Midnight Madness Medicare Style

Well, the holidays are long gone and I’m sure that some of you spent them working through issues related to your parent’s care.  The holidays are not ‘challenge free zones’ that allow us to step back and take a breath when we find ourselves in the caretaker role.  In fact, the holidays can be very stressful for a caretaker.

This past Christmas, I found myself helping with my own father’s hospital stay.  He was admitted on the Thursday night before Christmas with the holidays looming.  I was concerned about not only my father’s medical condition, but also the reality that it was unlikely that he would be able to return home again.

So, something that became very important to me (because of my knowledge of Medicare) was that I communicate with the physician in the hospital about assuring that my father was admitted for a 3 day stay (3 midnights).  This would allow him to access his Medicare benefits for a post hospital skilled rehabilitation stay.

With Christmas on Sunday, there was a real possibility that the hospital would try to discharge my father on Saturday (especially given the fact that there was little that they were finding clinically).  This is a common pattern in the acute care setting; clearing things out before holidays and/or weekends.  There is a lot of transfer activity between facilities on Fridays and the day before major holidays.  If they had discharged my father on Saturday, he would have lost out on access to his 100 day Medicare benefit period (I’ll discuss the 100 day benefit period more in a later blog).

Key Tip:                                                             

For a Medicare patient to access benefits for a skilled rehabilitation/nursing stay (in a rehab center or skilled nursing facility) they must have a 3 day qualifying hospital stay.  This means 3 midnights of a ‘head in the bed’ as it is sometime referred to in the industry; 3 midnights following the date of admission.

It turns out that with the holidays my father was in the hospital until Tuesday (more than giving him the qualifying stay).  We have since made the transition to a skilled nursing facility where he received therapy services under his Medicare A benefits and continues to stay as a resident.  The use of his Medicare benefits saved us >$2,000/week for the duration of his Medicare coverage!  That is information worth knowing!!!

If you are a caregiver/family member of a Medicare patient, I encourage you to learn the basics related to Medicare benefits and be an educated consumer.  This can help you greatly in managing the monetary resources available to the Medicare recipient.  If you don’t know where to access this information, seek help and guidance from someone who can help you (and visit www.medicare.gov for more details)!

On the journey with you…….Kathy

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