20 17 analysis of American immigrant medical insurance

The medical system of American immigrants is getting stronger and stronger. Many people can enjoy a good medical insurance system when they immigrate to the United States. What are the new changes in American medical insurance? Let's take a look at it with the overseas immigration network! Welcome to reading.

American medical insurance for new immigrants

To choose the type of medical insurance, we must first understand these high-frequency words that often appear in medical insurance:

Premium premium

Simply put, it is the amount of medical insurance you need to pay for yourself and your family. Generally, it needs to be paid monthly.

excess

The part you have to pay before the insurance claim. For example, your insurance plan is 65,438+0,000 yuan, which means you have to pay 65,438+0,000 yuan in advance for medical treatment and medicine during your insurance period (usually one year). Only when you spend more than 1 000 yuan on medical care and medicines in one year will your insurance begin to pay.

Copayment amount * * * Payment amount

It is a fixed amount that you need to pay every time you see a doctor and buy medicine. It's a bit like the domestic registration fee. Different medical items may charge different co-payments, such as family doctor's visit to 25 yuan, specialist's visit to 50 yuan and prescription drug purchase 15 yuan.

Co-insurance coverage * * *

It is the percentage that you must personally pay for each visit after you pay the out-of-pocket amount, but before reaching the annual maximum out-of-pocket amount (see next article, annual maximum payment amount). The insurance company will pay the rest of the bill. For example, your insurance plan is to co-insure 20%, that is, after you pay the deductible, you only need to pay 20% of the medical expenses, and the insurance company will pay 80% of the bill.

Maximum out-of-pocket expenses maximum annual payment

Refers to the maximum amount that you can personally pay during your insurance period (usually one year). Before you reach this limit, the insurance company and you will share your medical expenses according to the insurance rules. When your personal compensation reaches the prescribed upper limit, the insurance company will be responsible for your medical expenses 100%, with no upper limit.

In-network provider

Refers to the doctors, hospitals and pharmacies in your medical insurance company network. These participating doctors usually have agreements or contracts with hospitals and insurance companies and will charge fees according to the requirements of insurance companies. Insurance companies generally advise insured patients to give priority to doctors, hospitals and pharmacies with guaranteed services and expenses.

An out-of-network provider refers to a medical institution outside the insurance company's network.

Refers to doctors and hospitals that have not reached an agreement with insurance companies on services and fees. Choosing doctors and hospitals to join or not will greatly affect your payment. Generally speaking, the co-payment, co-payment and co-insurance of non-affiliated doctors and hospitals are much higher.

Primary care doctor, your family doctor or attending doctor.

As the main person in charge of patient medical care. They usually provide basic medical services and coordinate and supervise other care for patients. The attending doctor is usually a general internal medicine or home care doctor, but there are also pediatricians or gynecologists or obstetricians. Some insurance plans require you to choose the attending doctor who coordinates your medical care.

Flexible expenditure account (FSA)

Pre-tax medical accounts provided by employers to employees and managed by employers. Its greatest advantage is tax exemption. Employees can deposit a sum of money into their FSA account every year to pay for their medical expenses that will not be reimbursed by medical insurance during this year. Its limitation is that you must spend all the money in your account within a specified time (usually one year). Otherwise, your account balance will be confiscated. The legal upper limit of 20 15 FSA deposit is 2 550 yuan per person.