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영어 봐주세요...

물방울갯수 10
오바마케어를 안들고 벌금을 내다가 올해 벌금도 올르고 아이도 걱정되서..
올해 처음으로 건강보험을 들었어요 카이져요..
그런데 보내라는 서류 다 보내고 완료되었는데 어제 메일하나를 받았네요..
3장중 2장은 이해를 했어요 사진찍혀있는걸로 포토카피를 해서 1장 적는거 다 적어 같이 보내라고요
문제는 첫페이지 뭐때문에 보내라는건지. 이게 뭔내용인지를 파악을 못하겠네요..
저희부부는 몰라도 아이가 지금 2살이라 어려서 아프면 병원을 자주가야해서 혹시 중요한건데 안보내면 안될가같아서요...
미국온지 얼마 안되어서 부분적이해가 되다보니 전체뜻이 헷갈리네요..
부탁드릴게요 전체해석 도와주세요.. 번호붙여놓을게요..


1) You are receiving this notice because you are a new enrollee and maybe moving from new york medical assistance or another company's health benefit plan or dental plan to kaiser inc coverage. If you currently are receiving treatment, you have special rights in new york.


2) For example, if you old company gave you pre-approval to have surgery or to receive other service, you may not need to receive new approval from us to proceed with the surgery or to continue receiving the same services. Also if you ate seeing a doctor or other health care provider who is in-network provider with your old compant, and that provider is not in-network provider under your new plan, you may continue to see your provider for a limited period of time as though the provider were in-network provider with us.


3) The rules on how you can qualify for these special rights are described below

4) Prior approval for health care or dental services.
5) ● if you previously were covered under another company's plan, a prior approval (also called "preauthorization") for service that you received under your old plan may be used to satisfy a prior approval requirement for those services if they are covered under your new plan with us.
6) ● To be able to use the old prior approval under this new plan, you will need to contact us at the number on the back of your member ID card to let us know that you have a prior approval for the services and provide us with a copy of the prior approval. Your parent, guardian, designee or health care provider may also contact us on your behalf about prior approval.
7) ● There is a time limit for how long you can rely on the prior approval. For all conditions other than pregnancy , the time limit is 90 days or until the course treatment is completed, whichever is sooner. The 90 day limit is measured from the date your coverage starts under the new plan. For pregnancy, the time limit lasts through the pregnancy and the first visit to a health care practitioner after the baby is born.
8) ● Limitation on use of prior approvals; if your prior approval was for benefits or services provided through the new york medical assistance fee-for-service program, you may not use the prior approval unless it is for behavioral health or dental benefit authorized by a third-party administrator.
9) ● If you do not have a copy of the prior approval, contact your old company and request of copy. Under new york law, your old company must provide a copy of the prior approval within 10 days of your request.


10) Right to use non-network providers
11) ● If you have been receving service from a health care provider who was an in-network provider with your old company, and that provider is a non-network provider under your new health plan with us, you may be able to continue to see your provider as though the provider were an in-network provider. You must contact us at the number on the back your member ID card to request the right to continue see the non-network provider as if the provider were an in-network provider with us. Your parent, guardian, designee or health care provider may also contact us on your behalf to request the right for you to continue to see the non-network provider.





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님, 멘토가 되어 주세요.

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1) You are receiving this notice because you are a new enrollee and maybe moving from new york medical assistance or another company's health benefit plan or dental plan to kaiser inc coverage. If you currently are receiving treatment, you have special rights in new york.

이통지를 받은 이유는 새가입자이고 또 다른 보험이나 뉴욕 의료보조 프로그램 또는 치과보험에서 카이저로 옮겨오는것일수가 있기 때문입니다. 현재 치료를 받고 있는중이면 뉴욕에서 그런경우에 특권이있습니다.

2) For example, if you old company gave you pre-approval to have surgery or to receive other service, you may not need to receive new approval from us to proceed with the surgery or to continue receiving the same services. Also if you ate seeing a doctor or other health care provider who is in-network provider with your old compant, and that provider is not in-network provider under your new plan, you may continue to see your provider for a limited period of time as though the provider were in-network provider with us.

예를들면, 전 보험에서 수술이나 치료를 미리 허락한 상태의경우 카이저에서 또다시 허락을 받지않고 바로 수술이나 치료을 받을수있음을 알려드립니다. 그리고 현재 보는 의사가 전보험 넷웍에 가입되 있지만 카이저에 없을경우 잠시동안 카이저 넷웍의 의사인것처럼 보실수있습니다.

3) The rules on how you can qualify for these special rights are described below

이런 특권의 혜택을 받기위해선 아래에 기재된대로 하시면 됩니다.

4) Prior approval for health care or dental services.
5) ● if you previously were covered under another company's plan, a prior approval (also called "preauthorization") for service that you received under your old plan may be used to satisfy a prior approval requirement for those services if they are covered under your new plan with us.
6) ● To be able to use the old prior approval under this new plan, you will need to contact us at the number on the back of your member ID card to let us know that you have a prior approval for the services and provide us with a copy of the prior approval. Your parent, guardian, designee or health care provider may also contact us on your behalf about prior approval.
7) ● There is a time limit for how long you can rely on the prior approval. For all conditions other than pregnancy , the time limit is 90 days or until the course treatment is completed, whichever is sooner. The 90 day limit is measured from the date your coverage starts under the new plan. For pregnancy, the time limit lasts through the pregnancy and the first visit to a health care practitioner after the baby is born.
8) ● Limitation on use of prior approvals; if your prior approval was for benefits or services provided through the new york medical assistance fee-for-service program, you may not use the prior approval unless it is for behavioral health or dental benefit authorized by a third-party administrator.
9) ● If you do not have a copy of the prior approval, contact your old company and request of copy. Under new york law, your old company must provide a copy of the prior approval within 10 days of your request.


10) Right to use non-network providers
11) ● If you have been receving service from a health care provider who was an in-network provider with your old company, and that provider is a non-network provider under your new health plan with us, you may be able to continue to see your provider as though the provider were an in-network provider. You must contact us at the number on the back your member ID card to request the right to continue see the non-network provider as if the provider were an in-network provider with us. Your parent, guardian, designee or health care provider may also contact us on your behalf to request the right for you to continue to see the non-network provider.


3-11번은 그런 전보험과의 관계를 카이저에서 연결해서 받기위해서 해야만 하는 내용들입니다. 전보험이 없었으므로 무시하셔도 됩니다.


간단하게 이전보험을 통해서 치료중이거나 수술예약이 안된상태라면 그냥 무시하셔도 됩니다.
1) You are receiving this notice because you are a new enrollee and maybe moving from new york medical assistance or another company's health benefit plan or dental plan to kaiser inc coverage. If you currently are receiving treatment, you have special rights in new york.

이통지를 받은 이유는 새가입자이고 또 다른 보험이나 뉴욕 의료보조 프로그램 또는 치과보험에서 카이저로 옮겨오는것일수가 있기 때문입니다. 현재 치료를 받고 있는중이면 뉴욕에서 그런경우에 특권이있습니다.

2) For example, if you old company gave you pre-approval to have surgery or to receive other service, you may not need to receive new approval from us to proceed with the surgery or to continue receiving the same services. Also if you ate seeing a doctor or other health care provider who is in-network provider with your old compant, and that provider is not in-network provider under your new plan, you may continue to see your provider for a limited period of time as though the provider were in-network provider with us.

예를들면, 전 보험에서 수술이나 치료를 미리 허락한 상태의경우 카이저에서 또다시 허락을 받지않고 바로 수술이나 치료을 받을수있음을 알려드립니다. 그리고 현재 보는 의사가 전보험 넷웍에 가입되 있지만 카이저에 없을경우 잠시동안 카이저 넷웍의 의사인것처럼 보실수있습니다.

3) The rules on how you can qualify for these special rights are described below

이런 특권의 혜택을 받기위해선 아래에 기재된대로 하시면 됩니다.

4) Prior approval for health care or dental services.
5) ● if you previously were covered under another company's plan, a prior approval (also called "preauthorization") for service that you received under your old plan may be used to satisfy a prior approval requirement for those services if they are covered under your new plan with us.
6) ● To be able to use the old prior approval under this new plan, you will need to contact us at the number on the back of your member ID card to let us know that you have a prior approval for the services and provide us with a copy of the prior approval. Your parent, guardian, designee or health care provider may also contact us on your behalf about prior approval.
7) ● There is a time limit for how long you can rely on the prior approval. For all conditions other than pregnancy , the time limit is 90 days or until the course treatment is completed, whichever is sooner. The 90 day limit is measured from the date your coverage starts under the new plan. For pregnancy, the time limit lasts through the pregnancy and the first visit to a health care practitioner after the baby is born.
8) ● Limitation on use of prior approvals; if your prior approval was for benefits or services provided through the new york medical assistance fee-for-service program, you may not use the prior approval unless it is for behavioral health or dental benefit authorized by a third-party administrator.
9) ● If you do not have a copy of the prior approval, contact your old company and request of copy. Under new york law, your old company must provide a copy of the prior approval within 10 days of your request.


10) Right to use non-network providers
11) ● If you have been receving service from a health care provider who was an in-network provider with your old company, and that provider is a non-network provider under your new health plan with us, you may be able to continue to see your provider as though the provider were an in-network provider. You must contact us at the number on the back your member ID card to request the right to continue see the non-network provider as if the provider were an in-network provider with us. Your parent, guardian, designee or health care provider may also contact us on your behalf to request the right for you to continue to see the non-network provider.


3-11번은 그런 전보험과의 관계를 카이저에서 연결해서 받기위해서 해야만 하는 내용들입니다. 전보험이 없었으므로 무시하셔도 됩니다.


간단하게 이전보험을 통해서 치료중이거나 수술예약이 안된상태라면 그냥 무시하셔도 됩니다.