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Insurance Programs - Research Paper Example

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Health Sciences and Medicine Name: Instructor: University: Course: Date: Introduction Health insurance is there to help individuals cater for the extra cost of health care. There are a lot of medical costs that at times are costly for individuals to purchase; however, an affordable health insurance plan enables one to cover the expensive medical cost that might arise due to medical disorders, illness, and diagnosis test and doctor consultation fees…
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Insurance Programs
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Health Sciences and Medicine Introduction Health insurance is there to help individuals cater for the extra cost of health care. There are a lot of medical costs that at times are costly for individuals to purchase; however, an affordable health insurance plan enables one to cover the expensive medical cost that might arise due to medical disorders, illness, and diagnosis test and doctor consultation fees. Blue cross was a hospital care program that was formed in 1934 by E.A Van Steenwyk. It s main purposes was to act as a unifying force for hospital care program. Conversely, commercial insurance helps businesses and organization to protect them against unforeseen risk that might lead to loss or cause harm for the business (Stevens, 2003). This paper examines the common terms and regulations used by Blue Cross Blue Shields Plans And Commercial Insurance, their financing and reimbursement regulations, benefits, attributes, their financial security plan, future, funding and how the legislative changes impacted the plan. In addition it examines how the new health care regulations proposed by the federal government affects the plan. Blue Cross Blue Shields Company and Commercial Insurance The financing plans for Blue Cross and Blue Shield Company are structured in a simple way as they allow for flexible spending of both parties involved. The plan allows for aside pre-tax dollars to pay for eligible expenses that are recognized by the contract. Moreover, there are various accounts set to handle different cases like the Medical flexible account, Dependent care flexible spending account and Limited use flexible account (Field, 2007). The company reimbursement programs allow for fund parking through payroll deduction and convenient web-based interface to allow for cards on credits. This is greatly beneficial to society members as they can easily set aside the fees for their medical expenses through payroll deduction and access medical care without much difficulty. Commercial insurance is funded by the government and states. The federal government funds the insurance through paying the states a small percentage known as federal medical assistance percentage. Their reimbursement methods are calculated on the basis of efficiency, economy and quality care to those who are listed under the insurance in their respective geographic areas (Stevens, 2003). The financial security plan for Blue Cross Blue shield Association is secure since it is comprised of thirty nine insurance companies. This minimizes any unforeseen risks that might be experienced by the company and that would jeopardize their relationship with their clients. In addition with the number of insurance companies, customer satisfaction is excellent as they are completely insured of their medical expenses. Commercial health insurance plan financial security plan is stable as it is being jointly funded by the federal and state government, therefore, there is a certain percentage issued for the purposes in each financial. However, the future of Blue Cross and Blue Shield Association is not predictable due the changing health policies being introduced by the government in the health sector. Conversely, Commercial insurance is stable because the major funders are the ones responsible for creating health policies being used in the country (Stevens, 2003). The legislative changes have impacted the plan and the reimbursement to practice management for both Commercial insurance and Blue Cross and Blue shield association, since it has tasked the management with an enormous task of making complex decisions. They have been forced to include new taxes for their clients and this has led them to question their profitability and customer retention. The management is forced to make crucial decisions on cost to the company, employees and customers (Field, 2007). In my opinion, the new health regulation proposed by the government totally affects the plan I am choosing since I have to take into consideration certain things like increased taxes which affects my medical costs expenses. Conclusion In conclusion, both Blue Cross and Blue Shield Association are important since they care for the cost of health insurance premiums for different individuals under different medical conditions. They act to reimburse the insured for various medical expenses incurred due to illness or injury. As such individuals enjoy the benefits of health insurance without much difficulty when they are enrolled into the program and pay their monthly premiums which totals up to their insurance when faced with medical risk. References Raffel, M. W., & Barsukiewicz, C. K. (2002). The U.S. health system: Origins and functions. Australia: Delmar/Thomson Learning. Field, R. I. (2007). Health care regulation in America: Complexity, confrontation, and compromise. New York: Oxford University Press. Stevens, W. S. (2003). Health insurance: Current issues and background. New York: Nova Science Publishers. Read More
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