BHS 427 - Health Care Finance (Module 4-SLP) Essay

BHS 427 - Health Care Finance (Module 4-SLP) - Essay Example If the husband or wife has paid Medicare taxes when employed, such people are enrolled to Part A without paying monthly premium. If Medicare taxes have not been paid during employment, they can apply for Part A and pay premium which changes year by year. The premium rate for 2009 is as follows: Part B: Medicare medical insurance is taken mainly to avail those services which Part A does not cover and it is optional. It offers the rights like doctors’ services, outpatient care and other medical services. The premium is decided by the individual. Some pay a standard monthly premium of $96.40 and others on the basis of their income. A case if costs more than the â€Å"fixed-loss cost threshold amount (a dollar amount by which the costs of a case must exceed payments in order to qualify for outliers).† (Outlier payments, 2006). Medicare payments to hospitals fall under two categories-prospective payment and physician payment. The prospective payments include costs like operating cost, capital cost and outlier cost. Operating cost is paid if the patient has to stay long in the hospital. Capital cost includes cost for treatment and care to the patient. If a patient uses extraordinary resources then outlier cost is charged which is an additional payment. Physician payment is calculated on the basis of current procedural terminology (CPT) codes. The payment rate depends upon the Work RVU, Practise expense RVU and Malpractice RVU which may vary by region. What are the Medicare premiums and coinsurance rate for 2009?: Answer: For each benefit period you pay. (2008). U S Department of health & human services. Retrieved June 5, 2009, from