今天将带领大家学习一下跟健康保险相关的词汇和用语。
国外的医疗体系和国内的不太一样,这个时候买一个好的保险就显得很重要了。
1. Terms 词汇
Claim索赔
Copayment (Copay) 挂号费/定额手续费
Deductible 保险自付额
Benefit福利
Premium 保费;购买保险需要交纳的费用
Allowed amount保险为承保的医疗服务支付的金额
Coinsurance 共付额(按比例承担的部份医疗费用,通常承担的比例为15-30%不等,剩下的则都有医保公司来买单。)
Coverage保险的覆盖范围
Quote报价
HMO (Health Maintenance Organization) 健康维护机构; 必须选择一位 Primary Care Physician(家庭医师),要看专科的话,必须先到家庭医师那边拿 Referral 转诊(急诊与妇产科可以直接就诊,不需要referral),而这些专科医师都必须是网内的医生。保费通常较便宜。
PPO (Preferred Provider Organization) 优选医疗机构保险;不用选家庭医师,可以直接找专科医生看诊。医疗网内外的医师都可以看,但网外医生可能自行负担的金额较高。保费较高。
HAS (Health Saving Account) 健康储蓄帐户
Network Provider/In-network provider 网络内医疗机构;跟保险有合作关系的诊所,在网络内诊所看病保险报销更多
Out-of-pocket maximum 年度自付额上限
Contract合同
怎样挑选适合自己的保险?
2. Common Questions 常见问题
Can I pay my monthly premiums using HSA funds?
我可以用HSA基金支付每月的保费吗?
What type of plan is it?
这是什么样的保险方案?
How do I know what type of insurance plan is right for me and my family?
我怎么样才能了解什么样的保险计划适合我和我的家人?
How much does health insurance cost?
健康保险要多少钱?
Does my plan cover dental insurance and vision insurance?
我的保险方案里包含牙科保险和眼科保险吗?
How does Medicare coverage work? 、
医疗保险如何运作?
Copayment, deductibles, coinsurance … What’s the difference?
挂号费,自付额,共付额…有什么区别?
What happens if you have a preexisting condition?
如果你有投保前已存在的疾病怎么办?
What Are the Plan's Restrictions on Pre-Existing Conditions?
该方案对投保前已存在的疾病有哪些限制?
What can I Do if I’m not satisfied with my health policy?
如果我对我医疗保险里的条款不满意,我该怎么办
Does health insurance cover begin from day one?
健康保险从天开始吗?
Is hospitalization required to make a claim?
住院治疗一定要索赔吗?
Dialogues情景对话
A: I need information on purchasing health insurance.
我需要关于购买健康保险的信息。
B: Have you ever purchased health insurance before?
你以前买过健康保险吗?
A: No, this is my first time buying health insurance.
不,这是我次买健康保险。
B: You have a choice of HMO or PPO. Do you understand the difference?
你可以选择HMO或PPO。你了解它俩的区别吗?
A: I am not sure what those are.
我不太清楚。
B: Just so you understand completely: An HMO is a little cheaper, but you have limited choices of which doctor you choose.
那我解释一下:HMO收费比较便宜,但你选择的医生是有限的。
A: If I need to use my insurance, are the payments the same for a PPO and HMO?
如果我需要使用我的保险,PPO和HMO两个保险看病的费用是一样的吗?
B: By going to the providers on the HMO list, you save money in out-of-pocket expenses.
通过访问HMO网络内的诊所,你可以节省自付费用。
A: Can you give me a comparison between a PPO and an HMO?
你能给我一个PPO和HMO两个保险的对比吗?
B: We can email you a questionnaire and when we have all of your information, we will email you a quote.
我们可以通过电子邮件向你发送一份调查问卷,当我们掌握了你的所有信息后,我们将通过电子邮件向你发送一份报价。
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