If you have Medicare, ASK! You may stay in the hospital overnight, wear a hospital bracelet and even be decked out in a fancy hospital gown, but your hospital status could be “OBSERVATION.” That makes you an outpatient. Your hospital status (whether the hospital considers you an “inpatient” or “outpatient”) affects how much you pay for hospital services like x-rays, drugs and lab tests and may affect whether Medicare will cover the care you get in a skilled nursing
facility.
Observation services are hospital outpatient services given to help the doctor decide if the patient needs to be admitted as an inpatient or can be discharged. Observation services may be given in the Emergency Department or another area of the
hospital.
The NNORC has received several complaints from residents who “thought” they were admitted to the hospital only to find out weeks later when they receive an astronomical bill from the hospital that their stay was not covered. The NNORC is grateful to StateWide Senior Action Council for their help with these
residents.
Where can I get more help?
- If you need help understanding your hospital status, speak to your doctor or someone from the hospital’s utilization or discharge planning department.
- For info on Medicare Part A and Part B coverage, read your “Medicare and You” handbook or call 1-800-MEDICARE.
- To ask questions or report complaints about the quality of a Medicare-covered service, call your Quality Improvement Organization. Call 1-800-MEDICARE to get the phone number. You can also visit www.medicare.gov/contacts