Insurance Plans Case Study

Summary Description: Learn if your homeowner's insurance helps or covers an off-property claim. In addition, discover how an attorney will assist you in your time of need.

Geico Insurance, better known as Government Employees Insurance Company, is an insurance company which is located in Chevy Chase, Maryland. The company provides insurance coverage not only for automobile, but also for motorcycles, ATV’s, mobile homes, boats, RV’s, home renters, condo and life insurance. Geico Insurance was founded by the husband wife team of Lillian and Leo Goodwin Sr. in 1936. The concept of the organization was to provide reliable automobile insurance to federal government employees and their families. Leo Goodwin got his start while working as a civilian insurer for the United Services Automobile Association (USAA), which specialized in providing reliable insurance to military personnel. After going as far as he could in his career at USAA, Leo decide to take the experience he had acquired and opened his own insurance company. That following year, based on the assumption that federal employees as a group would constitute a less risky and more financially stable pool of insureds, he relocated his company to Washington DC, since it had the highest concentration of federal employees. It was in 1964 that that David Lloyd Kreeger became the company president, and help to steer it into a major insurance enterprise. In 1974, and under Kreeger’s leadership, Geico went public and began ensuring the general public. In 1948 he formed a group of investors and bought into Geico before it became public. By 1974 and under her leadership, Geico began insuring

Most state Medicaid programs provide reimbursement for health care-related transportation costs, different states have various standards by which their Medicaid programs will reimburse for telehealth expenses. A number of states with telehealth programs entered into a collaboration with state Medicaid programs to develop telehealth reimbursement policies, often with the anticipation that telehealth could offer transportation cost savings. There is no single widely-accepted standard for private payers. Some insurance companies value the benefits of telehealth and will reimburse a wide variety of services. Others have yet to develop comprehensive reimbursement policies, and so payment for telehealth may require prior approval.

Effective medication helps with the rising cost of health care. When medication is working, the patient’s visits to the hospital and doctor’s office will decrease. The cost of new medication is exceeding the buyer’s ability to pay for it, and pharmaceutical companies begin to lose money when the drug loses its patent. However, generic drugs become available for the medication, and patients can afford to purchase it to treat their disease or condition. National discussions with providers, payers, and health policy makers have seriously considered various solutions for mitigating drug cost, with the ultimate goal of allowing patients to access appropriate and necessary treatments (Li & Shane, 2017). The government no longer has to decide who gets the medication, and certain therapies because of cost. Insurance companies will now cover the drug in its generic form. On the other hand, the pharmaceutical companies can no longer profit from and generic drug, and are forced to make new and improved drugs for profit. The patient will benefit by getting the medication that is needed to have a better quality of

When senior executive at Best Employer Company (Heather) was vacationing in the USA, she expected to return injury free. As Human Resource Manager, it is my responsibility to familiarize myself with the company benefits and inform Heather of the details. I feel the information below is well researched and offer good support about why I selected each benefit.

Within the formulary the drugs are divided into tiers. Co-payments are based on the tier that the drug is in and range from tier 1, the least expensive drugs, to tier 3 the most expensive drugs. Each insurance company plan is allowed to add or drop drugs from their formularies and move drugs from one tier level to another throughout the year. An insurance company can also drop a drug in the middle of the year, but must continue covering the drug for anyone taking it until the next reenrollment period, at which time a new plan will have to be chosen that covers that drug (Gustaitis, 2007). Although not used a lot there is a fourth tier that is for specialty drugs only. Some plans use a flat-rate or assign a percentage co-pay to the higher tier drugs (Gustaitis, 2007). Other characteristics of the insurance company plans that they have control over are requiring prior authorization for a drug, using step therapy, limiting the quantity, participating at certain pharmacies, and having preferred pharmacies (Gustaitis, 2007).

: Insurance companies have the list of formularies that they agree to help cover but it is a tricky and a hassle to deal with. The patient must get a prescription of a similar drug first to make sure it works on them or even getting the doctor to prove that you need it. This is just to get coverage for an expensive drug. This can take weeks to do. It is a complicated list designed to give the patient the right drug for their conditions and that drug may not even be the first one that the doctor prescribes for them. It is a process to find out which one is right. When you fill a prescription of an approved drug of the formulary then you do not have to pay full price. Patients will have a copay through four different tiers. The first tier the patient pays a $20 copay on generic medications or a low cost medication, on the second tier, the patient pays a $40 copay for low cost brand names or a higher priced generic name drug. The third tier, the patient pays a $60 copay for brand name medication in which there is no generic, and the last and final tier which is number 4, the patient pays a $100 for the highest cost medication and/ or specialty drugs such as ones for chemotherapy. Some health care plan require the patient to pay full price for medication until they meet the deductible and then they can pay copays. Some formularies have coinsurance instead. The patient in these pays a percentage of

Obamacare is not universal healthcare. The United States actually has an extension of health insurance coverage that is the program we all call Obamacare. This extension of health insurance coverage is expected to cover an additional 26 million people by 2024. In understanding this concept, what we need to understand fully is that the United States does not have universal coverage. Obamacare does not eliminate uninsurance in America; instead, it cuts the number of people lacking coverage about in half. Even after Obamacare is fully implemented, budget forecasters still expect that 31 million Americans will lack insurance coverage which is a bigger group than the people buying coverage on the exchanges (Vox.com).

Would you please contact patient and verify 2ndry Ins. information . I just receive a denial from her 2ndry insurance that we have on system saying that the patient is coverage under another payer. We receive payment already from Medicare and I bill out on paper and attach the Medicare EOB to the claim to her 2ndry insurance on 3.1.2017 and now the payer denied the claim. I transfer the visits to self paid but if the patient provide to us her 2ndry Insurance information we can bill the claim back to the payer. Please advise.

Are prescription drugs overprescribed? Are patients being prescribed the correct medications that they actually need? Are generic drugs doing the same for the human body that marked up brand name medications are? These are some of the public’s biggest questions that can be easily answered by research. Everyone is affected by medication and healthcare in general today. Many real life scenarios are offered throughout this writing to support the argument. The following thesis statement is a worldwide problem. Unfortunately, the United States has the largest problem with inflation of drug cost and over-prescription of medications. Many people are to blame: drug manufacturers, insurers, prescribers, educators, and many others. A change is needed.

In recent years, rising drug prices in the United States raises have impacted patient access to medications, including potentially life-saving medications. It has become extremely difficult for patient to receive medications. The blame is being shifted from insurers, drug manufactures, and the government. Insurers are protesting that specialty drug costs are forcing them to jack up premiums. State Medicaid directors say spiking pharmacy costs are coercing them to make unfortunate coverage trade-offs. From the consumer’s perspective, there is a constant cycle of blame and no actual progress. Fortunately, there are possible solutions the US healthcare can implement to help alleviate rising drug costs; for example, an expedited Abbreviated

Making the decision to offer healthcare insurance to your employees, is not a light decision to make. As an employer, you have to take into account several different factors when choosing the right kind of corporate insurance plans. But if you do decide to get healthcare insurance for your employees, then congratulations, you have just made a very responsible decision, plus you will make your employees very happy. A healthcare insurance plan is also a good investment, since it may keep your employees more healthy. When you are choosing a healthcare insurance plan, you have to consider the following factors.

More than 30 million people who were previously uninsured now have the chance to be covered and more patients means more healthcare jobs for medical professionals looking for work. Now there are over half of uninsured people that can get low cost or free health insurance, some Americans can be assisted on out-of-pocket costs using their state’s Health Insurance Marketplace. There are now more private coverage options than ever, and all major medical coverage options must provide minimum essential coverage. ObamaCare’s many protections ensure that you can’t be dropped from coverage when you get sick or make an honest mistake on your application. You also can’t be denied coverage or treatment for being sick. Also, you can’t be charged more for

Medicare Advantage Plan (Plan C) is a type of Medicare health plan offered by private companies. It contracts with Medicare to provide all Part A and Part B benefits. This plan covers most Medicare services for a senior. (Source: medicare.gov)