Over the years, health insurance has received a bad reputation. From shady sales practices, to loopholes that allow an insurance to not cover as much as you thought that they would, insurance is a huge headache for most people. However, with current legislation in place, health insurance is a must. And although this policy is designed to help keep hospital and federal costs down by placing a greater responsibility on individuals to cover their own costs, many people see this as yet another complication of insurance.
One such example occurs when it comes to hospital admissions policy. In the past, Medicare policy allowed hospitals to transfer patients from the emergency department to a bed, keeping them for observation for 48 hours without actually admitting them into the hospital. Instead of being admitted, they are considered to still be an outpatient.
This legal loophole might not seem like a big deal, but it changes how insurance processes the paperwork, and it changes how much people who found themselves in this situation are billed. Federal reform is beginning to occur, and as of October 2016, the NOTICE Act has gone into effect. This requires acute care hospitals to inform patients orally after 24 hours that they are being held for observation and have not been admitted. Before 36 hours elapses, they must provide written notification of this. While a small step, it is a step in the right direction and at least allows patients to have a better understanding of what their costs are likely to be before they are hit with a huge bill. Seniors, and others that might be at a higher risk of hospitalization, are the ones who stand to lose the most from this practice.
This loophole also has allowed hospitals to escape a financial penalty if an in-patient is readmitted to the hospital within the next 30 days. Rather than being used as a way to give a patient the best care, it has the potential to be abused in order to help hospitals keep themselves away from excessive fees. This is not in the best interest of a patient and the NOTICE Act is designed to help curb this. Some states have already addressed this, others have not.
Despite any issues that you or your family might have with health insurance in general, or Medicare in particular, insurance does do a lot of good. And that’s especially true when it comes to the elderly in need of senior care. Those receiving senior care are at a high risk of needing emergency services already, and having a strong insurance policy in place to help offset costs is a good idea. If you have questions about which types of insurance are available and will be helpful to you, get in touch with an insurance specialist today. They can help provide you with information so that you can give yourself a better idea of what you need. Just beware of pushy sales tactics. If you find it helpful, have a family member join you at your meeting.
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