Plan Recommendations Discussion Replies Assignment
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages to Order 5-10 Pages Description/Paper Instructions
Plan Recommendations Discussion Replies Assignment
Unit 2 Discussion – Plan Recommendations
99 unread replies.99 replies.
Plan Recommendations
Patients will often look to healthcare providers for information healthcare plans, coverage, and options. Understanding and being able to communicate this information to patients is an important part of working in the healthcare field. Practice making recommendations in this discussion.
There are three patients: Joe, Scott, and Steve. Joe is 42, relatively healthy, and was a member of the Army for 20 years. Scott is 67 and suffers from chronic bronchitis. Steve is 25 and is battling stage 2 cancer.
These three patients can choose from one of the following plans (either from Group A or Group B):
Group A Plans: Medicare, TRICARE
Group B Plans: HMO, PPO, and POS
Joe, Scott, and Steve would like recommendations on the best plan options.
Instructions:
Select one patient (Joe, Scott, or Steve) and provide a Group A Plan and a Group B Plan that would be the best options for the provided parameters. Include the following:
A comparison of the two plans
Rationale for selection of the plans
A selection (between the two plans) of what the patient should ultimately choose and why.
Refer to the background material in this unit for assistance and complete outside research as appropriate. Be sure to cite your resources.
Please be sure to validate your opinions and ideas with citations and references in APA format.
Estimated time to complete initial post: 2 hours
This topic is valued at 40 points. Please review post and response expectations. Please review the rubric to ensure that your response meets criteria.
Cite any resources/references in APA formatting that were used in the discussion – if applicable.
Peer Responses/Participation
Due Sunday
Continue the conversation regarding patient plan options with classmates through response posts in the discussion board.
Instructions: In your responses to your classmates, include the following:
First response: Select a post where a classmate chose the same patient.
Do you agree with the plan options for the patient? Why or why not?
Do you agree with the final choice? Why or why not?
Additional responses: Select posts where classmates chose different patients.
Do you agree with the plan options for the patient? Why or why not?
Do you agree with the final choice? Why or why not?
Please be sure to validate your opinions and ideas with citations and references in APA format. Estimated time to complete: 1.25 hours x 3 (3.75 hours total)
REPLY TO
Joe is 42 and served for twenty years in the US army and he is relatively healthy. Since Joe served for twenty years that means he will get retirement monthly from the Veterans affairs office for the rest of his life this also includes healthcare he will be able for Tricare select that means his copay is 20% and it covers 80% . Than there is also Tricare for life that is Medicare part A and B combined and Tricare where the patient only pays for plan B and the monthly premium will be based on the individuals income and Your provider files your claims with Medicare.
Collapse SubdiscussionLucille Isom
MondayMay 11 at 5:37pm
Hello Class,
Steve is 25 and battling stage II cancer and as this type cancer refers to large tumors that grow deep into nearby tissue and determined by many cancer type such as breast cancer, lung cancer or prostate cancer. A person diagnosed with stage II cancer needs to have a plan that is supported by the cost of therapies and /or surgeries (“What is stage 2 cancer & how is stage 2 cancer treated?,” n.d.). If Group A Plans are selected such as Medicare, or Tricare, it’s best to also have a medicare supplement as most cancer treatment is covered. Depending on the plan (“Cancer treatment: Medicare supplement plan coverage,” 2019)you choose, your plan may pay for co-insurance amounts, deductibles and excess charges.
If Group B Plans (“Hmo, PPO, EPO, POS – How do they differ and which should you choose?,” 2013) such as HMO, PPO , and POS were chosen then certain requirements have to be met such as physician, referral, and prior authorization requirements. These plans also have provider that includes doctor’s, hospitals, and lab that in many cases contacted with a health plan.
Steve, a person with stage II cancer should ultimately choose a plan that fits his / their needs as well as an affordable plan. Group B plans should be chosen for this type of condition because they offer differentiated services, lower premium payments or cost -sharing plans with fewer restrictions. Although Health Care reform has opened many doors for individual left uninsured, pre-existing conditions are a risk and according to (Brandes, n.d.) options are now available. Things to consider are out of pocket maximum, premiums, and prescription cost.
References
What is stage 2 cancer & how is stage 2 cancer treated? (n.d.). Retrieved from https://www.cancercenter.com/stage-two-cancer (Links to an external site.)
Cancer treatment: Medicare supplement plan coverage. (2019, October 28). Retrieved from https://www.ehealthmedicare.com/medicare-supplement-articles/can-a-medicare-supplement-plan-help-pay-for-cancer-treatment/ (Links to an external site.)
Hmo, PPO, EPO, POS – How do they differ and which should you choose? (2013, September 21). Retrieved May 11, 2020, from https://www.verywellhealth.com/hmo-ppo-epo-pos-whats-the-difference-1738615 (Links to an external site.)
Brandes, A. (n.d.). I have cancer | Which health plan is best? Retrieved from https://blog.bernardbenefits.com/bid/195551/i-have…
“Medicare pays its portion and sends the claim to the Tricare For Life claims processor.
Tricare For Life then pays the provider directly for Tricare-covered services.” (Military.com,n.d) now compared to an HMO, PPO and POS plans where theirs is a higher co- payments and deductables where part of his retirement from the military he is eligible Tricare is part of the retirement plan provided to him.
Tricare.mil plans healthplans retrieved from https://www.tricare.mil/Plans/HealthPlans/TS (Links to an external site.)
Military.com(n.d)benefits Tricare for life retrieved from https://www.google.com/amp/s/www.military.com/bene…
Group A plan
Underage 65 with specific disabilities or end-stage diseases. (If you have Medicare due to a disability, you can continue your TRICARE Prime enrollment [if you qualify]. If you do, your Prime enrollment fees are waived. You can also get a refund for any Prime enrollment fees that you paid. Check with your regional contractor for details.)
But Group B plan
the difference between HMO, PPO, and POS
It’s open enrollment season at your job, and your employer offers you a choice between the most significant plan types: HMO, PPO, and PSO. It depends on your financial and medical situation – and preferences.
For instance, would you rather the flexibility of not having to go to a smaller group of providers in an HMO and don’t mind paying more upfront for your care via premiums? Then, a PPO might be right for you.
Do you not care about having an extensive network of providers, but paying as little as possible for health care is more important to you? Then, an HMO could be perfect.
Choosing the right health insurance plan is a personal decision and depends on your situation and preferences. Whether you ultimately choose a PPO, HMO, or POS, take costs, flexibility, coverage, and convenience into account when making that decisionReference: to an external site.)
Hmo, PPO, EPO, POS – How do they differ, and which should you choose? (2013, September 21). Retrieved May 11, 2020, from https://www.verywellhealth.com/hmo-ppo-epo-pos-whats-the-difference-1738615 (Links to an external site.)Cancer treatment: Medicare supplement plan coverage. (2019, October 28). Retrieved from https://www.ehealthmedicare.com/medicare-supplement-articles/can-a-medicare-supplement-plan-help-pay-for-cancer-treatment/ (Links to an external site.) ReplyReply to Comment
Collapse SubdiscussionTedrick JacksonTedrick Jackson
YesterdayMay 12 at 1:55pmManage Discussion Entry
Steve 20 years with stage 2 cancerGroup A planUnder age 65 with certain disabilities or end stage diseases. (If you have Medicare due to a disability, you can continue your TRICARE Prime enrollment [if you qualify]. If you do, your Prime enrollment fees are waived. You can also get a refund for any Prime enrollment fees that you paid. Check with your regional contractor for details.)But Group B planthe difference between HMO, PPO, and POSIt’s open enrollment season at your job and your employer offers you a choice between the biggest plan types: HMO, PPO and PSO.It really depends on your financial and medical situation – and preferences. For instance, would you rather the flexibility of not having to go to a smaller group of providers in an HMO and don’t mind paying more upfront for your care via premiums? Then, a PPO might be right for you.Do you not care about having a large network of providers, but paying as little as possible for health care is more important to you? Then, an HMO could be perfect. Choosing the right health insurance plan is a personal decision and depends on your situation and preferences. Whether you ultimately choose a PPO, HMO,or POS , take costs, flexibility, coverage and convenience into account when making that decisionMOAA’s TRICARE under 65 page. (2019, September 19). MOAA – MOAA Home Page. https://www.moaa.org/content/benefits-and-discounts/health/tricare-under-65/tricare-under-65-landing-page/ (Links to an external site.) ReplyReply to Comment
Collapse SubdiscussionAndrea WellsAndrea Wells
YesterdayMay 12 at 3:07pmManage Discussion Entry
Hello Everyone, Steve 25 years with stage 2 cancer
Group A plan
Underage 65 with certain disabilities or end-stage diseases. (If you have Medicare due to a disability, you can continue your TRICARE Prime enrollment [if you qualify]. If you do, your Prime enrollment fees are waived. You can also get a refund for any Prime enrollment fees that you paid. Check with your regional contractor for details.)
But Group B plan
The Difference Between HMO, PPO, And POS Assignment
It’s open enrollment season at your job and your employer offers you a choice between the biggest plan types: HMO, PPO, and PSO. It depends on your financial and medical situation – and preferences.
For instance, would you rather the flexibility of not having to go to a smaller group of providers in an HMO and don’t mind paying more upfront for your care via premiums? Then, a PPO might be right for you.
Do you not care about having a large network of providers, but paying as little as possible for health care is more important to you? Then, an HMO could be perfect.
Choosing the right health insurance plan is a personal decision and depends on your situation and preferences. Whether you ultimately choose a PPO, HMO, or POS, take costs, flexibility, coverage, and convenience into account when making that decision. ReplyReply to Comment
RUBRIC
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. GET THIS PROJECT NOW BY CLICKING ON THIS LINK TO PLACE THE ORDER
CLICK ON THE LINK HERE: https://www.perfectacademic.com/orders/ordernow
Also, you can place the order at www.collegepaper.us/orders/ordernow / www.phdwriters.us/orders/ordernow
Do You Have Any Other Essay/Assignment/Class Project/Homework Related to this? Click Here Now [CLICK ME]and Have It Done by Our PhD Qualified Writers!!