Curmudgeon's Corner

cur-mud-geon: anyone who hates hypocrisy and pretense and has the temerity to say so; anyone with the habit of pointing out unpleasant facts in an engaging and humorous manner

The Costly Difference Between 'Observation' and 'Treatment'

U.S., Healthcare, Quality of Life

I received an e-mail from a friend yesterday that discussed Medicare, Medicare Supplement policies and Medicare Advantage plans as those relate to hospitalization.  It appeared that this e-mail had been forwarded a few times and those make me want to investigate before I respond to them or send them on to others.

The e-mail pointed out the following:

If you go to a hospital and are advised that you are being admitted “for observation”, you should immediately run up the red flag.  On the other hand, if you’re told you are being admitted “for treatment” you need not become alarmed other than about whatever the treatment they believe you need involves.

If you are admitted “for observation” the entire cost of that stay will be on your shoulders.  Medicare won’t pay the charges.  Medicare Advantage won’t pay the charges.  Your Medicare Supplement policy will not pay the charges.

In checking with those who earn their living in this specific field, I learned that the e-mail was spot on.  If you are admitted “for observation” you’d better have your checkbook along and it better have some dollars in it that you can use to pay your bill.

These changes can be very subtle and yet they can be very expensive.  As we all move into the age where our government makes more and more of the decisions concerning our health care, this should serve as a lesson for each of us.

Please take the time to pass this on to anyone whom you know that is on one of these three plans of coverage.  And, make sure that they understand the difference between observation and treatment.  You’ll have helped them avoid big problems.

You will need to make your own decision as to whether you believe “observation” is appropriate for you.  If it is, make sure there is some budget payment plan available through the hospital if you’re not going to be able to pay the full amount due in one chunk.  In some cases, they can help with special payment plans that will provide discounts from the billed charges.

Be aware and make others you know aware.  I hadn’t heard this before and I would’ve made the mistake I was warned against.

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