The OV score is at 56%

timer Asked: Aug 29th, 2014

Question Description

Private and Public Insurance.docx 

Running head: PRIVATE AND PUBLIC INSURANCE Private and Public Insurance Carolyn Roberts Colorado Technical University Healthcare Management Capstone HSS491-1403B-01 Professor Paula Hagstrom August 27, 2014 1 PRIVATE AND PUBLIC INSURANCE 2 Private and Public Insurance Private Health insurance offers coverage for medicine, appointments with the doctor or emergency room, hospital halts and other medicinal expenses. Policies vary in what they cover, the extent of the deductible and co-payment, restrictions of coverage and the choices for treatment available to the policyholder. Health insurance can be openly purchased by any person, or it may be delivered through a firm. There are a number of companies which provide private health insurance, which includes Blue Cross, United Healthcare, or Aetna. The insurance security delivered by a nongovernmental sources, are called private insurance companies. ("InvestorWord," 2014) Public health insurance offers services and medicinal care for certain low-income persons and families who meet specific requirements. Medicaid is United States' public health insurance program managed by each state and is offered for qualified men, women and kids. Each state creates its own suitability and service procedures. Medicaid covers certain protective services and essential remedial care and ways due to illness or injury. Difference between public and private health insurance 1. Public health insurance is offered by government, whereas private health insurance is offered by private companies. 2. Public health insurance is subsidized by the government funds and private health insurance funded for in part or completely by the individuals being covered. 3. Public health insurance cannot be offered through an employer but private health insurance is offered through the employer or it also be purchased by the individuals PRIVATE AND PUBLIC INSURANCE 3 4. Private health insurance provides the safety of a ‘locked in date’, which means that their operation will not be on hold due to other patient’s needs. Such facility is not in public health insurance. 5. Waiting period is more in public health insurance, but lesser in private health insurance 6. In public health insurance, the doctor will be one who is on duty at that particular time, whereas in private insurance you can have choice of your desired doctor or surgeon to carry out the operation. (Maturza, 2014) and ("Canstar," 2013) Medicaid is a means-tested fitness and health services program for certain persons and families with small incomes and few possessions. Services that are often provided are: • health checkup and services for the children, • hospital and medical doctor services, • test center services and X-rays, • care in treatment homes or • Home healthiness care services. Medicaid does not pay cash to individuals, but functions in a program that sends expenses to the health care providers. States make these expenses based on a fee-for-service promise or through advance provisions such as Health Maintenance Organizations (HMOs). Each State is then compensated for a share of their Medicaid expenses from the Central Government. This Federal Medical Assistance Percentage (FMAP) is firm each year and rests PRIVATE AND PUBLIC INSURANCE 4 on the State's average per capita revenue level. Richer states get a lesser share than inferior states, but by law the FMAP must be ranging from 50% and 83%. States could impose minimal deductibles, on some Medicaid receivers for certain services. Following Medicaid beneficiaries excluded from cost allocation: ▪ Pregnant women, ▪ Children under age of 18 ▪ Hospital or nursing home patients who are likely to fund most of their revenue to institutional care. PRIVATE AND PUBLIC INSURANCE 5 References Public versus Private health insurance explained. (2013). Retrieved from Maturza, J. (2014). Public Vs. Private Health Insurance. Retrieved from Private insurance. (2014). Retrieved from

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