You go to the hospital with specific medical complaints. They give you an ID bracelet, a room, and a team of doctors and nurses to treat you. You may think you have been admitted to the hospital, but think again.
A recent disturbing trend, especially with elderly patients, is taking place. They are being held for "observation." Kept in the hospital for 48 hours or more, being treated like they are inpatients, only to later realize they are not.
How do they finally realize this? When the bills start coming in showing that they were only being "observed" -"not admitted", therefore, insurance carriers, Medicare specifically, will not cover that stay!PLUS, once this occurs, these patients will NOT qualify for Medicare coverage if they are then discharged to a nursing home. This label makes all the difference.
This trend is apparently the consequence of policies meant to reduce Medicare expenditures. However, it can leave patients facing higher co-pays for drugs and hospital services, and responsible for the FULL cost of subsequent skilled nursing care.
Steps are being taken to protect the patient and hopefully pass legislation that requires someone is given written notice that they are on observation status so that they can question or contest this at the time. Surveys show that most patients were never told they were simply being "observed" and not "admitted." They were never explained what the difference was if they were told.
In the meantime, in order to protect yourself, be sure you ASK when being kept at a hospital whether or not you are being "observed" or "admitted as an inpatient." If you are told its only "observation" ask WHY! Determine if your insurance company will cover the stay if it is classified that way. Find out if you can have your status changed to "admitted inpatient" if medically necessary. If all else fails and you are being told you would be kept only as someone being "observed" and it is not a medical emergency to stay, you may be better off going home and recovering from your illness as in the end it may be much cheaper for you!
Again, if you can't medically leave, have a family member or friend speak up on your behalf. Ask to speak to the doctor or patient advocate to change the status. If medically you need to stay in the hospital, you should be admitted. That simple. Surveys also show that people who argued this status because they were aware, were addressed right away by being admitted and/or discharged with proper instructions.
So educate yourself, speak up and be prepared.
