Health Insurance Social Science Paper

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Health Insurance Social Science Paper




Length: A 3-to 4-page, APA-formatted paper

Background: Medical Social Workers assist patients and their families with health-related problems and concerns. The Medical Social Worker performs a comprehensive assessment of a patient’s social, emotional, environmental, financial, and support needs and informs other members of the health care team about how these factors may affect the patient’s health and well-being. Medical Social Workers collaborate with the patient’s family or support system as well as other service provider agencies to develop a plan for the care of the patient.

After assessing the patient’s needs, the social worker will intervene as needed. Some patients may need help connecting with services in their community, such as a homeless shelter or drug treatment support. Other patients may need help understanding their medical condition and navigating the resources available to them, such as home care services, durable medical equipment, or discounts for medications.

Objective: The goal of this assignment is to demonstrate your understanding of the course materials on health insurance options, including an understanding of the differences between Medicare and Medicaid.

Client Scenario: You are a Case Manager Social Worker in a local medical clinic. John has been referred to you as he has expressed that he cannot afford the medication prescribed for his condition, and the doctor feels strongly that the medication is needed, given the results from his recent medical tests and diagnosis.

John is a 59-year-old single male and is a permanent U.S. resident. He suffers from chronic pain and has also been diagnosed with Major Depressive Disorder. He is not permanently disabled. John’s doctor prescribed Cymbalta for his depression, which is expensive. The doctor chose this medication based on John’s symptoms, which proved to be recurrent and persistent as well as non-responsive to other medications.

John is employed part-time and works approximately 18-20 hours per week. He makes less than $15,000 per year. John currently is not covered by any health insurance. He indicates to you that he missed the open enrollment deadline for the Affordable Care Plan. He asks you to help him apply for health insurance that he would qualify for and afford.

For this assignment, you are to:

1) Conduct an online search to investigate available indigent medication programs and identify the best program that could be used to assist John.

2) Conduct an online search to investigate available health insurance plans for John and assist him in how to apply. (*Tip: Do not enter your own information on a health insurance company query or they will harass you for weeks.)

3) Write a 3-to-4 page paper in APA format and proofread using Grammarly to cover the following:

a) Identify at least three medication assistance programs that you explored and provide a summary of them, concluding with the one that you would recommend for this client and why. (2 pts)

b) Identify at least two health insurance plans you would recommend to John and why. (2 pts)

c) Discuss the qualifications to be eligible for the health insurance plans and explain how it is feasible for John to apply given the costs and qualifications. (2 pts)

d) Discuss specifics of what you will need to do to help him prepare to apply for health insurance coverage. What documentation will he need for the application(s)? (2 pts)

e) After recommending the two health insurance plans, discuss the time it takes to apply and how long it will take before he will receive benefits from the programs you identified if he qualifies. (2 pts)

f) If John determines he cannot afford or does not qualify for health insurance coverage, discuss what other options he might have in your area to receive medical care for the uninsured. (2 pts)

g) Conclude the paper discussing your final recommendations for John to get the help he needs. (1 pts)

h) Paper is written in APA format and has been proofread for grammatical/spelling errors. (2 pts)

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