Health care plans
You are a new graduate, and you just started work at a medium-sized hospital with an attached clinic. You have been asked to review the five different types of health care insurance plans and the characteristics of each to make sure the central business office (CBO) is up-to-date on all the rules and regulations. It is important to be familiar with these plans and the characteristics of each because they play a vital role in the reimbursement process for your health care organization. Discuss the following:
- List the five different types of health care plans and 2–3 characteristics of each.
- Explain why it is important to understand the differences in these plans.
- What are some of the similarities between the plans?
- What are some of the differences?
- Would an out-of-date policy from one of these plans affect the facilities reimbursement? If so, how?
Note: It is important to remember that health insurance is a contract between a policyholder (the insured) and a third-party payer or government health program that reimburses the policyholder for all or a portion of the cost of treatment or preventive care given by a health care professional or physician.
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The major healthcare plans are;
Catastrophic health insurance plan
Under this plan, individuals are covered in the event they experience serious illness or an accident. This insurance plan does cover health care services such as shots or drug prescription. The major characteristic of this health care plan is that it is high deductible. This is because it provides safety to insured individuals. The other characteristic is that it is available in the market to people below the age of 30 or individuals exempted from paying healthcare fees because they receive hardship allowance (Wolper, 2004).
High deductible health plan
This insurance plan usually has higher deductibles and lower………………..
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