Being Informed on Being a Medicare Enrollee
 

I heard this before but forgot the correct term until now.

Are you a Medicare enrollee? If so, ask this question the next time you visit a hospital for care: “Am I admitted, or am I here for observation?”
Failing to do so could potentially cost you thousands of dollars.

Most here I sure know about this and ask the right question.
It's sad that the hospitals don't do the right thing for us seniors.

Stress is bad for cholesterol count. Worrying about could be, is unneeded stress.

Right! Even if it means costing you thousands of dollars.

There's a misunderstanding here...
 

Hospitals are required by law to inform patients if they're 'Observation' or 'Admitted'. It's a law that's been on the books for years. Google 'are hospitals required to tell patients if admitted or observation?'

BUT do hospitals tell the patient which one to choose so Medicare pays for the stay????

That's my whole point.

Your wrath is misdirected. So you think nurses/physicians, the ones who tell you that you're going to be 'admitted', are out to screw you? You think they have something to gain? Having been personally involved in this exact situation on many, many occasions, I made certain my patient understood the difference. If you want to be angry at someone please go after the government department that introduced 'Observation'. These 'Observation' cases are people that don't meet 'Admission' criteria but the attending physician doesn't feel it's safe to send them home. Be angry w those who developed 'admission criteria'. Be angry with those who took the physician's decision-making powers away. You know, the suits that sit behind a desk and haven't a clue.

So if they say observation then what ? Are we going to refuse the stay at the hospital?

:boom:

The biggest problem in health care today is bean counters and politicians being in charge of care instead of doctors and patients.

Excellent reminder. Do not stay for "observation" as you will be billed for it. If they don't feel you need to be admitted maybe think twice about staying,

One thing for sure, unless you are admitted to the hospital for three days before discharge, you are not admissible for subsequent resident physical therapy. If you are only in the hospital for observation and then wish to go to residential physical therapy, you pay the full cost. Or alternatively you’re limited to in-home physical therapy.

It’s the insurance companies far moreso than politicians. They’re the “death committees” so often criticized in prior TV commercials.

Last time I checked most hospitals are for-profit, when a for-profit company has to make a decision, "right or profitable" I think we know which they chose. It's called predatory capitalism and it is all around us.

I can't overstate how happy I am to no longer be in that healthcare system. I didn't realize I qualified for VA healthcare until I was retired. Now, 10 years later I am amazed at how great the Gainesville VA hospital is. I see all the issues with healthcare here in The Villages, and I am reminded of what I used to have to go through. My wife is also in the VA system and we often look at each other and say how we wish everyone could have healthcare that is focused on keeping us healthy instead of focused on making money like we have in the VA system.

Next time you get a chance vote for Universal health care, single-payer healthcare, or whatever catchy term they come up with. You won't regret it.

Medicare Enrollee
 

Prior to being a Medicare enrollee, I was admitted to the hospital because they knew what I needed. My insurance stated I needed to be placed on observation first. Because I was not, insurance didn’t want to pay. Hospital took care of it and they got their money

"Observation" vs "Admission"
 

2022 0608 Wednesday @ 09:31
Original Medicare with Supplement Plan N (or G) stipulates up to a $50 payment for observation. If admitted, there is no charge. Plans G and N are the most comprehensive for those who turned 65 on or before January 1, 2020.

Cool down Kiddo. Your response wins the angry test, not the commenter who attempted to help. A reminder that we are responsible for healthcare decisions down here is appreciated.

You’re right! VA Healthcare is now tops, as years ago it was terrible. I wonder why the change?

I agree. I don't know why the change is happening.

My brother is friends with a person that was put in charge of finding out what the problems were and how to fix them by some administration some years ago, I don't recall which right now, and that isn't important. What is important is that they are changing and in the right way. Until someone experiences it, no amount of explaining will help.

But, seeing all the complaints here, it makes me cringe to think I used to deal with all those things too.

This is NOT the patient's choice or even the MD. To qualify for Inpatient status you must have an illness that qualifies as serious enough and you have a 2 night stay expectation. If you are inpatient, your Medicare Part A pays. If you are Observation, Part B pays.

you make a great point. Also consider the thousands if hospital closings throughout the last few decades. A balance needs to be struck

you are obviously a veteran of these wars. Thanks for the insight

Insurance companies control US healthcare. The Doctors have lost out and are "owned" by the insurance companies.

Good advice. Great observation. My rule of thumb is to always carry your drivers license, Medicare card, insurance card(s) and Social Security in your wallet or purse.

The person asking you a question about Medicare is usually a billing clerk who is determining who to charge for the services rendered.

I hate to disagree. VA hampered by bureaucratic rules. I’m 64 and 2 years ago VA refused to give me Shingles vaccine because I was under 65 (even tho CDC recommends it for all over 50).

3 weeks ago tried to get appt with VA PCP for sore elbow. Nothing available for next two months so was advised by VISN line to go to Urgent Care (VA will pay for certain ones). UC sent me for X-ray. (Both UC and X-ray paid by VA). Back to UC for diagnosis- medial epicondylitis (golfer’s elbow). Now 3 weeks later again try to see VA PCP to discuss cortisone shot. Again no appts available for next 2 months. Appt clerk sends message to PCP with my request for cortisone shot. PCP says I have to get another X-ray and need to go to Gainesville for it. I ask why I can’t get X-ray at TV OPC and am told they can’t X-ray an elbow there! So even tho I have an X-ray paid for by VA, PCP says I have to get an X-ray done by VA and I have to drive to Gainesville for it!! That is just illogical.

Please allow me to correct your mischaracterization. Disgusted would be a more accurate description of how I was feeling vs. angered. There was too much slop-slinging that I just couldn't let it ride. Perhaps you might re-read and have a better understanding. I'm going to assume you'd prefer factual reminders that you're responsible for your healthcare decisions.