Back in January of 2014, Golden Years joined others in sounding the alarm on Medicare coverage of hospital admissions:
"Here's an important warning about Medicare payment (or lack thereof) for patients who are hospitalized merely 'for observation.' It can end up surprising senior citizens with thousands of dollars in unpaid medical bills -- bills that are the patient's responsibility.
"I'm guessing this is just a symptom of things to come as the working population dwindles and the ranks of Americans on Medicare and Medicaid continue to swell.
"In the case described in this video, long-term care insurance probably would have helped the patient to some extent.
"But with or without such insurance, it's up to each of us to pay attention -- especially if we hear the word 'observation' being bandied about.
Some background: Since October of 2013, Medicare had based its Part A coverage on the "Two Midnight Rule," which said that Part A would cover hospitalizations that included at least two midnights -- a classification that in turn determines other coverages, including for skilled nursing care.
It was apparently a hard-and-fast rule, and it generated a lot of provider "concerns." But finally, there's some good news: In a 12/31/15 update, Medicare announced that it has relaxed the rule a bit, allowing inpatient admissions to be covered under Part A on a case-by-case basis based on the admitting physician's judgment.
The change doesn't give healthcare providers a blank check; the documentation has to prove the necessity of inpatient status, and it's all subject to "medical review." But it sounds like providers will have at least a little leeway in formally admitting patients who may not satisfy the Two Midnight Rule.
Still, Medicare patients would be wise to check and double-check their admission status whenever hospitalization is recommended and Part A coverage is not crystal-clear. Most people have better ways to spend their hard-earned savings than on medical bills that they'd assumed would be Medicare Part A no-brainers.
"Here's an important warning about Medicare payment (or lack thereof) for patients who are hospitalized merely 'for observation.' It can end up surprising senior citizens with thousands of dollars in unpaid medical bills -- bills that are the patient's responsibility.
"I'm guessing this is just a symptom of things to come as the working population dwindles and the ranks of Americans on Medicare and Medicaid continue to swell.
"In the case described in this video, long-term care insurance probably would have helped the patient to some extent.
"But with or without such insurance, it's up to each of us to pay attention -- especially if we hear the word 'observation' being bandied about.
Some background: Since October of 2013, Medicare had based its Part A coverage on the "Two Midnight Rule," which said that Part A would cover hospitalizations that included at least two midnights -- a classification that in turn determines other coverages, including for skilled nursing care.
It was apparently a hard-and-fast rule, and it generated a lot of provider "concerns." But finally, there's some good news: In a 12/31/15 update, Medicare announced that it has relaxed the rule a bit, allowing inpatient admissions to be covered under Part A on a case-by-case basis based on the admitting physician's judgment.
The change doesn't give healthcare providers a blank check; the documentation has to prove the necessity of inpatient status, and it's all subject to "medical review." But it sounds like providers will have at least a little leeway in formally admitting patients who may not satisfy the Two Midnight Rule.
Still, Medicare patients would be wise to check and double-check their admission status whenever hospitalization is recommended and Part A coverage is not crystal-clear. Most people have better ways to spend their hard-earned savings than on medical bills that they'd assumed would be Medicare Part A no-brainers.
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