So I was working on MATE practice problem #19 and it is a question about Medicare coordination of benefits (COB). You have to use the given information to determine what the Medicare covered expense is using the exclusion method. The exclusion method is (C-M)% where C=covered expenses, M=Medicare payment and %=application of employer's provisions. Now the employer's provisions are a $500 deductible with 20% coinsurance after. Given is that the payment using the exclusion method was $400.
So we have (C-M)% = 400. Now C is given as 4500 so we have (4500-M)%=400. The MATE solution, however, solves by setting up the solution as: [(4500-M) - 500]*(1-.2)=400 solving for M gets M=3500. That makes sense and works, but that is assuming that the deductible was met, i.e. C-M>500. But what if C-M<500. Why can't M=4100 which would still get you a cost of $400 using the exclusion method? It seems to me like this question should have two different answers. Am I missing something?
So we have (C-M)% = 400. Now C is given as 4500 so we have (4500-M)%=400. The MATE solution, however, solves by setting up the solution as: [(4500-M) - 500]*(1-.2)=400 solving for M gets M=3500. That makes sense and works, but that is assuming that the deductible was met, i.e. C-M>500. But what if C-M<500. Why can't M=4100 which would still get you a cost of $400 using the exclusion method? It seems to me like this question should have two different answers. Am I missing something?
MATE Sample question #19
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