care reform
\nHealth care reform has made insurance accessible to everyone. As a consumer, it is important to be able to understand and compare health care coverage options. From a marketing perspective, consider consumers and why it would be important to understand consumer needs and how to market to different consumers based on their needs.<\/p>\n
Complete the Case Study Comparisons worksheet.<\/p>\n
Case Study Comparisons
\nPart 1
\nComplete the chart below that differentiates the following insurance types.
\nPlan Type<\/p>\n
Characteristics of Plan (5 to 7 characteristics)
\nTarget Audience for Plan
\nIndemnity Plan<\/p>\n
Preferred Provider Organization (PPO)<\/p>\n
Health Maintenance Organization (HMO)<\/p>\n
Consumer Directed Health Plan (CDHPs)<\/p>\n
Medicaid<\/p>\n
Medicare<\/p>\n
Part 2
\nReview the insurance plans and answer the following questions.
\nServices
\nBronze
\nSilver
\nGold
\nMonthly Cost
\n$163.00
\n$194.00
\n$245.00
\nDeductible
\n$6,000.00
\n$4,000.00
\n$1000.00
\nPrimary Care
\n$35.00 co-pay for three visits, then 20% of co-insurance
\n$30.00 co-pay\/provider\/day
\n$20.00 co-pay\/provider\/day
\nSpecialist Visit
\n$70.00 co-pay for three visits, then 20% of co-insurance
\n$60.00 co-pay\/provider\/day
\n$40.00 co-pay\/provider\/day
\nPreventive Care\/Screening\/Immunization
\nNo charge
\nNo charge
\nNo charge
\nDiagnostic Test (x-ray, blood work)
\n$35.00 co-pay or 20% of co-insurance if co-pay limit is researched
\nOffice visit co-pay or 20% of co-insurance
\nOffice visit co-pay or 20% of co-insurance
\nLevel 1 Prescription Drugs
\n$25 co-pay\/30 day supply
\n$15.00 co-pay\/30 supply
\n$15.00 co-pay\/30 supply
\nEmergency Room Services
\n20% of co-insurance
\n$350.00 co-pay\/facility\/day
\n$250.00 co-pay\/facility\/day
\nEmergency Medical Transportation
\n20% of co-insurance
\n20% of co-insurance
\n20% of co-insurance
\nUrgent Care
\n$75 co-pay
\n$60.00 co-pay\/provider\/day
\n$60.00 co-pay\/provider\/day
\nHospital Stay (Facility fee, physician\/surgeon fee)
\n20% of co-insurance
\n20% of co-insurance
\n20% of co-insurance<\/p>\n
1. Compare the plans above.
\n\u00b7 What are the major differences between the plans?
\n\u00b7 What are the major similarities between the plans?
\n\u00b7 If you were presented with these plans, what would be the major selling points and pitfalls of the plans for you?
\n2. Read and answer the questions below regarding the two consumers and refer to the Gold, Bronze, or Silver plans listed above.
\nConsumer A
\nBetsy has type 2 diabetes and high blood pressure. She visits the doctor often to keep her diabetes and blood pressure controlled. The doctor regularly checks her blood levels and prescribes level 1 prescriptions to help Betsy control her diabetes and blood pressure.
\n\u00b7 Betsy is considered a controlled diabetic but still uses her insurance plan frequently.
\no Compare the plans provided and determine the best plan for Betsy. Remember to consider deductibles and general costs for the services she would be using.
\n\u00b7 For a couple of years, Betsy was really taking care of herself. However, after suffering a broken leg and being more inactive, Betsy has gained weight and has not been diligent about controlling her diabetes. Betsy has found that she is requiring emergency room services and urgent care more often.
\no If Betsy was considering changing her insurance plan, which plan should she consider? Why?<\/p>\n
o How does the plan she should consider in this scenario compare to the plan choice from the first question?<\/p>\n
Consumer B
\nZach is a healthy 30 year old who rarely goes to the doctor and is not on any medication. He has been offered the following insurance plans and he is considering the plans for use of common alignments (i.e., colds) and for preventive tests.
\no Compare the plans and determine what would be the best plan for Zach.
\nZach has recently been hired as a construction worker and was considering changing his health plan. He realizes that this new job may have more hazards than his last job.
\no Which plan should Zach consider? Why?
\no How does the plan he should consider in this scenario compare to the plan choice from the first question? Remember to consider deductibles and general costs for the services he would be using.<\/p>\n","protected":false},"excerpt":{"rendered":"
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