Terran Baumgartner
10/24/2014
HIMS 1410- Principles of Insurance
Instructor: Jazmine Konyek
BlueCross BlueShield Association (BCBSA) is a company that consists of more than 450 independantly, and locally operated BlueCross BleShield plans that give health care coverage to more than 80 million Americans. The BCBS is located in Chicago, Illinois, and establishes standards for new plans and programs, Assists local plans with enrollment activities, national advertising, public education, professional relations, and statistical and research activites. They are contractors for processing medicare claims, and coordinate nationwide BCBS plans. BlueCross BlueShield didn’t become a national association until …show more content…
They cover Fee-for-service plans, Indemnity plans, Federal Employee Program plans, Medicare supplemental plans, and Healthcare Anywhere plans. Fee-for-service plans are what they would consider their traditional plans. The basic coverage covers hospitalization, obstetric care, newborn care, surgical feels, x-rays, diagnostic laboratory service, assistant surgeon fees, and intensive care. If you add the major medical coverage it will also cover office visits, outpatient nonsurgical treatment, allergy testing and injections, physical and occupational therapy, mental health encounters, prescription drugs, purchase of durable medical equipment, dental care, and private duty nursing. Indemnity coverage gives subscribers the benefit of using whatever health care provider they choose to use. They can choose between hospital-only or comprehensive hospital and medical coverage. Basically they have freedom to see whomever they want, whenever they want, without having to have a referral to do so. They also have many different coinsurance plans to choose from to help with the share of cost …show more content…
There are many different types of managed care plans. Some of the more popular types are preferred provider organizations (PPO), exclusive provider organizations (EPO), point of service plans (POS), and Health maintenance organizations (HMO). Health maintenance organization plans share the financial risks that come with having comprehensive medical services for a prepaid fee. Preferred provider organizations give cheaper health care with certain named providers. Exclusive provider organizations don’t have to have named primary care physicians but if they don’t go to the providers that are included in the plan they have to pay full price for whatever services they have had done. Point of service plans let you go to whatever doctor or hospital that you see fit, but under the understanding that they may have to pay a higher copayment for going to a physician or hospital that isn’t named specifically on their