Since most METARs are seniors, this news is worth posting here. It will have Macro impact since millions are affected.
**For Older Americans, Some Positive Health News**
**Three recent developments — incremental and undramatic but encouraging — are likely to improve the lives and health of seniors.**
**By Paula Span, The New York Times, Feb. 28, 2022**
**First, a federal appellate court recently ruled that if Medicare declines to pay for your rehabilitation in a nursing home after you’ve left the hospital, because you were “on observation,” you can appeal the decision... Medicare requires three consecutive days as an inpatient for you to be eligible for nursing home coverage. ... Last month, the U.S. Court of Appeals for the Second Circuit affirmed that Medicare beneficiaries have a constitutional right to appeal if hospitals reclassify them as observation patients. If patients win their appeals, traditional Medicare will pay for up to 100 days of nursing home care, and those who were previously forced to pay out-of-pocket could receive refunds. ...**
**In a second promising development, California is eliminating asset limits for older people who are trying to qualify for Medicaid, and other states are considering similar moves....In most states, if you are older than 65, you can amass no more than $2,000 in assets, or $3,000 for a couple (usually with a home and a car exempted)....**
**In a third piece of a good news, the Social Security Administration has finally announced that it will soon reopen its 1,200 local offices....** [end quote]
Hospitals are frequently registering elderly patients as being “under observation” rather than admitting them as inpatients. “Observation” services are considered outpatient services and are therefore billed and covered very differently by Medicare. Furthermore, time spent under observation doesn’t count toward the required three-day hospital stay for Medicare coverage of post-discharge care in a skilled nursing facility. Family caregivers and seniors alike should be aware of this practice to avoid being surprised by shockingly high care costs following a hospital stay.
If you are in the hospital, INSIST on being admitted! Don’t accept being held “for observation.” The difference could be many thousands of dollars.
It’s nice that Medicare is now being forced to accept appeals, but the appeal is a long, painful process. If possible, don’t allow yourself to be put on observation.