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What I’ll Pay in my policy?

#HealthInsurance #CoveredCalifornia #HealthCoverage #OpenEnrollment


What I’ll Pay in my policy?

我需要為保單支付什麼?

There are many factors at play when it comes to how much you’ll pay for health insurance —things like your location, age, and family size. You can get an estimate of costs by using the Shop and Compare Tool. But how are these costs broken down?

有很多因素會影響您要支付的醫療保險費用,例如您的居住位置,年齡和家庭人數。您可以使用“購買和比較工具”( Shop and Compare tool)來估算成本。但是這些費用如何分解?


Premiums: Your premium is the bill you get for having a health plan that is usually paid monthly. You or your employer, or both, pay it monthly, quarterly, or yearly.

保費:您的保費是您獲得醫療保險後所要付的帳單,通常是每月付一次。您,您的雇主或者兩者兼有需要每月,每季度或每年支付一次。


Out-of-pocket costs: a non-reimbursable expense paid by a patient. This could include any medical benefits that a plan doesn't consider "covered services." Your “out-of-pocket maximum” is a limit on how much you’ll have to pay for covered health services in a year. After that, your plan covers 100 percent of costs.

自付費用:患者所需支付的不可報銷的費用。這可能包括計劃中不屬於“承保服務”範圍內的任何醫療福利。您的“最高自付費用”限定在一年內您付了多少必須支付的承保醫療服務費用。之後,您的計劃將支付100%的費用。


• Deductible: The amount you owe for health care services your health insurance plan covers before your plan begins to pay. For example, if your deductible is $1,000, your plan won't pay anything until you have met your deductible for covered health care services. The deductible may not apply to all services.

免賠額:在計劃幫您支付費用前,您需要自付一定的金額。例如,如果您的免賠額為1,000美元,則您必須滿足自付額才能獲得承保的醫療保健服務,否則計劃不會支付任何費用。免賠額可能不適用於所有服務。


• Copay: A fixed amount (for example, $15) you pay for a covered health care service, usually when you receive the service. The amount can vary by the type of covered health care service.

共付額:您為承保的醫療服務支付的固定金額(例如,15美元),通常是在您接受該服務時支付。金額可能會因承保醫療服務的類型而異。


• Coinsurance: Your share of the costs of a covered health care service, calculated as a percentage (for example, 20 percent) of the allowed amount for the service. You pay coinsurance plus any deductible you owe. For example, if the health insurance plan's allowed amount for an office visit is $100, and you have met your deductible for the year, your coinsurance payment of 20 percent would be $20. The health plan pays the rest of the allowed amount.

共同保險:您所承保的醫療保健服務成本中的份額,以服務允許的金額的百分比(例如20%)計算。您需要支付共同保險費以及您所需付的任何自付額。例如,如果健康保險計劃允許的就診費用為$ 100,而您已滿足當年的自付額,則20%的共同保險金為$ 20。健康計劃將支付剩餘的允許金額。



Source 資料來源: www.coveredca.com


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