Answer to Question 1
B
Those who have insurance or government-financed insurance bear some of the expenses of healthcare through cost sharing. Typical cost sharing can be in the form of co-pays, deductibles, paying a portion of one's insurance premium, or paying costs above a fixed payment amount. Patients do not always understand cost-sharing methods and may need an explanation at the time of the visit. The best response is for the nurse to explain what a co-payment is. Most facilities have access to the coverage plan and can answer immediate questions until the patient is able to follow up with his or her insurance company. Stating that healthcare is expensive is merely stating the obvious; it may also be perceived as defensive rather than supportive. Co-payments are typically not part of an insurance premium and are only collected at the time of a service.
Answer to Question 2
A
Social workers counsel patients on financial, housing, marital, and family issues affecting healthcare. Owing to rising healthcare costs and diminished access to healthcare, particularly for aging populations, social workers are increasingly used to help move clients through the health system. Acknowledging the rising costs of medications does not assist the patient in solving the problem of his ability to pay for medications. The case manager cannot make any assumption that to alleviate the patient's concern for affording medications, it might be appropriate to have some medications discontinued. The home health nurse typically coordinates the care and services but is not typically the healthcare provider addressing financial concerns.