Essay on Health Insurance Plans

Managed care dominates health care in the United States. It is any health care delivery system that combines the functions of health insurance and the actual delivery of care, where costs and utilization of services are controlled by methods such as gatekeeping, case management, and utilization review. Different types of managed care plans came into development by three major factors. These factors include choice of providers, different ways of arranging the delivery of services, and payment and risk sharing. Types of managed care organizations include Health Maintenance Organizations (HMOs) which consist of five common models that differ according to how the HMO is related to the participating physicians, Preferred Provider Organizations

Health insurance comes as second nature to many of us. We grab that blue and white card and put it in our wallet and forget about it until we are sick or injured. When this happens, there it is, cushioning our fall like the extra padding it provided to cushion our wallets. This is not the case with everyone, however. Many Americans have no cushion to fall back on, no blue and white card to show the emergency room when they have an unexpected health concern. No HMO with a convenient co-pay amount when their son or daughter develops an ear infection.

The United States (U.S.) has a multitude of options for health care coverage. People have the option for private or public coverage. One example of public coverage is Medicaid and an example of private coverage is Blue Cross and Blue Shield (HCSC, 2015). There are many differences between each health care option, the biggest difference is the price you are paying. This paper will discuss the differences between private and public health insurances as well as the cost for each.

Health care plans are policies created to aid the patients in accessing medical services in form of insurance to cover the expenses incurred during treatment and hospital care. In analyzing the options given by two major health care plans elaboration will be based on two major insurance schemes namely indemnity insurance plan and Managed Care plan. All these vary yet with a common aim of providing medical services to the patients. In order for the analysis, consideration will be based on the costs and the coverage. These two plans differ in many important ways, more so in regard to how the services are offered, the way to obtain special care and the cost of care after recovery. Despite the diversities, the two care types share many

The cost of health insurance has changed drastically over the years as it has become more expensive. Depending on personal characteristic, the cost of health insurance may vary. For instance, as individuals grow older the more expensive it becomes. In this case, health insurance is more costly because “older individuals require more health care” therefore “the cost of providing health care is rising” (Madura &Atlantic, 2012). Not only does this affect the high cost of health insurance, but the number of individuals uninsured. As stated by Madura and Atlantic (2012), “about one in every five workers is uninsured” and has increased since then because health insurance has become unaffordable. As a result, individuals tend to seek health care elsewhere as they can no longer

Health insurance in the United States is a highly politicized issue. In recent years, many strides have been made to extend health insurance coverage to all Americans with the passage of the Patient Protection and Affordable Care Act (PPACA). While the program has been vigorously debated in the public realm, arguments are often centered around political ideology rather than economic theory. This paper seeks to challenge the entire structure of the current health insurance model, since its inception in the 1950s. Through the overuse of a third-party payer model, a magnitude of problems have emerged that severely diminish the efficiency of health care allocation in the United States. This paper proposes a model that seeks to correct issues of cost, access, and market efficiency by adapting the Medicare Part D payment scheme for an all encompassing insurance model.

Health insurance is provided by Medicaid and Medicare to elderly and disabled people and poor children. People working for large companies receive health insurance through their employer. Unfortunately, people working for small businesses, those self-employed, and the working poor are left without options to purchase health insurance at an affordable cost. This creates a divide between the haves and have-nots in terms of health care. Those who have health insurance will access the care they need, but those who do not have insurance will go without. This may include primary care interventions such as immunizations and regular health screenings. Rising health care costs have a direct effect on the number of uninsured individuals and, therefore, a direct effect the number of individuals that can access care.

Each state has their own policies for Medicaid eligibility, services and payments. Medicaid plans have three eligibility groups such as categorically needy, medically needy and special groups. Children's Health Insurance Program (CHIP) is a program that offers health insurance coverage for uninsured children under Medicaid. If Medicaid does not cover a service, the patient may be billed if the following conditions have been met such as the physician informed the patient before the service was performed that the procedure was not covered by Medicaid and if the patient has signed an Advance beneficiary Notice form. However, there are also conditions where the patient cannot be billed if necessary preauthorization was not obtained or service

When you look over your health insurance choices this year, there will be an option to select high-deductible health plan on the menu. These types of healthcare plans are increasingly becoming popular amongst healthcare seekers and consumers. So, why would anyone choose an insurance policy with greater out-of-pocket costs? Plans with higher deductibles typically have lower premiums, so you'll keep more of your paycheck. A High Deductible Health Plan (HDHP) is a plan that has a higher annual deductible than a typical health insurance plan; maximum limit on the sum of the annual deductible and out-of-pocket medical expenses that an enrollee must pay for covered expenses. The out-of-pocket expenses for a High Deductible Health Plan are

Insurance is a critical part in the health care of Americans that would use it for life threatening, unaffordable and spontaneous health issues. But instead insurance has created substantial problem because it is being utilized as a payment system for everyday primary health care and not to cure

In America, we not only have the problem of the non-insured but the under insured which causes just about as much problem as the underinsured. Each group has contributed to the vast growing cost of healthcare. Over the last decade or two, the amount of uninsured has risen due to the job market in the economy and the fact that most insurances are tied to employment, which is also a problem as the unemployment rate rises. The purpose of this paper is to explore this issue.

Health care can be described as a continued maintenance and advancement of overall health through constant provisions of medical services. Health insurance is very much needed as it serves as a protection for covered services (1279, Bonewit-West). It is important to have health insurance as it covers costs and you will pay less. Among some of these health insurances there are Medicare, Tricare, Medicaid and they all protect from financial loss without health insurance medical care would be costly. For the most part, financial burdens are mainly due from health care costs especially a burden for low income families, it has become an increasing problem regarding to this in 2010 they created the Affordable Care Act which would change the health care industry and improve the lives of others.

As a “comprehensive major medical insurance policy,” the Dumonts’ coverage includes basic health insurance for hospital, surgical, and physician expense needs, as well as major medical expense coverage. The latter is very important to extend the basic coverage to protect the Dumonts from the financial effects of a catastrophic illness or accident. The policy has a very adequate lifetime cap of $3,000,000 per insured. The Dumonts should continually analyze the health plans from both employers to determine which offers the best overall plan. But, the annual coinsurance, stop-loss amount, and family

Economic factors: Chances of getting highly paid jobs are increasing as customers are now well educated. Being highly qualified, persons are getting high salaries and thus they are now more interested in getting health insurance. Hence, the premium policies should be customized by the health insurance companies such as BUPA, for the individuals who are getting high salaries and these companies should also have policies that are worthy for the low income people.

There is a spacious room for lemon in insurance field. The price for health insurance is not fixed, it varies based on the level of the need an applicant may require for the insurance. As in the case of elderly people over the age 65, it is well known that it is very difficult for them to get health insurance because of its high price as they certainly will need it more than other applicants. On the other hand, employees working in companies are offered health insurance as a part of the companies’ policies and regulations. This actually create more room for lemon in the insurance field and less chance for old people who need it more. This ended up with adverse selection by the insurance companies. (A.Akerlof, Aug