請教一下…我想確定我的理解是正確的 舉例： Anthem PPO Share 7500 (31歲的保費是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 美國的PPO Insurance 看醫生要付US$40，拿藥是15 or 30%(看那個高） Deductible寫3500，然後又寫一個 Out-of-pocket是7500 這是指7500裡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% 也就是簡單的講，3500以內病人自己出 3500以上，40 Office Visit + 40% Drug(or$15) + 30% 其它醫療（像是檢查） 直到碰到7500為止（之後全保險公司出） 但這是以年為單位Reset.... Deductible是以次為單位還是… （我的理解有錯嗎？） 下面是我查到的定義 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. 這樣612每月也太扯了一點了吧..... --

※ 發信站: 批踢踢實業坊(ptt.cc) ◆ From: 131.179.64.241 ※ 編輯: chucheng 來自: 131.179.64.241 (10/12 03:16)