Determining if you’re an in-patient or out-patient in the hospital

It may not be something that you have dealt with in the past but with the new Affordable Care Act in place, it may be more difficult than before in determining if you are an in-patient or out-patient in the hospital.

How does this affect you? Let’s say you get hospitalized for 3 days, receiving meals, you’re hooked up to machines and then the next day the doctor lets you know they need to put you in a Skilled Nursing Facility (SNF) to make sure you are completely back on your feet for the next several days.  Then you find out that Medicare will not cover your SNF because you were not an in-patient for at least 3 days in a hospital. The hospital decided that they had you in for observation for those 4 days and you were not admitted and now Medicare will not pay their portion, leaving you paying thousands.

Check out the news article here about the rising issue and why it’s happening http://www.foxnews.com/politics/2014/02/06/frustrating-medicare-catch-who-in-patient-at-hospital-and-who-under-observation/

How can you make sure you’re not at risk?  Here at Sun Coast Legacy Advisors, we work with many Central Florida Medicare Advantage plans  that do NOT require a prior hospital stay. You get coverage at a skilled nursing facility from day one.

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Chaz Mulherin

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