How Medicare’s Conflicting Hospitalization Rules Cost Me Thousands Of Dollars

One of the terms that has emerged in the dealing with Medicare and hospital admittance is ” observation “. This is not the same as being admitted, and can play a huge role in your benefits as the following story details. As an agent this is one area I’m learning more about in order to share with my clients and people I have consultations with. Always make sure you know the status of ones hospital stay, whether admitted or under observation. It could make a huge difference in dollars.– Dave Obregon

A few months ago, I wrote a check for $12,000 but couldn’t figure out exactly why.

The payment was to secure a place for my mother at Sligo Creek Center, in Takoma Park, Md. It’s a nursing home and rehab center owned by Genesis Healthcare.

My mother was about to be discharged from Holy Cross Hospital, in nearby Silver Spring, after a fall. Medicare wouldn’t pay for her rehabilitation care.

So before the Sligo Creek Center would let her through the door, I had to prepay for a month — $12,000 — or nearly $400 a night.

Now, my mother had paid into Medicare her entire working life, and since she retired, the Social Security Administration has automatically deducted $130 for her basic Medicare premium from her $1,650 monthly check. On top of that, she pays about $300 a month for a prescription drug plan and supplemental “Medigap” insurance.

But because of dueling rules and laws that have been well-known to Medicare officials and members of Congress for years, none of that covered my elderly mother when she needed care. (click here)

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