He aha ka ʻokoʻa ma waena o Coinsurance vs. Copays?

Anter

• Ke maopopo nei i ka nui o kāu ʻaiʻē
• Pehea e hoʻonui ai i ka mea nui ma waho o ka ʻeke i kāu ʻaiʻē?
• Pehea e hana ai ka ʻinikua?
• ʻO nā mea hoʻolako pūnaewele a ma waho o ka pūnaewele
• Ke laina lalo

Uku ʻinikua

ʻO ke kumukūʻai o ka ʻinikua olakino pili pinepine i nā uku o kēlā me kēia mahina a me nā kuleana kālā ʻē aʻe, e like me ka copay a me ka coinsurance.

ʻOiai like ke ʻano o kēia mau huaʻōlelo, hana ʻokoʻa kēia mau hoʻonohonoho hoʻoliʻiliʻi. Eia ka haʻihaʻi:

• Coinsurance. Uku ʻoe i ka pākēneka paʻa (e like me 20 pākēneka) o ke kumukūʻai o kēlā me kēia lawelawe lapaʻau āu e loaʻa ai. Na kāu ʻoihana inikua ke kuleana no ka pakeneka i koe.
• Copay. Uku ʻoe i kahi huina paʻa no nā lawelawe kikoʻī. ʻO kahi laʻana, pono paha ʻoe e uku i $ 20 copay i kēlā me kēia manawa ke ʻike ʻoe i kāu kauka mālama mua. ʻIke paha i kahi loea i kahi copay kiʻekiʻe, predetermined.

ʻO kekahi mea e pili ana i ke kumukūʻai e ʻike ʻia ma ke ʻano he unuhi. ʻO kāu hōʻemi makahiki ka nui o ke kālā āu e uku ai no nā lawelawe ma mua o ka hoʻomaka ʻana o kāu ʻinikua olakino e kiʻi i kēlā mau kumukūʻai.

Kaukaʻi ʻia i kāu hoʻolālā ʻinikua olakino, hiki i kāu hōʻemi ʻia he mau haneli a i ʻole he mau tausani kālā i kēlā me kēia makahiki.

E heluhelu e aʻo hou e pili ana i ka coinsurance a me nā copay a pehea e pili ai i ka nui o ke kālā āu e ʻaiʻē ai ke loaʻa iā ʻoe nā lawelawe lapaʻau.

Ke maopopo nei i ka nui o kāu ʻaiʻē

Hiki i ka hoʻomaopopo ʻana i nā copay, ke kālā ʻana, a me nā unuhi ke kōkua iā ʻoe no nā kumukūʻai e loaʻa ai ka lāʻau lapaʻau.

ʻO kahi ʻano o ke kipa e koi wale i kahi copay. ʻO nā ʻano kipa ʻē aʻe e koi ai iā ʻoe e uku i kahi pākēneka o ka nui o ka bila (coinsurance), e hele ana i kāu unuhi ʻia, a me kahi copay. No nā kipa ʻē aʻe, uku ʻia ʻoe no ka huina o ke kipa akā ʻaʻole uku kope.

Inā loaʻa iā ʻoe kahi hoʻolālā e uhi ana i ka 100 pākēneka o nā kipa maikaʻi (nā māka o ka makahiki), koi ʻia ʻoe e uku i kāu copay i hoʻoholo mua ʻia.

Inā uhi wale kāu hoʻolālā $ 100 i kahi kipa maikaʻi, kuleana ʻoe no ka copay a me ke koina o ke kipa i kipa ʻia.

ʻO kahi laʻana, inā $ 25 kāu copay a ʻo ka nui o ke kumukūʻai no ka kipa $ 300, e kuleana ʻoe no $ 200 - $ 175 o lākou e helu ʻia i kāu lawe.

Eia nō naʻe, inā ua hui mua ʻoe i kāu hoʻoliʻiliʻi piha no ka makahiki, a laila e kuleana ʻoe no ka $ 25 copay.

Inā loaʻa iā ʻoe kahi hoʻolālā coinsurance a kū i kāu hōʻemi piha, e uku ʻoe i kahi pākēneka o kēlā $ 300 kipa maikaʻi. Inā he 20 pākēneka kāu helu ʻai kālā, me kāu ʻinikua e uhi ana i ka 80 pakeneka ʻē aʻe, a laila pono ʻoe e uku $ 60. E uhi kāu ʻoihana ʻinikua i ka $ 240 i koe.

E hōʻoia mau me kāu ʻoihana ʻinikua e ʻike pono ʻoe i ka mea i uhi ʻia a he aha kāu kuleana no nā lawelawe like ʻole. Hiki iā ʻoe ke kelepona i ke keʻena o ke kauka a nīnau e pili ana i ke kumukūʻai i manaʻo ʻia no kāu mālama ʻana ma mua o ka hele ʻana i kāu manawa i koho ʻia.

Pehea e hoʻonui ai i ka mea nui ma waho o ka ʻeke i kāu ʻaiʻē?

ʻO ka hapa nui o nā hoʻolālā ʻinikua i ka mea i kapa ʻia ʻo "maximum out-of-pocket." ʻO ia ka mea nui āu e uku ai i kahi makahiki i hāʻawi ʻia no nā lawelawe i uhi ʻia e kāu hoʻolālā.

I ka manawa e lilo ai kāu mea nui i nā copay, nā coinsurance, a me nā deductibles, pono i kāu ʻoihana inikua ke uhi i 100 pākēneka o nā koina hou aʻe.

E hoʻomanaʻo i ka huina o ka ʻeke i loko ʻaʻole e hoʻokomo i ke kālā i uku ʻia e kāu ʻoihana inikua i kāu kauka a i ʻole ka mea lawelawe olakino ʻē aʻe. ʻO ke kiʻi ke kālā pololei āu i uku ai no ke olakino.

Eia kekahi, e loaʻa i kahi hoʻolālā pilikino kahi haʻahaʻa o waho o ka ʻeke ma lalo o kahi hoʻolālā e uhi ana i kahi ʻohana holoʻokoʻa. E makaʻala i kēlā ʻokoʻa ke hoʻomaka ʻoe e hoʻolālā kālā i kāu lilo olakino.

Pehea e hana ai ka ʻinikua?

Hoʻolālā ʻia ka ʻinikua olakino e pale aku i kēlā me kēia ʻohana a me nā ʻohana mai ka piʻi nui ʻana o ke kumukūʻai o ke olakino. ʻAʻole ia he meaʻuʻuku loa, akā hiki iā ia ke mālama iā ʻoe i ke kālā i ka wā lōʻihi.

Pono nā insurer i nā uku no kēlā me kēia mahina. ʻO kēia nā uku āu e hana ai i ka ʻoihana inikua i kēlā me kēia mahina no laila he ʻinikua kāu e uhi ai i nā pilikia maʻamau a me nā pōʻino.

Uku ʻoe i nā uku inā kipa ʻoe i ke kauka i hoʻokahi manawa i ka makahiki a i ʻole lilo i mau mahina i ka haukapila. ʻO ka maʻamau, e uku ʻoe i nā uku haʻahaʻa o ka mahina no kahi hoʻolālā me kahi deductible kiʻekiʻe. Ke iho nei i ka mea hiki ke unuhi ʻia, hoʻonui pinepine ʻia nā kumukūʻai o ka mahina.

Hāʻawi pinepine ʻia ka ʻinikua olakino e nā luna hana i nā limahana hana manawa piha. ʻAʻole koho nā ʻoihana liʻiliʻi me ka lima wale o nā limahana e hoʻolako i ka inikua olakino ma muli o ka lilo.

Hiki paha iā ʻoe ke koho e loaʻa i ka ʻinikua olakino nāu iho mai kahi ʻoihana inikua pilikino, ʻoiai inā e hana piha ʻia ʻoe a loaʻa iā ʻoe ke koho no ka ʻinikua olakino i kākoʻo ʻia e ka luna hana.

Ke loaʻa ʻoe i ka inikua olakino, pono ʻoe e loaʻa i kahi papa inoa o nā kumukūʻai i uhi ʻia. ʻO kahi laʻana, he $ 250 ka huakaʻi i ka lumi pilikia ma kahi kaʻa kaʻahua.

Ma lalo o kahi hoʻolālā e like me kēia, inā ʻaʻole ʻoe i hālāwai me kāu hoʻoliʻiliʻi a hele ʻoe i ka lumi pilikia i kahi kaʻa kaʻahua, pono ʻoe e uku i $ 250. Inā ʻoe i hālāwai me kāu hōʻemi ʻia a uhi ʻia nā kaʻa kaʻa kaʻa kaʻa he 100 pakeneka, a laila manuahi kāu holo ʻana.

I kekahi mau hoʻolālā, uhi ʻia ke kaha nui ma 100 pākēneka, ʻoiai hiki ke uhi ʻia nā nānā ʻana a i ʻole nā ​​kānana ʻana ma 80 pākēneka. ʻO kēia ke kuleana o ʻoe no ka 20 pakeneka i koe.

He mea nui e loiloi i nā copay, nā coinsurance, a me nā deductibles i ke koho ʻana i kahi hoʻolālā. E hoʻomanaʻo i kāu mōʻaukala olakino.

Inā ʻoe e manaʻo ana e loaʻa i kahi ʻoki kino nui a i ʻole hānau i kahi pēpē i ka makahiki e hiki mai ana, makemake paha ʻoe e koho i kahi hoʻolālā kahi e uhi ai ka mea mālama inikua i kahi pākēneka kiʻekiʻe no kēia ʻano o nā kaʻina hana.

Ma muli o ka hiki ʻole iā ʻoe ke wānana i nā ulia pōpilikia a i ʻole nā ​​hopohopo olakino e hiki mai ana, noʻonoʻo pū i ka nui o kāu hiki ke uku i kēlā me kēia mahina a me ka nui āu e hiki ai ke loaʻa inā loaʻa iā ʻoe kahi olakino olakino ʻole.

ʻO ia ke kumu he mea nui e nānā a noʻonoʻo i nā koina i manaʻo ʻia, e like me:

• hoʻemi ʻia
• ʻoi loa o ka ʻeke
• uku uku mahina
• kopeka
• puʻukū kālā

Hiki i ka hoʻomaopopo ʻana i kēia mau lilo ke kōkua iā ʻoe e hoʻomaopopo i ka nui o ke kālā āu e ʻaiʻē ai inā makemake ʻoe i ka nui o nā lawelawe olakino i hoʻokahi makahiki i hāʻawi ʻia.

ʻO nā mea hoʻolako pūnaewele a ma waho o ka pūnaewele

E pili ana i ka ʻinikua olakino, he hōʻuluʻulu kahi hōʻuluʻulu o nā haukapila, nā kauka, a me nā mea lawelawe ʻē aʻe i kau inoa ʻia e lilo i mau mea lawelawe makemake ʻia ma kāu papa ʻinikua.

ʻO kēia nā mea hoʻolako pūnaewele. ʻO lākou ka mea a kāu ʻoihana ʻinikua e makemake ai e ʻike.

ʻO nā mea hoʻolako pūnaewele waho wale nō ka poʻe ʻaʻole i kau inoa ʻia i kāu hoʻolālā. ʻO ka ʻike ʻana i nā mea hoʻolako i waho o ka pūnaewele hiki ke manaʻo i nā kumukūʻai ʻoi aku i waho o ka ʻeke. ʻAʻole pili kēlā mau kumukūʻai i kāu lawe.

Eia hou, he mea nui ia e ʻike pono i ka ins and outs o kāu hoʻolālā ʻinikua i ʻike ʻoe i ka mea a me nā mea i uhi ʻia. Aia paha i kahi kauka kauka i waho o kou kaona, a i ʻole he mea paha āu e ʻike ai ke hele huakaʻi ʻoe.

Inā kānalua ʻole ʻoe inā ʻo kāu kauka makemake i loko o ka pūnaewele, hiki iā ʻoe ke kelepona i ka mea hoʻolako ʻinikua a i ʻole ke keʻena o kāu kauka e ʻike ai.

I kekahi manawa haʻalele ke kauka a hui pū paha i kahi pūnaewele hou. Ke hōʻoia nei i ke kūlana pūnaewele o kāu kauka ma mua o kēlā me kēia kipa hiki ke kōkua iā ʻoe e hōʻalo i nā kumukūʻai i manaʻo ʻole ʻia.

Ke laina lalo

Hiki i ka ʻinikua olakino ke lilo i mea paʻakikī. Inā he ʻinikua kāu ma o kāu luna hana, e nīnau iā wai ma kou haku ʻo ia ka mea e hoʻopili ai no nā nīnau. ʻO ka mea maʻamau kekahi ma ka ʻaoʻao kumuwaiwai kanaka, akā ʻaʻole mau.

Pono i kāu ʻoihana ʻinikua kahi keʻena lawelawe mea kūʻai aku e pane i kāu mau nīnau.

ʻO nā mea nui loa e noʻonoʻo i ka hoʻomaka ʻana o kahi hoʻolālā ʻinikua e ʻike:

• kāu mau koina āpau
• ke holo pono kāu hoʻolālā (he nui nā hoʻolālā ʻinikua e loli i ka waena o ka makahiki)
• he aha nā lawelawe i uhi ʻia a no ka nui

ʻAʻole paha ʻoe e hoʻolālā i kahi hana nui a i ʻole ʻeha, akā hiki i ka ʻinikua ke kōkua i ka hōʻemi ʻana i ka ukana kālā inā ʻike ʻoe i kahi pilikia olakino nui.