Question

iscussion Question 1: Types of Health Insurance

Health insurance is a type of insurance coverage that covers the cost of an insured individual's medical and surgical expenses. Depending on the type of health insurance coverage, either the insured pays costs out-of-pocket and is then reimbursed, or the insurer makes payments directly to the provider.

Research and describe the four major types of health insurance both the most preferred and least preferred, then identify which population groups are commonly covered by each.

Discussion Question 2: Social Insurance

A program of compensation provided and controlled by a government for the elderly, the disabled, or the unemployed people is known as the social insurance program. Acceptance in a social insurance program is not guaranteed and individuals seeking to be covered have to meet certain requirements. Social insurance may come in the form of healthcare or monetary compensation.

Define social insurance and describe the social insurance programs available in the U.S. Discuss how these programs affect access to care and the role the government plays in providing them.

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Answer 1

The Health care plan type that is best for a person depends on what that person and his family wants, and how much he / she is willing to spend.

The review of each type of health insurance plans :

· A ) Exclusive Provider Organization ( EPO ) : A managed care plan where services are covered only if a person use doctors, specialists, or hospitals in the plan's network ( except in an emergency ). EPO plans are a good choice if keeping costs down is important, if getting referrals seems like too much of an ordeal, and if you are willing to stay within network.

· B) Health Maintenance Organization ( HMO ) : A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-ofnetwork care except in an emergency. An HMO may require the person to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness. This type of plan is preferred by those who are generally healthy and do not want to spend a lot on a insurance policy that they rarely use.

· C) Point of Service ( POS ) : A type of plan where a person pay less if he/ she uses doctors, hospitals and other health care providers that belong to the plan's network. This type of plan who is willing to pay hefty money to have a plan which is good mix of freedom and affordability.

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· D ) Preferred Provider Organization ( PPO ) : A type of health plan where the person uses the providers in the plan's network. He/ She can use doctors, hospitals and providers outside of the network without a referral for an additional cost.

This type of plan is best for individuals who want a broader slate of doctors and facilities and do not mind paying slighly higher premiums.

a) Old - Age Survivors and Disability Insurance

Based on social insurance principles, the program provides monthly benefits designed to replace, in part, the loss of income due to retirement, disability, or death . Coverage is nearly universal. About 96% of the jobs in the United States are covered. Workers finance the program through a payroll tax that is levied under the Federal Insurance and Self Employment Contributions Acts ( FICA and SECA ). The revenues are deposited in two trusts funds ( the Federal Old-Age and survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund ) which pay benefits and the operating expenses of the program.

b) Unemployment Insuranc

Unemployment Insurance was initiated on a national basis in the United States as Title III and Title IX of the Social Security Act of 1935. It is a Federal - State coordinated program . Each State administers its own program within national guidelines promulgated under Federal Law. The program is designed to provide partial income replacement to regularity employed numbers of the labor force who become involuntarily unemployed. To be eligible for benefits , a worker must register at a public employment office, must have a prescribed amount of employment and earnings during a specified base period, and be available for work and able to work. In most States, the base period is the first four quarters of the last five completed calender quarters preceding the claim for unemployment benefits.

The amount of the weekly benefit amount a worker may receive while unemployed varies according to the benefit formula used by each state and the amount of the worker's past earnings.

c) Workers' Compensation

Workers' compensation program are almost exclusively financed by employers on the principle that the cost of work accidents is part of production expenses. Costs are influenced by the hazards of the industry and the method used to insure for liability. State and Federal workers' compensation laws cover the Nation's wage and salary labor force. Common coverage exemptions are domestic service, agricultural employment, and casual labor, although some programs cover agricultural and domestic workers. Many programs exempt employees of non profit, charitable , or religious institutions.