As a senior citizen, I was drawn to an article in Money by Amanda Gengler “This Could Hurt—a Lot,”( 8/12 pgs. 70-73). Much can depend on a name, as Shakespeare warned, especially when an elder person is hospitalized under traditional Medicare. Being admitted as an “in-patient” instead of “in for observation” can mean the difference between reasonable out of pocket expenses and the loss of thousands of dollars.
Most patients aren’t told their designation when they’re admitted, but, it would be wise to ask. After three days in residence as an “in-patient” a member of traditional Medicare is eligible for aftercare in a nursing home. A patient admitted for the same number of days but designated as “in for observation“ is not — a distinction that can have significant financial consequences.
Doctors used to determine a patient’s status, but under new regulations, Medicare representatives can second guess that decision. If the challenge is upheld, the doctor and the hospital are subject to stiff fines. According to Gengler, threat of oversight has made doctors cautious to the detriment of the patient.
I don’t pretend I can explain the Medicare system. And certainly, I can’t do it here. I raise the issue because there is an agency that can: Center for Medicare Advocacy – medicareadvocacy.org. I’ve tucked this web address away for future reference. Perhaps my readers might care to do the same.
(Courtesy of www.dailymail.co.uk)
