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中国留美女生遇天价医疗账单 怎样看病才省钱?

2017-09-04 11:11:09   中国青年网

5、Pre-Existing Condition(已存在医疗状况)

指在承保计划生效前,已显现的病患或创伤;及在承保计划生效前,已正接受由医疗护理提供者所提供或建议的治疗;或以一个普通而谨慎的人士而言亦会在其保单生效前,接受医疗建议、謢理或治疗。

在保单生效日怀孕亦属于“已存在的医疗状况”。怀孕所引致的并发症则不属已存在的医疗状况,亦不受“已存的医疗状况”所限制。

6、Out-of-Pocket Maximum (自付最高上限)

指一个医疗福利计划内会员需支付费用的上限。该最高金额为所有自付扣除金、定额手续费及共同保险金的总和,超过这个上限金额,保险公司将全部承担。

7、In Network(网内医院)

In Network(或称为PPO,即Preferred Provider Organization)是指保险公司合作的网络内优选供应组织,可理解为指定医院。每家医疗保险公司、每款医疗保险计划都有自己签约合作的医疗网络。

相反,Out ofNetwork(或称为Non-PPO),则指保险公司不合作的医疗组织,也可以理解为非指定医院。

InNetwork网内医院看病好处多,在美国有很大一部分医院和医生诊所同时签约了多家Network,通过类似会员制的方式,对医院来说能够招揽更多病人来看病;作为病人,在网络内医院看病有以下诸多好处:

1、协议价

你的网络会帮你向医院争取协议价优惠,收费优惠了,最后你要自付的也就少了。

2、自付少

因为保险公司要付给签约医院的费用降低了,自然也会帮你减少免赔额(Deductible)或定额手续费(Copay),同时提高报销比例(Coinsurance)。

3、直接结算

网络内医院的工作人员会直接把你的看病记录和收费项目发给保险公司,保险公司会直接跟医院结算可以报销的费用,不需要你垫付全部医药费,等保险公司报销后,医院会发给你一份自己应付的账单。

除了买保险之外,还有几项需要留学党谨记

1、除非特殊情况千万不要叫急救

和中国医疗保险体系不同的是,美国的急救服务非常昂贵,叫一辆救护车的费用可能要产生将近上万美元的费用,即便有保险支付一定的比例,最后学生自付的金额也是非常高的。

2、一般情况下,建议和医生提前预约时间就诊。

如果学生出现了紧急医疗情况需要尽快处理,学生可以去家附近的Urgent Care(急救护理中心)就诊,Urgent Care的工作时间相对久一点,有的地方会工作到晚上10点,有的地方可能24小时都开门。

3、如果情况不紧急的话,可以先去学校的学生健康中心(Student Health Center,SHC),对学生收费比外面医院要优惠很多,很多保险还能减免一部分学生的免赔额(deductible)和定额手续费(copay)。

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