p*********0
发帖数: 327 | 1 我和老公身体比较健康，最近主要考虑就是要宝宝，所以请妈妈们帮帮忙。谢谢啦
HMO Plans
No deductibles
No overall lifetime plan maximum
$15.00 co-pay for doctor’s visits
$15.00 urgent care visits (at the HMO’s facility)
$50.00 co-pay for emergency room visits
Co-pay waived if admitted to hospital
Co-pay for prescriptions
$5.00 generic
$15.00 brand
$45.00 non-formulary
No charge for hospitalization/surgeries
Health Maintenance Options Plans (HMO)
Blue Shield Access and Blue Shield NetValue
https://www.blueshieldca.com/bsc/calpers/calpers_welcome.jhtml
Kaiser Permanente
http:/my.kp.org/ca/calpers
PPO Plans
Administered by Anthem Blue Cross of California
$500 deductible per person and $1,000 per family per year
Office visit - $20 (not subject to deductible)
Emergency room - $50 deductible
Waived if admitted to the hospital
Prescription co-pay (retail)
Generic $5.00
Formulary brand name $15
Non-formulary brand name $45 |
s*******t
发帖数: 7746 | 2 what is the "Maximum out of pocket"? Choose the plan with lowest "Maximum
out of pocket"+ deductible(if any)+premium |
p*********0
发帖数: 327 | 3 HR就给了这些信息。。
【在 s*******t 的大作中提到】
: what is the "Maximum out of pocket"? Choose the plan with lowest "Maximum
: out of pocket"+ deductible(if any)+premium
|
t******0
发帖数: 412 | 4 其实最主要的是ppo的计划比较flexible, 对要找很多医生的人很有用，想找什么医生
找几个医生都可以自己说了算，而HMO就不行了，专科医生貌似一定要家庭医生refer才
能看。而且网络外的好像都不行。当然这里有个保费和自负额的区别，PPO肯定是要贵
些的，不知道MM这个是不是还有co-insurance的部分，类似10%或20%in network，还有
就是楼上说的maximum out of pocket 的金额。
【在 p*********0 的大作中提到】
: 我和老公身体比较健康，最近主要考虑就是要宝宝，所以请妈妈们帮帮忙。谢谢啦
: HMO Plans
: No deductibles
: No overall lifetime plan maximum
: $15.00 co-pay for doctor’s visits
: $15.00 urgent care visits (at the HMO’s facility)
: $50.00 co-pay for emergency room visits
: Co-pay waived if admitted to hospital
: Co-pay for prescriptions
: $5.00 generic
|
p*********0
发帖数: 327 | 5 对，有co-insurance，越好越贵。
【在 t******0 的大作中提到】
: 其实最主要的是ppo的计划比较flexible, 对要找很多医生的人很有用，想找什么医生
: 找几个医生都可以自己说了算，而HMO就不行了，专科医生貌似一定要家庭医生refer才
: 能看。而且网络外的好像都不行。当然这里有个保费和自负额的区别，PPO肯定是要贵
: 些的，不知道MM这个是不是还有co-insurance的部分，类似10%或20%in network，还有
: 就是楼上说的maximum out of pocket 的金额。
|
c*******e
发帖数: 9475 | |
p*********0
发帖数: 327 | 7 In a PPO, you pick your doctors from a list of “in-network” physicians.
You may pick your own primary care physician and any other doctors whom you
or your dependents normally see (for example, a pediatrician, dermatologist,
or cardiologist). If you need a specialist within the network, your
primary care physician will usually recommend someone.
Routine services are covered, as are emergency services if you need them
when you are out of the plan service area.
Instead of a fixed co-pay per visit, you pay a percentage of the cost of the
visit:
•PERSCare - 90/10 Plan (you pay 10% of covered visit costs)
o$250 hospital deductible per admission
•PERS Choice - 80/20 Plan (you pay 20% of covered visit costs)
•PERS Select – 80/20 (you pay 20% of covered visit costs)
【在 c*******e 的大作中提到】
: PPO住院/手术多少钱没有说啊？
|
