BHS 101 Course Assignment
Health Insurance Marketplace
DUE: MONDAY OCTOBER 26
When you go to the doctor, do you know what to expect for payment? If asked a question about your health insurance, would you know? Now that you can recall information about the ACA and the healthcare system, it is time for you to make sure you know information about your own health insurance. Below are typical questions asked of members about their healthcare plans. Your assignment is to research your own plan, and answer all questions below. You are not to “cut and paste” as this is called plagiarism. Instead, answer the questions in your own words and cite your source after the answer.
An appropriate citation would read:
Bernstein, M. (2002). 10 tips on writing the living Web. A List Apart: For People Who Make Websites, 149. Retrieved from http://www.alistapart.com/articles/writeliving.
For more help, go to https://owl.english.purdue.edu/owl/resource/560/01/
NOTE: Do you know the meaning of the following health insurance words: Formulary? Deduction? Prenatal? Note the last question “What vocabulary word(s) did I need to research and define? List the word and definition.”
In conclusion, the aim of this assignment is to become highly educated about your own healthcare plan. Later in the semester, you will use this information to compare and contrast against other plans.
When is my open enrollment period?
How do I obtain a primary care physician?
When do I need prior authorization?
What do I do in an emergency?
How many trips to the emergency room can I make without assuming costs?
What do I do if I need care at night or on the weekend?
How do I get behavioral health services (mental illness and substance abuse services)?
Can my plan help me manage chronic medical conditions?
Are there any pre-existing conditions that are not covered under my plan?
Doctors & Hospitals
How do I change my primary care provider? Explain.
Do I need a referral to see a specialist? Explain
Am I covered for services outside Boston Northeast area?
What kind of prenatal care and infant care do I have?
Where do I find a formulary?
What pharmacies are included in my plan’s network?
What other money saving benefits for prescriptions are offered as a part of my health insurance plan?
Rights and Responsibilities
Does my company keep my health information confidential?
What are my rights and responsibilities when purchasing my health insurance?
Are there any perks and benefits for being a member of my plan?
Is my health insurance paid privately, through an employer, or by the federal government?
What will be my premium if my insurance is through my employer?
What will be my deductibles?
What out-of-pocket expenses (maximum) will I incur for medical services or medications?
Outpatient services: (In system & out of system)
Will I have copays? How much?
What will be costs of specialist visits?
What are emergency room copayments?
What will be the cost of my coinsurance?
What are my inpatient costs for MRIs and CT scans?
What number do I call if I need help with a billing question?
Inpatient services: (In system & out of system)
What are inpatient physician service costs?
What are costs for surgical day care?
Does my healthcare plan offer preventive care guidelines and information? What and where?
Does my healthcare plan offer tips to help save money? What and where?
Are there other levels of coverage available in my health insurance plan? Explain.
Based on your individual needs, is my coverage adequate and/or should I consider another level for coverage? Explain.
What vocabulary word(s) did I need to research and define? List the word(s) and definition (s).
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