Question

Choose the insurance plan you want Sarah to be enrolled in: Medicare, Medicaid, TRICARE, Workers’ Compensation.

Choose her reason for the initial medical appointment and correctly use the necessary codes and compensation entitled by the insurance she is enrolled with.

Tell us how you would explain her insurance benefits, rights, costs, and billing under her particular plan.

Answer 1

(i) Sarah is 67 years old and has Medicare Part A and Part B as her primary health insurance coverage.
-In general, Part A covers:-
Hospital care
Skilled nursing facility care
Nursing home care
Hospice Home health service
COST:- Part A includes a monthly premium
- Part A if you or your spouse paid Medicare taxes while working for at least 10 years (40 quarters).
- If you do not qualify for premium-free Part A, the monthly premium in 2018 is $422.

(ii) Part B covers:-
- type 2 services
-Clinical research
-Ambulance services
-Durable medical equipment (DME)
- inpatient care
- outpatient care

COST:-
-Medicare Part B has a standard annual deductible ($183 in 2018) and a monthly premium ($134 for most Medicare enrollees). -After the deductible is met, you typically pay 20% of the cost of services and Medicare covers the rest.