Notice of Noncoverage: Know Your Medicare Hospital Rights Before it is Too Late

I strongly advise you to read this. Typically, when you enter a hospital you are in pain, or even unconscious. If you are a senior citizen on Medicare the hospital is required to give you information on your Medicare rights. Few people actually read the fine print. That can be a big mistake. I am going to tell you how to protect your hospital rights under Medicare. You are going to learn about the Notice of Noncoverage.

Congress Is under pressure to cut Medicare costs. Medicare pays the hospital a fixed fee for each medical condition. Even if one patient heals faster than another, the hospital is paid the same amount. If your stay is shorter then the hospital keeps the money. By discharging patients too early the patient loses but the hospital benefits.

During the mid-60s the average hospital stay for a 65-year-old patient was two weeks. Nowadays, the average stay for a 65-year-old patient is approximately 5 days. Even though medicine has made great improvements, some patients need longer care. We heal at different rates. Some patients are too timid or afraid to say anything to their doctors about not feeling well enough to leave the hospital. They are intimidated by the doctors and nurses.

My 83 year old mother was recently in the hospital for a blocked Esophagus. The next day after they removed the blockage she felt good. Two days later she felt horrible. The doctor was talking about releasing her. We thought it was too soon. Because she insisted on getting things in writing, she wound up staying for 12 days. She knew her rights.

As soon as they are feeling a little better the patients are pressured to leave the hospital. Only you and your doctor know how you are feeling. You have to stand up for your rights. Speak up if you don't feel well enough to leave.

If the hospital or your doctor is pressuring you to leave the hospital and you think that it is too soon you can ask for a hospital social worker or administrator to give you a written Notice of Noncoverage. The hospital cannot charge you, nor discharge you for three days until the Notice of Noncoverage is given to you in writing. Insist on it in writing. It is your right. Do not let them discharge you prematurely. You are the best judge of how you feel. Don't let them send you home still sick. Get the Notice of Noncoverage in writing.

This three-day window is especially important if you are going to go to a nursing or rehab facility instead of going home. This gives you three days to find a suitable place that is covered by Medicare. You don't have to go where they want to send you. You might find a place closer to home. A nicer place. Look out for yourself.

If your doctor and the hospital want you to leave, you can ask for a review of your situation by a Peer Review Organization (PRO). The PRO is a group of doctors paid by the federal government to ensure quality treatment for Medicare patients. After you receive the Notice of Noncoverage you are required to notify the PRO by noon of the first workday after receiving the Notice of Noncoverage. You cannot be charged until the PRO makes its decision. The hospital will give you the number of the PRO. Insist on it. The PRO has 3 days to make it's decision.

If the hospital and your doctor disagree on your being discharged the PRO will review the case. You may have to pay for one day of hospital care if the PRO agrees with the hospital.

The most important thing to remember is to get the Notice of Noncoverage in writing. You cannot be forced to leave the hospital until three days have passed after you get the notice. Know your rights. Your health and well being is too important.