso, u ka kenela leano la motsoali 'me u lule u le teng ho fihlela u le lilemo li 26, leha u ka:

• Nyala
• Ho ba le ngoana kapa ho mo holisa
• Qala kapa u tlohele sekolo
• Lula kahare kapa ka ntle ho ntlo ea motsoali oa hau
• Ha e boleloe e le motho ea itšetlehileng ka lekhetho
• Fana ka tlhahiso ea tlhahiso ea mosebetsi

Likhamphani tsa inshorense li ke ke tsa lekanyetsa tšireletso ea selemo le selemo kapa ea bophelo ea melemo ea bohlokoa.

Tlas'a tokelo ena, lik'hamphani tsa inshorense ha li khone ho beha moeli ho chelete e sebelisitsoeng ho melemo ea bohlokoa nako eohle eo u ngolisitseng moralo ka eona.

Melemo ea bohlokoa ea bophelo bo botle ke mefuta e 10 ea lits'ebeletso tseo meralo ea inshorense ea bophelo bo botle e tlamehang ho koahela. Merero e meng e koahela lits'ebeletso tse ling, tse ling li ka fapana hanyane ka mmuso. Lekola melemo ea moralo oa hau oa bophelo ho bona hore na moralo oa hau o akaretsa eng.

Melemo ea bohlokoa ea bophelo bo botle e kenyelletsa:

• Tlhokomelo ea bakuli
• Litšebeletso tsa maemo a tšohanyetso
• Ho kena sepetlele
• Bokhachane, boimana le tlhokomelo ea masea
• Litšebeletso tsa bophelo bo botle ba kelello le ts'ebeliso ea lithethefatsi
• Litlhare tsa lithethefatsi
• Litšebeletso tsa ntlafatso le lisebelisoa
• Tsamaiso ea mafu a sa foleng
• Litšebeletso tsa laboratori
• Tlhokomelo e thibelang
• Tsamaiso ea mafu
• Tlhokomelo ea meno le pono ea bana (pono ea batho ba baholo le tlhokomelo ea meno ha e kenyelelitsoe)

U na le tokelo ea ho fumana leseli le utloisisehang habonolo ka melemo ea hau ea bophelo bo botle.

Likhamphani tsa inshorense li tlameha ho fana ka:

• Kakaretso e Khuts'oane ea Melemo le Ts'ireletso (SBC) e ngotsoeng ka puo e utloisisehang habonolo
• Tlhaloso ea mantsoe a sebelisitsoeng tlhokomelong ea bongaka le ho fana ka litaba tsa bophelo bo botle

U ka sebelisa tlhahisoleseling lena ho bapisa merero habonolo.

U sirelelitsoe keketsehong e sa utloahaleng ea sekhahla sa inshorense.

Litokelo tsena li sirelelitsoe ka Rate Review le molao oa 80/20.

Rate Review e bolela hore k'hamphani ea inshorense e tlameha ho hlalosa phatlalatsa keketseho efe kapa efe ea 10% kapa ho feta pele e eketsa moputso oa hau.

Molao oa 80/20 o hloka hore lik'hamphani tsa inshorense li sebelise bonyane 80% ea chelete eo ba e fumanang ho tsoa ho li-premium tsa litšenyehelo tsa tlhokomelo ea bophelo le ntlafatso ea boleng. Haeba k'hamphani e sa etse joalo, u ka fumana theolelo ho tsoa k'hamphaning. Sena se sebetsa ho merero eohle ea inshorense ea bophelo bo botle, esita le e kholo

O ka se haneloe ho koaheloa hobane o entse phoso ts'ebelisong ea hau.

Sena se sebetsa liphosong tse bonolo tsa boruti kapa ho siea tlhaiso-leseling e sa hlokeng ho koaheloa. Litšenyehelo li ka hlakoloa haeba ho na le bosholu kapa litefiso tse sa lefelloeng kapa tsa morao.

U na le tokelo ea ho khetha mofani oa tlhokomelo ea mantlha (PCP) ho tsoa marangrang a moralo oa bophelo.

Ha o hloke ho fetisetsoa ho PCP ea hau ho fumana tlhokomelo ho ngaka ea lingaka / lingaka tsa basali. Hape ha ua tlameha ho lefa ho feta ho fumana tlhokomelo ea tšohanyetso kantle ho marang-rang a moralo oa hau.

U sirelelitsoe khahlanong le boiphetetso ba mohiri.

Mohiri oa hau a ke ke au leleka kapa a iphetetsa ho uena:

• Haeba o fumana mokoloto oa lekhetho o lefuoang ka ho reka moralo oa bophelo 'marakeng
• Haeba u tlaleha tlolo ea molao khahlanong le liphetoho tse theko e tlaase tsa Molao oa Tlhokomelo

U na le tokelo ea ho etsa boipiletso ka qeto ea k'hamphani ea inshorense ea bophelo bo botle.

Haeba moralo oa hau oa bophelo o hana kapa o emisa ho fana ka litaba, o na le tokelo ea ho tseba hore na hobaneng le ho etsa boipiletso ka qeto eo. Merero ea bophelo bo botle e tlameha ho u joetsa hore na u ka etsa boipiletso joang liqetong tsa bona. Haeba maemo a potlakile, moralo oa hau o tlameha ho sebetsana le ona ka nako e loketseng.

KEKETSO DITOKELO

Merero ea bophelo bo botle 'marakeng oa Inshorense ea Bophelo' me boholo ba merero ea bophelo bo botle ba mohiri le eona e tlameha ho fana ka:

• Lisebelisoa tsa kanyeso le tlhabollo ho basali ba baimana le ba anyesang
• Mekhoa ea thibelo ea bokhachane le tlhabollo (mekhelo e etsetsoa bahiri ba bolumeli le mekhatlo ea bolumeli e sa etseng phaello)

Litokelo tsa bareki tsa tlhokomelo ea bophelo bo botle; Litokelo tsa moreki oa tlhokomelo ea bophelo

• Mefuta ea bafani ba tlhokomelo ea bophelo

Webosaete ea American Cancer Society. Bili ea litokelo tsa mokuli. www.cancer.org/treatment/finding-and-paying-for-treatment/understanding-financial-and-legal-matters/patients-bill-of-rights.html. E ntlafalitsoe ka la 13 Mphalane 2019. E fihlile ka la 19 Hlakubele 2020.

Webosaete ea CMS.gov. Liphetoho tsa mmaraka oa inshorense ea bophelo. www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Market-Reforms/index.html. E ntlafalitsoe ka la 21 Phuptjane 2019. E fihlile ka la 19 Hlakubele 2020.

Healthcare.gov websaeteng. Litokelo le inshorense ea bophelo bo botle. Bophelo bo botle.gov/health-care-law-protections/rights-and-protections/. E fihliloe ka la 19 Hlakubele 2020.

Healthcare.gov websaeteng. Morero oa inshorense ea bophelo bo botle 'marakeng o koahela eng. Bophelo bo botle ba bophelo.gov/coverage/what-marketplace-plans-cover/. E fihliloe ka la 19 Hlakubele 2020.