Reference no: EM133235815

In the last lesson, you learned about insurance types and terms. For the following scenario, think about how you would explain this situation to the patient.

Mrs. Jones just turned 65 years old this year and became eligible for Medicare. She has Medicare A and selected Medicare B insurance to cover her outpatient services. She also has Medicare D for prescription plans. This is all of the coverage that she has because she did not obtain a Medigap plan.

Her deductible for the year has already been met for Medicare B. She received a statement from Dr. Smith's office that shows that for her appointment last month, there was a $100 charge. Medicare paid $80, and she must pay $20. She does not understand why she must pay the $20. Is this a justifiable charge or an error? How would you explain this to her? HINT: Medicare B is 80/20 coinsurance.