You have a say in when you leave the hospital

News and Views from Rita

There is nothing as sweet as a day in June. I’m not so sure about the rest of the country, but that really holds true for Alaska. When the leaves start bursting out of their pods, and the sun shines until midnight, I know I picked the right state to live in.

Medigap policies in Alaska

I have recently been asked about additional insurance if one has Medicare. If you have Medicare, both parts A and part B, you can also buy a supplemental insurance policy, sometimes called Medigap (a policy that fills in the gaps that Medicare doesn’t pay for). These policies are sold by private insurance companies that can help pay for costs that original Medicare does not cover.

In Alaska there are ten policies available and we can send you a listing of the companies that sell these policies and a brief recap of what is contained in these policies. We will also include the toll-free numbers of each company.

Let’s move forward, not back

As of this date, you might want to be aware that your Republican Congressional representatives have tried 56 times to repeal the Affordable Care Act (the one they call ObamaCare). If you do not want to go back to the times before ACA, when the insurance companies were able to refuse you because you had a pre-existing condition, or the insurance company was able to limit the amount of insurance you were allowed to buy, or your children were kicked off your policy when they turned 18, etc., then you had better contact your Congresspersons and tell them to stop their nonsense and get our country back to creating jobs by fixing the infrastructure, and to leave our healthcare alone.

Don’t leave the hospital until you’re ready

If you ever find yourself in a hospital room, waiting to go home, there is one important person to talk to before you put your shoes on, and that is the person called the Hospital Discharge Planner. This is the person responsible for making sure that your discharge plan is “safe and adequate,” in Medicare parlance.

If the hospital wants you to go home before you think that you are ready, don’t settle for a plan that you have reservations about. You can appeal any discharge decision. The hospital must provide Medicare patients with two documents: “An Important Message from Medicare,” which spells out your rights, including those concerning discharge, and the “Hospital-Issued Notice of Non-Coverage”.

If you decide to appeal, contact your Discharge Planner, who will contact an external group called a peer review, or quality improvement organization, to review the case. The hospital cannot force anyone to go home before that group makes its decision.

Unless you have Long-Term Care insurance, many services and items you think are necessary, may not be covered. Ask your doctor to help you make the case to the insurance company that the care or equipment is medically necessary or that progress is being made. If necessary, consider consulting with a social worker or lawyer to argue on your behalf.

Help, please?

I am still looking for some kind-hearted person, who would enjoy helping people who need help. Contact me about volunteering.

Rita Hatch is an Older Persons Action Group board member and volunteer for OPAG’s Medicare assistance program. Call her at 276-1059 or email ritaopag@gci.net.

 
 
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