非盈利的醫(yī)療衛(wèi)生機(jī)構(gòu)FAIR Health擁有全美國(guó)保險(xiǎn)理賠的數(shù)據(jù)庫(kù)。他們的數(shù)據(jù)顯示,在美國(guó),孕婦順產(chǎn)分娩且無(wú)并發(fā)癥的情況下,平均要向醫(yī)生繳納3,035美元。其中包含了產(chǎn)前和產(chǎn)后的日常護(hù)理費(fèi)用(但不包含超聲檢查和羊水診斷等)。如果你想在分娩時(shí)接受硬脊膜外麻醉(老實(shí)說(shuō),許多女性都會(huì)選擇這種麻醉),平均還要多掏2,132美元。根據(jù)居住地的不同,這些費(fèi)用也有很大差別。FAIR Health還發(fā)現(xiàn),在全美國(guó)范圍內(nèi),剖腹產(chǎn)的平均費(fèi)用為3,382美元,接受硬脊膜外麻醉還將產(chǎn)生平均1,646美元的額外費(fèi)用。
But that’s just for your doctors—not the hospital. In a separate study published in the journalHealth Affairs last year, researchers found that the cost of a hospital stay to give birth ranged from$1,189 to $11,986, and that was for what were considered low-risk deliveries.
不過(guò)這只是給醫(yī)生的費(fèi)用,不是給醫(yī)院的。在去年Health Affairs發(fā)表的另一篇研究報(bào)告中,科研人員發(fā)現(xiàn),生育還將產(chǎn)生1,189美元至11,986美元不等的住院費(fèi),這還是在分娩風(fēng)險(xiǎn)較低的情況下。
To be clear, your actual out-of-pocket costs will vary considerably depending on your healthinsurance policy.
這里需要明確指出,根據(jù)醫(yī)療保險(xiǎn)的不同,你需要支付的實(shí)際費(fèi)用會(huì)有很大差異。
Most people with insurance first have to fulfill a deductible—that is, pay a certain amount out ofpocket before insurance covers the bill. On average, employees in traditional PPO family plansneed to pay $2,012 as a family or $944 per person to meet their deductible, according to theKaiser Family Foundation.
大部分人在自費(fèi)醫(yī)療達(dá)到一定數(shù)額后,才能開(kāi)始享受保險(xiǎn)——也就是在保險(xiǎn)公司付賬之前先自掏腰包。根據(jù)Kaiser Family Foundation(KFF)的數(shù)據(jù),參加優(yōu)選醫(yī)療機(jī)構(gòu)(PPO)計(jì)劃的家庭平均需要支付2,012美元,或每個(gè)家庭成員支付944美元,才能達(dá)到保險(xiǎn)的條件。
After that, your insurer may still require you to chip in. You may owe co-pays or a percentage ofthe bill, called co-insurance. The average hospital co-pay is $308 per admission, and $281 per day.The average co-insurance rate is 19% of the bill, KFF found.
在此之后,保險(xiǎn)公司可能還會(huì)讓你掏錢。你可能需要支付一定比例的醫(yī)療費(fèi),即所謂的共同保險(xiǎn)。KFF發(fā)現(xiàn),每次住院的平均自付金額為308美元,或每天281美元,平均自付率為19%。
Charges can add up, particularly if you have complications. Fortunately, the Affordable Care Actputs a cap on what you’ll pay for in-network services. The legal out-of-pocket maximum is$13,700for family plans — though your insurer may set an even lower cap.
如果你出現(xiàn)了并發(fā)癥,費(fèi)用還會(huì)更高。幸運(yùn)的是,《平價(jià)醫(yī)療法案》(Affordable Care Act)規(guī)定了你在享受醫(yī)保網(wǎng)絡(luò)內(nèi)服務(wù)時(shí)需要支付的費(fèi)用上限。法律規(guī)定,參加醫(yī)療計(jì)劃的家庭,每年支付的醫(yī)療費(fèi)用最多不超過(guò)13,700美元,而你的保險(xiǎn)公司設(shè)定的上限可能還會(huì)更低。
Your medical claims can also vary depending on where you live. FAIR Health found the averagecost of vaginal delivery ranged from $1,614 in Mobile, Ala. to $9,279 in the Bronx, N.Y. You canfind typical prices in your area with FAIR Health’s Consumer Cost Lookup tool.
居住地不同,醫(yī)療理賠的費(fèi)用也會(huì)不同。FAIR Health發(fā)現(xiàn),順產(chǎn)的平均費(fèi)用從阿拉巴馬州莫比爾(Mobile)的1,614美元到紐約市布朗克斯(Bronx)的9,279美元不等。根據(jù)FAIR Health的消費(fèi)者成本查找工具,你可以看到對(duì)應(yīng)地區(qū)的通常價(jià)格。
If you’re insured, the best way to estimate what you’ll owe is to check if your health plan has aprice transparency tool (77% of large employers now offer them, according to Mercer). Thatshould tell you what you can expect to pay with specific providers in your network.
如果你已經(jīng)投保,估計(jì)你要掏多少錢的最好辦法就是看看你的健康計(jì)劃是否有價(jià)格透明度工具【美世咨詢(Mercer)表示,現(xiàn)在有77%的大型雇主都提供這種工具】。它能告訴你,在醫(yī)保網(wǎng)絡(luò)中的某家機(jī)構(gòu)生育大概要花多少錢。
If you’re not insured, you’ll have to wait until the next Obamacare open enrollment period to buyhealth coverage, or until you have your baby — whichever comes first. Having a child qualifies youfor a special open enrollment period, but just being pregnant does not.
如果你尚未投保,就得等到奧巴馬醫(yī)改規(guī)定的下一次保險(xiǎn)購(gòu)買開(kāi)放期(open enrollmentperiod),或是等到你有孩子為止——無(wú)論哪項(xiàng)都可以。擁有小孩能讓你享有購(gòu)買保險(xiǎn)的特別開(kāi)放期,不過(guò)只是懷孕的話可不行。