Health Care Reimbursement and Billing
Both Mrs. Zwick and Mr. Davis face significant issues in the presented scenarios. Mrs. Zwick has multiple considerations under Medicare Parts A, B and D, in addition to her hospital-acquired urinary tract infection. Meanwhile, Mr. Davis must address the severe time constraints and costs of COBRA in light of his job termination. These two scenarios underscore current difficulties and complexities of current health care in the United States.
Discussion of Mrs. Zwick's coverage under Medicare Parts A, B and C
Medicare Part A (often called "hospital insurance") (U.S. Department of Health and Human Services, 2011, p. 15) assists in covering inpatient hospitalization and skilled nursing facilities, hospice and home health care (U.S. Department of Health and Human Services, 2011, p. 14). There is usually no monthly premium if you and/or your spouse paid Medicare taxes while employed (U.S. Department of Health and Human Services, 2011, p. 28). However, if you have to buy Part A, you will have to pay up to $451 per month (U.S. Department of Health and Human Services, 2011, p. 28). Medicare Part A will cover Mrs. Zwick's 5-day inpatient hospital stay, including her semi-private room, general nursing, meals, and miscellaneous services and supplies provided by the hospital (Medicare Consumer Guide, 2012). She will pay a deductible of $1,156 and no copayment because this is within days 1 -- 60 of her benefit period (U.S. Department of Health and Human Services, 2011, p. 34). The skilled nursing home for rehabilitation is also covered because it is deemed medically necessary after more than 3 days of medically necessary inpatient hospital stay (U.S. Department of Health and Human Services, 2011, p. 35). In addition, according to the 21-day projected stay...
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