Write an imaginary case study for your hypothetical patient.

Insurance

Compare the costs of covering healthcare services provided by this insurance in your area.

Best Doctors insurance is an international health insurance in the Caribbean, Canada and Latin America. The patient lives in The United States it would be more convenient if the insurance company aforementioned would have had an office in the country. Nevertheless, the site provided by the aforementioned insurance company offers a very easy to use online platform. Additional, apart from offering a n intuitive signing up online platform this insurance companies offers services and contacts of specialist on various conditions such as diabetes and cardiovascular diseases. The online platform also provides information and stories touching on various diseases handles by the company. Still, this insurance company has a comprehensive privacy policy to handle their client’s information confidentially and discreetly (Members2, 2021). Likewise, the information on how the client’s data will be handled and for how long is explicitly explained in the website thus ensuring that the patient makes an informed decision when choosing them as their preferred medical insurers. However, the website is rather vague and offers no direct amount of the premiums they offer on the website. This is a major problem as it will make many clients shy away from signing up for their services.

What insurance type is best suited for healthcare coverage of your hypothetical patient’s disease type?

The patient has a chronic condition therefore he will need medication and frequent visits to the care provider. He also has high chances of having long hospital stays or advanced medical procedures. Therefore, he would require a health insurance that helps minimize out of the pocket costs.

There are different types of health insurance which include, health maintenance organization, Preferred provider organizations, Point-of-service plan and Exclusive provider organizations (Alcalá, 2018). Health maintenance organization provides a local network of hospitals and doctors participating in the insurance. A person is supposed to choose from the network provided. The insurance also requires a person to choose a primary care provider from the network. The costs of the health maintenance organization are very low compared to other insurers.

An exclusive provider organization offers a person a network of participating providers to choose from. In most cases, it does not provide coverage for out-of-network care except during emergencies. If a person visits a hospital or provider that is outside the pan`s network, they will have to pay all the services themselves.

Point of service plan allows the person insured to choose care providers that are within the network or outside the network. If they see a provider who is outside the network, the costs are higher and the person is responsible for filling the claims. Preferred provider organization provides a large network of hospitals or providers from which a person is supposed to choose from. A person is also allowed to choose providers out of the network but they would have to pay more out of the pocket cost. Choosing a primary care provider is also not necessary.

According to the above report, the best type of insurance for the patient is the health maintenance organization.

References

Alcalá, H. E., Roby, D. H., Grande, D. T., McKenna, R. M., & Ortega, A. N. (2018). Insurance type and access to health care providers and appointments under the Affordable Care Act. Medical care, 56(2), 186-192.

Members2. (2021). Best Doctors. Retrieved December 3, 2021, from https://members.bestdoctors.com/mp2/s/?language=en_US#/