Part B: It is no secret that patients ask many questions about their insurance. In fact, many will assume the doctor’s office knows everything about insurance. Understanding various insurance structures will give you the tools needed to assist your patients. In the following scenarios, imagine you are answering the phone at a health care center and patients are calling with insurance questions.

Write a 90- to 175-word response to each of the following questions.

Format your answers according to APA guidelines and cite any sources accordingly.

1. Mrs. Jones calls the office and explains, “It is open enrollment and my employer is offering us a choice between a PPO plan and an HMO plan. Can you tell me the difference between them and which one you would recommend?”

1. Mary calls the office and asks, “I am so confused. Can you please help me understand the difference between an EPO and a POS plan? Everyone at work is asking, and I know you would be able to tell me.”

1. John calls the office and asks, “I was laid off and cannot afford the COBRA plan from my employer, but my insurance agent said an indemnity plan would be affordable. Can you tell me about this indemnity plan?”

Mr. Thomas calls the office and asks, “My employer is offering us cafeteria plans for next year, and I know this means I basically build my own plan, but could you tell me, of the PPO, HMO, or traditional comprehensive plan, which one or ones will enable me to go out-of-network for care? I do quite a bit of traveling and this concerns me”

Answers

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