Were You An Inpatient Or Outpatient? A Medicare Quicksand Trap You Need To Know About!

by Karl on August 19, 2013[printfriendly]



You may think we’re talking about belly buttons but I am referring to hospital inpatient or outpatient status under Medicare. This is one of the latest quicksand traps that you have to be aware of. Here’s how it works.

You go to the hospital with a problem. You think you are being admitted to the hospital because you are in a room of the hospital. You stay there for three days then go to a Medicare certified skilled nursing facility for rehab care.

Under current Medicare guidelines, Medicare will pay for up to 20 days in rehab after a three day hospital stay. You stay for 10 days then go home. A short time later you get a bill from the nursing home for $22,000. What gives? On top of that you get a bill from the hospital for the Medicare Part B deductible.

This is why you got the bills: you were not admitted to the hospital. You were in “observation” status. Therefore your stay was not covered under Medicare Part A which covers hospital service.

Depending on the type of insurance coverage, there may be a Part B deductible payment.

But all of the rehab stay is not covered. You must pay 100% of the rehab bill out of pocket!

Lesson of the story is that if you are in the hospital for more than a few hours, ask the doctor or the hospital staff if you’re an inpatient or outpatient. It makes all the difference in the world! More things like this are happening as hospitals look to cut costs because of Obamacare. 

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Call the office if you have questions or you can set up an appointment for a consult.


Karl Kim California's 1st Retirement Crisis Planner  Your Medi-Cal Specialist

Karl Kim, CFP, CLTC is the President of Retirement Planning Advisors, Inc. and is a Medi-Cal specialist. His office is located in La Mirada, CA and can be reached at 714-994-0599 or at RetirementCrisisPlanning.com He has submitted over 1000 applications with a 99.9% success rate over the past twenty years. This is meant to be an educational article. Do not make any decisions solely on the information contained herein. Consult your tax advisor, financial planner and attorney before taking any action. We are not responsible for any inaccuracies or misinformation.

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