Insurance Plans are renowned for their provision of free or low-cost coverage to several families with limited income in the US. Today, people capitalize on insurance plans during economic crises and the implications have been amazing. The following is a scenario in which an individual or family is currently making use of the Insurance Plan program but plans to move to another state.
Peter Johnson is a young child aged 11 years and has a chronic skin disease. His family currently makes use of the Florida Kidcare Insurance Plan program, which has provided low-cost coverage; hence, aiding in the treatment of Johnson’s chronic skin disease. His family has a low income, and this is one of the major reasons for their embrace of the Florida Kidcare Insurance plan. However, the family of Peter Johnson plans to move to the state of California, and this will force them to embrace the health Insurance plans of California.
Below is a chart that compares the rate of individuals who are uninsured to health insurance plans in the states of New York, California, Florida, and Texas.
Chart: Percent of adults ages 19-64 who are uninsured
Taking into consideration the above states, the state with the best Health Insurance plan especially for young children is Florida, and this is because the state’s plan does not include a charge for Medicaid for Children (Winter, 2013). Besides, for Florida Kidcare programs, the monthly premiums paid are dependent on the size and income of the child’s household (Winter, 2013). This implies that individuals or families with low incomes do not find it difficult to pay the monthly premiums. Therefore, even though Johnson’s family may be moving to California, they should stick to Florida’s health insurance plan for young children.
Program features and characteristics
Today, insurance plans are being embraced by most states in the US due to the benefits accompanying them. First, the insurance plans have been beneficial to several individuals and families with low income by providing low-cost coverage (Smith & Medalia, 2014). Second, there are other insurance plans, such as the Florida Kidcare Insurance plan that provides free coverage to young children with various health complications. It should be noted that Insurance Plans have various characteristics. For instance, the beneficiaries of various insurance plans must be of ages that are specified by the plans. Moreover, every insurance plan has income eligibility requirements that must be met by the beneficiaries. On the other hand, there are costs that accompany various Insurance Plans (Smith & Medalia, 2014).
The state recommended for the scenario (Peter Johnson) is Florida because of the myriads of benefits and advantages accompanying their insurance plans especially the Florida Kidcare where no charge for Medicaid for children is required. Below is a visual indication of the Florida insurance plan:
Description of the decision-making process
What are the most important features that impacted the state choice of the scenario?
Apparently, choosing the state with the best health insurance plan that would help solve Peter Johnson’s family problems was not an easy task. There are several important features that influenced or rather impacted the state choice. First, the type of health insurance plan that was preferable and that would help solve Johnson’s situation played an integral role in choosing the state. Johnson was aged 11 and was considered a child. Therefore, the type of insurance plan had to be one that dealt with children’s health complications. Looking at the states of California, New York, and Texas, none of them had insurance plans that provided free or low-cost coverage to young children from families with low income. This left Florida as the only option as it had an insurance plan in place that was purposefully for children under the age of 19 years. Second, the myriads of benefits that accompanied Florida’s health insurance plan had a major impact on the state choice. For instance, Florida’s insurance plan articulated that no charge for Medicaid was required of children or their families.
Besides, the insurance plan of Florida gave the option that monthly premiums were dependent on the size and income of the child’s household (Constantine et al, 2007). Notably, the insurance plans of states such as California, Texas, and New York lacked such benefits, and this underscores why Florida’s insurance plan was chosen for the scenario. Unlike the insurance plans of Texas, New York, and California, Florida’s Kidcare insurance plan clearly outlines the eligibility of the children in a position to benefit from the plan. Florida Kidcare insurance plan states that children must be under age 19. The plan adds that the children must be uninsured, must meet income eligibility requirements and that the beneficiary must be a US citizen or a qualified non-citizen. The Florida Kidcare also states that the child who is the beneficiary must not be eligible for Medicaid and that he or she must not be in a public institution (Constantine et al, 2007). Such clear stipulations are not evident in the insurance plans of other states and thus, underscores why Florida was preferred in the scenario.
The preference of Florida’s Kidcare insurance plan in the scenario is also owed to the low costs paid by the beneficiaries of the plan. Arguably, the monthly premiums of the plan of $15 or $20 were slightly less than those of the insurance plans of the states of Texas, California, and New York (Constantine et al, 2007). Also, the efficiency of the insurance plans of every state played an integral role in the decision-making process. It came out that Florida’s Kidcare insurance plan was more efficient and successful as compared to those of the states mentioned earlier. In fact, Texas was seen to have the highest number of uninsured individuals, and this meant that insurance plans were yet to kick off in the state, and this impacted on the state choice in the scenario. It was also evident that more children had previously benefitted from Florida’s Kidcare program, and no other state’s insurance plan would be more convincing.
What difficulties were faced in choosing a state?
A plethora of difficulties or challenges were faced in the scenario when choosing the state of Florida over other states such as California, New York, and Texas. Thus, a critical examination of the difficulties or challenges would be crucial, and this would help influence the future choice of states with the best health insurance plans. One of the challenges faced when choosing a state was that all the aforementioned States had health insurance plans. This is an insinuation that there was confusion on choosing that state among the four had the best insurance plan that would help address the problem in the scenario. The other challenge experienced when choosing the state was that there was a lack of information on the type of plan that would be crucial in addressing the problem highlighted in the scenario.
Essentially, with relevant information on the type of plan required, choosing the state would be a fast and easy task yet this was not the case, hence, the people involved were forced to do thorough research on the type of plan that would help address the issue highlighted in the scenario, and they ended up choosing a Kidcare insurance plan that was available in the state of Florida. Subsequently, the other difficulty faced in choosing the state was the similarity in the cost of medical care in the aforementioned states. Seemingly, a similar cost of medical care in every state would make it hard for an individual to choose a state. However, if one state provided low costs of medical care, it would be easier for an individual to choose it over other states (Irvine et al, 2013).
The other irrefutable difficulty faced when choosing a state was the lack of knowledge of the benefits included in the insurance plans of each of the aforementioned states. It cannot be ignored that before choosing an insurance plan, and an individual should be made aware or have an idea of the benefits that would accompany it. In the scenario, Johnson’s families had no idea of the benefits of the insurance plans of other states such as California, New York, and Texas. It is arguable that their choice of the state was only determined by the knowledge they had on the benefits of Florida’s Kidcare insurance plan. It is important that when choosing an insurance plan an individual or family should understand how disputes over claims are handled (Irvine et al, 2013). Thus, it can be concluded that the lack of information on the handling of disputes over claims in each of the aforementioned states’ insurance plans was a major difficulty in choosing a state. It is also a prerequisite that the individual or family interested in an insurance plan should have information on the financial stability of the insurer. However, this was not the case in the scenario. Therefore, it can be concluded that the lack of information on the financial ability of each state to fund or support their insurance plans was a difficulty faced in choosing a state.
It is also essential for an individual or family with the interest of benefiting from an insurance plan to have a clear understanding of the restrictions accompanying a particular insurance plan (Irvine et al, 2013). With this, it is highly likely that a perfect and efficient insurance plan will be selected. Thus, it is arguable that one of the difficulties faced in choosing the state was the lack of information on the restrictions accompanying the insurance plans of each of the aforementioned states.
Under what circumstances would you recommend a different state, and why?
Despite the choice of Florida, there are other circumstances that would influence the recommendation of a different state. In the scenario, it is highlighted that Johnson’s family would move to the state of California. Thus, the movement of the family to California would prompt the choice of California’s insurance plan. Without a doubt, while staying in California, it would be easier and faster for Johnson and the family to have access to insurance plans in the state of California. This would prompt the choice of California’s insurance plan.
The other circumstance that would influence the recommendation of a different state is an enhancement or improvement of the benefits accompanying insurance plans of other states (Martinez & Cohen, 2009). For instance, an improvement of the benefits accompanying Texas’ insurance plan would prompt its choice. This is because through an improvement of the benefits, the insurance plans will be considered more efficient. Apparently, an enhancement or an improvement of the benefits accompanying the insurance plans could include a significant reduction in the monthly premiums paid by the individuals or families interested in the insurance plans. Additionally, an improvement could also include the effective utilization of resources to ensure good results for the beneficiaries of the insurance plans.
The other circumstance that would influence the recommendation of a different state other than Florida in the scenario is the significant reduction of medical care costs in other aforementioned states. Undoubtedly, every individual would give preference to a healthcare institution that provides services at reduced costs (Martinez & Cohen, 2009). This is because reduced costs would make services affordable to individuals from every economic background. Similarly, if there were a significant reduction in the medical care costs in other states such as Texas, California, and New York, the recommendation of a different state other than Florida would be justifiable. This is owed to the fact that every individual or family will be headed to states that provide services that are affordable to every person including those with low income.
Constantine, R. J., Murrin, M. R., Guo, J., Wang, Y., Louis de la Parte Florida Mental Health Institute., & Florida. (2007). Evaluation of Florida’s Medicaid managed mental health plans year 10 report: Administrative data component. Tampa: Louis de la Parte Florida Mental Health Institute, University of South Florida.
Irvine, B., Clarke, E., & Bidgood, E. (2013). Healthcare systems: the USA. London CIVITAS.
Martinez, M. E., & Cohen, R. A. (2009). Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey January-September 2008. National Center for Health Statistics, March.
Smith, J. C., & Medalia, C. (2014). Health Insurance Coverage in the United States: 2013. US Department of Commerce, Economics and Statistics Administration, Bureau of the Census.
Winter, R. E. (2013). Unraveling U.S. health care: A personal guide. Lanham, Md: Rowman & Littlefield.