LP3.1 Written Assignment: Health PlansThis assignment will assess the competency 2. Examine the...

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LP3.1 Written Assignment: Health PlansThis assignment will assess the competency 2. Examine the unique nature of the third party payer system.Directions: In a minimum of 2 full pages, write a paper that answers the questions provided below.• Please answer the questions in a double-spaced word document.• Remember to cite references, APA format, journal scholar and be legible sourceAction Items:1. Describe the 5 types of health plans and their characteristics.2. Explain the 4 methods of how providers are paid.3. List and describe the 3 categories of health plan revenue.

Robert · Accepted Answer

1 
Question 
Describe the 5 types of health plans and their characteristics. 
Answer
Health plan providing Health Maintenance  
The individual pays premium and deductible for availing care beyond entitled benefits. It 
provides for co-payment for all types of care and does not require the beneficiary to fill out claim 
forms (Niemann, 2006). 
Health plan providing a preferred health provider  
The beneficiary pays premium and higher deductible for doctors not in the network. Plan 
provides coinsurance and requires beneficiary to pay difference in out of the pocket expenses for 
seeing an out of network doctor. There is little paperwork but requires claim forms for doctors 
out of network (Niemann, 2006).  
Health plan that provides an Exclusive Health Provider 
Requires beneficiary to fully pay costs for seeing a service provider not in the network, except in 
emergencies. One pays lower premium than the preferred provider plan and deductibles and 
requires coinsurance. It involves practically no paperwork ("Different Types of Health Plans”, 
2017)  
Health plan at Point-of-Service  
The beneficiary pays premium and deductible for other than preventive care services and a higher 
deductible for providers that are not in the network. Plan provides for co-insurance and involves 
paperwork (Niemann, 2006).

LP3.1 Written Assignment: Health Plans This assignment will assess the competency 2. Examine the unique nature of the third party payer system. Directions: In a minimum of 2 full pages, write a paper...

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