Letter: Medicare classification hurts seniors
To the editor of THE EAGLE:
As a retiree of the county and a Medicare recipient, I was recently made aware through our retirement newsletter of the changes to our Medicare Part A. Medicare recipients have always felt confident that when we have to be hospitalized, our Medicare Part A will pay for it. Not necessarily.
In our newsletter we were informed that a 99-year-old woman hit her head and passed out. She was brought to the hospital in an ambulance and admitted for three days and then was sent to a rehabilitation center. Upon her return home, she received bills from the hospital and rehabilitation center for thousands of dollars. She found that in order for Medicare Part A to pay for her stay in the rehabilitation center, she must have been admitted to the hospital under "Inpatient" for a period of three days. She had been admitted under "Observation" for the first day and under "Inpatient" for two days. Medicare did not pay for her observation stay nor for the rehab stay because she did not meet the three-day Medicare "Inpatient" requirement. Her supplemental insurance which pays 20 percent of what Medicare pays, paid nothing for the observation stay and rehab stays.
I have become aware of an individual who had a similar situation happen to her at BMC. This person who lives in an assisted living facility here in Berkshire County, became sick and was brought by ambulance to the hospital and admitted for a two-day stay. Upon her return home, she received a bill for $11,000 for her hospital stay that was totally unlike any of her other hospital stays that were always paid by Medicare and her supplemental insurance.
When a family member contacted the hospital, they were told that their mother had been admitted under "Observation" instead of "In patient." Their mother had a heart condition, diabetes, and many other health problems. How, she asked could she had been admitted under "Observation."
This is a question we would like answered. What happened to our Medicare Part A that is suppose to cover us when we are in the hospital? If the hospital feels it is important enough to keep us overnight, why should we be classified as being under "Observation" without telling us, and then sending us a bill for thousands of dollars? For many of the elderly this is their life savings that makes the difference between buying their medication and paying for their food. Now we have to be afraid that this will happen to us.
When did Medicare change, and if so, why? Someone please let us know.