ONLY ANSWER IF U CAN DO THE REQUIREMENTS Using the Managed Care Answer Guide, pgs. 17-23, Analyze and Evaluate your managed care plan* either through your private/government insurance or from the health care exchange (Obamacare) using the nine criteria (pg.17). Based upon your evaluation, does your health plan meets your needs? Why or why not? *You do not have to give the actual name of your health plan. Requirements: Submit your essay in a Word document. This assignment must be at least 500 words, with at least four references cited properly in APA format, and a title page (APA format). This assignment must be well- written with proper grammar, spelling, and punctuation. Follow the rubric. http://www.patientadvocate.org/requests/publications/Managed-Care.pdf

Well Care Rx (HMO) is a Medicare Advantage HMO plan. This is for people living in Chicago .it is managed care plan offering services through selected network providers in each locality. The plan also covers Part D drugs.
BENEFITS OFFERED or COVERED SERVICES-the plan offers Preventive services including vaccination, obesity, CVS screenings. It offer Primary care physician visits for free. Specialists visits involve co-pay of $25.for emergency care and urgent care, there is no charge if admitted with 24 hrs. or else we will have to offer a co-pay.
The plan also offers dental, vision , mental services , wellness services and podiatry services with different co-pays.the plan also offer free trips around 20 per year but ambulance usage involves co-pay. Also for medical equipments like wheel chairs , a co-pay is included
The advantage, is lower out-of-pocket costs i.e. premium, co-payments etc
COST VS. BENEFITS
The premium is $14.50 per month, with Part D deductible is $405.00 per year( I pay 100% of your prescription costs until I have spent $405.00)
One of the most important features of plan is Maximum Out-of-Pocket (MOOP) limit. Maximum Out-of-Pocket expense is $3,400annually .
Primary care visits are free whereas specialty visits and surgeries involve co-pays. Hospital stay involves co-pay for the first week. After that it is free for 80 days. Responsible for 100% of cost for all out-of-network services (EXCEPT emergencies).
But the plan is not transferable out of the service area.
SERVICES OF THE PRIMARY CARE PHYSICIAN
Primary care visits are free. Referrals are required from primary care physician to visit other healthcare providers like specialists.
PRESCRIPTION DRUG BENEFITS
Part D deductible is $405.00 per year Tiered System. Tier 1 drugs are offered complete coverage. This included pure generics. For other drugs co-pay is included/
PROVIDER NETWORK AND GEOGRAPHIC SERVICE AREA
ONLY Limited network of providers (e.g., doctors, hospitals, skilled nursing facilities) have been provided which is disadvantage
COMMITMENT TO QUALITY OF CARE AND SERVICE
The plan follows ICD-10 Compliance and Hcca compliance. It is also accredited by quality institutions.
CUSTOMER SATISFACTION
3 star rating is provided in Medicare navigators site – based on all the major nine criteria
In customer satisfaction score, the plan scores 5 out of 5 which shows the commitment to customer care. The plan has served 4.3 million customers.
LIMITATIONS, MAXIMUMS, or EXCLUSIONS- the plan’s disadvantage is limitations ins the amount of payments
COBRA
COBRA – include transferability/portability of plan. it is available For up to 18 months after termination from job
my healthcare plan meets all my basic needs and is suffcient in terms of premium and co-paymnets. the preventive services offered are comprehensive. As I am primarliy on preventive services, this pla is apt for me. also the cosutomer service is good
 
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