Fee For Service Plan My Health Care Coverage

Written by AcademicWritingTips.org

Wednesday, 15 September 2010 22:00 –

Fee-for-Service Plan: My Health Care Coverage

Abstract

Health care has become one of the most expensive commodities in America today. This has been aggravated by lack of proper planning in the health sector which was made worse by the current economic crisis. There has been an increased demand for medical insurance in the country. The price for the same has risen with the demand. A lot of people have ended up without medical coverage. That is why the current Obama’s administration health care reforms are drawing a lot of interest from politicians and the public at large. So much is at stake here.

Introduction

This essay is going to provide the kind of health care coverage that I have. I am going to provide the source of my coverage finances and the operation costs that I do incur. This will include my out of pocket costs and the percentage of the coverage. I will also provide the limitations of my coverage, together with the exclusions that I am subjected to.

Fee-for-Service Plan: My Health Care Coverage

My health care cover is the fee-for-service plan. In this plan, my insurer covers part of my physician and hospital bills while I cover the rest. I do pay monthly premiums to the insurance company. Since I am a business person who is not employed, I pay for my own cover. In other words, it is a personal cover plan.

Fee-for-Service Plan: My Health Care Coverage

Written by AcademicWritingTips.org

Wednesday, 15 September 2010 22:00 –

I incur certain amount of out of pocket costs (Corragh, 2009). Every year, I have to pay deductibles before my provider begins to pay (Corragh, 2009). This amounts to $340 for me alone. This is because it is a comprehensive plan cover. It covers both basic and major medical expenses. There are also other expenses because I have to pay a certain amount of money towards my health care bill. My coinsurance is 20%, while my provider pays for the other 80% (Pamela, 2008). The cap of my plan is $1,500. That is when the insurer comes to pay for my extra expenses (Wartight, 2008).

One of the major limitations of my plan is that I have to keep each and every shred of evidence when I attend hospital. This is because they are needed by the provider when I am claiming my payments. Sometimes, these receipts get misplaced and I am unable to place claims. The cover does not provide for preventable health care services, such as insurance. However, this is my option. There are also other exclusions from my cover. These are unnecessary cosmetic surgeries and dental services.

Options for a Non-Military after they Lose their Cover

An individual might find themselves without health cover one day. This may be as a result of losing a job, divorce, death etc. There are options for such an individual to continue enjoying health cover.

One such option is the COBRA. This is also referred to as Consolidated Omnibus Budget Reconciliation Act (Wartight, 2008). It gives the person who was previously enjoying group cover the option to continue enjoying the benefits that they might have lost. This is for a limited duration. This is also referred to as continuation coverage. Any person who was enjoying group coverage- such as that provided by an employer with more than fifty employees- on the day prior to the event that made him lose the job has the right to COBRA (Pamela, 2008).

Fee-for-Service Plan: My Health Care Coverage

Written by AcademicWritingTips.org

Wednesday, 15 September 2010 22:00 –

Another option for such people is provided for under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) (Corragh, 2009). Under this act, a person who has preexisting health conditions, for example a genetic condition, has the right to be provided with cover (Corragh, 2009). Hitherto, employers denied such people access to their group coverage. The only time that the employee or individual can be denied cover is when for within the last six months before enrolling for the plan, a recommendation for medical care or treatment was provided (Pamela, 2008).

References

Corragh, J. L. (2009). Health care in America. 1st ed. Long Beach: Cengen Books, 345-349.

Pamela, F. V. (2008). “Types of medical cover in America: Making the big choice.” Medical

Journal, 23(2 ), 28.

Wartight, B. S. (2008). Challenges of public health insurance plans. 3RD ED. New York: Wiley & Sons, 120-123.