Tuesday, December 22, 2015

Could clients with Medicare Part B qualify for WWC services as underinsured?

Question: Clients with only Medicare Part A qualify for WWC clinical services. Could clients with Medicare Part B qualify as underinsured if they are unable to pay their co-pay/co-insurance?

Answer: Clients who have Medicare Part B
as health insurance are not eligible for WWC clinical services. If they are under 65, however, they can be enrolled in WWC care coordination.

In general, Medicare Part A covers hospital care, skilled nursing facility care, nursing home care, hospice, and home health services. Medicare Part B cover two types of services, medically necessary services and preventive services. Part B will cover a screening mammogram once every 12 months and diagnostic mammography when medically necessary in women 40 or older. Part B also covers Pap tests, pelvic exams, and clinical breast exams every 24 months for all women and every 12 months for those considered high risk for cervical cancer.

Additional information can be found here:
https://www.medicare.gov/coverage/your-medicare-coverage.html.

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