Trista Xiuchuan Lu • Source: Yifeng 2017 Summer Issue
The American healthcare system is different from that of most western countries in the world, and the terms used in this article are therefore applicable only in America. While the terms discussed here are not numerous, they can be very confusing to new immigrants who are not familiar with health insurance and are not fluent in English. Even native English speakers in the US can get confused as well. The concepts that are discussed in this short article are the ones you will always encounter in health insurance marketing material and coverage documents. This article hopes to offer some help to translators who are new to this area.
Deductible
It refers to the amount of money that the insured has to pay before insurance companies start paying. In other words, it is the amount the insurance companies can “deduct” from their coverage. For example, if the deductible of your plan is $4,000, it means that the insurance company will start paying after you have finished paying $4,000. There are several ways to translate this term into Chinese to make the concept clear to a Chinese audience, such as “扣除额”, “自付额”, “自负额” and “免赔额.“
When people hear the word “deductible”, they may get confused and think that a certain amount can be deducted from their medical bills. However, the deduction is in fact not applied to the insured’s bill, but to insurance companies’ payment. The Chinese translations of the term provided above are all acceptable; all of them appear in government literature and marketing material, etc. Personally I think “免赔额”, directly back translating to “the amount not covered”, is the best, as it is the clearest, and people will not confuse it with the term “out-of-pocket”, which will be discussed below as well.
Co-pay/Copayment
This refers to the fixed amount that you pay upfront for each doctor’s visit. It is similar to “挂号费” in China, except that “挂号费” is determined by the hospital or the doctor, whereas the co-pay is determined by the insurance companies and it can differ from plan to plan.
The common translation for this term is a literal one, “共付款”. Some translators translate it as “定额手续费”, which is more easily understandable but less common. You may also use the Chinese term “挂号费”, which is less accurate.
Coinsurance
This term is usually literally translated as “共同保险”. It refers to the percentage of the cost covered by the insurance plan that the insured needs to pay.
For example, if the covered medical bill is $100, and the coinsurance of the plan is 20%, the insured will need to pay $20 and the insurance company pays the rest.
Out-of-Pocket
The above three terms are all “out-of-pocket” expenses that will be determined by each plan. As mentioned before, the insured is usually required to pay a co-pay for each doctor’s visit and the portion of medical bills up to the deductible amount before the insurance starts to kick in. After the deductible is fulfilled, the insured still has to pay a part of the bill according to the coinsurance rate specified in the policy.
Some plans set a maximum out-of-pocket amount. Once the insured pays the requisite out-of-pocket amount, he or she will no longer need to pay anything towards any medical expenses, not even the co-pay. And this term is usually literally translated as “自付额”.
Medi-Share
People don’t talk about “Medi-Share” as often as they talk about other terms in health insurance. That is because this term is not used in your regular health insurance but rather in “a Christian healthcare sharing ministry where members share each other’s medical expenses”. There are several Chinese translations for this term, such as “医疗共享会”, “医保互助会”, “医保共享会”.
However, “Medicare” and“Medicaid” are generally not translated in government documents or insurance company marketing material. Being similar to these two, “Medi-Share” should probably be left untranslated.
Creditable Coverage
This is a somewhat tricky term. People can mistake “creditable” with “credible”, which has a different meaning. I have known translators who translated “creditable coverage” as “好的承保”, and that is just wrong.
In the US, people who have pre-existing medical conditions may be denied insurance coverage or required to pay a much higher premium when they change plans. But people may have to change health insurance plans even when they like the plans they have. For example, if you are a college student about to graduate or if you change jobs, you will have to change your health insurance plan.
“Creditable coverage” refers to certain types of insurance plans or coverage, such as a group plan and a student plan, that qualify a potential insured who has pre-existing conditions to switch insurance plans without having to wait for a long exclusion period or pay a monetary penalty.
“Creditable” here literally means “deserving public acknowledgment “, or as the word itself suggests, something that “can be used as credit”. My suggestion for the translation of this term is “受认承保”. Below is a sentence extracted from some marketing material: People who already have creditable coverage and continue to use this coverage without purchasing a Medicare Part D plan will not be subject to the 1% per month premium penalty for late enrollment.
Translating “creditable coverage” as “good coverage (好的承保)” doesn’t seem to matter too much—to some extent, this kind of coverage is in fact “good” coverage. However, it is also very clear that changing the term to simply “good coverage” neglects the nuance behind the policy and doesn’t help the readers to understand their policies.
Trista Xiuchuan Lu is an ATA certified English to Chinese translator based in New York City. She has extensive experience in areas such as healthcare, insurance, business, and legal translation. Trista is also a theater aficionado.
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