I just got an email from my mother about regular Medicare.
Her words: Apparently, seniors are labeled “under observation” in rehab after a hospital visit. Then the bill is not paid by Uncle Sam. Seniors must be labeled “inpatient”.
She’s one of the five remaining peeps who get their info from Brian Williams. Has anyone heard anything like this? Is it another hidden gem in O’care?
Yes, it is a rule just started Oct 1, and hospitals are now having to deal with this. Basically, there is guidelines established by a company called Milliman. The hospital reviews the patient’s signs and symptoms with Milliman guidelines, and the patient gets categorized as observation or inpatient. If you are in the hospital less than 2 midnights, you can also be categorized as observation. Observation status means more out of pocket expense for the patient. Medicare pays less, and you do not qualify for nursing home or rehab placement. This is one of the subtle ways funding for Medicare has decreased. If you hospital participates in Medicare- as they all do- then they have to apply the same rules to private pay health insurance. Thats right- the private BCBS policy follows Medicare rules. Any law pertaining to Medicare also applies to everyone else.
bfl
I’m on Medicare and sent this article to all of my kids last summer when I first heard about it.
Astonishing.