HSM420 Course Discussions Week 1

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HSM420 Course Discussions Week 1
Managed care has allowed many individuals to receive care that they were unable to receive prior…

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HSM420 Course Discussions Week 1

HSM420 Course Discussions Week 1

All Students Posts – 60 Pages

Indemnity Versus Managed Care – 33 Pages

Early models of health insurance in America were what we call “indemnity plans” or traditional health insurance plans. What is meant by an indemnity plan, and how is managed care different from traditional indemnity insurance?

Why was managed care created? Was indemnity not suitable?  With the Affordable Care Act, are we still concerned with managed care backlash?  Managed care has allowed many individuals to receive care that they were unable to receive prior to its existence.  Having said that, it is also noted that managed care has changed throughout the years.  Services have been streamlined, coverage has been minimized.  Many of the affordable managed care plans do not offer the needed coverage.  How has the Affordable Care Act changed this?  What are the effects of healthcare reform on indemnity insurance? How has managed care changed from its time of inception?  How has the Affordable Care Act changed indemnity plans?  Will they continue to be an option?  What are some of the financial incentives offered by managed care plans?  What incentives offered for indemnity plans?  What can be done to stop the rising costs?

Yes, you still need to select the plan that is right for you.  While the Affordable Care Act has opened the door for families to obtain insurance there are still differences in the types of plans offered.  If you have a pre-existing condition you would not have to worry about whether or not you would be insurable but you would have to consider what each plan offered.  With a pre-existing condition you don’t want to choose a plan that is the most basic because it may not have the coverage you need to cover your condition or treatments.

It is very important to educate yourself on what each plan offers because they are all different.  Certain testing or procedures may not be covered in one tier but may be covered in another tier.  You also need to take into consideration the cost of the plan.  Within the Market Place the policies vary in price.  One policy may have a lower out of pocket cost but has higher premiums and another is the opposite having a higher out of pocket cost and lower premiums.  We must always be aware of what we are purchasing when choosing a health plan even with the Affordable Care Act in place to ensure we select the plan that is the best fit…

Managed Care Impacts – 27 Pages

There can be no doubt that managed care has impacted everyone involved with healthcare delivery in America. What do you see as some of the most significant impacts of managed care for patients?

When choosing employer sponsored healthcare plans, there are limits to our choices.  Do employees have as many provider options as managed care intended?  Many employees had their hours reduced so that the employer would not have to offer health insurance as mandated by law.  What can be done to address this issue?  With managed care, is our access limited?  Should we not have access to quality care?  If we have long waiting periods to see a physician are managed care’s objectives being met?  Do you think that these provisions have assisted in controlling healthcare costs?  Do you think that they are too strict?  How has healthcare reform affected your managed care choices?  With managed care, is our access limited?  Should we not have access to quality care?  If we have long waiting periods to see a physician are managed care’s objectives being met?

This has definitely affected many people. Another thing I would like to add is high prescription costs. My father-in-law has Medicare insurance and another supplemental insurance, but some of the prescriptions are NOT covered by his managed care plans, or are extremely expensive. He still works to earn an income to be able to support these types of expenses. I sometimes feel like when you retire, you never really retire because there will always be expenses that come up and you can’t live off of social security payments and earned savings…

HSM420 Course Discussions Week 1