{"id":6529,"date":"2023-09-12T22:25:00","date_gmt":"2023-09-13T06:25:00","guid":{"rendered":"https:\/\/smartandresponsible.com\/blog\/?p=6529"},"modified":"2023-09-05T09:35:19","modified_gmt":"2023-09-05T17:35:19","slug":"hp1","status":"publish","type":"post","link":"https:\/\/smartandresponsible.com\/blog\/hp1\/","title":{"rendered":"\u5065\u5eb7\u4fdd\u967a\u306e\u30bf\u30a4\u30d7\u306e\u9055\u3044\u3092\u7406\u89e3\u3059\u308b"},"content":{"rendered":"\n<p>\u30a2\u30e1\u30ea\u30ab\u306e\u5065\u5eb7\u4fdd\u967a\u30d7\u30e9\u30f3\u306e\u4e2d\u3067\u6700\u3082\u53e4\u304f\u304b\u3089\u3042\u308b\u306e\u306fHMO\u3067\u3059\u3002\u6628\u4eca\u3067\u306f\u3001HMO\u306e\u52a0\u5165\u8005\u6570\u30d9\u30fc\u30b9\u306e\u30b7\u30a7\u30a2\u4e0b\u304c\u308a\u3064\u3064\u3042\u308a\u3001\u534a\u6570\u8fd1\u304f\u304cPPO\u306b\u306a\u3063\u3066\u3044\u307e\u3059\u3002\u307e\u305f\u3001HDHP\u3082\u3060\u3093\u3060\u3093\u3068\u6d78\u900f\u3057\u3066\u304d\u3066\u3044\u307e\u3059\u3002<\/p>\n\n\n\n<p>HMO\u3001PPO\u3001POS\u3001EPO\u3001HDHP\u306a\u3069\u306e\u7565\u8a9e\u3092\u3088\u304f\u898b\u307e\u3059\u304c\u3001\u3053\u308c\u3089\u306f\u5927\u304d\u304f\uff12\u3064\u306e\u30ab\u30c6\u30b4\u30ea\u30fc\u306b\u5206\u985e\u3067\u304d\u307e\u3059\u3002\u3072\u3068\u3064\u306f\u3001\u533b\u5e2b\u30fb\u75c5\u9662\u306e\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u306b\u3064\u3044\u3066\u306e\u8003\u3048\u65b9\u3068PCP\u306e\u6307\u540d\u304c\u5fc5\u8981\u304b\u3069\u3046\u304b\u306e\u9055\u3044\u306b\u3088\u308a\u5206\u985e\u3059\u308b\u65b9\u6cd5\u3067\u3059\u3002\u3082\u3046\u3072\u3068\u3064\u306f\u3001Deductible\u306e\u5927\u304d\u3055\u306b\u3088\u308b\u5206\u985e\u6cd5\u3067\u3059\u3002<\/p>\n\n\n\n<p>\u307e\u305a\u524d\u8005\u306e\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u5185\u5916\u3068PCP\u306b\u5bfe\u3059\u308b\u8003\u3048\u65b9\u306e\u9055\u3044\u3067\u306e\u5206\u985e\u304b\u3089\u898b\u3066\u307f\u307e\u3059\u3002<\/p>\n\n\n\n<div style=\"height:44px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u306e\u5185\u5916-pcp\u306e\u6709\u7121\u304c\u6c7a\u3081\u3066\">\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u306e\u5185\u5916\u3001PCP\u306e\u6709\u7121\u304c\u6c7a\u3081\u3066<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"h-hmo-health-maintenance-organization\">HMO \uff08Health Maintenance Organization\uff09<\/h3>\n\n\n\n<p>HMO\u306fmanaged care\u3068\u3044\u3046\u540d\u306e\u3054\u3068\u304f\u3001\u6307\u5b9a\u3057\u305fPCP\uff08Primary Care Physician\uff09\u306b\u3088\u308a\u533b\u7642\u30b5\u30fc\u30d3\u30b9\u304cmanage\u3055\u308c\u308b\u30bf\u30a4\u30d7\u3067\u3059\u3002PCP\u3092\u6307\u5b9a\u3059\u308b\u3053\u3068\u304c\u5fc5\u8981\u3067\u3001\u7279\u6b8a\u306a\u8a3a\u65ad\u691c\u67fb\u3092\u53d7\u3051\u308b\u5834\u5408\u3084\u5c02\u9580\u533b\u306e\u8a3a\u65ad\u3092\u53d7\u3051\u308b\u5834\u5408\u306b\u306f\u3001PCP\u306eReferral\u304c\u5fc5\u8981\u3067\u3059\u3002\u4fdd\u967a\u306f\u3001\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u306e\u4e2d\u3067\u306e\u533b\u7642\u30b5\u30fc\u30d3\u30b9\u306e\u307f\u3092\u30ab\u30d0\u30fc\u3057\u3001\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u5916\u3067\u30b5\u30fc\u30d3\u30b9\u3092\u53d7\u3051\u305f\u5834\u5408\u306f\u57fa\u672c\u7684\u306b\u4fdd\u967a\u306e\u88dc\u511f\u5bfe\u8c61\u306b\u306a\u308a\u307e\u305b\u3093\u3002Referral\u3082\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u5185\u3067\u306e\u307f\u884c\u308f\u308c\u307e\u3059\u3002<\/p>\n\n\n\n<p>PCP\u306bManage\u3055\u308c\u308b\u306e\u3067\u533b\u5e2b\u3084\u75c5\u9662\u3092\u9078\u3076\u30d5\u30ec\u30ad\u30b7\u30d3\u30ea\u30c6\u30a3\u304c\u4f4e\u3044\u3067\u3059\u304c\u3001\u305d\u306e\u5206\u533b\u7642\u30b5\u30fc\u30d3\u30b9\u3084\u533b\u7642\u8cbb\u3082manage\u3055\u308c\u308b\u306e\u3067\u3001\u60a3\u8005\u81ea\u8eab\u304c\u533b\u7642\u30b5\u30fc\u30d3\u30b9\u3092\u6bd4\u8f03\u691c\u8a0e\u3057\u305f\u308a\u533b\u7642\u8cbb\u3092\u541f\u5473\u3057\u305f\u308a\u3059\u308b\u5fc5\u8981\u6027\u306f\u3042\u307e\u308a\u3042\u308a\u307e\u305b\u3093\u3002\u7d50\u679c\u7684\u306b\u3001\u30d5\u30ec\u30ad\u30b7\u30d3\u30ea\u30c6\u30a3\u304c\u4f4e\u3044\u5206\u3001Copay\u3001 Deductible\u3001Coinsurance\uff08HMO\u306e\u5834\u5408\u3001\u306a\u3044\u5834\u5408\u3082\u3042\u308b\uff09\u304c\u4f4e\u3081\u306e\u3053\u3068\u304c\u591a\u304f\u3001\u533b\u7642\uff0d\u30d3\u30b9\u3092\u53d7\u3051\u305f\u3068\u304d\u81ea\u5df1\u8ca0\u62c5\u984d\uff08out-of-pocket\uff09\u304c\u4f4e\u304f\u6291\u3048\u3089\u308c\u308b\u3067\u3057\u3087\u3046\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"h-ppo-preferred-provider-organization\">PPO \uff08Preferred Provider Organization\uff09<\/h3>\n\n\n\n<p>PPO\u306f\u901a\u5e38\u3001\u5229\u7528\u3067\u304d\u308b\u533b\u5e2b\u30fb\u75c5\u9662\u306e\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u304c\u5927\u304d\u3081\u3067\u3001\u307e\u305f\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u306e\u5916\uff08out-of-network\uff09\u306b\u533b\u7642\u30b5\u30fc\u30d3\u30b9\u3092\u6c42\u3081\u308b\u3053\u3068\u3082\u6bd4\u8f03\u7684\u5bb9\u6613\u306b\u3067\u304d\u307e\u3059\u3002\u901a\u5e38PCP\uff08Primary Care Physician\uff09\u3092\u6307\u5b9a\u3059\u308b\u5fc5\u8981\u304c\u306a\u304f\u3001\u5fc5\u8981\u306b\u5fdc\u3058\u3066\u5c02\u9580\u533b\u306e\u8a3a\u65ad\u3092\u76f4\u63a5\u3001\u3064\u307e\u308aPCP\u306eReferral\u306a\u3057\u3067\u3001\u53d7\u3051\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3059\u3002<\/p>\n\n\n\n<p>\u7279\u5b9a\u306e\u533b\u5e2b\u306b\u898b\u3066\u3082\u3089\u3044\u305f\u3044\u3068\u3044\u3046\u5e0c\u671b\u304c\u3042\u308b\u5834\u5408\u3001\u3042\u308b\u3044\u306f\u7279\u6b8a\u306a\u533b\u7642\u30b5\u30fc\u30d3\u30b9\u304c\u5fc5\u8981\u306a\u306e\u3067\u81ea\u7531\u306b\u533b\u5e2b\u3084\u75c5\u9662\u3092\u9078\u3076\u30d5\u30ec\u30ad\u30b7\u30d3\u30ea\u30c6\u30a3\u304c\u5fc5\u8981\u306a\u3068\u304d\u306b\u306f\u6709\u5229\u306a\u30d7\u30e9\u30f3\u3067\u3059\u3002\u81ea\u5206\u3067\u533b\u5e2b\u3092\u9078\u629e\u3059\u308b\u30d5\u30ec\u30ad\u30b7\u30d3\u30ea\u30c6\u30a3\u304c\u3042\u308b\u5206\u3001\u533b\u7642\u30b5\u30fc\u30d3\u30b9\u3092\u541f\u5473\u3057\u305f\u308a\u5024\u6bb5\u3092\u6bd4\u8f03\u3057\u305f\u308a\u3068\u3044\u3046\u4f5c\u696d\u304c\u5fc5\u8981\u306b\u306a\u308b\u5834\u5408\u3082\u3042\u308b\u3067\u3057\u3087\u3046\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"h-pos-point-of-service\">POS \uff08Point of Service\uff09<\/h3>\n\n\n\n<p>POS\u306fHMO\u3068PPO\u306e\u30cf\u30a4\u30d6\u30ea\u30c3\u30c9\u3067\u3001HMO\u3092\u30d9\u30fc\u30b9\u306b\u3057\u306a\u304c\u3089\u3082\u3001\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u5916\uff08out-of-network)\u3067\u533b\u7642\u30b5\u30fc\u30d3\u30b9\u3092\u53d7\u3051\u308b\u3053\u3068\u3092\u53ef\u80fd\u306b\u3057\u3066\u3044\u308b\u30bf\u30a4\u30d7\u3067\u3059\u3002PCP\u306eReferral\u304c\u3042\u308c\u3070\u3001out-of-network\u306e\u30b5\u30fc\u30d3\u30b9\u3092\u53d7\u3051\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3059\u304c\u3001\u30b3\u30b9\u30c8\u306fHMO\u3088\u308a\u9ad8\u3081\u306b\u306a\u308a\u307e\u3059\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"h-epo-exclusive-provider-organization\">&nbsp;EPO \uff08Exclusive Provider Organization\uff09<\/h3>\n\n\n\n<p>EPO\uff08Exclusive Provider Organization\uff09\u306f\u3001\u6bd4\u8f03\u7684\u77e5\u3089\u308c\u3066\u3044\u306a\u3044\u30d7\u30e9\u30f3\u30bf\u30a4\u30d7\u3067\u3059\u3002HMO\u306e\u3088\u3046\u306b\u3001\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u5185\u306e\u533b\u7642\u30b5\u30fc\u30d3\u30b9\u306e\u307f\u3092\u30ab\u30d0\u30fc\u3057\u3001\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u306f\u4e00\u822c\u7684\u306b\u5927\u304d\u3081\u3067\u3059\u3002EPO\u306f\u3001PCP\u304b\u3089\u306eReferral\u3092\u5fc5\u8981\u3068\u3059\u308b\u5834\u5408\u3082\u3042\u308a\u307e\u3059\u304c\u3001\u5fc5\u8981\u3068\u3057\u306a\u3044\u5834\u5408\u3082\u3042\u308a\u307e\u3059\u3002\u4fdd\u967a\u6599\u306fHMO\u3088\u308a\u9ad8\u3081\u3067\u3059\u304c\u3001PPO\u3088\u308a\u4f4e\u3081\u3067\u3059\u3002<\/p>\n\n\n\n<div style=\"height:53px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-deductible\u306e\u9ad8\u4f4e\u304c\u6c7a\u3081\u3066\">Deductible\u306e\u9ad8\u4f4e\u304c\u6c7a\u3081\u3066<\/h2>\n\n\n\n<p>\u6b21\u306b\u3001Deductible\u306e\u9ad8\u4f4e\u3067\u306e\u5206\u985e\u3092\u898b\u307e\u3059\u3002Deductible\u304c\u9ad8\u3044\u3082\u306e\u3092HDHP\u3068\u3044\u3046\u7dcf\u79f0\u3067\u547c\u3073\u3001\u305d\u3046\u3067\u306a\u3044\u3082\u306e\u306b\u306f\u7279\u306b\u540d\u524d\u3092\u3064\u3051\u307e\u305b\u3093\u3002HDHP\u3067\u3042\u308b\u3053\u3068\u304c\u3001HSA\u3092\u5229\u7528\u3067\u304d\u308b\u3053\u3068\u306e\u6761\u4ef6\u306b\u306a\u308a\u307e\u3059\u3002<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"h-hdhp-high-deductible-health-plan\">HDHP\u3000\uff08High Deductible Health Plan\uff09<\/h3>\n\n\n\n<p>HDHP\u306f\u3001Deductible\u304c\u9ad8\u304f\u8a2d\u5b9a\u3055\u308c\u305f\u5065\u5eb7\u4fdd\u967a\u306e\u3053\u3068\u3067\u3042\u3063\u3066\u3001\u672c\u6765\u4e0a\u306eHMO\u3001PPO \u3001POS\u3001EPO\u3068\u30d1\u30e9\u30ec\u30eb\u306b\u5217\u8a18\u3055\u308c\u308b\u3079\u304d\u3082\u306e\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002HMO\u3001PPO \u3001POS\u3001EPO\u306e\u3069\u308c\u3067\u3082\u3001Deductible\u304c\u9ad8\u304f\u8a2d\u5b9a\u3055\u308c\u3066\u3044\u308c\u3070\u3001\u305d\u308c\u3089\u306fHDHP\u306b\u306a\u308a\u307e\u3059\u3002\u8a00\u3044\u63db\u3048\u308c\u3070\u3001HMO\u3067\u3082HDHP\u3067\u306f\u306a\u3044\uff08Deductible\u304c\u4f4e\u3044\uff09\u30d7\u30e9\u30f3\u304c\u3042\u308c\u3070\u3001HDHP\uff08Deductible\u304c\u9ad8\u3044\uff09\u30d7\u30e9\u30f3\u3082\u3042\u308a\u307e\u3059\u3002\u524d\u8005\u306f\u3060\u305f\u306eHMO\u30d7\u30e9\u30f3\u3001\u5f8c\u8005\u306fHDHP\/HMO\u30d7\u30e9\u30f3\u3067\u3059\u3002PPO\u3001POS\u3001EPO\u306b\u3064\u3044\u3066\u3082\u540c\u3058\u3067\u3059\u3002<\/p>\n\n\n\n<p>\u300cDeductible\u304c\u9ad8\u3044\u300d\u3068\u3044\u3046\u306e\u306f\u30012023\u5e74\u306e\u6570\u5b57\u3067\u3044\u3048\u3070\u3001Deductible\u304c\u500b\u4eba\u3067 $1,500\u4ee5\u4e0a \u3001\u5bb6\u65cf\u3067$3,000 \u4ee5\u4e0a\u3067\u3042\u308b\u3053\u3068\u3092\u3044\u3044\u307e\u3059\u3002\u3053\u306e\u6570\u5b57\u306f\u5e74\u3005\u898b\u76f4\u3055\u308c\u307e\u3059\u3002<\/p>\n\n\n\n<p>HDHP\u306f\u3001\u4e00\u822c\u7684\u306bDeductible\u304c\u9ad8\u3044\u5206\u4fdd\u967a\u6599\u304c\u4f4e\u3044\u3067\u3059\u304c\u3001\u3044\u3063\u305f\u3093\u533b\u7642\u30b5\u30fc\u30d3\u30b9\u3092\u4f7f\u3046\u3053\u3068\u306b\u306a\u308c\u3070\u81ea\u5df1\u8ca0\u62c5\u984d\u304c\u5927\u304d\u304f\u306a\u308a\u307e\u3059\u3002Deductible\u304c\u9ad8\u3044\u304b\u3089\u3067\u3059\u3002\u5065\u5eb7\u3067\u307b\u3068\u3093\u3069\u533b\u7642\u30b5\u30fc\u30d3\u30b9\u3092\u4f7f\u308f\u306a\u3044\u4eba\u306b\u3068\u3063\u3066\u306f\u3001\u5927\u304d\u304f\u4fdd\u967a\u6599\u3092\u524a\u6e1b\u3067\u304d\u308b\u53ef\u80fd\u6027\u304c\u3042\u308a\u307e\u3059\u3002<\/p>\n\n\n\n<p>HDHP\u52a0\u5165\u8005\u306f\u3001Health Savings Account (HSA)\u304c\u5229\u7528\u3067\u304d\u307e\u3059\u3002HSA\u3078\u306e\u7a4d\u307f\u7acb\u3066\u306f\u3001\u6240\u5f97\u7a0e\u63a7\u9664\u306b\u306a\u308a\u3001\u5229\u56de\u308a\u306f\u975e\u8ab2\u7a0e\u306e\u307e\u307e\u904b\u7528\u3001\u533b\u7642\u8cbb\u306b\u4f7f\u3048\u3070\u975e\u8ab2\u7a0e\u306e\u307e\u307e\u4f7f\u3048\u307e\u3059\u3002\u96c7\u7528\u4e3b\u63d0\u4f9b\u306eHDHP\uff0bHAS\u304c\u3042\u308b\u5834\u5408\u306f\u3001\u96c7\u7528\u4e3b\u304c\u30d9\u30cd\u30d5\u30a3\u30c3\u30c8\u306e\u4e00\u74b0\u3067HSA\u3078\u4e00\u5b9a\u91d1\u984d\u306e\u62e0\u51fa\u3092\u3057\u3066\u304f\u308c\u308b\u5834\u5408\u3082\u3042\u308a\u307e\u3059\u3002\u307e\u305f\u3001\u96c7\u7528\u4e3b\u63d0\u4f9b\u306e\u3082\u306e\u3067\u306f\u306a\u304f\u3001\u500b\u4eba\u3067\u52a0\u5165\u3057\u305fHSHP\u306e\u5834\u5408\u306f\u3001\u500b\u4eba\u7684\u306bHSA\u3092\u958b\u304f\u3053\u3068\u3082\u53ef\u80fd\u3067\u3059\u3002<\/p>\n\n\n\n<div style=\"height:54px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u306e\u91cd\u8981\u6027\u3068\u8003\u3048\u65b9\">\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u306e\u91cd\u8981\u6027\u3068\u8003\u3048\u65b9<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\" 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