Hospitals must put you on notice! There was a recent change in Medicare Law that is important to retirees. The new law requires that hospitals notify you of your out of pocket costs.
Recently, after a bad fall, a 79-year-old woman was taken to a hospital for 6 days of “observation.” This was followed by almost 5 months of rehabilitation and skilled nursing care at a nearby nursing home. The cost to this lady: more than $40,000!
The hospital insisted that she had never been formally admitted to the hospital as an inpatient. Because she was never admitted, under federal law, Medicare would not have to pay for her nursing home stay. The money had to come out of her own pocket.
This retiree’s experience and many, many others inspired a new Medicare Law. It now requires hospitals to notify you if you may incur huge out of pocket expenses. This happens if you go beyond 24 hours without being formally admitted to the hospital.
This new law went into effect in January 2016. In the past hospital have been keeping Medicare patients in “observation status” for fear of being penalized by Medicare for inappropriate admissions.
While you are in the hospital under observation you can be held liable for substantial hospital bills.
In addition, Medicare will not pay for any nursing home care unless you have spent 3 consecutive days as “inpatient” in the hospital.
You see, time spent under observation doesn’t count toward these three days. This happens even if you spent 4 or 5 days in the hospital and receive extensive hospital services like tests, treatment, or medication ordered by your doctor.
Under the new law, the hospital must provide you with a notice if you are in the hospital for more than 24 hours for observation.
Otherwise you might be on the hook for all of your medical bills – not Medicare. As you are well aware being in the hospital if only for 24 hours those bills could be substantial.
Moral of the story, if you are on Medicare, make sure when you are going into the hospital the doctor admits you as an inpatient – not just for observation.
If you have questions on this or anything else, please give us a call at 1-800-825-2919. It listed right up here!
I’m Dale Stringer – thanks for watching!