The number of people being seen under observation has increased over 88% in the past six years, according to the Medicare Payment Advisory Commission. Simply staying in the hospital can be charged as an outpatient service. It is possible to stay several days in the hospital and be there under observation, which is considered outpatient. Medicare does not require beneficiaries be notified when they are receiving observation status. To date at least only Maryland and New York have passed laws mandating hospitals to tell patients when they are under observation care. When you are hospitalized, ask if you have been admitted as an inpatient. Don’t wait for the bill to try to get it changed. Also, see article on Skilled Nursing Facility & Home Health Care)
What does this mean based off your form of insurance?
If you have Original Medicare only: The total amount billed to you for this outpatient service can be more than it would be if were an inpatient in the hospital.
If you have a Medicare Advantage Plan: The total amount billed for the outpatient service will be dependent on what your plan charges. Senior Savings Services can look up the copays of your plan to let you know what this amount is according to your plan.
If you have a Medicare Supplement Plan: The total amount billed for the outpatient service will fall under what the percentage of Medicare Part B coinsurance your plan covers. Senior Savings Services can help you understand how your plan covers this.
If you are in the hospital for observation and go to a skilled nursing home to receive care, Medicare will not help cover any of the skilled nursing facility costs.
Below is a recent news video on observation status (sorry for the short ad before video plays):
The news article and video can also be seen here.
Here is another story:
Have questions on observation stays? Contact Senior Savings Services at 1-800-592-0819.