Week 8, Unit 1

Filing a medical insurance claim (I); 의료보험금 신청하기

미국의 경우 국가의료보험 (National Health Care Program) 제도가 없기 때문에 개인적으로 보험에 가입하지 않으면 병원에 가게 되었을때 그 비싼 병원비에 턱이 빠지지 않을 수 없다.

<보험관련어휘>
HMO (Health Maintenance Organization)
premium: 보통 매달 붇게되는 보험 불입금
claim: 보험료 청구

TASK
1) What does the medical insurance holder need to do get his money back?
2) Ask the Agent to send you the claim form and explain your situation. You had a cold and had to see a doctor a couple of times

Agent: Claims and adjustments. May I help you?
Holder: I hope so. I recently had an accident that had to be taken care of with a whole series of doctor’s appointments and prescriptions. I need a claim form to get me out of debt.
Agent: Why don’t you give me your policy number and we’ll get things moving to reimburse you.
Holder: Just a second. Let me find my card. Here we go. Is it the number at the top of the card that you want?
Agent: Yes. It should be a six-digit number with a letter at the end.

( Dialogue를 다시 들으시려면 플레이버튼을 선택해주세요. )

1) Starting conversations; 대화 시작하기
A: How much do you pay for your insurance policy? (보험료는 얼마나 내나요?)
B: My monthly premium is $ 50. (매달 $50 이요.)

A: Can I speak to a claim administrator? (보험금 지급 담당자좀 바꿔주세요.)
B: Hold on. I’m putting you through. (기다리세요. 돌려드릴께요.)

A: I was diagnosed with lung cancer, and have to undergo lung surgery. Does my insurance cover the surgery? (페암으로 진단 받아서 수술을 받아야 합니다. 제 보험이 수술도 해당되나요?)
B: I’m sorry, but it doesn’t. (죄송하지만 안되겠는데요.)

2) reimburse
A: How can I get my money back? (어떻게 환급 받을 수 있나요?)
B: Is it outpatient or inpatient treatment? (외래환자인가요, 입원환자인가요?)

The hotel reimbursed me for the amount they had overcharged me. (호텔 측은 내게 과도하게 청구한 금액을 보상해 주었다.)
I was reimbursed by the utility company for the damage to my house. (집에 입힌 손해에 대하여 utility 회사는 변상을 했다.)

3) Asking for a claim form:
A: What do I do with a claim form? (이 청구양식을 어떻게 해야 하나요?)
B: It should be completed and returned to us. (작성해서 돌려보내 주세요.)

I caught a terrible cold, and went for a couple of doctor’s appointments. Can you send me a claim form?