Homework answers / question archive / Health Insurance/Procedure Comparison Profile: Insurance   Location: Virginia   Job: Kindergarten teacher   Procedure: Total Hip replacement   Age Gender: 60 F   Part A: Health Insurance 1

Health Insurance/Procedure Comparison Profile: Insurance   Location: Virginia   Job: Kindergarten teacher   Procedure: Total Hip replacement   Age Gender: 60 F   Part A: Health Insurance 1

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Health Insurance/Procedure Comparison Profile: Insurance

 

Location: Virginia

 

Job: Kindergarten teacher

 

Procedure: Total Hip replacement

 

Age Gender: 60 F

 

Part A: Health Insurance

1.            You have your persons age and occupation. Consider your job, look up your likely income here: https://www.bls.gov/oes/current/oes_mn.htm#11-0000Links to an external site.

Is the regional wage different than the state wage?

https://apps.deed.state.mn.us/lmi/oes/Links to an external site.

 

1.            Although most people get insurance through their employer - for the purposes of this assignment please assume your person is choosing to finance and purchase health care on their own. Depending on their age; Go to the appropriate health insurance website (e.g. MNsure under 65; Medicare 65+) and chose 2 plans to compare https://www.mnsure.org/shop-compare/index.jsp

2.            Using 3 metrics (e.g. cost sharing + premium) about the health insurance plan make a bar graph to show the comparison in Excel.

3.            Based on all this information (including from Paper 1) what insurance plan would you chose? Do you qualify for any cost sharing reductions or advanced premium tax credits?

Part B: Procedure/Prices

1.            Now that you have selected a hospital in Paper 1 Part A and an Insurance plan in this paper, your task will be to try to figure out how much it will cost you at either a hospital or clinic. First you must learn a bit about the procedure (can it be done outpatient or does it have to be inpatient?) What CPT/DRG would be used? In a few sentences describe the procedure.

2.            Once you decide if you will be going to a hospital or clinic for the procedure, your task is to find a price. Hospitals by federal law need to post their prices online, clinics in MN are required to post top 25 billed procedures. If you can not find it on their website you may want to use http://www.mnhealthscores.org/cost-of-services-procedures-ratingsLinks to an external site.

•             Please contact me (loome011@d.umn.edu) if you are having trouble finding an estimate.

•             Another resource: https://www.nytimes.com/2021/08/22/upshot/health-care-prices-lookup.htmlLinks to an external site.

•             https://turquoise.health/ Links to an external site. 

1.            Factor in your insurance you chose in Part A, how much will it cost you under this insurance (spell out the math for me using deductible/coinsurance - IN A TABLE FORM) vs. being uninsured? So you will have 2 columns with and without insurance and then each cost sharing step ==> deductible, coinsurance etc.

2.            Reflect on the cost of insurance and the cost of getting a procedure using the contextual information about your person. Do you think it will be affordable or not? Do you think they will need to save up? Can they delay the procedure or is it emergent ?

Structure of Paper

Part A: Insurance

•             Para 1: Describe your persons occupation/wages/city (1 and 2)

•             Para 2: About the insurance options you have, describing the graph you have created for the assignment (what metrics you chose), compare and contrast the 2 insurance plans (3 and 4)

•             Para 3: Describe why you chose the insurance plan using the data from Para 1 and Para 2 (5)

Part B: Procedure:

•             Para 1: Describe the procedure

•             Para 2: Describe how much it will cost you (using insurance and not)

•             Para 3: Interpretation of costs with fictitious person’s circumstances.

Information on graphs: You can include the graphs either in the body of the paper or at the end, your choice. They should be made in excel with appropriate titles, labels, axes titles, easy to read, then can be copied into Word for submission as one document.

Information on references: Please include any references to websites at the end- I do not care what format you use- just be consistent and make sure to include any information that would help me find the resource again if need be

Rubric (75 points)

25 points content /information/processing

•             23-25 Excellent: Your comparisons and conclusions have been thought out well. You have been able to critically analyze or contextualize the information presented in a way that adds meaning to the paper and is original.

•             20-22 Good: Your comparisons and conclusions are generally well thought out, but lack originality and / or the appropriate context.

•             17-19 Needs Improvement: Your comparisons and conclusions do not fit at all with the context. Perhaps they add very little at all to the data, or are non-existent

•             0-16 Incomplete: Missing information the assignment asks for.

25 points data/graphs/presentation

•             23-25 Excellent: All graphs are labelled appropriately included axes, titles, data sources in footnotes. Data were selected thoughtfully. Graphs were easy to read and understand.

•             20-22 Good: Some missing labels/footnotes. Data were selected thoughtfully. Graphs were mostly able to be understood, with a few minor issues.

•             17-19 Needs Improvement: Graphs hard to understand.

•             0-16 Incomplete: No Graphs/Data included.

25 writing/grammar/citations

•             23-25 Excellent: You have flawless writing that is clear and makes a compelling case. Everything is cited. You are concise in your comparisons.

•             20-22 Good: No significant errors were made. Your writing may require additional proofreading. Citations not all included. Your comparisons are there, but more conciseness is needed to understand the comparison directly.

•             17-19 Needs Improvement: Your writing is unclear and even if the information seems accurate, it has been communicated

•             0-16 Incomplete: Writing is not in paragraph form, just bullet points. No citations.