medicare warning

[papasar]

Thought this was worth passing along


VERY IMPORTANT IF YOU ARE ON MEDICARE
Beware of Medicare-do not let the hospital admit you with the words, "Under Observation." Insist on "In-Patient"designation
For your information and use when and if hospitalized on Medicare or your family or parents are hospitalized. See the nbc news video below.
I saw this on NBC News last night and thought I should send it to all my friends on Medicare as fair warning. I've included the segment for you to view. Basically, if I understand it correctly, do not let the hospital admit you with the words, "Under Observation." Insist on "In-Patient"designation. Otherwise, you will be responsible for the hospital expenses. It might be wise to inform family members too.
The Two Words That Cost Medicare Patients Thousands - Video on NBCNews.com

[DiamondWillow]

Re: medicare warning

Interesting, thanks for passing it on.
Gene

[Eddy-Smiles]

Re: medicare warning

It also depends on what kind of supplement insurance policy you have. Some of them will not pay if Medicare denies payment but others will pick up the check if it is medically necessary even if Medicare denies it.

[ragiarn]

Re: medicare warning

It is not as simple at you think. Patients who are placed on the observation list are not sick enough, (based on Medicare rules which have been in place for the past 10 years or more) to be admitted to the hospital but too sick to be sent home.

Even if a patient is admitted to a hospital as a regular admission for 3 days and subsequently are transferred to a Skilled nursing facility, Medicare will only pay for about 1 week-10 days of the SNF nursing facility. Longer stays in the SNF will not be paid for. This has been true for the past 40 years. Once a patient's condition has bee stabilized in a SNF Medicare is no longer responsible for continue care.

You can insist all you want to have your hospitalization status changed from observation to full admission however if your condition does not meet certain criteria Medicare will not pay for the hospitalization. These are not new regulations but regulations that have been in place since Medicare went into effect in 50 years ago.

[tbox61]

Re: medicare warning

Stuff like this infuriates me. It seems like a person is always shooting at a moving target with these rules. Frankly, I don’t see how the elderly deal with these type of changes. My mother is 90, and my father in law is 88…I don’t know how they would navigate this maze unless my wife and I stayed on top it.

Hang on, it is going to get worse. With the implementation of Obamacare, I am not looking forward to the $700+ BILLION cuts to MediCare over the next decade. I will be looking at retiring in the next 12 years or so. I am not so sure MediCare will still be viable when I retire.

[DiLeon]

Re: medicare warning

Warning number two.....do not change you insurance if you got Medicare. At time of divorce,... I lost my regular insurance but had my Medicare. I had no money so state recommended that I go on Medicaid...which I did for two months, with Medicaid paying for my Medicare payments. I got some money and canceled Medicaid after two months....but Medicare would not change payments to like it was before....leaving me with no insurance. When I kept calling the Federal and State about the Medicare payments, they told me point blank this is because of Obama Care. Two months of solid phone calls and 30 some letters,... I have zero insurance for the last seven months. Government will screw you over any way they can.....watch out.

[RobK]

Re: medicare warning

Ohio Senator Sherrod Brown is to introduce legislation to eliminate this "observation" protocol.

[ragiarn]

Re: medicare warning

Ohio Senator Sherrod Brown is to introduce legislation to eliminate this "observation" protocol.

If he eliminates the observation protocol, what happens to the patient who does not meet the criteria for admission but needs more time for work up and stabilization before being sent home?

There are certain criteria for admission to an acute care hospital which have been in place for years. If they are not met the insurance companies, medicare included, will not pay for the admission.

The observation protocol was put in place in the past decade to help patients and physicians to deal with this dilemma. Insurance companies will pay for observation protocol but will no pay for inappropriate admissions.