Financial Health -Health Insurance Options - Essay Example

Phase one

The recommended insurance option in this phase is the job-based insurance plan. The elements of this option include the guarantee for renewal and cannot be canceled in case of sickness. The option is also portable and can substitute a pre-existing health insurance plan. The reimbursement requirements according to this option are active employment status and a completed time with the employer before the plan commences. The restrictions of this option include the limits on the coverage of pre-existing conditions for some time and the limitation to the plan options provided by the employer.

Phase two

The healthcare insurance option recommended at this phase is the Consolidated Omnibus Budget Reconciliation Act. The option is available to employees and the beneficiaries under the initial insurance option. The reimbursement requirements cover the employee in case of the death of the employee or involuntary termination of employment. The plan only operates in situations where the qualifying event satisfied under the consolidated omnibus reconciliation act, which includes the death of the employee. The restrictions of this plan, however, exempt plans where the existing options are small employer plans. The plan does not cover the individual for a long duration of time and has a restriction to a maximum of 36 months.

Phase three

In phase three, the recommended health care option is the Medicare program, which is an insurance option for elderly people above the age of 65. The requirements for reimbursements as per this policy are that one must be above the age of 65 or under the age of 65 and disabled. The beneficiary of this program must be an American citizen or have had a continuous residence for 5 years. The downside of Medicare as provided by Green & Roswell (2012), is that some health care services not covered by the program. Medicare does not cover supplementary medical expenses and services and the beneficiary must seek alternative options in instances the requirement of these services required.

Phase four

Pre-existing condition insurance plans recommended for this phase in the health care provider services for Sophie. This program provides access to health care services to individuals who cannot assess health care insurance due to their pre-existing conditions. For eligibility for reimbursement, according to this program is the lack of insurance cover for the past 6 months and the individual must have a pre-existing medical condition. The program, however, does not cover individuals with other insurance coverage options and eligibility is strictly available where there is no other cover. The beneficiary must also be enrolled in a high-risk pool and does not have a limited benefit plan.

Phase five

The recommended health care insurance option in phase five is Medicaid. Medicaid is a program that ensures the provision of medical services to individuals with low income and limited resources. In order to benefit from this option, an individual must not necessarily be poor but must meet some other criterion. The program is available for low-income individuals institutionalized like the case of Sophie. The program also extended to the medically needy individuals who do not meet the requirements of low-income individuals. The limitations of this program according to Green & Roswell (2012) are the eligibility criteria applied in the determination of beneficiaries. The program acts as the last option in the provision of health care services and one can only benefit where all other options exhausted.