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Sheba MasihAssignment #5: Health ChoiceHMGT 420 Health Care Facilities ManagementProfessor: Jerome BozekDue: May 7th, 2017
Health Choice1.Benefits Offered and Services CoveredThe questions would be asked to determine the benefits and covered services offered are as listed. Who determines length of stay in the hospital? Are Routine Examinations Covered? What,when and where is emergency care covered? What programs help patients with chronic disease? What preventive services and programs are available? Does the plan cover post-hospital care, such as home care visits if needed? How does the plan cover prescriptions? Will I be able to use my current doctors? Will I Have to Call My Doctor Before Going to the Emergency Room? What Are the Plan's Restrictions on Pre-Existing Conditions? What Happens When I am Away from Home? Health Choice Program gives health care services to most eligible Medicaid participants. The participants enroll in a Managed Care Organization (MCO) of their liking and select a primary care provider (PCP) to oversee their medical needs. Health Choice enrollees are given benefits similar to those available to Maryland Medicaid recipients through the Medicaid fee-for-service system. Through classification of recipients by healthcare utilization, Health Choice ensures greater payments for the sickest patients a few special payment categories to MCOs including: a payment for delivery costs for expectant enrollees; enrollees under age one; and enrollees with HIV/AIDS.2.Cost vs. Benefits It offers various services for a reduced cost and even some are for free. They are as follows: Free prescriptions and over the counter medicines; free visual care for children as well as adults; low-cost dental care for adults; routine PCP’s visits and physical assessments; emergency services; immunizations for children; mental health services; drug abuse treatment and counseling; mammograms; incentives for expectant women; some conditions such as