지금 온라인으로 의료보험을 알아보는 중인데요. Accident를 따로 들수있는 옵션이 있는데 이건 꼭 들어야 하나요? 만약에 애들이 운동하다 다치거나하면 기본 의료보험으로는 커버가 안되고 순전히 질병으로 인한것만 커버가 되는건가요? 그리고 vision 같은 것도 옵션인데 안경과 관련된 의료행위에 대한 커버인가요? 아님 질병이나 사고에 의한 눈과 관련된 모든 게 이 옵션을 들어야만 커버되는 건가요? 이런 옵션들이 따로 있으니까 기본인슈런스가 어디까지 커버하는지 상당히 궁금합니다. 미리 감사드립니다

제가 본 의료보험에 대한 detail은 아래와 같은데 알기쉽게 설명해 주시면 감사하겠습니다. 그리고 이정도의 보험이면 괜찮은 건지도... 무슨 암호해독하는 기분입니다. 보시고 자세하게 암호를 해독^^해 주시면 정말 감사하겠습니다.


Details At a Glance
Plan Type: PPO
Office Visit for Primary Doctor:
Find Doctors Visit 1-3 $30 copay, deductible waived Visit 4+ deductible then 0%
Office Visit for Specialist: Visit 1-3 $30 copay, deductible waived Visit 4+ deductible then 0%
Coinsurance: None
Annual Deductible: Family:$6,000($3,000 per person)
Separate Prescription Drugs Deductible: None
Prescription Drugs: Generic: Preferred Generic: $10 Copay Rx Option 1: $10 Copay
Brand: Preferred Brand: You pay 100% at Blue Cross' discounted rate (deductible doesn't apply) Rx Option 1: $50 Copay
Non-Formulary: Non-Preferred: No coverage Rx Option 1: $90 Copay
Annual Out-of-Pocket Limit: Family:$6,000($3,000 per person)
Includes deductible
Lifetime Maximum: Unlimited
Health Savings Account (HSA) Eligible: No
Out-of-Network Coverage: Yes (Details in plan brochure below)
Out of Country Coverage: Yes. Paid as in-network benefits if through a WorldWide BlueCard Provider (View Details)
Physicians
Primary Care Physician (PCP) Required: No
Specialist Referrals Required: No
Preventive Care Coverage
Periodic Health Exam: No Charge
Periodic OB-GYN Exam: No Charge
Well Baby Care: No Charge
Prescription Drug Coverage
Generic Prescription Drugs: Preferred Generic: $10 Copay Rx Option 1: $10 Copay
Brand Prescription Drugs: Preferred Brand: You pay 100% at Blue Cross' discounted rate (deductible doesn't apply) Rx Option 1: $50 Copay
Non-Formulary Prescription Drugs Coverage: Non-Preferred: No coverage Rx Option 1: $90 Copay
Mail Order for Prescription Drugs: Generic: Preferred Generic: $20 Copay Rx Option 1: $20 copay for formulary generic drugs
Brand: Preferred Brand: You pay 100% (deductible doesn't apply) Rx Option 1: $100 copay brand-formulary
Non-Formulary: Non-Preferred: No coverage Rx Option 1: $180 copay for non-formulary
Days Supply: 90
Separate Prescription Drugs Deductible: None
Hospital Services Coverage
Emergency Room: $250 copay for first visit, thereafter no charge after deductible
Outpatient Lab/X-Ray: No Charge after deductible
Outpatient Surgery: No Charge after deductible
Hospitalization: No Charge after deductible
Maternity Coverage
Pre & Postnatal Office Visit: Prenatal: No charge Postnatal: Not covered
Labor & Delivery Hospital Stay: Not Covered
Additional Coverage
Chiropractic Coverage: No Charge after deductible
Mental Health Coverage: Optional benefit
Substance Abuse Coverage: Optional benefit
Out-of-Network Coverage
Out-of-Network Authorization Required: No
Out-of-Network Deductible: $6000/$12000
Out-of-Network Coinsurance: 40% after deductible
Out-of-Network Out-of-Pocket Limit: $9000
Additional Information
A.M. Best Rating: A- as of 03/22/2012
Application Fee: No
Electronic Signature for Application Available: Yes
Will insurance company obtain and pay for medical records? Yes
Additional information about this health insurance plan is available in the documents below.
Plan Brochure
Exclusions and Limitations
Summary of Benefits & Coverage (Not available)
The Summary of Benefits & Coverage can be found at healthcare.gov. A paper copy of this Summary of Benefits & Coverage is available upon request by calling our toll free number. Click here to view the Uniform Glossary of Coverage and Medical Terms.