Creating a hospital system that can instill the best quality of care for the patients is dependent upon the type of funding that will be received. Funding comes from donors and other single parties but majority of the time it comes from the insurance companies. There are thousands of health insurance companies available. A state insurance, like Molina healthcare, allows the low-income families and people with disabilities to receive care at a lower cost. A federal insurance that people receive once they turn 65 years of age is Medicare. Medicare is made up of Part A for hospital coverage and Part B for medical coverage. Additional Medicare coverage that is optional includes Part C for Medicare Advantage and Part D for prescription drugs. Third party payors, which are mostly private insurances include United Health Care, Aetna, Blue Cross Blue Shield, and Humana. Each insurance company has its own coverage, costs, and benefits. Hence, financial problems are occurring among patients due to the increased cost of sharing in insurance plans like higher deductibles and copayments (Bain et al., 2016).
There are different types of Molina healthcare. There is Medicaid, Molina Medicare, Integrated Medicaid/Medicare, and the Molina Marketplace. Molina Medicaid provides healthcare to a wide variety of people who qualify for government funded insurance programs. Molina Medicare offers advantage plans to those who have Medicare and/or Medicaid coverage. These plans are comprehensive and have access to quality health care facilities and professionals at little to no cost. Integrated Medicaid/Medicare is a member-centered care plan for those who qualify. It is aimed to meet the unique needs of the clients. Lastly, the Molina Marketplace offer plans that eliminate financial limitations for quality care and allow Medicaid members the freedom to stay with their providers until they are fully transitioned to the marketplace. This is known as exchange in other states.
Molina Healthcare offers several benefits for their clients. Some of these benefits include non-emergency medical transportation, non-medical transportation, preventive and comprehensive dental services, vision, women’s health care services, and over-the-counter (OTC) benefits (Molina Healthcare, 2018). These advantages of Molina help the underprivileged populations receive the care they need by aiding in transportation to their appointments and providing basic and preventative health services with no copay. Molina is an example of managed health care, which by nature, aims to lower healthcare costs (Nickitas, Middaugh, & Aries, 2016). Although they offer several benefits, managed care does not focus on ensuring quality care. The main goal is to lower costs for their clients which is demonstrated by little to no out-of-pocket copays.
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