Unit 2 AssignmentKelley WhitcombKaplan UniversityHI215-01: Reimbursement MethodologiesProfessor Kathleen SobelJuly 20, 2015Medicaid is one of the biggest insurance plans you can get in any state. In the state of Indiana, it is based off of your income. There is a certain amount (income) you have to make to determine if you will receive Medicaid or Healthy Indiana Plan (HIP). HIP is still a form of Medicaid, but you would have to pay monthly cost for it and have certain set of co-pays for certain services that is needed. HIP Plus is the recommended plan for members as it provides health coverage for a low, predictable monthly cost. HIP Plus also covers dental and vision services. If you do not pay your monthly payment you can be removed from …show more content…
Just like how technology can be a good thing, it can also be a bad thing. A computer malfunction or glitch can cause many headaches for people waiting on a reimbursement. Medical billing and coders must make sure they provide the correct information needed so the proper people can get the reimbursement. If the coding or billing information is incorrect then insurance companies can deny it and you will get a lot of unhappy people.My major concern with health insurance is it just costs way too much. Most people cannot afford insurance, or if they can it’s basically their whole entire paycheck. A family of fourcan pay a ridiculous amount of almost $1,000 per month. My house payment is less than what some people pay a month for health insurance. Yes, we need a roof over our head and we should have insurance, but when push comes to shove people are going to choose a roof over their head than health insurance. A lot of Americans cannot afford the “Affordable” Care Act either and if they don’t have insurance they are less likely to seek treatment or help for an illness or serious complications. For example, my boyfriend’s dad worked all day doing dry wall and they would live pay check to pay check to support a family of five but they just could not afford health insurance. He is a diabetic but he was not able to take the medications he needed to control it andnow his organs are shutting down. The doctors told him he is a ticking time bomb and lucky to be alive now. Also, people should not be denied to have insurance based on the pre-existing conditions. I cannot help the fact that I have asthma, and my dad cannot help the fact that he has type 1 diabetes. You should be accepted no matter what conditions you have or how much you
Health insurance comes as second nature to many of us. We grab that blue and white card and put it in our wallet and forget about it until we are sick or injured. When this happens, there it is, cushioning our fall like the extra padding it provided to cushion our wallets. This is not the case with everyone, however. Many Americans have no cushion to fall back on, no blue and white card to show the emergency room when they have an unexpected health concern. No HMO with a convenient co-pay amount when their son or daughter develops an ear infection.
Some disadvantages of the current health care system in the United States is tons of people have no healthcare insurance at all and many of the insurance coverages have such high premium and deductibles people can't afford it. For you to be eligible for Medicaid you have to have a very low income. To get Medicare you have to be a certain age and Medicare doesn't cover all health care costs. For Private health care insurance you have to have a clean bill of health and if you have health conditions they will deny you coverage. But if private insurance companies are willing to give you insurance the premiums are so high and the
The federal Affordable Care Act (ACA) together with Illinois Public Act 98-104 will increase access to health coverage as a critical step toward improving the health of the people of Illinois (HFS, 2014). Illinois residents can use the health insurance marketplace, but easily compare health plans and see what costs are better for them before buying a plan. Every plan is covered essential benefits such as preventive care, doctor visit prescription drugs, maternity care, emergency services, hospital stays and more. Residents can succeed for financial help through the Marketplace to lower monthly premiums and out-of-pocket costs. Insurances companies’ cannot reject residents that apply for coverage for they are sick or have a preexisting health condition. People can receive Medicaid for the first time low-income adults who are legal residents, regardless of parental or health status may be eligible for health coverage through Medicaid. Adults that have incomes at or below 138% of the federal poverty level on the family may be eligible. Application for benefits Eligibility is an easier to apply for Medicaid, SNAP, and the Medicare Savings. Indiana purpose of healthcare reform for residents is enrolling adults in its new Healthy Indiana Plan. The plan was offered in the state of Indiana. With the plan,
There are also several cons within the ACA which one is most people that have insurance through the marketplace have very high deductibles. With a person having a high deductibles when they go to the doctor for minor things they are still having to come out of pocket when they went to doctor visits due to the deductibles.. This can turn into a problem for some people due to their finances. Another big issue is being fined if you do not have health insurance. I do not believe that this is fair due to the circumstances of people lives. It is said that the fine will increase over time. I look at it like this there are people that try to apply for Medicaid within their state, and are turned down due to them being over qualified. Than we they go and apply for insurance through the marketplace it is too much so for some people they cannot win within this situation. I believe the government should look at it from all standpoints.
The new and improved health care system in America seems to fall short for many people. The Affordable Care Act made history after President Obama signed it into law on March 23, 2010. This bill is going to create a change in how the current system operates which has kept approximately 46.3 million people uninsured. Those numbers are very disturbing by themselves but if we include all of those who are also underinsured then we add on another 25 million. The ACA is has promised to reduce those numbers dramatically. Even though the plan is to reduce these numbers there will still be people without health care coverage. Some will fall in between somewhere which makes them not eligible for Medicaid but also not able to pay the premiums
Obamacare is an extremely controversial topic amount American people. What was originally supposed to help the uninsured receive insurance has turned out to be anything but that. Obamacare is one of the most unproductive investments that Obama and his administration team have unveiled. The time and effort they spent on Obamacare could have been spent coming up with a valid and cost effective way for uninsured Americans to obtain health coverage. Obamacare has caused many Americans to remain uninsured, and many have lost their existing coverage due to the new Affordable Healthcare Act. A solution to the problem is to let Americans choose the insurance they want and allow the government to crack down on insurance companies, not dictate what Americans can and cannot do.
“ObamaCare contains many benefits, especially for low and middle income families and business” (“ObamaCare: Pros and Cons”). Many people have been having concerns on the cost of the insurance because it has raised in cost. There is a new law out there that President Barack Obama passed called ObamaCare. ObamaCare is also known to be The Affordable Care Act (ACA). The goal of this act was to make sure every American had health insurance by January 2014. ObamaCare went from being something good, to a controversial issue towards Americans. This topic is very debatable in positive and negative ways, it just all depends on how it effects someone. One of ObamaCare’s requirements were to have companies provide health insurance to people
There are Currently 32 million people without health insurance in the United States. This means that roughly 83 per cent of citizens have to live day by day hoping they won’t get sick. For this reason, President Obama signed the U.S health reform bill into law. The health reform will make health care more affordable for citizens. Employers with more than 50 employees will be forced to provide coverage for all, or they will have to pay a fine. It will also make health insures more responsible. For example, health insurance carriers are forbidden from placing lifetime dollar limits on policies, from denying coverage to children because of pre-existing conditions, and from canceling policies because someone gets sick. It will also expand
The Affordable Care Act makes it possible for the US population to have access to low cost health insurance. It also protects individuals from being dropped from coverage when they get, be denied treatment, or get charged more for being sick. The main problem is that many people don’t like the mandate because taxes are heavy on people with high incomes and on the healthcare industry. Since the system is private it can also be confusing and customers risk themselves paying more or less money. The higher the price individuals pay the better the quality. Insurance establishments are forced to cover sick
Everybody talks about how bad the US healthcare system is, which it might be a little bad, but it is not all bad. In the last one hundred years, the life expectancy went from 47 to 78, and 3.5 years in the last decade. That is a huge difference. Since 1960 heart disease went down 56 percent. Doctor visits used to be for when people knew they were going to die, but now they will not die when they go to the doctor. Even though all of those good things have happened, there is still a lot of bad things about the US healthcare. There is an average of 101,000 preventable deaths per year in the US. Most of those deaths happened because of the way the healthcare system is organized. Race, income, and environment influences who gets access to healthcare and who does not, which is just wrong. Even though the life expectancy rate went up, it is still significantly lower than other countries. Over half of people who do not have healthcare are African-American. There are more hospitals in wealthier area, and public hospitals are closing where they are most needed.
Another important aspect of the Affordable Care Act to look at is how it is making the healthcare market a more fair and humane place. Before the ACA was signed into law, private insurance companies dominated the insurance market and had a huge say in how much they would charge you, what they would cover and most importantly if they would even grant you coverage at all due to a pre-existing medical condition. “Before the ACA, someone with cancer or mental health problems, for example, often was unable to find affordable health insurance. Some couldn't find any insurer to cover them.” (O’Donnell) Under Obamacare, unfair practices such as
However, some people still find Obamacare flawful and rule out the positivity it impacts on people and focus on the negative it causes. The fact that one must at least have an insurance plan that covers 10 minimum essential health care services to have health insurance now or through Obamacare services bugs most. The government also limits patient choice through federal regulation of the insurance market, government interference in the decisions patients make with their doctors, and the rising dependence of government health programs.
For as long as I can remember it has always been essential for cars to be insured, but not always has the human body required health insurance. This topic has always sparked interest to me because us as human beings are far more worthy than cars, at least I would say. So when President Obama passed the “Affordable Health Care Act” in 2010, I was firmly in favor. Health insurance covers cost of medical expenses and surgical expenses for insured individuals. Which can only be helpful in any situation versus harmful. Although, health insurance can be very costly it is worth it. Nothing is more important than your health.
Throughout the 20th century and into the 21st century the United States has always had a realization that there was a problem with obtaining affordable health insurance. The Patient Protection and Affordable Care Act (ACA) also known as Obamacare, was signed into law in March 2010. This law enables people who were unable to afford healthcare the ability to obtain a healthcare plan at an affordable rate. In 2009 a survey was taken as to the amount of people in the United States that carried health insurance. In table one below you can see over 50 million people in the United States did not have any type of insurance, which is close to 17 percent of the population (see table 1 below). “According to the Kaiser Family Foundation, “32%
According to the US Census Bureau, around 33 million people in the United States of America did not have health insurance in 2014. That is about 10.4 percent of the US population. I was fortunate enough to have insurance growing up. I remember when my father lost his job when I was quite young, my mother was very worried because he had no health insurance. He was not worried about it as much as she was, but unfortunately, he fell off his bike and fractured his knee and forearm. He was so stressed out about how he was going to pay for it because unemployment was definitely not going to help. He had to take out a loan and luckily got a job soon after so he could pay it off quickly. Many people are not able to pay off loans for medical services so quickly. We live in the richest nation on earth and we should not go without health care. It could stop medical bankruptcies, improve public health, reduce overall healthcare spending, and help small businesses. Health care should be a necessary government service. According to a 2009 study from Harvard