Question

Answer every question in full sentences. For part 2, assume a doctor's appointment and a lab test each cost $100 when determining which plan the consumer should choose.

Review the following insurance plans and then answer the questions below.

Services	Bronze	Silver	Gold
Monthly cost	$163	$194	$245
Deductible	$6,000	$4,000	$1,000
Primary care	$35 co-pay for three visits, then 20% of co-insurance	$30 co-pay/provider/day	$20 co-pay/provider/day
Specialist visit	$70 co-pay for three visits, then 20% of co-insurance	$60 co-pay/provider/day	$40 co-pay/provider/day
Preventive care/screening/immunization	No charge	No charge	No charge
Diagnostic test (x-ray, blood work)	$35 co-pay or 20% of co-insurance if co-pay limit is reached	Office visit co-pay or 20% of co-insurance	Office visit co-pay or 20% of co-insurance
Level 1 prescription drugs	$25 co-pay/30-day supply	$15 co-pay/30-day supply	$15 co-pay/30-day supply
Emergency dept. services	20% of co-insurance	$350 co-pay/facility/day	$250 co-pay/facility/day
Emergency medical transportation	20% of co-insurance	20% of co-insurance	20% of co-insurance
Urgent care	$75 co-pay	$60 co-pay/provider/day	$60 co-pay/provider/day
Hospital stay (facility fee, physician/surgeon fee)	20% of co-insurance	20% of co-insurance	20% of co-insurance

1. Compare the plans above.

• What are the major differences between the plans?
• What are the major similarities between the plans?
• If you were presented with these plans, what would be the major selling points and pitfalls of each plan for you?

Answer 1

Answer:

Major differences are -

1.Monthly cost of 3 different plans.

2. Deduction available is higher in bronze but lower in gold plan.

3. Primary care and specialist visit have difference of co payment and co payment with 20% of insurance after certain visit number.

4. Level 1 prescription drug and urgent care and diagnostic test have only difference between bronze plan and gold and sliver plan combined.

5. Emergency dept. Service is major difference.

Major similarities :

1. Preventive care and emergency medical transportation and hospital facility have no charge in all plans.

2. Gold and sliver plan is similar in diagnostic test, level 1 prescription drug and urgent care.

Major selling point of plans will be emergency dept service , emergency medical transportation, urgent care and hospital stay fees and monthly cost of the plans.

Pitfall for bronze plan will be specialist visit and emergency dept service.

Pitfall for silver plan and gold plan are only monthly cost and deduction.