保险费用 Insurance, Copays and Costs

By the end of this module you can…

• Collect the copay, and say what it’s for.
• Explain the deductible and coinsurance with real numbers.
• Explain networks and referrals simply.
• Give a cost estimate, and offer self-pay prices and payment plans.
• Handle “insurance didn’t cover it” calmly and helpfully.

Key vocabulary

Fourteen words from this module. Tap the speaker to hear each one.

Insurance

• 共付额gòng fù éCopay
• 免赔额miǎn péi éDeductible
• 共同保险gòng tóng bǎo xiǎnCoinsurance
• 网络内wǎng luò nèiIn-network
• 网络外wǎng luò wàiOut-of-network
• 转诊单zhuǎn zhěn dānReferral
• 预先授权yù xiān shòu quánPrior authorization
• 家庭医生jiā tíng yī shēngPrimary care doctor

Paying

• 自费zì fèiSelf-pay
• 费用估算fèi yòng gū suànCost estimate
• 账单zhàng dānBill
• 分期付款fēn qī fù kuǎnPayment plan
• 刷卡shuā kǎTo pay by card
• 收据shōu jùReceipt

Ten core phrases

The lines from this module’s take-home phrase sheet. In the course you can print them on one page for your pocket.

1. 我们先帮您核实一下保险。Wǒ men xiān bāng nín hé shí yí xià bǎo xiǎn.Let us verify your insurance first.
2. 您今天的共付额是三十块。Nín jīn tiān de gòng fù é shì sān shí kuài.Your copay today is $30.
3. 共付额是固定的费用，一般看病当天付。其他的要看保险怎么付。Gòng fù é shì gù dìng de fèi yòng, yì bān kàn bìng dāng tiān fù. Qí tā de yào kàn bǎo xiǎn zěn me fù.A copay is a set amount, usually paid that day; the rest depends on the plan.
4. 您今年的免赔额还没满，所以这次的费用可能要您自己付。Nín jīn nián de miǎn péi é hái méi mǎn, suǒ yǐ zhè cì de fèi yòng kě néng yào nín zì jǐ fù.Deductible not met yet, so you may pay for this visit yourself.
5. 保险付百分之八十，您付百分之二十。Bǎo xiǎn fù bǎi fēn zhī bā shí, nín fù bǎi fēn zhī èr shí.Insurance pays 80%; you pay 20%.
6. 这个专科医生不在您的保险网络里。Zhè ge zhuān kē yī shēng bú zài nín de bǎo xiǎn wǎng luò lǐ.This specialist isn’t in your insurance network.
7. 您的保险需要家庭医生开转诊单。Nín de bǎo xiǎn xū yào jiā tíng yī shēng kāi zhuǎn zhěn dān.Your plan needs a referral from your primary care doctor.
8. 我可以给您一个大概的费用估算。Wǒ kě yǐ gěi nín yí ge dà gài de fèi yòng gū suàn.I can give you a rough cost estimate.
9. 您可以分期付款，每个月付一部分。Nín kě yǐ fēn qī fù kuǎn, měi ge yuè fù yí bù fen.You can pay in monthly installments.
10. 您也可以打保险卡背面的电话问一下。Nín yě kě yǐ dǎ bǎo xiǎn kǎ bèi miàn de diàn huà wèn yí xià.You can also call the number on the back of your card.

What’s in Module 3

1. Part 1 · Warm-UpWarm-Up: Insurance and You
2. Part 2 · The Words for CostsReading the Pinyin · Saying 自己付的钱 vs. Writing 共付额 · Vocabulary · Flash Cards · Explaining Coinsurance
3. Part 3 · At the DeskThe Copay Script · Explaining the Deductible · Key Patterns · Networks and Referrals · Cost Estimates · Medicare and Medicaid
4. Part 4 · When Insurance Says NoInsurance Didn’t Cover It · Payment Plans and Help · Never Let Cost Stop Care
5. Part 5 · Concerns & PayingWhat Patients Say · Taking Payment · Three More Words
6. Part 6 · Role-PlayRound 1 · Guided Conversation · Round 2 · Controlled Practice · Rounds 3, 4 & 5 · Independent
7. Part 7 · Knowledge CheckModule 3 Knowledge Check
8. Part 8 · Wrap-UpModule 3 Homework · Take-Home Phrase Sheet · Module 3 Wrap-Up · 下次见