Premium Essay

Comparison of Health Care Plans

In: Science

Submitted By bikergal
Words 271
Pages 2
Comparison of Health Care Plans There are several different health care plans available for consumers, and businesses as well as physicians. An Indemnity Plan: under this plan the insurance company which is known as the payer protects the policy holder against costs of medical services and procedures. This plan has higher costs to the consumer but also offers freedom of choice for providers. Health Maintenance Organization (HMO): Offers Limited provider network, but does cover preventative care, lower co payments, does not cover any out of network non-emergency services. Point of Service (POS): Offers in network and out of network providers, lower co-payments for in network, and higher costs of co-payments for out of network providers. Preventative care is covered. Preferred Provider Organization (PPO): Offers preferred providers you can also use out of network providers but at a higher cost. Referrals are not required for specialists, discounted fees, and need preauthorization for some procedures. Higher costs for out of network providers, preventative care coverage varies. It is my opinion that the PPO will provide more coverage for the least amount of money for the consumer but does not favor the provider; the provider is given a list of what is a covered expense and the rest they have to write off. I have a PPO for my insurance plan from my employer and I get papers from the insurance company with a detailed explanation of what is covered and what is not a covered expense.

References
Valerius, J., Bayes, N., Newby, C., & Seggern, J. (2008). Medical insurance: An integrated claims process approach (3rd ed.). Boston, MA:…...

Similar Documents

Premium Essay

Comparison of Health Care

...Health Care Policies and Regulations Compared According to Jun, Osborn, and Squires of the Commonwealth Fund, in their International Profiles of Health Care Systems (2012), the role of the government in the Norwegian health care system is that the government is fully responsible for funding and controlling the health care system (para. 1). However, if citizens want to opt out of the government-controlled health insurance and purchase private insurance, they are able to do that, as well. This is sometimes the choice of some people when waiting lists are long and they choose to go to another country for treatment (Shafrin, para. 4). I have also heard from relatives that this is sometimes the case in Canada, as well, where there is also truly “universal” health care. However, the role of the government in health care in the United States is ever evolving and ever changing. Before the Affordable Care Act was passed in 2010 the role of the government was mostly regulatory, with the exceptions of Medicare and Medicaid and certain other special programs for people who needed financial assistance to access health care. That role is ever evolving now, though. Who is covered in these two countries? In Norway, the answer is simple: Everyone. 100% of the citizens are covered (Jun, Osborn, Squires, 2012, p. 86). In the United States, it is not as clear of a picture. According to Jun, Osborn, & Squires (2012), “In 2010, 56 percent of U.S. residents received primary care......

Words: 788 - Pages: 4

Premium Essay

Health Care Ethic Plan

...Assignment: u10a1 Final Health Care Organizational Ethics Plan Project Due Date: 12/14/2012 Ethnic is based on the rules and guidelines an individual uses to govern his life, as well as the manner in which he interacts with others. A personal code of ethics is a necessary ingredient to achieve success or overcome adversity. In the absence of rules, it's difficult to hold oneself accountable for poor decision-making or bad behavior. On the other hand, organizational ethics are the principals and standards by which businesses operate. They are best demonstrated through acts of fairness, compassion, integrity, honor and responsibility. The key for business owners and executives is ensuring that all employees understand these ethics. One of the best ways to communicate organizational ethics is by training employees on company standards. While ethical behavior in medical practice has been demonstrated to be beneficial to patients and medical staffs, unethical behavior has caused significant injury to them. Performing ethical behavior in healthcare by, for example, preserving patient confidentiality, medical staffs should respect patients’ autonomy, abide by their obligation to reciprocate patients’ trust, and preserve public confidence in the staff-patient relationship in healthcare. In a long run, patients who trust their medical providers to safeguard their secrets are more likely to seek prompt care for stigmatized health conditions and to disclose sensitive......

Words: 1575 - Pages: 7

Premium Essay

The Need for a National Health Care Plan

...The Need for a National Health Care Plan in the United States Working in the health care industry for the past thirty years has permitted me to gain first hand, up close and personal knowledge of the health care system in our country. Dealing with the facets of humanity over the past ten years who have no health care coverage, or those who are aided by the state in which they live has led me to form a definite opinion’s about the necessity for a national health care plan. My thought process about the national health plan has evolved around major components of health care, affordability, accessibility, and quality of care. At a time in society when the United States is trying to bounce back from deep recession, a joblessness rate hovering around eight percent, homelessness, and so many underemployed among other things we have the tenacity to engage in an ongoing debate over the need for national healthcare national healthcare. While I understand that a great deal of my fellow citizens feel that a national health care plan is not necessary, I feel that given information that may not have been accessed by them a common ground can be reached and the validity of the need solidly established. The United States is the only remaining industrialized nation without a national health plan is it any wonder that we feel privileged enough even to argue the issue. Jobless, homeless, underemployed, members of our society would gladly step to the podium and proclaim they are unable to...

Words: 1010 - Pages: 5

Premium Essay

Comparison of Canadian and U.S. Health Care Systems

...Comparison of U.S. and Canadian Health Care Systems Quinn Sullivan California State University East Bay Abstract Health care is an essential service needed by citizens. As a result, the government plays an important role by designing an appropriate health care system for its citizens. In this paper, a comparison between the health care system in the U.S. and Canada has been made. Using various literary sources, the comparison has been done considering the four components of health care services delivery; financing, insurance, delivery, and payment. The findings indicate that the health care system in the U.S. is expensive but more efficient than the single-payer health care system in Canada. The findings have further been analyzed to ascertain its implications on the U.S. citizens, as well as the Canadians. The paper concludes that the health care system in the U.S. does not favor the middle-class earners, and thus recommends an improved system. Table of Contents Abstract 2 Table of Contents 3 1. Introduction 4 2.1 Health Care Delivery ...5 2.2 The Cost of Health Care and Administrative Overheads 6 2.3 Health Insurance 6 2.4 Funding 7 3. Analysis of Findings 8 4. Conclusion 9 5. Recommendations 10 6. References 11 1. Introduction Health care is among the basic needs of human beings. The need is not discriminative because everyone has an equal chance......

Words: 2335 - Pages: 10

Free Essay

Health Care Comparison

...Millennium Health Goals INTRODUCTION Millennium Development Goals (MDGs) placed health at the center of development. This represents the dedication by governments globally to cut hunger, reduce poverty, solve poor health, and deal with the lack of education among others. Of the eight millennium development goals, three of these goals are directly related to health. Without significant commitments and dedication from rich and developing nations, these goals will never be met. This paper will capture issues related to MDGs realization especially the realization of reduced child mortality rate in my community in Massachusetts. Achieved MDGs According to World Health Organization (WHO) (2013) several MDG targets have been achieved while others are close to reach. For instance, the fraction of individuals who live in abject poverty has been halved (World Bank 2014). The World Bank notes that the percentage of individuals who subsist on resource below $ 1.25 each day dropped from 47% in the year 1990 to 22% in the year 2010 (Gwatkin,2002 ). In addition two billion people gained access to clean drinking water. Health wise, remarkable gains have been achieved in the fight against tuberculosis and malaria. This is good news to the health sector. Between the year 2000 and 2010 the mortality rates from malaria fell considerably by more than 25%. 1.1 million deaths related to malaria were averted. Between the year 1995 and 2011 a total number of 51 million patients suffering......

Words: 1371 - Pages: 6

Premium Essay

Health Status and Health Care Services in China with Comparison to the United States

...Health Status and Health Care Services in China with comparison to the United States HSM310 Introduction to Health Services Management Course Project December 12, 2010 A health care system refers to the comprehensive organization, structures and strategies through which Medicare and health care is made available by the government to its citizens. A health care system is a product of countries politics. It is a nations system of governance that will dictate upon the most convenient model of health care to adopt. There is no universally acceptable method, and in adopting each; a government has to take into account a variety of factors, which would range from available finances vis-a-vis the total population. A comparison of two models of health care or two countries approach to the provision of health services has to encompass the core issues of financing and health care management. Health sector is the most vital industry in a country and how effectively or ineffectively it is handled goes forth to reveal the social, political and economic policies of a country towards its citizens. A biggest investment of a government has to be in its people and what better way to do it than to invest in the health sector. The purpose of this paper is to focus at the comparison of the United States health care system with that of China. It will focus at financing and management of both systems, how they compare and contrast as well as the merits and demerits of each. Despite the......

Words: 2196 - Pages: 9

Premium Essay

Action Plans Health and Social Care

...Level 3 Diplomas Health and Social Care ACTION PLAN Zoe Newell Date | Goal/target set | Action to be taken to achieve goal/target | Date to be met by | How goals targets achieved. Knowledge/skills gained | November- December 2014 | Hand in unit 22 task 2 in and put it onto Moodle. | I will do this by making sure that I get all the information and get on with the task so that I don’t fail if I miss the deadline, so therefore if I was to get a referral then I could get it in as quick as possible to be able to meet the grade | Friday 14th November | I achieved this goal that I set by making sure I used time keeping skills to be able to make sure that I handed in the work on time. I used organisational skills to be able to plan what I need to put into my work and that I met the criteria for that piece of work. | November- December 2014 | Hand In on Moodle unit 19 task 1 | I will do this by making sure that I gather the correct information to be able to complete this and understand the criteria so that I am able to do the assignment without any problems | Friday 21st November | I achieved this goal by making sure that i listened to when the teacher was going over the criteria, so that I fully understood what I had to do to achieve this unit to the best of my ability, so therefore I was able to hand in the work on time. | November- December 2014 | Hand in on Moodle task 1 of unit 29. | I will make sure that I do this by getting the right information and taking...

Words: 393 - Pages: 2

Free Essay

Health Status and Health Care Services in Republic of Korea with Comparison to the United States

...Health Status and Health Care Services in Republic of Korea with comparison to the United States HSM310 Introduction to Health Services Management Course Project Date submitted: 2/27/2015 Table of Contents Executive Summary……………………………………………3 Demographics………………………………………………….5 Mortality, Infant mortality data………………………………..7 Causes of death………………………………………………..8 Other…………………………………………………………..9 Quality of Life………………………………………………..10 Analysis of trends…………………………………………….13 Conclusion……………………………………………………14 References: ………………………………………………….16 Executive Summary This report will provide an overview of the policies and the practices that supports the quality of care in the Korean healthcare. As of 2014, Republic of Korea has a population of 49.3 million, which is a slight decrease of an estimate of 50 million in 2013. With the rapid economic development and less than thirty years, the Korean Healthcare system has gone from inadequate medical infrastructure and a fragmented health financing system to an established health care system characterized by universal coverage and substantial acute medical facilities. The Korean health system has not slowed down after it had achieved universal coverage in 1989. In 2000, the national government has continued to adjust the health care system structure and delivery mechanism in response to the social and political changes, culminating a single-payer system. The......

Words: 4287 - Pages: 18

Premium Essay

An Overview of the Canadian Health Care System with a Comparison to the United States Heath Care System Canadian and American Health Care

...Running head: An Overview of the Canadian Health Care System with a Comparison to the United States Heath Care System Canadian And American Health Care Parween Nooruddin Stratford University Abstract The reason for this exploration paper is to look at healthcare systems in two very progressed industrialized nations: The United States of America and Canada. The principal piece of the exploration paper will concentrate on the portrayal of healthcare system in the aforementioned nations while the second part will dissect, assess and measure up the two systems in regards to value and proficiency. Canadian And American Health Care In this research paper I will be comparing Canadian and American HealthCare systems. In this paper I will provide a description of health care system for each country. I will also analyze, evaluate and compare the two systems regarding equity and efficiency. We begin by giving a general portrayal and examination of the structure of Healthcare systems in Canada and the United States. CANADA’S HEALTH CARE – OVERVIEW Canada's health care system is a group of socialized health insurance plans that provides coverage to all Canadian citizens. It is openly subsidized and controlled on a common or regional premise, inside rules set by the national government. Under the health care system , singular natives are given preventive care and medical treatment from essential consideration doctors and in addition access to clinics, dental surgery and......

Words: 1310 - Pages: 6

Free Essay

Health Status and Health Care Services in Australia with Comparison to the Unitstates

...Guidelines: Keys to Course Project Success In this assignment, you will write a term paper comparing the U.S. health care system to a country of your choice. Deliverables for your paper will be due in Modules 1, 3, 5, and 7. APA formatting is required. When submitting each of your assignments, please use the following file name format: HCA302_AssignmentName_FirstInitialLastName.docx. So if your name is John Smith and you are submitting Writing Assignment 1, the name of the file will be HCA302_WritingAssignment1_JSmith.docx. Points will be deducted for any late submissions. Module 1 (Writing Assignment 1): Term Paper Topic/Title: Choose a Country (Graded) Students may choose any country to submit for approval in Module 1. This is the beginning of the Term Paper project, and you may use the template located in the Doc Sharing. This assignment requires a cover page with the title indicating the country you wish to compare to the U.S. health care system. Before you submit your country, make sure you are able to find at least three primary sources with enough information to write a quality paper that meets the length requirements and for comparing key indicators of the U.S. health care system to your choice country. Primary sources are the WHO, NIH, CDC, OECD, the county's national health care website, government websites, and so on. NOTE: There is a comprehensive database of health care statistics for 30 different countries, including the U.S., from the Organization for Economic......

Words: 1058 - Pages: 5

Premium Essay

Health Status and Health Care Services in Germany with Comparison to the United States

...Name: Zlatan Karamujic Phone: 208-891-8982 Email: bjzforever@gmail.com Health Status and Health Care services in Germany with comparison to the United States HSM310 Course Project Date submitted: Table of contents Executive summary Population and Health Status Availability of Health Services Expenditures Macroenvironmental Influences on the Health Care System Summary Comments References Introduction One of the world’s strongest economies belongs to Germany. With a size of population of 82.56 million, Germany is on rank 16 in the world, but interesting fact about the country is that, since 2005, the population is decreasing every year. According to www.worldometer.info, back in 2005 number of people who lived in Germany was 83,835,978 and shows a decrease of 0.11% for the past 10 years, even though total fertility rate went from 1.35 to 1.42. Fertility rate is calculated as the average number of children an average woman will have during her reproductive period. Additionally, statistic from the same sources shows that the Germany’s population is slowly aging. While median age in 2000 was 39.9 years, in 2015 is already 46.3 years. If the population keeps aging at the same rate in the next 2 decades, Germany’s health system will face a huge challenge in an effort to keep their population......

Words: 1709 - Pages: 7

Premium Essay

Health Care Plan Analysis

...The Health Care Plan under Kansas Department of Health and Environment provide with four different insurance. There are two major categories. Plan A and Plan C. Plan C is Health Savings Account (HSA) or Health Reimbursement Account (HRA) with high deductibles. The HealthCare Plan that the employee will purchase for it will be of Plan A BCBS with the monthly cost of $70.02 which include the cost of dental and basic vision. This plan is better than others because it possess normal risk and has an average deductible and coinsurance. As an employee I will be making $42000 per year and spending around $840.24 as a health expense. Being in my late 20’s I expect to have more visits to hospital than in the past years of my life. Under the influence of our assumption we predict our consumer behavior of moderate visits to physicians and are willing to spend less on health insurance. As a mother of two children and a husband, I would prefer to enroll for Plan A under Non Network Provider with BCBS because it gives maximum coverage to the family at a reasonable price. The Plan C has high deductible which will be costly for the family due to which we decide to purchase Plan A with BCBS because one of our child chronic problem. We assume that our child needs extensive care and we might be making more trips to the hospital than those of an average family. This assumption states that the risk is higher of spending more on hospital, so to mitigate the risk we will buy an expensive insurance...

Words: 325 - Pages: 2

Premium Essay

Health Status and Health Care Services in the United Kingdom with Comparison to the United States

...Name: Elise Perkins Phone: 773-241-**** E-mail: *********@rocketmail.com Health Status and Health Care Services in the United Kingdom with comparison to the United States HSM310 Introduction to Health Services Management Course Project Date submitted: 11/29/2015 Table of Contents Executive Summary………………………………………………………………………………………………. 3 Population and Health Status………………………………………………………………………………………………………………... 3 Demographic characteristics of population Mortality, Infant mortality data, causes of death Other data of health status Related information (such as on quality if life); analysis Availability of Health Services………………………………………………………………………………….. 4 Basic organization/general description of services institutions, providers of care Issues related to access Utilization of services (data, if available) Other related information/analysis Expenditures………………………………………………………………………………………………………. 5 How are health services paid for; any roles for the government here Data on total expenditures Other related information/analysis Macroenvironmental influences on the health care system……………………………………………… 6 Political Socioeconomic Cultural Technological/Other relevant influences Summary comments…………………………………………………………………………………………….. 7 Problems Opportunities Other related comments regarding this country's health care services Comparison to the United States: what works better, what is not working as well Concluding comments:......

Words: 2264 - Pages: 10

Premium Essay

Comparison of the Healing of America and Delivering Health Care in America

...Comparison of The Healing of America and Delivering Health Care in America Shahab Vaziri James Madison University In chapters nine through the appendix of The Healing of America by T.R. Reid, it is illustrated about the advanced endeavors, which Reid goes on, to find out about the ins and outs of foreign health care policies and how the United States can borrow ideas, even if the country is a suffering third-world country. Chapter nine is entitled out of pocked because it has the theme of people in foreign countries attempting to buy insurance in any manner that involves cash without any entitlement or responsibility after the fact. Many poor foreign nations in Africa and South Asia are heavily reliant on the out-of-pocket model that deals with paying for care with currency, and if that is not available then “potatoes or pottery or dairy products or babysitting services or whatever he can scratch up” will work (Reid, 2010 A). Although America does have insurance plans for people to buy into, the extremely poor people use the out-of-pocket model and are more likely to get sick and stay sick without insurance. The same holds true for countries with out-of-pocket polices, according to Shi and Singh; they have the “least resources and the greatest health burden” (Shi and Singh, 2015 A). This illustrates that Reid and Shi and Singh agree upon the fact that being poor and sick in a developing country is more detrimental than being sick in America without health......

Words: 1650 - Pages: 7

Premium Essay

Health Care Organizational Ethics Plan

... Health Care Organizational Ethics Plan Amanda Paschal Ethics and Decision Making in Health Care June 6, 2016 Contents Introduction 3 Theoretical aspects of organizational policy 3 Ethical Decisions and Judgment 5 Informed Consent 6 Regulatory issues and policies of informed consent are addressed. 7 Finance issues 8 Patient care issues 9 Human resources issues 9 Legal issues 10 Regulatory issues 11 Protocols to address patient safety issues 12 Protocols to address patient access issues 14 Ethical responsibility for transparency in health care 15 End of life and quality of life issues 17 Alternatives in decision-making for health care administrators to resolve ethical dilemmas within the organization 19 Conclusion 20 References 22 Introduction Healthcare is the treatment of health related issues such as prevention, diagnosis, treatment and prevention. Healthcare is provided by Doctors, nurses and other licensed healthcare professionals. Who work at an office or a facility which would be a healthcare organization. By definition “An organization, by its most basic definition, is an assembly of people working together to achieve common objectives through a division of labor, people form organizations because individuals have limited abilities. An organization provides a means of using individual strengths within a group to achieve more than can be accomplished by the aggregate efforts of group members working individually. Business organizations (in......

Words: 8018 - Pages: 33

Детский | Tech Learning November 2011 Reup | Universal soldier Day of recko.. DVDRIP