What are the differences between a point of service insurance plan and a fee for service plan?

S475 Quiz 2 Fall 2015
Please copy this into a word document. Once you have completed your answers submit it in the assignment tab for quiz 2. It is due by 10:00pm on 12-4-15 at 10:00pm.
Name: _____________________________________________________________
You are working as a home health care nurse in your home state. You are assigned to care for a 19 year old quadriplegic that was recently injured in a devastating motorcycle accident. He is currently on his parents’ insurance, but his mother is very concerned that they will reach their one million dollar “umbrella” limit and will not have insurance coverage. She asks you to explain the difference between Medicare and Medicaid.

In two paragraphs please explain the difference between Medicare and Medicaid in regards to financing, and coverage to this 45 year old 9th grade high school dropout and her 19 year old high school graduate son. Please use the exact conversational language you would use with this family. (15 points)

After explaining the differences between Medicare and Medicaid, the mother and son are interested in applying for Medicaid. Please respond to the following questions (10 points total):

In your home state, where could your mother and son apply for Medicaid? (2 points)

In your home state, what is a Medicaid “waiver”? (3 points)
What are some barriers to accessing Medicaid? (5 points)

You are working in at Community Health Center as a registered nurse, and one of your patients asks you about health insurance. Please respond to the following questions (10 points):
What are the differences between a Point of Service Insurance Plan and a Fee for Service Plan? (5 points)
Would you recommend they consider being part of a Health Exchange if that is an option? (5 points)
You are working as a school nurse and found a high level of children that are obese and overweight. After talking with the principal you decide to begin doing BMI measurements as part of evaluating a healthy weight program.
What are two issues to consider as you begin checking BMIs? (5 points)
You set up a counseling session with the parents of one obese 8 year old. What are two points you want convey to the parents? (5 points)
What are two other school based interventions you might consider as part of your healthy weight program? (5 points)

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