Medicare Part A Hospital Inpatient or Under Observation? A Costly Difference

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MEDICARE PART A Hospital Inpatient or Under Observation? A Costly Difference!

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In this video, you’ll learn:

✅The difference between being a hospital inpatient and being under observation

✅What is a Medicare qualified hospital stay and why it’s important

✅Why Medicare may not cover the cost of rehabilitation

✅How to protect yourself from unexpected Medicare out-of-pocket costs

RESOURCES AND OTHER MENTIONS IN THIS VIDEO:

How to set up a representative to contact Medicare on your behalf:

NBC New York 4: Medicare Denies Post-Hospital Care Costs for Patients 'Under Observation'

MOON: Medicare Outpatient Observation Notice

Kaiser Health News:

 

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19 thoughts on “Medicare Part A Hospital Inpatient or Under Observation? A Costly Difference

    • It’s great to see you here…thanks for participating in this conversation. The MOON notice was enacted in August of 2015; however hospitals and critical access hospitals didn’t begin using the MOON until August of 2016. And, according to CMS.gov, they weren’t required to use it until March 8, 2017. In the case of the gentleman in the video, I don’t believe the hospital gave him the MOON since it wasn’t “required” at the time of his stay.

    • That is really too bad. You would think (hope) the SNF would have alerted him about the lack of coverage. There are just too many ways we get mislead and abused due to lack of information. Thanks again for alerting us.

  1. Joann, Thank you. Another very important video. I think this is one of your most important messages. The subject you just covered is the most confusing for medicare patients and as seen in your video can be the most costly.
    The following is quoted from a article by Benjamin Pearce.

    “Families need to inquire in regards to their loved one’s status – inpatient or outpatient. Families should check daily and see IN WRITING that they are actually ADMITTED to the hospital and that they have INPATIENT STATUS”

    • Mr. Chadwick…you were the catalyst for this video. I don’t know if you remember giving me the suggestion earlier this year…so, thank you! I agree. This is an important topic, and I hope this message is shared far and wide. Mr. Pearce’s quote is spot on. Families need to be involved and request written proof of hospital status.

  2. Thanks, great video and important. I had no idea. Is their value to requesting actual admission or is the hospital telling the doctor what to do?

    • I’m always of the mindset that it doesn’t hurt to ask. But, it will come down to your doctor’s judgement based on your need for medically necessary hospital care…and, yes, I do think there’s some pressure by the hospital when it comes to making the final decision. According to the Office of the Inspector General, “the number of inpatient stays decreased and the number of outpatient stays increased since the implementation of the 2-midnight policy”. Which just reiterates the importance of being on top of your status if you’re in the hospital.

    • Did the hospital industry lobby for the 2-midnight rule? Do they benefit from getting Part B payments vs. Part A?

    • Good questions. I’m not sure about the hospital industry involvement. Part B claims can add up…so, there could be benefit to having more outpatient services.

  3. Another informative video – thank you. My wife is currently going through some testing which cold lead to hospital care. I wasn’t aware of the difference between “observation” and “inpatient”. Could prove to be invaluable info.

    • Thank you for the positive feedback and for sharing your personal situation. I certainly hope everything goes well with your wife’s testing, and she won’t require hospital care. If she does have a stay in the hospital, I hope this information gives you the tools necessary to stay on top of her hospital status.

  4. Once again you capture and share very informative information to help us seniors navigate the Medicare system, thanks!

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