Question

4 Lis two different populations who would qualify for Medicaid 5 Outline managed care requirements for patient referral 6. Describe the processes available for the verification of eligibility for services CASE STUDY all class members and determine the various types of insurance coverage that are represented by the students Have each student call to verify their own health insurance benefits, Choose a medical procedaure, such as the flu shot end have the students call and verify the amounts of coverage for that particular procedure KPLACE APPLICATIONS or more of these activities and share your resalts with the class, if appropriate I. Working in suall groups, obtain a quote for health insurance coverage for a family of four from your local health insurance marketplace using the following demographics Covered F Father Mother Son Daughter Age 38 15 or four from which to obtain quotes Use the internet to reseuetf health insurance policies and 2 Develop a scepanio appointunent with a gastroenterologist for stomach pain. Create a timeli primary Care ine fom when the patient first visits the weeks to see for a patient with a health maintenance organization (HMO) insurance provider (PCP) to when the patient can see the specialist. Include in the timeline the PCP before requesting the referral from the insurance plan and wanting the putlent to return in 2 negkCation bow they feel.

Answer 1

4.

a) Pregnant women

b) People with disability

5. Managed care requirements for patient referral

Managed care plans are a type of health insurance.All patients need referral services must be seen by a Primary Care Physicians (PCP). If a patient need referral from PCP , he need to be seen by a specialist. The specialist then inform the insurance company that the patient's PCP has approved of his visit to a specialist.

6. Eligibility criteria

-having limited assets ; People with income up to 133% of poverty line including adults without dependent children

- Categories like US citizen or Lawfully admitted immigrants ; Anyone seeking Medicaid should prove the citizenship or resident alien.

-Pregnant and disabled regardless of immigration status

-Child, if he or she is a U.S Citizen

- HIV Positive people, those progress to AIDS