Talk of The Villages Florida - Rentals, Entertainment & More
Talk of The Villages Florida - Rentals, Entertainment & More
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Medicare and hospitals
Some thing you should look at. If you go into the hospital for what ever and you are there as observation and when you are discharged and need a nursing home Medicare will not pay. If you were admitted and there for 3 days Medicare will pay. This is in the (new obamacare) rules so make the hospital admits you as a patient and your not there for observation. It could break you,hope no one gets caught on this
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#2
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I am sorry to have to correct you on this one, this is a an old Medicare rule, you must have 3 night stay in hospital to qualify for the Skilled Nursing stay,(first 20 days covered at 100% should you qualify for the skilled need) then 21-100 days at at copay for the patient. Has nothing to do with ObamaCare.
Hospitals are using the Observation stay should the patient not meet criteria for the inpatient stay. And you are correct that Observation days do not apply toward the 3 night stay. When in Observation you may incur outpatient copays and may pay for maintainance drugs when in hospital. Depends on the hospital billing practices. I do this for a living on a daily basis. |
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#5
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TednRobin...thanks for the correct information. Amazing how so many people blame Obamacare...
We had the experience with my 90 year old mother who fell, was in the hospital for 3 days but was NOT "admitted"..she was there under "observation". Off to the nursing home for a 30 day rehab and she had to pay the $6,000 for the stay. Medicare did pay for the P/T. It is very important to ask the nurse or someone if the patient has been "admitted". |
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From what I remember, TedNRobin is (are?) correct. I experienced this with my 94 year old dad when he was ill. I worked very closely with the hospital advocate and the nursing home advocate to avoid our paying anything and they were extremely helpful. This was long before Obamacare.
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Bronx ♫ Los Angeles ♫ Hadley, Sept. 08 and then the beautiful village of Mallory Square 2014 ♫ A true friend is someone who thinks that you are a good egg even though he knows that you are slightly cracked." (For those who know me) I consider ON TIME to be when I get there..... |
#7
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Good info TedNRobin...thanks.
To add to the confusion...Humana Gold Plus...a medicare advantage plan...does not require a hospital stay to be covered in a SNF Point is...tricky business..know your coverage or talk to a knowledgeable social worker.
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Philly>Spokane>Lancaster,Pa>FLORIDA LatDoc |
#8
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Always ask to speak with your case manager when you are hospitalized. If you have any thought you might need a SNF or Rehab stay on discharge, the facilities are usually running full, don't wait till the day of discharge to start the process. Always be sure what status you were admtted under, OBS vs admit. Hospitals should be making you aware up front what your status is, some hospitals now have you sign a form that you were notified on admisson of your status. It is your right to know. Happy to help. Robin |
#9
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Just a POV from another TVRH nurse (me):
Our case managers don't let this fall though the cracks. They stay on top of the doctor to make sure the right admission status is placed. It has been my experience that if you need rehab of some sort we make sure you know your options, both medically and financially. We don't blind side anyone. |
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