Managed care has grown exponentially during the last several years as a result of increased health care costs, population growth, and the expense of new technologies
As discussed in class, managed care has grown exponentially during the last several years as a result of increased health care costs, population growth, and the expense of new technologies. As a result, case managers have to quickly learn how to navigate the different managed care plans in order to locate the most appropriate resource for the client. For this assignment, you will assess your current health care plan and provide the below information regarding your plan (If you do not have a health care plan, then speak to a friend or family member regarding his/her health care plan.)
Please respond to the following:
Name of Health Care Plan (example: Blue Cross/Blue Shield of Louisiana), address, and contact numbers.
What does your health care plan cover? Hospitalization, pharmacy, mental health treatment, substance abuse treatment, specialists? Detail the type of coverage you have.
Is your health care plan a PPO, HMO, or Point of Service? Explain.
What is your premium and deductible for the health care plan? Do you have to pay co-pays? If so, what is the co-pay?
Do you have out of pocket expenses?
Who is your PCP? Address? How do you locate a specialist?
Answer: Also for this assignment, choose a specialist from the list of the providers (orthopedist, cardiologist, etc.) and a mental health provider. Contact the specialist and the mental health provider of choice, and ask if they are a provider for your health care plan. Provide the name, address, phone number, contact person, and information gained from the phone contact in this assignment. There are 2 phone contacts required for this assignment.
Answer: What is your perception regarding the access to the above information? Did you have difficulty locating the information? If so, what type of difficulty? What would you recommend to make the information more accessible?
This assignment should be written in paragraph for. Include an introductory and concluding paragraph. No abstract is required.
This assignment is worth 30 points. Again your paper should follow APA (7th ed.) format, including a title page, body, and reference page. Your paper should be typed, double-spaced, grammatically correct, with 1 inch margins, and at least 3 pages in length (body only). Utilize Chapter 2 of the Woodside & McClam text for this assignment. Most managed care plans (Medicare, Medicaid, BCBS, Humana, etc.) have a website that provides most of the required information for this assignment. Cite the health care plan website as a reference
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