BlueCross BlueShield

Transcript

BlueCross® BlueShield® Bik’ehgo Haa !h1y3 )oly4h7g77: Standard Option
Haa 1h1y3 bee Hoo’a’7g0ne’: 01/01/2015 – 12/31/2015
Haa !h1y3 Bee H1 Haz’1n7g77
Naaltsoos b1 hadilyaa7: T’11 H0 T’47 !d1 Hash’diilyaa -or- T’11 H0 D00 Ha’1[ch7n7 D00 Bim1d0’ | Bik’ehgo haa 1h1y32doo7g77: PPO
D77 47 t’00 ch’7’7t’32go hane’ 1t’4. D77 nahat’1 bik’ehgo naa 1h1y1n7g77 yaa halne’7g77 47 FEHB Plan brochure (RI 71-005) d77 yid77[tah. FEHB
Plan brochure saad dabik1’7g77 t’11 7iyis77 b7h0ln77h: saad doo hazh0’0’ bee b44d1h0zin7g77 d7igi 1t’4ego 11[dei[n7go (definitions), d00 b1
hadilyaa7 bee b1 haz’1n7g77, (limitations), d00 doo bee h1 haz’32dah7g77 (exclusions), d77 t’11 1t’4 FEHB Plan brochure-g0ne’ yaa halne’.
Naa’1h1y3 bee haz’1n7g77 [ahda a[’22 1t’4 [eh, Medicare n7k1 an1’1lwo’go k0t’4edoo. {a’ naaltsoos bik’ehgo shaa 1h1y1n7g77 FEHB Plan brochure
shich’8’ 1doon77[ n7n7zingo, koj8’ www.fepblue.org/brochure d7n77[‘88[. $7 doodago koj8’ b44sh bee hod77lnih 1-800-441-BLUE.
Na’7d7kid danil7n7g77
Na’7d44kid Baa Hane’
Ha’1t’77 biniinaa ho[ b44h0zingo y1’1t’44h
Deductible t’11 1t’4ego d7kw77
b4eso nijil44h?
$ t1a’di neezn1diin d00 bi’22
ashdla’diin b4eso 350/ t’11 h0 t’47
1d1 h1sh’diilyaago
$ tsosts’idi neezn1diin b4eso 700/
h0 1d1 hash’diilyaa d00 ha’1[ch7n7
d00 bim1 b1 hadadiilyaago
Deductible 47 d7kw77 a['22 1t’4?
Bee h1k1 e’elyeed7g77sh bik’ehgo Dooda.
n’jiil4e [eh?
Aoo’. Azee’77[‘7n7 &iyis7g77
Choo’7n7g77 Choo’98go: $5,000 (T’11
H0 T’e7y1 Hak’4esti’go); $6,000
T’11 sh7 shib4eso nihesh[4
(H0 d00 Hooghan Haz’1n7gi
b7ighah yileeh7g77, out–of–pocket
Bik’4’asti’go)
limit, w0lta’7g77 daats’ 7 shaa
Azee’77[’7n7 b4eso 1ch’33h naa’nil
1h1y3 biniiy4 naash1ago shaa
bee ats’77s baa 1h1y3 h1 had7t’4h7g77
oob88h7g77 t’11 sahdii b1 h0l=-go
doo yi[ a[ha’deet’1n7g77 Choo’98go:
w0lta’?
$7,000 (T’11 H0 T’e7y1
Hak’4esti’go); $8,000 (H0 d00
Hooghan Haz’1n7gi Bik’4’asti’go)
Deductible 47 b4eso 1n4elt’e’ 1[ts4 a[tso n’d77l44[, b7ighah ni’77n7l1ago 1ko 7nda
d77 nahat’1 chool’9 yee has’1n7g77 h1 na’iil4e doolee[. Copayments d00
coinsurance 1n4elt’e’ niidooly4[7g77 bik’4 na’77n7l1 ndi doo deductible,
bich’8’j8’ w0lta’ da. T’11 Yasni[t’ees t’11[1’7g00 yoo[k11[ bik’ehgo deductible
1n4elt’e’ nizh’dool44[7g77 bee h11h1lzhiizh. Naa 1h1y32go chool’9 bee
haz’1n7g77, [a’ deductible bich’8’j8’ w0lta’. D77 nahat’1 bik’ehgo naa 1h1y1n7g77
deductible azee’77[’7n7 yoosb1n7g77, 47 doodago t’1adoole’4 bee 1daa
1h0ly1n7g77, t’11 d77 t’4iy1 deductible bich’8’j8’ w0lta’ doolee[. A[tso deductible
bik’4 ni’77n7l1ago chool’9 bee haz’1n7g77 d7kw77 b33h da’7l9, d00 d77 h1iit’4
chool’9 deductible bich’8’j8’ w0lta’doo, nahat’1 binaaltsoos naaki’7g0ne’ (page
2) bik1’7gi yisdzoh. bik11’ yisdzoh.
Bee ‘1ka’an1’alwo’7g77 haash99 daat’44sh99 d77 deductibles t’1adoo b7ighah
‘7inilaa da nidi t’11’akoh, nidi d77 naaltsoos had7t’4h7g77 [a’ bee ‘1ka’an1’awo’
b22h da’7l7n7g77 yee ‘ak’4’asti’7g77 naaltsoos 2 g0ne’ si[tsooz7g77 bik11’
n11h4edzoo7g77 nanini[’98 doolee[.
D77 out-of-pocket limit woly4h7g77 47, t’11[1’7 n1hahji’ t’11 ni nib4eso aa’1h1y3
bik’4 nah7l4ego b7ighanji’ n’d77l44[. Out-of-pocket limit [ahda catastrophic
maximum dei[n7. D77 b4eso b7ighahji’ na’77l7l1ago doo bil1ahji’ [a’ nin11diidl44[
da.
Na’7d7kid: Naaltsoos nit[‘iz7 bee 44h0dzin7 naa y7t32 bine’d66’ b44sh bee hane’7 bik11’, 47 doodago kwe’4 hane’ d7n77[‘88[ www.fepblue.org/contact
Ni[ hahoodzoh7j7 bib44sh bee hane’7 bik11’. Saad biyaa da’asdzoh7g77 doo ni[ b44h0zingo, Glossary woly4h7g77 hadid77’88[.
Glossary woly4h7g77 kwe’e d7n77[‘88[ www.fepblue.org/sbc 47 doodago naaltsoos [a’ shich’8’ 1dooln77[ n7n7zingo koj8’
b44sh bee hod77lnih 1-800-411-BLUE.
1/20
Ha’1t’7i 47 out–of–pocket limit,
doo bi[ w0lta’ da?
D77 nahat’1 bik’ehgo naa 1h1y1n7g77
yaa halne’7g77 47 FEHB Plan
brochure (RI 71-005) d77 yid77[tah.
Haa 1h1y1n7d66’ h1 niyiil4h7g77
daats’7 n1hahj8’ haada n4elt’e’j8’ Dooda.
beehaz’3?
Azh2 naa 1h1y32j8’ t’11 1t’4 bik’4 na’77n7l1 ndi doo out-of-pocket limit
bich’8’j8’ w0lta’da.
Aa’1h1y3 chool’7n7g77 a[’22 1t’4ego b33h da’7l9, d00 1n4elt’e’ bee n7k1
adoowo[7g77, d00 d7kw77da azee’77[’7n7 choid77[’88[, specific d00 d77 t’11 1t’4 nahat’1
yaa halne’7 naaltsoos naaki’7g0ne’ (page 2) bik1’7gi yisdzoh.
D77 haa 1h1y3 bee naaltsoos
hadilyaa7g77, plan, daats’7 azee’
77['7n7 bi[ a[ha’deet’1n7g77 t’47
chool’9?
D77 nahat’1 azee’77[’7n7 yi[ a[ha’deet’1n7g77, 47 doodago azee’77[‘7n7, [ahgo 1t’4ego
azee’ yee dahosin7g77 chool’9 bee haz’1n7g77 [a’ chois7n7[’88dgo, b33h 7l7n7g77 d77
Aoo’. Kwe’4 fepblue.org/provider
nahat’1 [ahji’ n1 n’dool44[, 47 doodaii t’11 1t’4 yik’4 n’dool44[.D77 baa 1h0lch88h
azee’77['7n7 bi[ a[ha’ dadeest’1n7g77 doolee[: azh3 azee’77[’7n7 d00 azee’1l’7n7g77 nahat’1 yi[ a[ha’deet’32 ndi [ahda
azee’77[’7n7 doo bi[ a[ha’deet’1n7g77 chodayoo[’9. [Nahat’1 azee’77[’7n7 yi[
d00 azee’1l’9 bi[
a[ha’dadeest’1n7g77is b7zhi’
a[ha’dadeest’1n7g77 preferred dabidii’n7, 47 doodaii azee’77[’7n7 nahat’1 yee atah
dabik11’.
danil7n7g77 providers in our network choid77[’88[.]D77 naaltsoos nahat’1 yaa
halne’7 naaki’7’g0ne’ (page 2) azee’77[’7n7 a[’22 1t’4ego yich’8’ na’iil4h7g77 azee’
yee dahosin7g77 d00 chool’9 b33h da’7l9 bik11’ yisdzoh.
Azee’ 77['7n7 ats’ 77s biyi’
dahon7’32di bik’ ehgo azee’
1dei['7n7g77, specialist,
danil7n7g77, choizhdoo['88[go
daats’7 naaltsoos h1 1l’88hgo,
referral h0l=-go, t’47 bee haz’3?
Dooda.
Azee’77['7n7 ats’77stahdi nahaz’32di be’azee’77['7n7 specialist nidin0ol’88[7g77 t’11 bee
n7h0lniih.
Aoo’.
Aa’1h1y32j8’ chool’7n7g77 d77 nahat’1 doo yee has’32da, d77 47 nahat’1 binaaltsoos
hast3’7g0ne’ (page 5) bik11’ daasdzoh. D77 nahat’1 binaaltsoos FEHB brochure
woly4h7g77 yaa halne’, chool’9 doo bee haz’32da (excluded services) d7n77[‘88[.
D77 haa 1h1y3 bee naaltsoos
hadily117g77, plan, daats’7 1k1
an1’1lwo’ [a’ doo yee has’
32dago doo yik’4 ni’dool4e[da?
2 / 20
• Copayments 47 b4eso t’11 [1h1gi 1n4elt’e’ nin1j7dl44h, ashdla’1adah b4eso da, $15, azee’77['7n7 insurance bik’4sti’go h1k1 iilwo’go bik’4 ni’jil44h.
• Coinsurance 47 insurance bik’4sti’go h1k1 o’oolwodgo b33h azl99’ [ahd00 ni nid77l44[7g77 0oly4. !n4elt’e’ nid77l44[7g77 47 t’11[1’7 b4eso bik’ehgo
y11l w0lta’go, percent ha’n7n7g77, binahj8’ h1k1 o’oolwodgo b33h 7l9 beehaz’1n7g77, allowed amount haash99 n4elt’e’ nid77l44[.Bee ak’i’diit88h
biniy4 hane’go, azee’ 1l’98gi h1k1 o’oolwod d00 b7hwiisk32go b33h7l7n7g77 t’11[1’7 dim77ly1zy7, $1,000, bee haz’32go, d77 nahat’1 allowed
amount-7g77 47 binahj8’ bik’4 nid77l44[7g77 y7d0oltah. Naakidoot['izh b7ighahgo, 20%, w0lta’go naakidi neezn1diin, $200, bik’4 nid77l44[.
Nahd44’deductible nih4ly4h7g77 t’ahdoo b7ighah yileehdago 47 nan7l4h7g77 [ahgo 1t’4edoo.
• !n4elt’e’ nid77l4[7g77 47 d77 nahat’1 yee h1k1 adoolwo[7g77 47 b33h 7l9 bee haz’1n7g77, allowed amount. Azee’77['7n7 doo bi[ a[ha’deet’1n7g77 out-ofnetwork provider b33h 7l9 bee haz’1n7g77 bil11hg00 haa yoosb32go, 47 bil11hg00 sil99’7g77 bik’4 n’d77l44[.Bee ak’i’diit88hgo baa hane’ 7g77,
azee’1l’9 doo bi[ a[ha’deet’1n7g77 h1k1 o’oolwod d00 n7isk32go b33h7l7n7g77 t’11[1’7 dim77ly1zy7 d00 bi’22 ashdla’di neezn1diin, $1,500, y33h
da’as[98’go. !ko bee haz’1n7g77, t’11[1’7 dim77ly1zh7, $1,000, bii’oh7g77 47 ashdla’di neezn1diin b4eso, $500, d77 nid77l44[.(D77 k0t’4ego, b4eso bee
h1k1 adoowo[7g77 d00 aa’1h1y3 b33h 7l7n7g77 doo ahee[t’edago d77 balance billing dei[n7.)
• D77 naaltsoos bik ehgo naa 1h1y1n7g77, plan, 47 azee’77['7n7 bi[ a[ha’deet’1n7g77 k0t’4h7g77 choin7['98doo ni[ n7. Azee’77[‘7n7 k0t’4h7g77 chojoo[‘98go
nahat’1 b33h 7l7n7g77, deductibles, co-payments, b4eso t’11 [1h1gi 1n4elt’e’ nin1j7dl44h7 d00 co-insurance, h1k1 o’oolwodgo b33h azl99’ [ahd00
nid77l44[7g77. H11l1 d77 1daat’4h7g77 t’11 ni nib4eso nih7l4. D00 azee’77['7n7 k0t’4h7g77 chojoo[‘98go t’11 a’ohgo nijiil4e [eh.
K0t’1o azee’77['7n7
choo’9 bizhdidoolt'ih
Azee’77['7n7
naalnish7gi baa
y7n7y1ago
(n11s naaltsoos
n11n1stsooz7g77)
H1k1 an1’1lwo’ bee 1h1y32
doolee[
D77 azee’77[’7n7 bi[
a[ha’dadeest’1n7g77
k0n4elt’e’ nid77l44[.
Azee’77['7n7 7iyis77
hak’id4ez’99’7g77 t7jiidz1ago
T1diin b4eso b33h 7l9
h1k1 eelwodgo, 47 doodago
t’11[1’7di hodin4l’88’go
naa[niih hodoolna’7g77 bich’8’ $20/visit
azee’ h22h 1yiilaa
Azee’77['7n7 ats’77stah
biyi’dahon7’32di bik’ehgo
azee’ 77['7n7, specialist, [a’ baa
$30/visit
jigh1ahgo
D77 azee’77[’7n7 doo bi[
a[ha’dadeest’32dah7g77
k0n4elt’e’ bik’4 nid77l44[
(d00 b33h 7l7n7g77 [a’
bii’ohgo, (balance billed)
47d0’ bik’4 nid77l44[)
Haa’1h1y32go chool’7 b33h
azl99’, ni bee n7h0lniih7g77
47 35% coinsurance d77
nid77l44[, neezn1diin
naadiingo bits’1dzohgo
K0n7zahj8’ bee haz’3 d00 bee h1 hoo’a’
doolee[7g77
!den
!den
3 / 20
Azee’77['7n7
naalnish7gi baa
y7n7y1ago
(n11s)
doolee[
Azee’77['7n7 [ahgo
1daat’4h7g77, other
practitioner, bich’ 8’
nijiy1ago
Ats’77s bich’33h na’anishgo
n1hodi’n4l’88h d00 naa[niih
bich’8’ haa an1’1tsih
Ats’77s naalkaah n1
1lyaago
(n11s naaltsoos
n11n1stsooz7g77)
Azee’77['7n7 hw77shgh11n
da deik’22s7g77: Naadiin
b4eso t’11[1’7di
hodin4l’88’go $20/visit
Azee’77['7n7
dajidiniihg00 tsah h22h
adeitsih7g77:
Haa’1h1y32go chool’7
b33h azl99’, ni bee
n7h0lniih7g77 47 15%
coinsurance d77 nid77l44[,
neezn1diin naadiingo
bits’1dzohgo
be’azee’77['7n7 47
t1diin d00 bi’22 ashdla’
b4eso b33h 7l9 $35/visit
Doo b33h 7l7n7da
Ats’77s naalkaah agh1d7ldlaad
d00 hadi[ naalkaah
bits’1dzohgo
(d00 b33h 7l7n7g77 [a’
47d0’ bik’4 nid77l44[)
doolee[7g77
Hw77gh11n, hak’os da, ay0o diniihgo,
azee’77[‘7n7 [a’ hats’in d00 hadoh
nayii[n1’go hasht’e’ niits’-’: Yasni[t’ees
t’11[1’7g00 yoo[k11[ d00 N7[ch’itsoh
t1diin d00 t’11[1’7ji’ n1h11hj8’, naadiindi
24 chod77[‘88[ visits t’11[1’7 jiz7n7go.
N1h11hj8’ t’11[1’7di choidoo’88[go bee
haz’1n7
!den
4 / 20
Ats’77s naalkaah n1
1lyaago
(n11s)
Azee’ bee y1’1t’44h
jidoolee[7g77 [a’
n11zhn7dzingo
Azee’ bee haa 1h1y3
baa hane’7g77
h1d7n7’99’go kwe’4
d7d77’88[
fepblue.org/pharmacy
(n11s naaltsoos
n11n1stsooz7g77)
doolee[
Ats’77s bi[ an1’1lzho’go
bigh1d7dlaad (CT/PET scans,
MRIs 1daat’4h7g77)
bits’1dzohgo
1 G0ne’ Haz’1n7g77: Azee’
n11n1 [a’ azee’ be’elyaah7g77,
Generic, dei[n7igo a’ohgo
b33h da’7l9
b7zhi’ 1daalyaa, brand name
dei[n7igo d00 7iyis77
choo’7n7g77, preferred brand
drugs, dei[n7
Azee’ b1 hooghandi
azee’ nahanii’go:
bits’1dzohgo
B7k1 4’4ln44hgo: Azee’
h1 w0keed7g77
ashdla’1adah b4eso b33h
7l9 $15/prescription
bits’1dzohgo
h1 w0keed7g77
(d00 b33h 7l7n7g77 [a’
47d0’ bik’4 nid77l44[)
doolee[7g77
!den
Azee’ b1 hooghandi azee’ nahanii’go:
![ts4 azee’ h1 w0keedgo, n1hast4diin j9h
b7ighahgo (90-day) haa doo’ni[ bee
ak’4’asti’
Naaltsoos Nin1hajeeh7g77 bee
‘1ka’anida’awo’: 22-90 j9h b7ighahgo haa
doo’ni[ bee ‘ak’4’asti’
Azee’ h1 h44keed7g77 [a’ 1[ts4 bee l3’
aleehgo 7nda bee haz’3h.
5 / 20
doolee[
b7zhi’ 1daalyaa, brand name
dei[n7n7g77, doo ay0o
choo’98da d00 t’11 [3 b33h
da’7l9, d77 non-preferred,
dei[n7
jidoolee[7g77 [a’
n11zhn7dzingo
(n11s naaltsoos
n11n1stsooz7g77)
azee’77[‘7n7 dahaniih7g77
chodayoo[‘7n7g77
bits’1dzohgo
h1 w0keed7g77
azee’ nahanii’go: 30%
T’11 h0 hab4eso [ahd00
azee’77['7n7 bich’8’
nijil44h7g77 Azee’77[7n7
azee’ yee dahaniih7g77:
$35/ azee’ h1
y44keed7g77 t1diin j9h
b7ighahgo (30-day) haa
doo’ni[; $95/ azee’ h1
doo’ni[
(d00 b33h 7l7n7g77 [a’
47d0’ bik’4 nid77l44[)
doolee[7g77
‘&iyis7g77 b33h ‘al7n7g77: 4 d00 5 G0ne’
Honi’1n7g77 ‘azee’ h1 y44keed7g77 nil47
30- j9h b7ighahgo haa doo’ni[ bee haz’3h;
t’11[1h7di h1 haadilb98hgo bee ‘ahoot’i’
Azee’77[7n7 azee’ yee dahaniih7g77: t1diin
j9h b7ighahgo (90-day) haa doo’ni[ t1adi
(3rd ) h1 haadeelb88d bik44d00
Azee’ h1 h44keed7g77 [a’ 1[ts4 bee l3’
aleehgo 7nda bee haz’3h.
6 / 20
jidoolee[7g77 [a’
n11zhn7dzingo
(n11s)
Azee’1l’98gi doo
1k0ne’
hwiisk32dago
na’algizh bee
ina’anish biniy4
jin7y1ago
hona’azhnishgo
doolee[
azee’77[‘7n7 dahaniih7g77 doo
bi[ nida’anish7g77
chodayoo[‘7n7g77
Azee’1l’99g0ne’
hona’azhnishgo
chodaoz’88d7g77 d00
jizd11g0ne’ bik’4 ni’iily4
(ats’77s naalgizhgo haa
1h1y1n7g77)
Azee’77['7n7 honaashnishgo
b4eso yoosb1n7g77
azee’ nahanii’go: 30%
T’11 h0 hab4eso [ahd00
azee’77['7n7 bich’8’
nijil44h7g77 Azee’77[7n7
azee’ yee dahaniih7g77:
$55/ azee’ h1
doo’ni[; $155/ azee’ h1
doo’ni[
bits’1dzohgo
bits’1dzohgo
(d00 b33h 7l7n7g77 [a’
47d0’ bik’4 nid77l44[)
doolee[7g77
Azee’1l’9 bi[
a[ha’deest’1n7g77 d00
azee’1l9 doo bi[
a[ha’deest’1n7g77 t’11 1[a
35% coinsurance, d77
nid77l44[, neezn1diin t1diin
d00 bi’22 ashdla’go
bits’1dzohgo
{a’ ats’77s naalgizh 1[ts4 h1 bee l3
aleehgo t’4iy1.
7 / 20
doolee[
(d00 b33h 7l7n7g77 [a’
47d0’ bik’4 nid77l44[)
Azee’ 1l’99g0ne’ y4ego ach’8’
hodiin1ahgo ts98[go 1k1
i’iilyeedg0ne’
hona’azhnishgo
bits’1dzohgo
Y4ego ach’8’ hodiin1ahgo ts98[go 1k1
adoowo[, d77gi 1j7t’4ego t’4iy1 bee haz’3
T’11[1’7 j98ji’ t’11[1’7di
neezn1diin b4eso b33h
7l9 $100/day
T’11[1’7 j98ji’ t’11[1’7di
neezn1diin b4eso b33h 7l9
$100/day
Chid7 naat’a’7 bee azee’1l’99g00
hodi’doog4e[go 47 doodago t0 biyi’d00
n1h0dii[t4h7g77 bee azee’1l’99g00
hodi’doog4e[go: T’11[1’7 j98ji’ t’11[1’7di
neezn1diin b4eso b33h 7l9 $150/day
$30/visit
!den
T’11 k’ad azee’77['7n7
sh7k1 adoolwo[
Y4ego 1j7t’4 jileehgo hach’8’
jin7zingo
hodiin1ahgo bee azee’1l99g00
hodi’g44h7g77 choo’88hgo
T’1adoo hooy1n7 hach’8’
1n1h00t’i haleehgo 1k1
i’iilyeed choo’88hgo,
azee’1l’7n7y1zh7
doolee[7g77
8 / 20
doolee[
Azee’1l’99g0ne’ h1k1
e’elwo’go chodaa’7n7g77
bik’4 ni’iily4 (bik’4
jizd1h7g77)
Azee’1l’99g0ne’ yah
ajigh1ahgo
Azee’77['7n7 honaashnishgo
b4eso yoosb1n7g77
H1ni’ 47 doodago
hanits4kees 1t’4ego
47 doodago
Anits4kees d00 y7n7 n11lzh-tsi’na’ii[1h1
[j7 h1k1 an1’1lwo’ biniiy4
hodineeszi[go biniiy4
azee’77[‘7n7 baa n7j7d1ahgo
jin7y1ago
(n11s naaltsoos
n11n1stsooz7g77)
Naakidi neezn1diin d00
bi’22 ashdla’diin b4eso
1[ts4 nijil44h 1ko 7nda
azee’1l’99g0ne’yah
ajigh11h,
$250/admission
bits’1dzohgo
Azee’77[‘7n7 y7daat’4ego
[a’ chois7n7[‘88dgo,
$20/visit, naadiin b4eso
b33h adool44[ d00 n11n1
[a’ choo’9 bee haa
1h1y32go 47 15%
coinsurance neezn1diin
ashdla’1adahgo
bits’1dzohgo
(d00 b33h 7l7n7g77 [a’
47d0’ bik’4 nid77l44[)
T1a’di neezn1diin d00
bi’22 ashdla’diin b4eso
azee’1l’99g0ne’ yah
ajigh11h, ($350 admission)
d00 nid00 bee n7h0lniih 47
35% coinsurance,
neezn1diin t1diin d00 bi’22
ashdladiigi an4elt’e’go
nid77l44[.
doolee[7g77
Azee’77[‘7n7 h1 l3 a[eehgo 7nda
azee’1l’99g0ne’ yah ajigh11h
!den
9 / 20
doolee[
Azee’77[‘7n7gi
1daat’4h7g77
hodin4[‘98’go 47 doo
Anits4kees d00 y7n7 n11lzh-- b33h 7ll7n7 da; $250,
[j7 h1k1 an1’1lwo’ biniiy4
naakidi neezn1diin d00
azee’1l’99g0ne’ yah aj77y1ago bi’22 ashdladiin b4eso
H1ni’ 47 doodago
47 doodago
ajigh11h $250/admission
tsi’na’ii[1h1
Azee’77[‘7n7 y7daat’4ego
jin7y1ago
[a’ chois7n7[‘88dgo,
(n11s naaltsoos
$20/visit, naadiin b4eso
n11n1stsooz7g77)
T’1adoole’4 tsi’na’ii[1h1
b33h adool44[ d00 n11n1
hodineeszi[go 1k1 an1’1lwo’ [a’ choo’9 bee haa
1h1y32go 47 15%
biniiy4 n7j7d1ahgo
coinsurance neezn1diin
ashdla’1adahgo
bits’1dzohgo
Azee’77[‘7n7gi
H1ni’ 47 doodago
1daat’4h7g77
hodin4[‘98’go 47 doo
T’1adoole’4 tsi’na’ii[1h1
b33h 7ll7n7 da; $250,
47 doodago
hodineeszi[go 1k1 an1’1lwo’
tsi’na’ii[1h1
naakidi neezn1diin d00
biniiy4 azee’ 1l’99g0ne’ yah
bi’22 ashdladiin b4eso
aj77y1ago
jin7y1ago
(n11s)
ajigh11h $250/admission
Joolts32go
Aw44’ t’ahdoo yich77go d00
yizhch99d00 bik’ij8’
azee’77['7n7 haa 1h1ly3 biniiy4
n7j7d1ahgo
Doo b33h 7l7n7da
(d00 b33h 7l7n7g77 [a’
47d0’ bik’4 nid77l44[)
doolee[7g77
35% coinsurance ‘azee’
‘77[‘7n7 y3ego dahaniih7g77
Naa’1h1y1n7d00 biniiy4 azee’1l’99g0ne’
bi[ yah ‘an1’1d1h7g77
s7n7d1 doolee[7g77 yee l3 da’asi[99’go 7nda
biniiy4go; 35% coinsurance azee’1l’98di s7n7d1 doo
haz’3h bee ‘aa’1hay1n7g77
!den
35% coinsurance ‘azee’
‘77[‘7n7 y3ego dahaniih7g77
Naa’1h1y1n7d00 biniiy4 azee’1l’99g0ne’
bi[ yah ‘an1’1d1h7g77
s7n7d1 doolee[7g77 yee l3 da’asi[99’go 7nda
biniiy4go; 35% coinsurance azee’1l’98di s7n7d1 doo
haz’3h bee ‘aa’1hay1n7g77
‘Oots’32go hooghandi n1’ak’22s7g77 doo
bee ‘ak’4’asti’ da
10 / 20
doolee[
Aw44’ dooch77[ biniy4
azee’1l’99g0ne’ yah aj77y1ago
h1k1 e’elwo’ d00 haa 1h1y3
Doo b33h 7l7n7da
(d00 b33h 7l7n7g77 [a’
47d0’ bik’4 nid77l44[)
doolee[7g77
!den
11 / 20
H22h dahoo’a’d00
bik’i’j8’ hadziil d00
y1’1t’44h
n7zhdoodlee[ biniiy4
haa 1h1y3
(n11s naaltsoos
n11n1stsooz7g77)
(d00 b33h 7l7n7g77 [a’
47d0’ bik’4 nid77l44[)
doolee[7g77
T’11 haghangi haa 1h1y3
bits’1dzohgo
Yasn7[t’ees t’11[1’7g00 yoo[k11[ d00
N7[ch’itsoh t1diin d00 t’11[1’7ji’
n1h11hj8’, naadiin ashdla’di d77 bita’gi
(50 visits) ndi’n0ol’88[go bee haz’3
Hats’77s d00 h1ni’da bidziil
1n1ln4eh
Haj47 b22h haz’32go
biniiy4 azee’77[‘7n7 baa
n7j7d11h: Haa’1h1y32go
chool’7 b33h azl99’, ni
bee n7h0lniih7g77 47 15%
neezn1diin
ashdla’1adahgo
bits’1dzohgo
Na’ad1 biniiy4, naanish
[ahgo 1t’4h7g77
b7n11h0jii[‘aahgo, saad
ho[ nant[‘ahgo d00 doo
y4ego ha]ts4kees
naalnishgo: Azee’77['7n7
7iyis77 hak’id4ez’99’7g77 47
naadiin b4eso ($20)
b33h 7l9 t’11[1’7
n1hodi’n4l’88[go bee
haz’3, azee’77[‘7n7 ats’ 77s
biyi’ dahon7’32di bik’
ehgo azee’ 1dei['7n7g77 47
t1diin b4eso ($30)
t’11[1’7 n1hodi’n4l’88[go
Hats’77s d00 h1ni’da bidziil 1n1ln4eh,
saad da ho[ nant[‘ahgo bee haa’1h1y32go,
n1h11hj8’, d77 bita’gi tsosts’idiin d00
bi’22 ashdla’ (75 visits) hodi’n0ol’88[go
bee haz’3. !ko ndi chool’9 bee
y1’1joo[44[go t’47 h1 bee haz’3.
doolee[
12 / 20
doolee[
Na’ad1 biniy4 haho’diln44h
y1’1t’44h
haa 1h1y3
(n11s naaltsoos
n11n1stsooz7g77)
Azee’ neik1h1 haa
1dahaly32gi jizd1
Ats’77s y7k1 an1lwo’7, bee
na’ad1h1 1daat’4h7g77
chojoo['9
Na’ad1 biniiy4, naanish
[ahgo 1t’4h7g77
b7n11h0jii[‘aahgo, saad
ho[ nant[‘ahgo:
hak’id4ez’99’7g77 47
naadiin b4eso ($20)
b33h 7l9 t’11[1’7
n1hodi’n4l’88[go bee
haz’3, azee’77[‘7n7 ats’ 77s
biyi’ dahon7’32di bik’
ehgo azee’ 1dei['7n7g77 47
t1diin b4eso ($30)
t’11[1’7 n1hodi’n4l’88[go
Doo bee haz’32da
bits’1dzohgo
(d00 b33h 7l7n7g77 [a’
47d0’ bik’4 nid77l44[)
doolee[7g77
Hats’77s d00 h1ni’da bidziil 1n1ln4eh,
saad da ho[ nant[‘ahgo bee haa’1h1y32go,
n1h11hj8’, d77 bita’gi tsosts’idiin d00
bi’22 ashdla’ (75 visits) hodi’n0ol’88[go
bee haz’3. !ko ndi chool’9 bee
y1’1joo[44[go t’47 h1 bee haz’3.
Doo bee haz’32da
!den
!den
13 / 20
y1’1t’44h
haa 1h1y3
(n11s)
Na’1[ch7n7 biwoo’da
bin11’da baa 1h1y3
(n11s naaltsoos
n11n1stsooz7g77)
(d00 b33h 7l7n7g77 [a’
doolee[
47d0’ bik’4 nid77l44[)
T’11 y4ego 1j7t’4ego t’00
haa 1h1y32go yoo[k1a[go:
Doo b33h 7l7n7da
T’11 haghandi haa
T’11 y4ego 1j7t’4ego
1h1y32go h0 yoo[k1a[go,
t’00 haa 1h1y32go
t’1adoo bita’ hoo’a’7:
yoo[k1a[go: Doo b33h
Naakidi neezn1diin d00
7l7n7da
bi’22 ashdladiin b4eso b33h
7l9 t’11[1’7di $350/episode
T’11 haghandi haa
1h1y32go h0 yoo[k1a[go, Azee’1l’98di haa 1h1y32go
T’11 7iyis77 1j7t’4ego t’00 haa t’1adoo bita’ hoo’a’7:
h0 yook1a[go: T1a’di
1h1y32go yoo[k1a[go
Naakidi neezn1diin d00 neezn1diin d00 bi’22
bi’22 ashdladiin b4eso
ashdla’diin b4eso 1[ts4
b33h 7l9 t’11[1’7di
nijil44h 1ko 7nda
$250/episode
ajigh11h, $350/admission,
Azee’1l’98di haa
1h1y32go h0 yook1a[go: d00 nid00 bee n7h0lniih 47
35% coinsurance
Doo b33h 7l7n7da
neezn1diingo t1diin d00
bi’22 ashdla’go
bits’1dzohgo, d7igi
an4elt’e’go nid77l44[
hak’id4ez’99’7g77 47
naadiin b4eso b33h 7l9
(20/visit PCP); azee’77['7n7
Bin11’ yee oo’98doo biniiy4
b7’neel’22h
ats’77stahdi nahaz’32di
be’azee’77['7n7 t1diin
b4eso b33h 7l9 t’11[1’7di
hodin4l’88’go ($30/visit
(specialist)
doolee[7g77
Local Plan, nahat’1 b7h0lnih7g77, 1[ts4 h1
l3 a[4ehgo 7nda t’11 y4ego 1j7t’4ego h0
yook1a[j8’ haa 1h1y32doo. Azee’1l’9
y4ego 1j7t’4ego t’00 aa’1h1y32j8’
binaaltsoos h0l0n7g77g0ne’ haa 1h1y32go
t’1adoo bita’ hoo’1’7 t1diindi yidoo[k11[
(30 consecutive days).
H1ada 1j7t’4 biniinaa haa’1h1y3 d00 1j7t’4
binahj8’ hats’77stah naalkaah7g77 t’4iy1
biniiy4 na’alkaahgo bee haz’3
14 / 20
doolee[
Bin1k’eesinil7 1ln44h
Na’1[ch7n7 biwoo’da
bin11’da baa 1h1y3
(n11s)
Biwoo’ b1 n1n4l’88h
bits’1dzohgo
T11ts’1adah bin11haij8’
13: K4yah hotsaago bi[
ha’oodzoh7g77 (states)
azee’ b33h 7l7n7g77
b7d44t’i’; 1ko Maximum
Allowable Charge
(MAC) d77 1n4elt’e’j8’
bee haz’3, doo 47 d77
bil11hgo b33h 7l98da
doolee[. !ko MAC d00
naakits’1adah b4eso $12
kwe’4 bitahgi b33h 7l9
doo
T11ts’1adah d00
bil11hg00 bin11haigo
13: !ko MAC d00
ts44bii b4eso $8 kwe’4
bitahgi b33h 7l9 doo
(d00 b33h 7l7n7g77 [a’
47d0’ bik’4 nid77l44[)
doolee[7g77
Han11’ b22h dah haz’32go biniiy4
n1k’eesinil7 ha 1n1l’88h7g77 t’11[1’7
n1k’eesinil7 h1 1dooln77[, d77 47 t’11
haiit’4ego da han11’ b22h dah haz’1n7g77
t’11 y4ego b22h dah hoo’a’go
Chool’9 d00 b33h 7l9 bee
haz’1n7g77 bil11hg00 haa
woosb32go 47
ch’7n7idee’7g77 bik’4
nizh’dool44
n1h11hj8’, t’11[1’7 jiz7n7go naakidi
chojoo[‘9
15 / 20
!k1 an1’1lwo’ d00 haa 1h1y3 doo h1 bik’4 ni’iily4edah7g77 d00 t’11 h1 bik’4 ni’iily4h7g77:
!k1 an1’1lwo’ DOO h1 bik’4 ni’iily4h7g77 (D77 doo t’11 1t’4 bik1a’da. Naaltsoos bik’ehgo naa 1h1y1n7g77 FEHB brochure biyi’g0ne’ doo bik’4
n7da’d0odl4dah7g77 bik11’ yisdzoh, excluded services.)
•
•
Hanii’da t’1adoo 1t’4h4go bik’i na’anish
t’00 nishsh0n7 doolee[ jin7zingo
Ad7zh’n0olts22[ bich’8’ji’ biniiy4 haa
1h1y32go
•
•
•
N7zaad hoolzhishg00 haa 1h1y32go l2’7
yisk32go
Azee’ neik1h1 t’11 ni t’4iy1 yaa 1h1ly32go
Han11’ doo 1t’4h4dago h1 baa 1h1y32go
•
•
•
Doo 1j7t’4h4go hakee’ h1 baa 1h1y32go
Azee’ neik1h1 haa 1dahaly32gi jizd1
Hats’iin7 jidoolee[ bich’8’ chodaol’7n7g77
H1k1 an1’1lwo’ h1 bik4 ni’iily4h7g77 (D77 doo t’11 n7t’44’ bik11’ yisdzoh da. Naaltsoos bik’ehgo naa 1h1y1n7g77 FEHB brochure biyi’g0ne’ choo’9
bee haz’1n7g77 d00 b33h 7l7n7g77 bik11’ yisdzoh.)
•
•
Azee’77[’7n7 dajidiniihg00 ts’ah yaa ade7tsih7
Habid [ahji’ b4’4t[’0ogo bich’8’ doo [3
ajiy32da
•
•
Azee’77[’7n7 hats’in, hw77shgh11n da
deik’22s7g77
Awoo’ h1 baa 1h1y32go
•
•
Haj44ka[go bee azhdiits’a’7
U.S. bi[ hahoodzoh bil11hg00 ch’aa nanin1ago
doo y4ego 1n7t’4ego azee’77[’7n7 [a’ nidi’n0ol88[.
Kwe’4 d7n77[’88[ www.fepblue.org/overseas
Beehaz’1anii bik’ehgo naa 1h1y1n7g77 t’11 n11sg00 bee nik’i ad4est’99’ doo:
D77 naaltsoos bee ha’d7t’4h7g77 biyaad00 bee ‘ak’4’asti’ nits’33’ nahj8’ ‘1dzaago, ‘11d00, t’11 ha’4t’77sh99 biniinaa7g77 beego, 31-j9h t’11 jiik’4h bee
‘ak’4’asti’7g77 n1 n11s bee nik’7n11’asti’ bee n1’an11hoot’i’ doolee[ sh2’shin d00 t’11 h1aj8’ sh99 bee ‘ak4’asti’ bee nik’7n11’asti’go n11hoolzhish doolee[
(TCC) yi[n7h. ‘!k0ne’ bee ni[ hoolzhishgo ni TCC bee n1 ‘adahazt’i’7g77 haash99 nidzahj8’ bee n1haz’32 doolee[ d00 premium woly4’h7g77 ni nahil4e
doolee], ‘eii d7g77 daats’7 d77 naaltsoos bee ha’d7t’4h7g77 biyaadoo bee nik’4’asti’go premium woly4h7g77 nahil4h65 t’ah h0d11higo nahil4e doolee[. t’11
n11sg00 bee nik’7n11’asti’go bee n1 ‘adahaz’t’i’7g77 n11n1 [a’ bee nin11dahaz’32 doolee[ sh2’ahin.
Naaltsoos bik’ehgo naa 1h1y1n7g77 bee nik’i ad4est’99’ doolee[7g77 FEHB brochure biyi’g0ne’ bik11’. D00 naalnish7gi na’7d7[kid doo/ naanish joosb3 bi[
dahaz’1n7g77 da chojoo[‘9. $7 doodago naa’1h1y32ji’ b44sh bee hod77lnih (naaltsoos nit[‘iz7 bine’d66’ bik11’), 47 doog00 koj8’ d7d77’88[
www.opm.gov/insure/health.
16 / 20
Ha’1t’7ida doo ni[ aan77g00 4’elyaago d00 nihoot’32go baa saad hod77[ee[ d00 nihoot’1n7g77 baa n1hwiid7n0ot’88[:
Naa 1h1y32go ha’ 1t’ 7ida baa saad hon7[=-go 47 doodago ha’ 1t’ 7ida doo n1 l3 azl99’ g00 nihoot’ 32go n7d7n0ol’ 88[ did7inii[ 47 doodago baa n1hwiid7n0ot’88
biniy4 naaltsoos nid77[tsos. Doo n1 l3 azl99’g00 nihoot’32go n7d7n0ol’88[ did7inii[ 47 doodago baa n1hwiid7n0ot’88[ biniy4 naaltsoos nid77[tsos. Naaltsoos
bik’ehgo naa 1h1y1n7g77 FEHB brochure biyi’g0ne’ d7n77[‘88[ Section 3, “How you get care,” d00 Section 8, “The disputed claims process”. Bee n1haz’
1n7g77da, 1k1 e’elyeeda, d77 kwe’4 hane’7g77da, b7na’ 7d7[kidgo 47 naaltsoos nit[‘iz7 bine’d66’ b44sh bee hane’ bik11’7g77j8’ b44esh bee hod77lnih.
Da’ d77 Bee Ak4’asti’7g77sh t’11 Hoyahgo !l7n7g77 &iyis7 bee Ak’4’asti’7g77 bee H0l=-go !yosin?
Boh0n4edz32go Na’iily4h Bee Aa’1hay3 Bibee Haz’1anii (Affordable Care Act) biyaad00 k’asd33’ t’11 ‘1t’4 din4 d77 “hoyahgo 1l7n7g77 bee ak’4’asti’” bee
b1’adahazt’i’7g77 ats’77s baa’1hay3 bee ak’4’asti’ bee dah h0l= doolee[ n7igo yee has’3h. D77 naaltsoos bee ha’d7t’4h7g77 bee ak’4’asti’7g77 biyaad00
hoyahgo 1l7n7g77 bee ak’4’asti’ bee b1’ahoot’i’go 1yosin.
Da’ d77 Bee Ak4’asti’7g77sh t’11 Hoyahgo Bee Haz’1anii !l7n7g77 B7ighahgo y7neel’3h?
Boh0n4edz32go Na’iily4h Bee Aa’1hay3 Bibee Haz’1anii (Affordable Care Act) biyaad00 hoyahgo bee haz’1anii 1l7n7g77 bee aa’1dahay1n7g77 bee naaltsoos
hadad7t’4h7g77 yee hadeidiilaah. Hoyahgo bee haz’1anii 1l7n7g77 47 60% (actuarial value) b7ighah. D77 naaltsoos bee ha’d7t’4h7g77 bee ak’4’asti’ 47 d77
hoyahgo bee haz’1anii 1l7n7g77 bee aa’1dahay1n7g77 d77 naaltsoos bee ha’d7t’4h7g77 doo y7ighahgo 1yosin da.
Saad A[‘22h !daat’4h7g77 Choo’98go Bee !ka’an7da’awo’7g77:
[Spanish (Español): Para obtener asistencia en Español, llame al numero de teléfono para Servicio al Cliente localizado atrás de su tarjeta de
identificación.]
[Tagalog (Tagalog): Kung kailangan ninyo ng tulong sa Tagalog pakitawagan ang numero ng telepono ng Serbisyo sa Kostumer na nakasulat sa likod ng
inyong Identification Card.]
[Chinese (中文): 如果您需要華語援助, 請致電給會員證背面的客戶服務電話號碼.]
[Navajo (Dine): Diné k’ehjí yá’áti’ bee shíká’adoowoł nohsingo naaltsoos nihaa halne’go nidaahtinígíí bine’déé’ Customer Service bibéésh bee hane’é biká’ígíí
bich’į’ dahodoołnih.]
–––––––––––––Haa 1h1y32go b33h da’7l7n7g77 bee ak’i’diit88h biniy4 bik’ehgo 1dahoolyaa, naaltsoos bik’ehgo naa’1h1y1n7 d7n77[‘88[.–––––––––––––––––
17 / 20
Bee ak’i’diit88h biniy4 1k1
i’iilyeed b33h7l9 baa
hane’7g77:
D77 naaltsoos an11hooltahgo bik11’7g77 47 d77
t’00 jin7k’ehgo hane’7g77 hazh0’0 yaa halne’.
D77 t’00 bee ak’idi’doot99[ biniy4 hane’
1lyaa7g77 47 bik’ehgo haa 1h1y3, plan,
azee’77['7n7 chojoos’88dgo b33h da’7l7n7g77 d00
h1 bik’4 ni’iily4h7g77 baa 1ko hwiid7n0odz88[
biniy4 1lyaa.
D77 b33h7l9
dabik1ago baa
hane’7g77 47 bee
ak’idi’doot99[
biniy4 1lyaa.
D77 jin7k’ehgo y11l
dabik11’7g77 47 t’00 bee
hane’7g77 1daat’4. Naa 1h1y3
bee n1 oonishd66’ 47 [ahgo
1dan4elt’e’go nidooly44[
daan7idoo.
Naaltsoos an11hooltahg0ne’ 47
haa 1h1y32go b33h da’7l7n7g77
bee ak’i’diit88h biniy4 bik’4
1dahoolyaa.
Aw44’ yizhch98go
(T’1adoo 1t’4eg00 azhch98da)
Hats’77s ch’iy11n doo hazh0’0 choyoo['9
yileeh naaki bee w0j7h7g77 bich’8’ 1daa
1h1y3 (k’ad 1k0j7t’4ego)
 Azee’ 77['7n7 haa yoosb1n7g77: Tsosts’idi
m77ly1zh7 d00 bi’22 ashdladi neezn1diin d00
bi’22 d7zdiin b4eso $7,540
 Haa 1h1y1n7d66 nay7l4 Tsosts’idi m77ly1zh7
d00 bi’22 t1adi neezn1diin d00 bi’22
n1h1st’4diin b4eso $7,390
 B7k1 an1’1lwo’ii niidool44[t’11[1’7di
neezn1diin b4eso $150
 Azee’ 77['7n7 haa yoosb1n7g77: Tsosts’idi
m77ly1zh7 d00 bi’22 ashdladi neezn1diin d00
bi’22 d7zdiin b4eso $5,400
 Haa 1h1y1n7d66 nay7l4 Tsosts’idi m77ly1zh7
d00 bi’22 t1adi neezn1diin d00 bi’22
n1h1st’4diin b4eso $4,040
 B7k1 an1’1lwo’ii niidool44[t’11[1’7di
neezn1diin b4eso $1,360
Haa 1h1y32go b33h7l9 a['22 nidaasdzo:
Azee’ 1l’ 98g0ne’ am1 yik’ 4
$2,700
sid1h7g77
Asdz1n7 yilts32go d00 a[ch77h d00
$2,100
bik’ ij8’ baa 1h1y3
Azee’ 1l’98g0ne’ aw44’ yik’4
$900
sid1h7g77
$900
Hwe’ iilghaazh
$500
B7k1 an1’ 1lwo’ 7g77 niidool44[
$200
Azee’ h1 1n1l’ 88h
$200
Agh1’ d7ldlaad
$40
Naa[niih bich’ 8’ azee’ h22h 1l’ 9
Ah7ilta’ go
$7,540
Haa 1h1y32go b33h7l9 a['22 nidaasdzo:
$2,900
Azee’ h1 1n1l’ 88h
$1,300
Bee na’anish7 chodaa’7n7g77
Azee’77[‘7n7 baa n7j7d1ahgo
$700
n1hon4l’88h
$300
Nahodi’ nitin7g77
$100
B7k1 an1’ 1lwo’ 7g77 niidool44[
$100
Naa[niih bich’ 8’ azee’ h22h 1l’ 9
Ah7ilta’ go
$5,400
B7k1 an1’ 1lwo’ii niidool44[:
B4eso haa’1h1y1n7g77 b33h 7l7n7g77
T’ 11 [1h1gi 1n4elt’e’ nin1j7dl44h
H1k1 o’oolwodgo b33h azl99’
[ahd00 nid77l44[7g77
Doo bee haz’32da7g77 d00 t’11
n7t’44’ bee haz’32da
Ah7ilta’ go
$0
$0
$0
B7k1 an1’ 1lwo’ii niidool44[:
B4eso haa’1h1y1n7g77 b33h 7l7n7g77
T’ 11 [1h1gi 1n4elt’e’ nin1j7dl44h
H1k1 o’oolwodgo b33h azl99’
[ahd00 nid77l44[7g77
Doo bee haz’32da7g77 d00 t’11
n7t’44’ bee haz’32da
Ah7ilta’ go
$350
$200
$730
$80
$1,360
$150
$150
18 / 20
Aa’1h1y32j8’ chool’9 t’00 be’elyaah7g77
!k1 o’oolwodgo b33h da’7l9 bik’i’di’doot88[ biniiy4 baa hane’7g77 b7na’7d7kid d00 baa hane’:
Ha’1t’77l1 baa nits1h1kees go
binahj8’ 1k1 o’oolwodgo b33h da’7l9
bik’eh 1dahoolyaa?
•
•
•
•
•
•
•
Chool’9 b33h da’7l7n7g77 doo b4eso 1ch’33h
naa’nil bee ats’77s baa 1h1y3 bik’4 nihely4,
premiums doo atah bi[ 44lta’da.
Y11l b33h7l9 1daalyaa7g77 47 adahwiis’11g00 1k1
e’elwo’go bik’4 nidahaly4h7g77 bik’ehgo 1lyaa.
W11shindoondi Ats’77s Baa !h1y3 bi[
haz’33d66’ nih1 1dayiilaa, 11d00 doo haa’7da
b7l1’ashdla’ii bi[ haz’3 1da’a['9 d00 doo [a’
insurance plan bik’ehgo 1lyaada.
B7k1 e’elyeed7g77 bits’77s 1t’4h7g77 biniinaa
doo h22h yit’98da 47 doodago t’11 77d33’
1j7t’4h7g77 doo hak’i’j8’ si’32da.
!k1 an1’1lwo’ d00 haa 1h1y3 t’11 a[tso t’11
[a’7 yihah7g77 biyi’ bik’ehgo 1daalyaa.
Azee’77['7n7 yoosb1n7g77 doo [a’ n11 hodl=-da.
Out-of-pocket nizhdool44[ 47 kwe’4 baa
hane’7g77 t’47 b7d44t’i’, doo 47 ni nid77l44[
bik’ehgo 1lyaada.
Haa’1h1y1n7g77 azee’77['7n7 bi[
a[ha’deet’1n7g77 t’47 honaashnish.
Haa’1h1y1n7g7 azee’77['7n7 doo bi[
a[ha’deet’1n7g77 providers honaashnizhgo 47
[3 b33h7l98doo ]t’66’.
Bee ak’i’di’doot99[ biniy4 baa
h00ne’7g77sh t’11 7iyis77 ha’1t’77 yaa
halne’?
Bee 1k’i’diit88hgo baa h00ne’7g77 daats’7
n11sg00 shaa n7’7ib88h7g77 bik’ehgo
y7n7shta’doo?
Azee’77['7n7 h1 7’iilaa binahj8’ hane’7g77 1[ts4 nijiil44h,
deductibles, d00 [ahd00 nijiil4, copayments, d00
coinsurance, 47 h1k1 o’oolwodgo b33h azl99’ [ahd00
nizhdool44[7g77 ah7deidzogo baa 1ko hwiinidzin.
Aa’1h1y32ji’ chool’7n7g77 b33h da’7l9 d00 haiit’4ego
1j7t’4h7g77 baa 1h1y32doo. {ah doo chool’9 1t’4h7g77
doo yee dahaz’32da d00 [a’ doo t’11 1t’4 chool’9 yik’4
das[4ehda.
 Dooda. D77 baa h0ohane’go b33h7l9 1daalyaa7g77
Bee ak’i’diit88hgo hane’ 1daalyaa7g77sh
bik’ehgo n11sg00 bik’ehgo sh7k1
i’doolwo[?
 Dooda. Azee’77['7n7 h1 7’iilaa7g77 47 t’00 binahj8’
hane’. N1 4’4lyaago d00 n7k1 o’oolwod7g77 sh99
[ahgo 1t’4e doo t’11 1niid binahj8’ h00ne’7g77
biniy4 n7k1 o’oolwodgo ne’azee’77['7n7 1n7[n7n7g77
bik’ehgo, nin11hai7g77, nich’8’ an1h00t’i’7g77, d00
t’11 d7kw77g00sh99 1dahoot’4h7g77 a[d0’ binahj8’
doo ahehoo[t’4eda doo.
47 doo k’ad b33h da’7l9 1daat’4h7g77 1t’4eda.
Choo’98go bee y11l b33h da’7l9 bik’ehgo haa
iidoob88[7g77 w0lta’ doo biniy4 1t’4eda. They are for
comparative purposes only. Naa’1h1y32go bik’4
nih7ly4h7g77 [ahgo 1t’4ego doolee[. B33h da’7l7n7g77
azee’77[‘7n7g77 yoosb1n7g77, d00 b4eso n1t’33’ nich’8’
nin1doodl4h7g77 nahat’1 yee haz’1n7g77 da [ahgo
1t’4edoo.
Da’ Bee 1k’i’diit88hgo baa h00ne’7g77
bee Insurance a[h22 nideeshni[?
Aoo’. Ats’77s baa 1h1y3 b33h da’7l9 Summary of
Benefits and Coverage, haa 1h1y3 bee h1
haz’1n7g77, woly4ego insurance hadadeidi['9 47
binahj8’ a[h22 nizhdooni[.Nid77l44[ n7n7g0ne’ bee
44h0zin. D77 aa’1h1y3 n7idool44[ bee 44h0zin,
d77d7h7g77 a[ch’id7go b4esogo bee aa’1h1y3 bee
haz’1n7g77 [3 doolee[.
19/3
Aa’1h1y32j8’ chool’9 t’00 be’elyaah7g77
Ha’1t’77sh a[d0’ hadeesh’98’go insurance
a[h22 naashnilgo?
Aoo’. Aa’1h1y3 b33h 7l7n7g77, b4eso ni
nid77l4[7g77 47 7iyis77 b7h0lnih. Aa’1h1y3 b33h
7l7n7g77 doo 7l98dag00 47 azee’77['7n7 bich’8’ t’11
h0 hab4eso nijiil4h7g77, 1ko b4eso 1neelt’e’
nijiil4h7g77, out of pocket costs, [3 nijiil4e [eh.
!1[ ha’n7n7g77 deductibles, copayments,
d00 n1k1 o’oolwodgo b33h azl99’ [ahd00
nid77l44[7g77
co-insurance. !k1 an1’1lwo’ h1 bik’4 ni’iily4
biniy4 b4eso yah ajiiln7i[go y1’1t’44h. !1[
ha’n7n7g77 47 Health Savings accounts (HSAs),
d00 flexible spending arrangements (FSAs) 47
doodago health reimbursement accounts
(HRAs) 47 b4eso t’11 h0 nin1j7dl44h7g77 h1k1
an7daalwo’go h1 nidayiil4.
20/3

BlueCross BlueShield

Transcript

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