Health care reform has made insurance accessible to everyone. As a consumer, it is important to be able to understand and compare health care coverage options. From a marketing perspective, consider consumers and why it would be important to understand consumer needs and how to market to different consumers based on their needs.
Case Study Comparisons
Part 1
Complete the chart below that differentiates the following insurance types.
| Plan Type
| Characteristics of Plan (5 to 7 characteristics) | Target Audience for Plan |
| Indemnity Plan | ||
| Preferred Provider Organization (PPO) | ||
| Health Maintenance Organization (HMO) | ||
| Consumer Directed Health Plan (CDHPs) | ||
| Medicaid | ||
| Medicare |
Part 2
Review the insurance plans and answer the following questions.
| Services | Bronze | Silver | Gold |
| Monthly Cost | $163.00 | $194.00 | $245.00 |
| Deductible | $6,000.00 | $4,000.00 | $1000.00 |
| Primary Care | $35.00 co-pay for three visits, then 20% of co-insurance | $30.00 co-pay/provider/day | $20.00 co-pay/provider/day |
| Specialist Visit | $70.00 co-pay for three visits, then 20% of co-insurance | $60.00 co-pay/provider/day | $40.00 co-pay/provider/day |
| Preventive Care/Screening/Immunization | No charge | No charge | No charge |
| Diagnostic Test (x-ray, blood work) | $35.00 co-pay or 20% of co-insurance if co-pay limit is researched | Office visit co-pay or 20% of co-insurance | Office visit co-pay or 20% of co-insurance |
| Level 1 Prescription Drugs | $25 co-pay/30 day supply | $15.00 co-pay/30 supply | $15.00 co-pay/30 supply |
| Emergency Room Services | 20% of co-insurance | $350.00 co-pay/facility/day | $250.00 co-pay/facility/day |
| Emergency Medical Transportation | 20% of co-insurance | 20% of co-insurance | 20% of co-insurance |
| Urgent Care | $75 co-pay | $60.00 co-pay/provider/day | $60.00 co-pay/provider/day |
| Hospital Stay (Facility fee, physician/surgeon fee) | 20% of co-insurance | 20% of co-insurance | 20% of co-insurance |
Consumer A
Betsy has type 2 diabetes and high blood pressure. She visits the doctor often to keep her diabetes and blood pressure controlled. The doctor regularly checks her blood levels and prescribes level 1 prescriptions to help Betsy control her diabetes and blood pressure.
Consumer B
Zach is a healthy 30 year old who rarely goes to the doctor and is not on any medication. He has been offered the following insurance plans and he is considering the plans for use of common alignments (i.e., colds) and for preventive tests.
Zach has recently been hired as a construction worker and was considering changing his health plan. He realizes that this new job may have more hazards than his last job.
