Part 1
\nComplete the chart below that differentiates the following insurance types. Include 5 to 7 characteristics, as well as the target audience, for each identified plan type.
\nPlan Type
\nCharacteristics of Plan Target Audience for Plan
\nIndemnity Plan<\/p>\n
Preferred Provider Organization (PPO)<\/p>\n
Health Maintenance Organization (HMO)<\/p>\n
Consumer Directed Health Plan (CDHP)<\/p>\n
Medicaid<\/p>\n
Medicare<\/p>\n
Part 2
\nReview the following insurance plans and then answer the questions below.
\nServices Bronze Silver Gold
\nMonthly cost $163 $194 $245
\nDeductible $6,000 $4,000 $1,000
\nPrimary care $35 co-pay for three visits, then 20% of co-insurance $30 co-pay\/provider\/day $20 co-pay\/provider\/day
\nSpecialist visit $70 co-pay for three visits, then 20% of co-insurance $60 co-pay\/provider\/day $40 co-pay\/provider\/day
\nPreventive care\/screening\/immunization No charge No charge No charge
\nDiagnostic test (x-ray, blood work) $35 co-pay or 20% of co-insurance if co-pay limit is reached Office visit co-pay or 20% of co-insurance Office visit co-pay or 20% of co-insurance
\nLevel 1 prescription drugs $25 co-pay\/30 day supply $15 co-pay\/30 supply $15 co-pay\/30 supply
\nEmergency dept. services 20% of co-insurance $350 co-pay\/facility\/day $250 co-pay\/facility\/day
\nEmergency medical transportation 20% of co-insurance 20% of co-insurance 20% of co-insurance
\nUrgent care $75 co-pay $60 co-pay\/provider\/day $60 co-pay\/provider\/day
\nHospital stay (facility fee, physician\/surgeon fee) 20% of co-insurance 20% of co-insurance 20% of co-insurance<\/p>\n
1. Compare the plans above.
\nWhat are the major differences between the plans?
\nWhat are the major similarities between the plans?
\nIf 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, Silver, or Bronze 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.
\nBetsy is considered a controlled diabetic; she uses her insurance plan frequently.
\nCompare the plans provided and determine the best plan for Betsy. Remember to consider deductibles and general costs for the services she would be using.
\nFor several 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 department services and urgent care more often.
\nIf Betsy was considering changing her insurance plan, which plan should she consider? Why?
\nHow does the plan she should consider in this scenario compare to the plan choice from the first question?
\nDescribe the impact diabetes as a chronic disease has on health care costs.<\/p>\n
Consumer B
\nZach is a healthy 30 year old who rarely goes to the doctor and does not take any medication. He has been offered the insurance plans above. He is considering the plans for use of common ailments (e.g., colds) and for preventive tests.
\nCompare the plans and determine which would be the best plan for Zach.
\nZach has recently been hired as a construction worker and is considering changing his health plan. He realizes that this new job may have more hazards than his last job.
\nWhich plan should Zach consider? Why?
\nHow 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":"
Case Study Comparisons Part 1 Complete the chart below that differentiates the following insurance types. Include 5 to 7 characteristics, as well as the target audience, for each identified plan type. Plan Type Characteristics of Plan Target Audience for Plan Read More …<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[15],"tags":[],"class_list":["post-431897","post","type-post","status-publish","format-standard","hentry","category-essay-paper-writing"],"_links":{"self":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts\/431897","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/comments?post=431897"}],"version-history":[{"count":0,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts\/431897\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/media?parent=431897"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/categories?post=431897"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/tags?post=431897"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}