• Health Plans Grid – Learning Objective 1 – Recognize differences in commercial, managed care and federal insurance plans and understand their origins and evolution.
This exercise is designed to expose you to additional information regarding Medicare and other insurance plans. In addition have you practice translating healthcare language (rules, regulations, etc.) into understandable everyday language. This will benefit you as you enter the healthcare world after school in being able to translate regulations, etc., to your staff and peers within the healthcare facility.
Your uncle, John Smith, is going to turn 65 in three months. He is self-employed and has owned his own homebuilding business for the past 40 years. He has purchased his own health insurance plan through an independent agent for over 20 years. Now that he will be eligible for Medicare, he wanted to know more about the program. He saw a commercial about Medicare on TV and it suggested to the viewers that they visit www.medicare.gov.
John went to the Medicare Web site, but there was so much information and unfamiliar terminology that he became frustrated and quit. He asked a few of his friends that were on Medicare how they chose their plans and they said they just signed up for the “simple plan” rather than choosing something else that “might not be quite right.”
• Your mother told your Uncle John that you were in a health-related major at the university, so he called you up for some advice. The following website can assist in getting information on a variety of planshttp://www.individualhealthquotes.com/listings.jsp. Prepare an Insurance grid comparing 3 commercial insurance plans and Medicare Choices (all four parts) for Uncle John. Your grid should be detailed and include the following: name of the company, monthly cost, deductible(s), co-payment(s) or co-insurance, max-out-of pocket, plan type, examples of covered services (i.e. dental, medical, mental, eyes, etc.). Make sure the grid is easy for Uncle John to understand. Also provide your uncle with a list of Web sites or other services that he may want to use to help him make his decision. At the bottom of your grid indicate which plan Uncle John should go with and explain your answer.