An Unexpected Hospital Visit: Beware the Gotcha!

This week hasn’t gone the way I expected. For those of us who are seniors or have seniors in our lives, that sentence carries weight.

At bedtime on Monday, I got a call that my 90 year old mother had been brought to the ER. She was disoriented and not herself. We waited. Calls in the wee hours. More tests and waiting. If you’ve worked with hospitals, you know the drill.

But here’s a gotcha you need to know in this situation: what’s your admission status?

Medicare only pays for skilled nursing and rehab services after a three day, inpatient hospital admission. You need to be “admitted” for three midnights. Otherwise, you pay for rehab yourself.

Hospitals have a sneaky other status, “observation.” You have the same doctor, the same care, the same room even, but you’re being observed. You’re not officially admitted to the hospital.

Don’t take the risk. Ask the doctor and the staff explicitly if your event is observation or admission. Be a nag. Be explicit. Who’s paying for follow-up care depends on the answer.

(Yes, Mom has been admitted, and she’s getting the care she needs.)

Want to learn more about the Gotchas in our healthcare system? Check out my e-book, Medicare 101: The Good, The Bad and the Gotcha. (The observation status gotcha is in Chapter 7.) Read a sample of the book here.

What hospital gotchas keep you up at night? Let's talk in the comments.