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Honored Contributor
Posts: 13,484
Registered: ‎11-24-2013

Re: Medicare won’t cover you if you’re hospitalized for observation.

@Mindy D Many of your posts would be easier to read if you would use paragraphs. I just don't read items that go on and on with no break.

 

I know you post a lot of medical things which is fine. I would read some of them if they were broken up for easier reading.

Esteemed Contributor
Posts: 5,671
Registered: ‎03-10-2010

Re: Medicare won’t cover you if you’re hospitalized for observation.

The Medicare and you book tells you to make sure with your Dr. To put you as an impatient.  My friend went through this recently and we both read  it.

Honored Contributor
Posts: 13,510
Registered: ‎05-23-2010

Re: Medicare won’t cover you if you’re hospitalized for observation.

[ Edited ]

Just my opinion, but as far as I’m concerned, there shouldn’t even be anything called “Observation Status” once you are in a hospital room. From my point of view, if you are in a hospital room, you should be considered “ADMITTED” and an “INPATIENT.” The only decent alternative is to change the Medicare rules to say that all observation services received in a hospital be deemed inpatient. 

Honored Contributor
Posts: 18,187
Registered: ‎07-26-2014

Re: Medicare won’t cover you if you’re hospitalized for observation.

[ Edited ]

@kidznpupz wrote:

Does anyone know how your Medicare supplement fits into this scenario? I have Plan G .


@kidznpupz   Read you insurance booklet that explains YOUR coverage.  It should be self explainatory what you are asking.  If not, strongly suggest that you contact your supplement carrier to have them explain it to you in laymen's terms.

 

As someone already mentioned, supplemental ins is primary over Medicare.  In some cases, Medicare is primary. 

What YOUR plan pays should be clearly written in your policy as well as the EOB's from Medicare.

"Never argue with a fool. Onlookers may not be able to tell the difference."


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Super Contributor
Posts: 385
Registered: ‎03-28-2019

Re: Medicare won’t cover you if you’re hospitalized for observation.

@Mindy D While you may be providing important info, please break up the text. It is very difficult to read long, streaming sentences.

Honored Contributor
Posts: 13,510
Registered: ‎05-23-2010

Re: Medicare won’t cover you if you’re hospitalized for observation.


@lovesrecess wrote:
Medicare is primary since the insurance company doesn’t want to pay any more than they have to. I think I may have posted the opposite earlier...my mistake

If you are employed, your employee insurance is primary over Medicare.

Honored Contributor
Posts: 13,510
Registered: ‎05-23-2010

Re: Medicare won’t cover you if you’re hospitalized for observation.

[ Edited ]

If you can find this article online, I suggest reading it. It’s on the site verywellhealth .com

“What Is Hospital Observation Status?”

 
 
Another excellent article is on the site Kaiser Health News. It’s entitled “FAQ: Hospital Observation Care Can Be Costly For Medicare Patients.”  It’s written by Susan Jafee  

 

Esteemed Contributor
Posts: 5,419
Registered: ‎03-09-2010

Re: Medicare won’t cover you if you’re hospitalized for observation.



@kidznpupz wrote:

Does anyone know how your Medicare supplement fits into this scenario? I have Plan G .


@kidznpupz   Read you insurance booklet that explains YOUR coverage.  It should be self explainatory what you are asking.  If not, strongly suggest that you contact your supplement carrier to have them explain it to you in laymen's terms.

 

As someone already mentioned, supplemental ins is primary over Medicare.  In some cases, Medicare is primary. 

What YOUR plan pays should be clearly written in your policy as well as the EOB's from Medicare.


Medicare will pay first for any covered procedures,and then your Plan G pays. Please check your Explanation of Benefits booklet or call the company with any questions. 

Esteemed Contributor
Posts: 5,882
Registered: ‎03-10-2010

Re: Medicare won’t cover you if you’re hospitalized for observation.

@Nuttmeg :  The real answer as to which insurance is primary is: it depends.  Read up on it; as a 75 yr old Federal Govt retired with private bcbs, Medicare is primary for me but your situation is always different from mine (for ex. If you are still working it depends on the size of your company and which insurance you have.  Google it or check out Social Security site and read it for yourself.

Esteemed Contributor
Posts: 5,882
Registered: ‎03-10-2010

Re: Medicare won’t cover you if you’re hospitalized for observation.

@nutmeg3 :  The real answer as to which insurance is primary is: it depends.  Read up on it; as a 75 yr old Federal Govt retired with private bcbs, Medicare is primary for me but your situation is always different from mine (for ex. If you are still working it depends on the size of your company and which insurance you have).  Google it or check out Social Security site and read it for yourself.