Please help!

Medicare Cost Sharing 2021 Medicare Costs at a Glance a Part A Premium Premium-free with qualifying work history, (monthly) $471 each month without Part A Deductible You pay: and Coinsurance $1,484 deductible for each benefit period Days 1-60: $0 coinsurance for each benefit period Days 61-90: $371 coinsurance per day of each benefit period Days 91 and beyond: $742 coinsurance per each "lifetime reserve day" lifetime Beyond lifetime reserve days: All costs Bo over your life for each benefit period (up to 60 days Skilled Nursing Facility stay In 2021, you pay . $0 for the first 20 days of each benefit period $185.50 per day for days 21-100 of each benefit period All costs for each day after day 100 of the benefit period Part B Premium (monthly) Part B Deductible and Coinsurance The standard Part B premium amount is $148.50 (high earners pay more) $203 per year and then 20% of the Medicare-approved amount Home health No time limit- based on medical necessity criteria Nothing for services: durable medical equipment (DME) is included in Medicare Part B, see table 3.2 Hospice No time limit- based on physician certification Limited costs for outpatient drugs and inpatient respite care . Part B annual deductible: In 2021. you pay $203 for your Part B deductible. After you meet your deductible for the year, you typically pay 20% of the Medicare-Approved Amount for these: . Most doctor services (including most doctor services while you're a hospital Inpatient) o Outpatient therapy Durable Medical Eguipment (Ome) Clinical laboratory services: You pay So for Medicare-approved services, Home health services: $for home health care services. 20% of the Medicare-Approved Amount for durable medical equipment (dme). Medical and other services: You pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you're a hospital inpatient), outpatient therapy, and Durable Medical Equipment (Ome) [Glossary] . Outpatient mental health services: You pay nothing for your yearly depression screening if your doctor or health care provider accepts assignment. 20% of the Medicare-approved amount for visits to your doctor or other health care provider to diagnose or treat your condition. The Part B deductible applies. If you get your services in a hospital outpatient clinic or hospital outpatient department, you may have to pay an additional copayment or coinsurance amount to the hospital. Partial hospitalization mental health services: You pay a percentage of the Medicare-Approved Amount for each service you get from a doctor or certain other qualified mental health professionals if your health care professional accepts assignment. You also pay coinsurance for each day of partial hospitalization services you get in a hospital outpatient setting or community mental health center, and the Part B deductible applies. . Outpatient hospital services: You usually pay 20% of the Medicare-approved amount for the doctor or other health care provider's services. For services that can also be provided in a doctor's office, you may pay more for outpatient services you get in a hospital than you'll pay for the same care in a doctor's office. However, the hospital outpatient copayment for the service is capped at the inpatient deductible amount. In addition to the amount you pay the doctor, you'll also usually pay the hospital a copayment for each service you get in a hospital outpatient setting, except for certain preventive services that don't have a copayment. In most cases, the copayment can't be more than the Part A hospital stay deductible for each service. The Part B deductible applies, except for certain preventive services If you get hospital outpatient services in a critical access hospital. your copayment may be higher and may exceed the Part A hospital stay deductible. The information on the previous pages reflects the 2021 cost sharing (deductibles and Coinsurance) for Part A Inpatient, Part A Skilled Nursing Facility, Home Health, Hospice and Part B Outpatient. Calculate the cost sharing amount for a beneficiary in the following scenarios. Scenario A Sandra was sent to Acadiana Laboratory to get some blood work done for her primary care physician. She has already met her outpatient deductible for the year. What is the cost sharing amount for Sandra for the laboratory services? Scenario B This is the third inpatient admission for Jackson this year. Jackson satisfied his deductible during the first admission. The first admission was 30 days. The second admission was 25 days. The length of stay for the third admission was 13 days. (These 3 admissions are considered all part of the same benefit period.) What is the cost sharing amount Jackson owes for the third inpatient admission? Scenario Anna is receiving home health services three times per week at her home. The Home Health Agency approved two pieces of durable medical equipment (DME) which include a lift chair and a walker. The total allowable charge for the two DME items is $950.00. The total allowable charges for home health services for the most recent 60 day episode of care totals $1,435.00. Anna has already met her inpatient and outpatient deductible for the year. What are the cost sharing amounts for the home health services and the DME? Scenario D Savannah saw her primary care physician in January for a sinus infection. The total allowed charges for the visit was $155.00. This was the first healthcare encounter for Savannah this year. What is the cost sharing amount for the physician visit? $ Scenario E After each of the three inpatient admissions, Jackson (from Scenario B) was transferred to a Skilled nursing facility (SNF). The first stay in the SNF was for five days and then he was discharged home. After the second hospital admission he was transferred to the SNF and stayed in the SNF for ten days and then discharged home. After the third admission, he was again transferred to the SNF where he stayed for seven days. (These 3 SNF stays are considered all part of the same benefit period.) What was the Jackson's cost sharing amount for his three stays in the SNF? Medicare Cost Sharing 2021 Medicare Costs at a Glance a Part A Premium Premium-free with qualifying work history, (monthly) $471 each month without Part A Deductible You pay: and Coinsurance $1,484 deductible for each benefit period Days 1-60: $0 coinsurance for each benefit period Days 61-90: $371 coinsurance per day of each benefit period Days 91 and beyond: $742 coinsurance per each "lifetime reserve day" lifetime Beyond lifetime reserve days: All costs Bo over your life for each benefit period (up to 60 days Skilled Nursing Facility stay In 2021, you pay . $0 for the first 20 days of each benefit period $185.50 per day for days 21-100 of each benefit period All costs for each day after day 100 of the benefit period Part B Premium (monthly) Part B Deductible and Coinsurance The standard Part B premium amount is $148.50 (high earners pay more) $203 per year and then 20% of the Medicare-approved amount Home health No time limit- based on medical necessity criteria Nothing for services: durable medical equipment (DME) is included in Medicare Part B, see table 3.2 Hospice No time limit- based on physician certification Limited costs for outpatient drugs and inpatient respite care . Part B annual deductible: In 2021. you pay $203 for your Part B deductible. After you meet your deductible for the year, you typically pay 20% of the Medicare-Approved Amount for these: . Most doctor services (including most doctor services while you're a hospital Inpatient) o Outpatient therapy Durable Medical Eguipment (Ome) Clinical laboratory services: You pay So for Medicare-approved services, Home health services: $for home health care services. 20% of the Medicare-Approved Amount for durable medical equipment (dme). Medical and other services: You pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you're a hospital inpatient), outpatient therapy, and Durable Medical Equipment (Ome) [Glossary] . Outpatient mental health services: You pay nothing for your yearly depression screening if your doctor or health care provider accepts assignment. 20% of the Medicare-approved amount for visits to your doctor or other health care provider to diagnose or treat your condition. The Part B deductible applies. If you get your services in a hospital outpatient clinic or hospital outpatient department, you may have to pay an additional copayment or coinsurance amount to the hospital. Partial hospitalization mental health services: You pay a percentage of the Medicare-Approved Amount for each service you get from a doctor or certain other qualified mental health professionals if your health care professional accepts assignment. You also pay coinsurance for each day of partial hospitalization services you get in a hospital outpatient setting or community mental health center, and the Part B deductible applies. . Outpatient hospital services: You usually pay 20% of the Medicare-approved amount for the doctor or other health care provider's services. For services that can also be provided in a doctor's office, you may pay more for outpatient services you get in a hospital than you'll pay for the same care in a doctor's office. However, the hospital outpatient copayment for the service is capped at the inpatient deductible amount. In addition to the amount you pay the doctor, you'll also usually pay the hospital a copayment for each service you get in a hospital outpatient setting, except for certain preventive services that don't have a copayment. In most cases, the copayment can't be more than the Part A hospital stay deductible for each service. The Part B deductible applies, except for certain preventive services If you get hospital outpatient services in a critical access hospital. your copayment may be higher and may exceed the Part A hospital stay deductible. The information on the previous pages reflects the 2021 cost sharing (deductibles and Coinsurance) for Part A Inpatient, Part A Skilled Nursing Facility, Home Health, Hospice and Part B Outpatient. Calculate the cost sharing amount for a beneficiary in the following scenarios. Scenario A Sandra was sent to Acadiana Laboratory to get some blood work done for her primary care physician. She has already met her outpatient deductible for the year. What is the cost sharing amount for Sandra for the laboratory services? Scenario B This is the third inpatient admission for Jackson this year. Jackson satisfied his deductible during the first admission. The first admission was 30 days. The second admission was 25 days. The length of stay for the third admission was 13 days. (These 3 admissions are considered all part of the same benefit period.) What is the cost sharing amount Jackson owes for the third inpatient admission? Scenario Anna is receiving home health services three times per week at her home. The Home Health Agency approved two pieces of durable medical equipment (DME) which include a lift chair and a walker. The total allowable charge for the two DME items is $950.00. The total allowable charges for home health services for the most recent 60 day episode of care totals $1,435.00. Anna has already met her inpatient and outpatient deductible for the year. What are the cost sharing amounts for the home health services and the DME? Scenario D Savannah saw her primary care physician in January for a sinus infection. The total allowed charges for the visit was $155.00. This was the first healthcare encounter for Savannah this year. What is the cost sharing amount for the physician visit? $ Scenario E After each of the three inpatient admissions, Jackson (from Scenario B) was transferred to a Skilled nursing facility (SNF). The first stay in the SNF was for five days and then he was discharged home. After the second hospital admission he was transferred to the SNF and stayed in the SNF for ten days and then discharged home. After the third admission, he was again transferred to the SNF where he stayed for seven days. (These 3 SNF stays are considered all part of the same benefit period.) What was the Jackson's cost sharing amount for his three stays in the SNF