Medicare is virtually always on the national nightly news. Insurers are looking for new and inventive methods of Controlling the Cost of Medicare as people live longer and the cost of health care rises.
Our Alexi Senior Living care staff has noticed a rise in the use of “Observation” status at nearby hospitals. Observation can extend evaluation time. Doctors don’t always know whether to hospitalize or release patients. This is Unacceptable!
An inpatient hospital stay is paid in full by traditional Medicare Part A, minus your fixed deductible. Observation status, on the other hand, is covered by Medicare Part B, which covers outpatient services and requires a 20% co-payment. The 20% co-payment will almost certainly be higher than the Medicare Part A fixed deductible. Medicare covers nursing home care after 3 days if you fulfill skilled services standards. You’ll be responsible for your entire nursing home stay. When you consider that the average rehab stay costs $400 per day, it rapidly adds up!
What strategies do you use to advocate for yourself?
1) Just because you’re in a hospital bed doesn’t mean your stay is covered.
2) Inquire with the care manager or utilization review nurse about your status, such as if you are being treated as an observation patient or if you are being admitted.
3) If you’re under observation, you should file an appeal while you’re still in the hospital.
4) Making your case in person is easier than waiting till you’re a file in the Medical Records department.
5) Keep in mind that once you’ve been discharged, the hospital can’t change your status.
We recommend that you make a complete disclosure of your medical history. Have your primary care physician call the hospitalist who is caring for you, if required. Small things might make a big difference when it comes to assessing your position. Your medical team should be notified of any changes to your baseline level of functioning. Remember, the grease goes to the squeaky wheel. Health care is a financial, psychological, and physical investment. And no one cares as much about your health as you do!
If you or a loved one needs Medicare insurance and don’t know where to start contact local senior living facilities today. You can also call our senior living Chicago suburbs company at (815)534-5389 for medicare assistance and other topics like Physical Activity.
