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FEATURED ARTICLE

How "NOT" To Be Denied Coverage

The "Pumpkin" Rule

By Susan B. Geffen

This may be the most important article I have ever written. 

In fact, if you have come to one or more of my "Raising UP Your Parents" seminars, you know that I always:

1) emphasize that Medicare is not long term care and does not act like a long term care policy and 

2) plead with everyone to make sure that if you are discharged from the hospital your physician lists your stay as having been "admitted" as opposed to "under observation." 

 
I do not want any of you to be denied coverage for this or billed separately for every procedure and drug, which will cause your co-pays to mount until you owe thousands of dollars under Part B. 

I have now drilled it into everyone's heads that post-hospital nursing home care is only covered by Medicare upon discharge from a 3-day qualifying inpatient hospital stay. Many people really are in the dark about this so consider yourself lucky. 

In fact, last year there were over 600,000 citizens who were admitted to hospitals as "outpatients" on "observation status," many receiving the same care as inpatients. 

 
To combat this, several physicians have suggested that if you have to go to the hospital, try to get there before midnight as if you cross two midnights, you're an inpatient for purposes of Medicare Part A (surgical procedures, diagnostic tests and other treatment). 

A new Medicare regulation - the so-called "pumpkin rule" requires doctors to admit people they anticipate staying for longer than two "midnights," but to list those expected to stay for less time as observation patients.

Click here to read the rest of this important article

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