Health Insurance Project
docx
keyboard_arrow_up
School
Davenport University *
*We aren’t endorsed by this school
Course
252
Subject
Health Science
Date
Dec 6, 2023
Type
docx
Pages
8
Uploaded by KidBoulder10052
Running head: HEALTH INSURANCE PROJECT
1
Health Insurance Project
Eligibility for A Premium Subsidy
Dzung Nguyen
Grand Rapids Community College
HEALTH INSURANCE PROJECT
2
Health Insurance Project
Healthcare costs for the past few years have increased exponentially leaving many
Americans unable to pay for the healthcare insurance or even apply for one in that matter. It is
not until the Affordable Care Act or Obamacare changes that problem providing health insurance
to American with health problems such as cancer without the fear of being denied coverage. With
that said though there are still many Americans without any health insurance and finding the
health insurance plan that would suit one needs is increasingly difficult with the rising prices
even with Obamacare.
As a nineteen-year-old teen living in Michigan with a mindset of making an income of at
least $21,000, my research will span through what it is like as an individual searching for a
health insurance plan that fit two scenarios: First, being healthy and undertaking non-threating
activities; Second, having Type I diabetes and also not engaging in non-threating activities.
These two assumptions will be the focus of choosing a health insurance plan that is both low on
cost and high on benefits for that individual, which in this case would be myself.
Making at least $21,000 at the age of 19 paying for health insurance premium without aid
can be taxing to an individual.
Part of the reason why Obamacare was passed was to make
health insurance more affordable to Americans. One of the ways to make health insurance
affordable was to offer tax credit or subsidies on premiums that Americans have to pay each
month. My age and income, as of today, qualifies for a $18 per month subsidy. This means the
$18 per month will help pay for the monthly premium amount that I have to pay. Upon finding
the following plans tailored to the health condition present there were 58 specific health
insurance plans that are available to me by both the assumption of being healthy and having Type
HEALTH INSURANCE PROJECT
3
I. All 58 plans were narrowed down to 12 with each having different plans chosen based on the
two assumptions.
Healthy Plan
Being as it may a healthy individual plan can vary upon specific needs which are
different from person to person. In my case I don’t require frequent visits to hospitals unless I’m
put into a dire situation such as being in an accident. I do go to great lengths to take advantage of
my health insurance, meaning I use the annual checkups and flu shots to prevent me from getting
sick. These mindsets of mine ultimately affect my choices of choosing the perfect health
insurance that is most beneficial to me. Of course, there are many health insurances that are
available to me. With that said, I based my choices on my general good health and also my
concern for cost.
The list I complied are 12 plans that are narrowed down from the 58 assortment of health
insurance plans tailored to the assumptions of being healthy. Each ranges from different tiers
from bronze to platinum which is the highest tier available in health insurance. This list excludes
the catastrophic insurance plan because the plan may sound good in the short run due to the plan
charging lower premium than other plans. Having a low premium in the long run the high
deductible or the amount I have to pay out of pocket before the insurance will cover my expenses
will be a huge financial burden if I were to say get hit by a truck and need medical attention.
Each of the 12 plans chosen are based upon several key things including premium,
deductible, out of pocket maximum, coinsurance, and copay. My premium for each of the 12
plans is reduced by the $18 per month subsidy (tax credit). For example, in the plan Blue Cross®
Partnered Silver provided by Blue Care Network of Michigan the premium before the subsidy
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
HEALTH INSURANCE PROJECT
4
was $120 and after subsidy it’s reduce my net premium to $102. The cost of the deductible that
I’ve chosen are relatively low with the exception of three. The out of pocket maximum is the
amount I have to pay within a period for covered health insurance. This means when I reached
the amount the health insurance plan will pay 100% of the policy period. About half of the plans
have a different range of out of pocket maximum with some reaching up to $6,000 raising the net
cost while others are in $1,500 range having a low net cost on my income if I were in an
accident. The coinsurance is the cost I have to pay for healthcare which is calculated in
percentage. For example, the highest coinsurance plans are the bronze I’ve chosen with the
percentage of 50% that essentially means I have to pay half of the cost instead of the normal
amount of 20% lowering the benefits if I were to choose the plan. Copay is the fixed amount I
have to pay for healthcare like specialist visits, prescriptions, ER, and primary visits which varies
from plan to plan.
From the 12 health insurance plan chosen I would likely enroll due to higher maximum
benefits overall would be Humana Silver 3800/Michigan HMOx provided by Humana Medical
Plan, Inc. This decision is based upon the economic impact on my current income and the notion
of being healthy. With a lower than usual premium and having the added benefits of a lower
copay this essentially means it’s the ideal plan that would fit my needs with my current income
of $21,000. Although the plan has a higher deductible than the plans with $50 of deductible,
having a lower deductible does not benefit me. This is due to the fact that being healthy I do not
need frequent healthcare. A combination between a low premium, lower copay than other similar
plans, and an average out of pocket maximum will not cause a detrimental impact on my income
if I gotten to an accident. Basically the health insurance plan is a balance between both low cost
and high benefits.
HEALTH INSURANCE PROJECT
5
Type I Diabetes Plan
Type I diabetes
is chronic condition caused by the lack of insulin produced from the
pancreases. Having Type I diabetes is very different from being a healthy person looking for
health insurance. A person with Type I diabetes unlike a healthy person requires more healthcare
than an average person and more frequent specialist visits, therefore, increasing the healthcare
expenses. Although having Type I diabetes didn’t limit the amount of available plans, with 58
health insurance plans still remaining just like the healthy assumption. This means Type I
diabetes doesn’t affect the supply side of choosing health insurance but instead affects the
demand side. So, going by the choices of finding a lower cost in the healthcare and lesser
deductible I didn’t followed my previous selection of health insurance plans, instead I devised a
new list of insurance plans based on the assumption of having Type I diabetes.
Each of the plan chosen follows a distinct pattern having a lower deductible. Unlike a
healthy person that find a lower deductible not as useful due to not having frequent healthcare, to
a person with Type I diabetes it is invaluable to them. The benefits of having a lower deductible
translates to the net cost of each of those individual plans. When I need constant treatment, I
don’t have to worry about the health insurance plan being too high to pay at the beginning. To
illustrate the top three health insurance plans from the list of 12 are selected based on the
economic benefits and cost. My Priority POS RxPlus Silver and My Priority POS Silver 1400
both provided by Priority Health, shares several things in common including the ones on the list
of 12. Both having a low deductible of $50, the range of $1,500 to $1,600 out of pocket
maximum, and a premium from the range of $130 to $140 after subsidy which in the long run
won’t cause a significant impact on my current income. The added coinsurance of 30% which is
10% higher than normal may cause higher prices to stack up with the flat fee of copay, but
HEALTH INSURANCE PROJECT
6
overall the lower deductible and the mid-range of both out of pocket maximum and premium
makes up for it by lowering the net cost to cover the insurance. Lastly Blue Cross Partnered
Silver provided by Blue Care Network of Michigan the top first choice of the list 12 and
provides the adequate amount of benefits over cost out of the top two choices. Though the
increase of $450 deductible may cause some problems when starting to pay for treatment but
bear in mind that with the sacrifice of a higher deductible comes with added benefit. A lower out
of pocket maximum of $1,450, a $102 after subsidy premium, and 20% decrease in coinsurance
compared to the two top choices outweighs the negative. That being said if I choose to enroll to
the following plans it is based upon having Type I diabetes which changes the choices made
from being healthy.
Benefits of Enrolling in Health Insurance
Health insurance in the US today is like a leverage to help Americans pay for the rising
prices of healthcare expenses. If an American does not have health insurance what would happen
if they are put in a life threaten situation and have no money to cover for the financial burden.
Yes, the healthcare today requires many adjustments before it would be feasible with cost being
very high for insurance plan but in the state is today it is a vast improvement before ACA was
passed. If I currently don’t have health insurance, I would have to face the cold reality being sick
and not having nothing to turn to due to the lack of income to pay for healthcare expenses.
Health insurance is like a safeguard, without health insurance America would be put into disarray
from paying the healthcare expenses. Enrolling to a new health insurance that provides
preventive healthcare and health screening with no copay is like a dream sent. Not only will it
insures me that I won’t be bankrupt the next time I need medical care, but also causing me to
fully utilize the healthcare at its highest potential due to the advantage of no copay. Having
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
HEALTH INSURANCE PROJECT
7
health insurance outweighs the cost in America society today with the chances to enroll to
Medicaid if paying for health insurance is not currently possible.
Factoring the willingness to pay for health insurance is affected by the health status an
individual is currently in. Like both the assumption of being healthy and having Type I diabetes,
having one condition changes the perceptive of paying for health insurance just like choosing the
health insurance plan. When I have Type I diabetes it is not of a matter of choice to choosing to
pay for health insurance because there is no alternative to it. The opportunity cost goes up the
roof if I decide to not pay for health insurance. I will potentially miss out of medication that can
save my life. Therefore, the relative cost of being uninsured is shifted towards being insured than
missing out on life saving healthcare.
This is true for being healthy as well except being healthy changes the opportunity cost.
When I am healthy and don’t pay for health insurance I am missing out on potential things that
could save my life and securing my income if I were in an accident. At the same time, I don’t
need constant medical care to keep me from die because I am already healthy and plus paying for
health insurance is taxing. When I factor relative cost of being insured and not being insured one
side is not fully subsided to the other, but not having health insurance can lose on the many
benefits that are included. Benefits of which can mean leading a life without worry about the
hundred and thousands of dollars to pay for healthcare.
HEALTH INSURANCE PROJECT
8
References
Get 2016 health coverage. Health Insurance Marketplace. (n.d.). Retrieved February 15, 2016,
from https://www.healthcare.gov/
Type 1 diabetes. (2014, August 02). Retrieved February 15, 2016, from
http://www.mayoclinic.org/diseases-conditions/type-1-diabetes/basics/definition/con-20019573