First Assignment Attached Files: BASICS OF HEALTH INSURANCE.docx (18.185 KB) MAN

Question

First Assignment Attached Files: BASICS OF HEALTH INSURANCE.docx (18.185 KB) MANAGED CARE 2.doc (36.5 KB) 1. Briefly describe the most important facts of the Affordable Care Act related to Health Benefit Plans 2. Tell me your concept of health care savings accounts 3. Describe briefly the concept of Medicare Part A and Medicare Part B 4. Describe the characteristics of CMS known as the Health care financing administration 5. Describe the relevant aspects of Medicaid as health benefit or health coverage 6. Tell me briefly the relevant aspects of Tricare/champv 7. Describe the following elements and importance: a. Precertification of hospital admissions b. Approval referrals. c. Network d. Assignn benefitis 8. Briefly explain the characteristics of Health Maintenance Organizations or HMO and importance on managed care program 9. Tell me the concept of Preferred Provider Organizations 10. Relate the important facts of Patient-Centered Medical Homes.

Explanation / Answer

1, The Affordable care Act helps for women's health with out insurance and those who are under insured or face discrimination in the market place.. The private insurance market remain in place under the ACA and most of the Americans eligible for coverage..it is a best choice of insurance plans..ACA holds insurance companies accountable and end the discriminary practices to cover the health care costs incurred by those with out insurance.. Health reform law eliminates discriminatory insurance practices for pre-existing condition..This new law makes insurance more easy by new exchange and provides tax credits to make insurance more affordable..ACA makes health care coverage more secure..It helps members of Congress get their health care coverage same like other Americans.. And the new laws provides benefits like annual wellness visit, preventive care with out copays and the gradual closing of the Medicare prescription drug benefit..ACA helps for coverage more affordable to small business by tax credits it helps them purchase insurance allow them to get lower rates as big corporations..ACA was enacted before,so millions of people lost coverage due to increase the insurance cost.. Health law reduced the cost of insurance saving their cost..The ACA makes every premium dollar spent by requiring insurers spend at least 80% of premium on patients..

2, Health savings account is a tax-deductible savings account for qualified high-deductible health plan (HDHP).. we can withdraw our HSA funds with no taxes or penalties to pay for qualified medical expenses..

3, Medicare part A covers following services:

- inpatient hospital care:

After admission Medicare part A cover upto 90 days benefit period in a general hospital and 60 lifetime reserve days and 190 lifetime days Medicare certified psychiatric hospital..

- skilled nursing facility (SNF) care:

Medicare covers room charge, range of services, medication,tube feeding and wound care..if you qualify for coverage it covers 100days of benefit period..

- home health care:

Medicare covers service in home if you want home care and skilled care..it covers 100 days of daily care with unlimited amount of intermittent care..

- hospice care:

It provides care once the patient condition confirm by the Physician represent that patient is terminally ill.. this coverage will help patient as long as they need care..

Medicare part B is a medical insurance covers medical services and supplies medically needed for health condition.. this service include outpatient care,preventive services, ambulance service plans durable medical equipment..it covers physical therapy, preventive visit,flu and hepatitis B shots, cardiovascular screening.. people those who are eligible for Medicare part A eligible for Medicare part B enrolling and paying a monthly premiums..If you are not eligible for Medicare part A for getting eligibility to Medicare part B you must be 65 years or older,must be U.S citizen..

4, The centers for Medicare and Medicaid services (CMS) is part of the U.S department of health and human services..CMS will look after federal health care program, incentive program for EHR..

  

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