13 May Discusses Components of Affordable Quality Care The learner discusses components of managing affordable quality care with stakeholders.
An essential skill for health and human services professionals is understanding how the financial aspects of healthcare in the United States works. One of the most important financial aspects for both healthcare professionals and clients is insurance. Clients will interact with insurance in different ways depending on their unique situations. Healthcare professionals must understand the differences in health insurance plans, and an individuals’ access to those plans, in order to provide effective care for everyone.
This task challenges you to apply your knowledge of the different types and parts of health insurance plans. You will apply your knowledge of health insurance to three different clients which are in three different situations. You will need to understand the unique needs of each client and determine the best course of action for each client to take.
Note: All references used should be current, within the last five years.
Scenario
Client A is 29 years old and has a full-time job with a large technology company. Their company offers multiple types of employer-provided heath insurance options. The client is in good health and generally only goes to the doctor to receive an annual physical.
Client B is 48 years old and has just retired from the military. The client started working at a small manufacturing business with fewer than 50 full-time employees. The client has chronic conditions that need to be constantly monitored by health professionals.
Client C is 72 years old and has been retired for five years. The client is on a fixed income and takes multiple prescriptions for various health related issues. The client is in good health otherwise and does not need to undergo any major medical procedures in the near future.
Requirements
Your submission must represent your original work and understanding of the course material. Most performance assessment submissions are automatically scanned through the WGU similarity checker. Students are strongly encouraged to wait for the similarity report to generate after uploading their work and then review it to ensure Academic Authenticity guidelines are met before submitting the file for evaluation. See Understanding Similarity Reports for more information.
Grammarly Note:
Professional Communication will be automatically assessed through Grammarly for Education in most performance assessments before a student submits work for evaluation. Students are strongly encouraged to review the Grammarly for Education feedback prior to submitting work for evaluation, as the overall submission will not pass without this aspect passing. See Use Grammarly for Education Effectively for more information.
Microsoft Files Note:
Write your paper in Microsoft Word (.doc or .docx) unless another Microsoft product, or pdf, is specified in the task directions. Tasks may not be submitted as cloud links, such as links to Google Docs, Google Slides, OneDrive, etc. All supporting documentation, such as screenshots and proof of experience, should be collected in a pdf file and submitted separately from the main file. For more information, please see Computer System and Technology Requirements.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.
Note: All references used should be current, within the last five years.
HMO, PPO, and HDHPs
A. Client A’s employer offers a high deductible health plan (HDHP) in addition to traditional health management organization (HMO) and preferred provider organization (PPO) health plans.
1. Describe, in detail, the differences between HDHP, HMO, and PPO health plans.
2. Explain why the client in the scenario should select either an HDHP, HMO, or a PPO health plan. Use supportive evidence to fully explain your choice.
Access to Insurance Options
B. Client B needs health insurance coverage to ensure their chronic conditions are monitored and treated.
1. Explain whether Client B’s employer is required, by law, to offer medical insurance to its employees.
2. Identify two alternate health insurance options available to Client B.
a. Explain why Client B is eligible for both health insurance options.
Medicare
C. Client C is qualified to receive health insurance through Medicare. The client was approached by a health insurance company regarding the purchase of supplemental Medicare health coverage.
1. Describe, in detail, the Parts of Medicare.
2. Explain whether the client should consider purchasing supplemental health insurance for Medicare Part B and Medicare Part D.
D. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.
E. Demonstrate professional communication in the content and presentation of your submission.
File Restrictions
File name may contain only letters, numbers, spaces, and these symbols: ! – _ . * ‘ ( )
File size limit: 200 MB
File types allowed: doc, docx, rtf, xls, xlsx, ppt, pptx, odt, pdf, csv, txt, qt, mov, mpg, avi, mp3, wav, mp4, wma, flv, asf, mpeg, wmv, m4v, svg, tif, tiff, jpeg, jpg, gif, png, zip, rar, tar, 7z
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