请教一下…我想确定我的理解是正确的 举例： Anthem PPO Share 7500 (31岁的保费是612/月) --------------------- Plan Type PPO Office Visit for Primary Doctor $40 Copay Office Visit for Specialist $40 Copay Coinsurance 30% after deductible Annual Deductible Individual:$3,500 Separate Prescription Drugs Deductible $750 applies to Brand-name prescription drug Generic Prescription Drugs $15 copay or 40% coinsurance, whichever is greater Brand Prescription Drugs $15 copay or 40% coinsurance, whichever is greater after $750 annual brand name deductible (2 member max) Annual Out-of-Pocket Limit Individual:$7,500 Includes deductible Lifetime Maximum Unlimited Health Savings Account (HSA) Eligible No Out-or-network Coverage Yes 美国的PPO Insurance 看医生要付US$40，拿药是15 or 30%(看那个高） Deductible写3500，然後又写一个 Out-of-pocket是7500 这是指7500里面都是一年的病人自付上限吧？ 40％是指drug的部份 其它的部份是30% 也就是简单的讲，3500以内病人自己出 3500以上，40 Office Visit + 40% Drug(or$15) + 30% 其它医疗（像是检查） 直到碰到7500为止（之後全保险公司出） 但这是以年为单位Reset.... Deductible是以次为单位还是… （我的理解有错吗？） 下面是我查到的定义 Coinsurance: The amount that you are obligated to pay for covered medical services after you've satisfied any co-payment or deductible required by your health insurance plan. Coinsurance is typically expressed as a percentage of the charge or allowable charge for a service rendered by a healthcare provider. For example, if your insurance company covers 80% of the allowable charge for a specific service, you may be required to cover the remaining 20% as coinsurance. 这样612每月也太扯了一点了吧..... --

※ 发信站: 批踢踢实业坊(ptt.cc) ◆ From: 131.179.64.241 ※ 编辑: chucheng 来自: 131.179.64.241 (10/12 03:16)