Got a nasty shock today re coverage by Medicare Part B when my status was upgraded to "Observation."

[CTyankee]

It is confusing. I was admitted under "admitted" and was upgraded to "observation" for about 48 hours, then reverted to "admitted" again. I was shocked and could just see the bill! But a nurse at the hospital confidently told me my second "admitted" wiped out any hospital charges incurred my 48 hours under "observation."

I hope this is something that the hospital used to circumvent or "fix' this costly and unproductive charge to seniors. She said my tests would be covered but nursing care even for 48 hours is very expensive. It was a relief.

The management care team sent a rep to my room and gave me a form to sign. It was confusing and I was out of it but I thought it was a routine form the hospital management always gets you to sign to prove they informed you of your option.

Hope the nurse was right...can't wait to see the bill otherwise....

[TheMastersNemesis]

1. We Had A Similar Situation In December Where "Observation" Was Used.

It looks like we were covered, but had to refuse admittance. The procedure that would have been done would not have worked based on later diagnosis.

[enough]

2. Crazy system where you have to be hyper-vigilant about the fine print

at the very time when you are sick, hurting, and stressed out. You practically need a lawyer or an accountant with you in the ER.

[CTyankee]

3. Since the hospital changed my status back to "adminitting" I am hoping this was its attempt to

see to it that my charges would be covered.

I don't blame the hospital staff for informing me of this change while I was out of it but hope that this is a loophole the hospital used to protect my Medicare benefits.

if I get a bill I will call the Patient Care Management office at the hospital for further advice.

What I do wonder is why they just didn't keep me under admitted? I was actually pleased that I was upgraded because that meant I was getting better. It was only after a friend I talked to by phone told me of the situation and how bad the "observation" status is...

[procon]

4. The nurse is not the right person to discuss your insurance coverage.

Speak to the people whose job is to actually know such things. Ask the nurse how to contact the hospital billing office or Medicare specialist. Some hospitals may have patient services staff, advocates or ombudsmen to assist patients with these concerns.

[CTyankee]

6. I was freaking out. The nurse was a calming influence. jThe Care Management Staff was not there.

I think they did the right thing. Patient first!

[MANative]

5. That's a problem under most insurance, not just Medicare Part B

Had a similar experience about 18 months ago and it cost me dearly. If I'd been admitted, it would have cost me only about $1200 instead of $3900. Out of pocket. Lesson learned. If that were to ever happen again, I'll insist on being admitted or released.

[CTyankee]

7. I think the hospital did the right thing by admitting me under the standard admitting rubric.

jThey told me I was upgraded to Observation because they wanted me to know I was not in that bad a shape. It actually hnelped me feel better.

I was exhausted from the stress being in the hospital in the first place and as you must know, you can have real problems from all the noise going on. The place was packed, too. There was no room available (flu season). I was grateful when they found me a room. I concentrated on the positive but I'm glad our friend told me of the consequences of the status switch, but it turns out it was not applicable because of the way they handled it. I am grateful...

[MANative]

10. So glad to hear that it worked out in your favor, and hope you're feeling up to par.

Nowhere more stressful than a hospital ER or triage room. I can personally attest.

[CTyankee]

11. thanks. well, fortunately, the nursing care was superb. The nurses were always there on call and

ready to help get you some ice, or another blanket, or help you adjust in the bed with all the tubes going in. But it was a relief to go home to my own shower...

[MANative]

12. That's awesome. The few times I've been hospitalized, I've been so impressed...

With the dedication and caring of nursing professionals. They are amazing men and women. I'd never have the courage to do what they do.

[marybourg]

8. Concentrate on getting well.

My DH has been "admitted" and "not admitted, under observation" several times each. We were never asked to pay anything beyond his normal 20% copay (which his supplement paid if he had already met his yearly deductible). There was no difference, in our experience.

[CTyankee]

9. I'm sure this will meet my deductible for the year in one fell swoop...but I don't think it's much..