Joseph Amico is covered by BlueCross and Medicare. His BlueCross plan has an 85-
ID: 450924 • Letter: J
Question
Joseph Amico is covered by BlueCross and Medicare. His BlueCross plan has an 85-15 coinsurance and a $100 deductible. This year’s Medicare deductible is $110. He was seen at the clinic on January 11(the first visit this year); charges for the office visit were $135. Claims were submitted to BlueCross as primary payer and to Medicare as secondary payer.
What amount will BlueCross be responsible for?
What amount will Medicare be responsible for?
What amount will Joseph be responsible for?
Joseph saw the doctor again in February. Charges for the office visit and tests were $215.
What amount will BlueCross be responsible for?
What amount will Medicare be responsible for?
What amount will Joseph be responsible for?
Explanation / Answer
What amount will BlueCross be responsible for?
Blue cross pays 85% of 135 = $114.75
What amount will Medicare be responsible for?
Since the amount is below $110 Medicare pays Nil
What amount will Joseph be responsible for?
Joseph pays 15% of 135 = $20.25
What amount will BlueCross be responsible for?
Blue cross pays 85% of 215 = $182.75
What amount will Medicare be responsible for?
Since the amount is below $110 Medicare pays Nil
What amount will Joseph be responsible for?
Joseph pays 15% of 215 = $32.25
Related Questions
Navigate
Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.