Medicare Part A Hospital Inpatient or Under Observation? A Costly Difference

MEDICARE PART A Hospital Inpatient or Under Observation? A Costly Difference!

In this video, you’ll learn:

✅The difference between being a hospital inpatient and being under observation

✅What is a Medicare qualified hospital stay and why it’s important

✅Why Medicare may not cover the cost of rehabilitation

✅How to protect yourself from unexpected Medicare out-of-pocket costs

RESOURCES AND OTHER MENTIONS IN THIS VIDEO:

NBC New York 4: Medicare Denies Post-Hospital Care Costs for Patients 'Under Observation'

[Lysander-Spooner]

One thing new Medicare members may find confusing is the "Annual Wellness Visit." Can you do a video explaining what is free under the wellness visit and what comes under Part B? I know that each year prior to Medicare I had an annual physical with lab tests from my doctor. Now I learn that the wellness visit is not really an exam at.

[ggjr]

I see this was a few years ago but I don’t think things have changed. If someone is so ill they need to be released to skilled nursing they are sick enough they should have been admitted.

[thomaschadwick]

Joann, Thank you. Another very important video. I think this is one of your most important messages. The subject you just covered is the most confusing for medicare patients and as seen in your video can be the most costly.
The following is quoted from a article by Benjamin Pearce.

"Families need to inquire in regards to their loved one's status - inpatient or outpatient. Families should check daily and see IN WRITING that they are actually ADMITTED to the hospital and that they have INPATIENT STATUS"

[kategurtowsky]

very clear. Good explanation. Thanks

[wordgeezer]

If your supplementary insurance lapses, because of Alsheimers, your medicare is useless. My sister was hospitalized for five days and was not admitted. I asked them to admit her and the office representative changed the subject. I asked her if she would like that in writing and she ignored that also. I later found out that there is a privatized company between the hospital and the insurance companies. My sister worked for State Farm insurance for many years and has a retirement plan. I have State Farm insurance myself, so went to my agent and asked if he could help me with this problem. He admitted to me that he didn't have authority and that i would have contact the main office. As I left, I asked about their logo "Like a good neighbor State Farm is there"?

[joemoynihan]

Once again you capture and share very informative information to help us seniors navigate the Medicare system, thanks!

[davidmbeckmann]

As a Hospitalist this is probably the biggest nightmare in current hospital medicine. Many older patients and their families have not thought realistically about the future. So when patients can no longer live independently, their homes are refuse dumps, they live with cat's, thing's are growing in the fridge, etc; they are often brought to the ED by concerned family whose major concern is that they can't live alone anymore and family sure can't stay with them. The ED does a evaluation, can't really find anything but a weak, slightly cognitively impaired 87 year old female, then does the usual ED trick, gets a UA and calls asymptomatic bacturia a " UTI " and plops them in observation. It is left to the Hospitalist and social workers to explain that inpatient requires at least 2 Midnight's of real hospital care; taking pills, getting a PT evaluation, and basic nursing care AIN'T REAL INPATIENT HOSPITAL CARE and if you fib a bit and admit for three days to get their SNF stay payed, ( which requires three midnights of real Hospital care + an ongoing need for PT ), well, that's Medicare fraud, folks! In our town, the SNF requires up front payment of $7, 000 before accepting such a patient. Welcome to Insanity.

[dmcrosby]

WOW! This was very valuable information and we need to find a solution to mitigate this issue.

[joychelminski]

Great video Joann! Thank you for the valuable information.

[kingfish]

How would someone know if they were under observation vs admitted? I feel the discharging doctor and social worker at the hospital involved in setting up the transfer to SNF ought to know this 3 midnight rule.

[dbrozzman]

Another informative video - thank you. My wife is currently going through some testing which cold lead to hospital care. I wasn't aware of the difference between "observation" and "inpatient". Could prove to be invaluable info.

[silverbil]

Thanks, great video and important. I had no idea. Is their value to requesting actual admission or is the hospital telling the doctor what to do?

[Remedigap]

What are your thoughts about the impact your hospital status has on your rehabilitation care?

[thirumagalnatarajan]

Hi mam
I have a doubt
Alternate code for medicare insurance 99235