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Information for new students 
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2008-06-12 13:52:24, Hit : 6,313, Vote : 431 |
ÀǷẸÇè¿¡ °üÇØ ±Ã±ÝÇØ ÇϽô ºÐµéÀÌ ¸¹À» °Í °°³×¿ä.
ÀÏ´Ü Çб³¿¡¼ RA ȤÀº TA µîÀ¸·Î ¿ù±ÞÀ» ¹ÞÀ¸½Ã´Â ºÐ (Maryland State Employees and Retirees)¿¡°Ô
ÇØ´çÇÏ´Â ÀǷẸÇè¿¡ °üÇÑ À̾߱âºÎÅÍ.
(1) Medical Plan (º´¿øº¸Çè)
PPO plan ( BC/BS PPO or MLH Eagle PPO)
POS plan (Aenta POS or BC/BS MD POS or MD IPA Preferred POS)
HMO plans (BlueChoice HMO or Kaiser HMO or Opomum choice HMO)
(2) Dental Plan (Ä¡°úº¸Çè)
dental benefits providers dental HMO
United Concordian dental HMO
United Concordian dental PPO
(3) Prescription (¾àº¸Çè): ÇÑÁ¾·ù³×¿ä À̰Ç.
ÀÌ·¸°Ô ¼¼ °³ÀÇ ¼·Î´Ù¸¥ º¸ÇèÀ» "¾Ë¾Æ¼ °ñ¶ó¼" µé¾î¾ß ÇÕ´Ï´Ù.
°³ÀÎ ÃëÇâ¿¡ µû¶ó ÀǷẸÇ踸 ÇÏ½Ç ¼öµµ ÀÖ°í, Ä¡°úº¸ÇèÀ̳ª ¾àº¸ÇèÀ» °°ÀÌ ÇϽǼöµµ ÀÖ½À´Ï´Ù.
¸ÕÀú Medical Plan ¿¡ °üÇØ.
- PPO (Preferred Provider Organization):
ÁÖÄ¡ÀÇ(Primary Care Physician) °í¸¦ ÇÊ¿ä¾ø°í, Referral ¹ÞÀ» ÇÊ¿ä ¾ø°í, ¾Æ¹« ÀÇ»çÇÑÅ׳ª ¹æ¹® °¡´É
´Ù¸¸, in-network (ÇØ´ç Àǻ簡 PPO º¸Çè network¿¡ ÀÖ´Â »ç¶÷À̸é) ÀÇ °æ¿ì ÁÖÄ¡ÀÇ (¸¸¾à ÀÖÀ¸¸é)´Â 15ºÒ,
´Ù¸¥ Specialist´Â 25ºÒ co-payment(¹æ¹®½Ã¸¶´Ù ³»´Â µ·) ³»¾ßÇÔ. Out of networkÀÇ Àǻ縦 ¹æ¹®ÇÒ °æ¿ì, ÀÏ´Ü ¸ðµç µ·À» º»ÀÎÀÌ ³»°í ³ªÁß¿¡ reimburse ÇÒ ¼ö ÀÖ½À´Ï´Ù. ±Ùµ¥ ´ëºÎºÐÀÇ ÀÇ»ç ¿ÀÇǽº¿¡¼ PPO´Â ´Ù ¹ÞÀ¸¹Ç·Î Á¦ÀÏ ÆíÇÏÁö¸¸, µû¶ó¼ º¸Çè·á°¡ Á© ºñ½Ô´Ï´Ù.
- POS (Point of Service): ÁÖÄ¡ÀǸ¦ °ñ¶ó¾ß ÇÕ´Ï´Ù.
¿¹¸¦ µé¾î ÀϹÝÀûÀ¸·Î ³»°ú (internal medicine)À̳ª °¡Á¤ÀÇÇаú(Family care?) Àü¹®ÀǸ¦ ÁÖÄ¡ÀÇ·Î °ñ¶ó³ù´Âµ¥
°©Àڱ⠴ٸ®°¡ ºÎ·¯Á®¼ Á¤Çü¿Ü°ú¿¡ °¡¾ßÇѴٰųª, ´«º´ÀÌ ³ª¼ ¾È°úÀǻ翡°Ô °¡¾ßÇÑ´Ù°í Çϸé referral À» ¹Þ¾Æ¼ ¹æ¹®ÇÏ¸é µË´Ï´Ù.
ÁÖÄ¡ÀÇ ¹æ¹®½Ã 15ºÒ, ´Ù¸¥ Specialist´Â 25ºÒ co-payment ÀÔ´Ï´Ù.
- HMO (Health Maintenance Organization): in-network¾È¿¡ ÀÖ´Â Àǻ翡°Ô¸¸ Áø·á¹ÞÀ» ¼ö ÀÖ½À´Ï´Ù.
¿ä°Ô Sicko °°Àº ¿µÈ¿¡¼µµ ¹®Á¦°¡ ¸¹Àº º¸ÇèÀä,
ÀÏ´ÜÀº ÀÇ»çµéÀÌ HMO¸¦ Àß ¾È ¹Þ´Â ¿ÀÇǽº°¡ ¸¹½À´Ï´Ù. µéÀº À̾߱䵥, ȯÀÚ¸¦ ¸î¸íÀ» º¸°Ç Àǻ翡°Ô ¶³¾îÁö´Â µ·Àº µ¿ÀÏÇÏ°Ô Ã¥Á¤µÇ¾î
±»ÀÌ ÈÀÚ¸¦ º¸·Á°í ¾Ö¾²Áö ¾Ê´Â´Ù°í ÇÕ´Ï´Ù. ±×·¡¼ÀÎÁö, ¿¹¾àÇѹø ÇÏ·Á¸é appointment °¡ ¸Å¿ì¸Å¿ì ´Ê°Ô ÀâÈ÷±âµµ Çϰí (ÀÌ¹Ì ±×떄µÇ¸é º´ÀÌ ´Ù ³ªÀ» Á¤µµ·Î..) °³ÀÎÀûÀ¸·Î º°·Î ºñÃßÀÔ´Ï´Ù.
http://dbm.maryland.gov/dbm_publishing/public_content/dbm_search/employee_services/health_benefits/2009_health/2009_benefits_booklet.pdf
ÀÌ°Ç 2008-2009 State of Maryland Health Benefit ºÏŬ¸´ÀÔ´Ï´Ù.
pdf ÈÀÏ·Î 69ÆäÀÌÁö(±×·¯´Ï±î ºÏŬ¸´ 65ÆäÀÌÁö)¸¦ º¸½Ã¸é ¼±Åà °¡´ÉÇÑ ¸ÞµðÄà Ç÷£ÀÌ ³ª¿Í ÀÖ½À´Ï´Ù.
À§¿¡ ¸»¾¸µå¸° ¼¼°¡Áö ¹æ½ÄÀÌ ÀÖ°í
¿©·¯ º¸Çèȸ»çµéÀÌ ÀÖÀ¸´Ï, ±× Áß¿¡¼ »ç¶÷ ¼ö¿¡ ¸ÂÃç ¼±ÅÃÇÏ½Ã¸é µË´Ï´Ù.
¿¹¸¦ µé¾î º»Àΰú ¾Æ³», ¾Æ±âÀÇ ¸ÞµðÄà Ç÷£À» °í¸¥´Ù°í ÇÒ¶§
M.D.IPA preferred POS·Î 3+ people ¸¦ ¼±ÅÃÇÑ´Ù°í Çϸé,
2ÁÖ¿¡ Çѹø¾¿ 77.68ºÒÀ» ¸ÞµðÄà º¸ÇèÀ¸·Î ³»°í (ÇÑ´ÞÀ̸é 155.36 ¶È°°³×¿ä)
¾àº¸Çè prescriptionÀÇ °æ¿ì (employee + 2 or more) 2ÁÖ¸¶´Ù 35.45ºÒ¾¿ ³À´Ï´Ù.
±×·¯´Ï±î 2ÁÖ¿¡ ´ë·« 120ºÒ, ÇÑ´ÞÀÌ¸é ´ë·« 240ºÒ ³»´Â °ÍÀÌÁÒ.
¿©±â¿¡ Ä¡°úº¸Çè±îÁö ÇÑ´Ù¸é, DPPO·Î 2ÁÖ¿¡ 21.96ºÒ ÇÑ´Þ¿¡ 43.91ºÒÀÌ´Ï±î °ÅÀÇ 300ºÒÀ̳׿ä.
ÀӽŠ¹× Ãâ»ê °èȹÀÌ ÀÖÀ¸½Å ºÐµéÀº Pos ÀÌ»óÀÇ º¸ÇèÀ» ÇϽøé Àü¾× º¸ÇèÀ¸·Î Ä¿¹öµÈ´Ù°í ¾Ë°í ÀÖ½À´Ï´Ù.
µû¶ó¼ °á·ÐÀº "3°¡Áö Áß¿¡ º»ÀÎÀÌ ¿øÇÏ´Â ¼ºñ½º¿¡¼ ¿øÇÏ´Â º¸Çèȸ»ç¸¦ °ñ¶ó ½ÅûÇÏ½Ã¸é µÈ´Ù"ÀÔ´Ï´Ù.
°æ¿ì¿¡ µû¶ó ¾àº¸ÇèÀ̳ª Ä¡°úº¸Çè ¾øÀÌ ÀÖ´Ù°¡ ÀÏÀÌ Ä¿Áö¸é ±×³É º¸Çè¾øÀÌ Çϰڴٴ °æ¿ìµµ ¸¹ÀÌ ÀÖ½À´Ï´Ù.
¾îÂ÷ÇÇ ¾àº¸Çè 1³âÀ̸é 700-800ºÒ, Ä¡°úº¸Çè 1³âÀ̸é 500ºÒ Á¤µµ µé¾î°¡´Ï±î (3ÀÎÀÌ»ó °¡Á·)
ÀÏÀÌ ÅÍÁö¸é ±×³É ±×µ·³»°í ¾à»ç¸Ô°í Ä¡·á¹Þ°í ¾Æ´Ï¸é µ·À» ¼¼À̺êÇÑ´Ù..´Â °ÍÀÌÁÒ.
State of Maryland health benefit¿¡ ÇØ´çµÇÁö ¾Ê´Â ºÐµéÀº
Çѱ¹¿¡¼ ¾Æ¹« À¯Çлýº¸ÇèÀ̳ª ¹¹³ª µé°í ¿À¼Åµµ »ó°ü¾ø°í
º¸Çè ¾øÀÌ ¿À¼Åµµ »ó°ü¾ø½À´Ï´Ù. (IES ¿¡ È®ÀÎÇÑ °á°ú, º¸Çè ¾ø¾îµµ Çб³µî·Ï¿¡ ¹®Á¦ ¾ø´Ù°í ÇÕ´Ï´Ù)
º»ÀÎÀÌ ½Åü°ÏÀåÇÑ 20´ë ³²¼ºÀ¸·Î »ýÀü º´¿ø°¥ÀÏÀÌ ¾ø´Ù´Â ºÐÀº ½Ñ º¸Çè ¾Æ¹«°Å³ª (ȤÀº ±×¸¶Àúµµ ¾øÀÌ) µéÀ¸¼Åµµ µÇ°í,
°¡Á·À̳ª ¾ÆÀ̰¡ ÀÖ°í ÀÚÁÖ ¾ÆÆÄ¼ º´¿ø °¥ÀÏÀÌ ¸¹´Ù´Â ºÐÀº ºñ½Ñ º¸Çè·á¿¡µµ ºÒ±¸Çϰí ÁÁÀº º¸ÇèÀ» °í¸£¸é
¾Æ¹«·¡µµ ÆíÇϰí ÇýÅõµ ¸¹ÀÌ ÀÖ°ÚÁÒ.
Àß »ý°¢ÇØ º¸½Ã°í ¸¾¿¡ µå´Â °É·Î °ñ¶óÁÖ¼¼¿ä~~!!!!!
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