auditorium-572776_1280 (1)Every month, I try to hold free Medicare Seminars in my hometown. I send out invites sometimes, but most of the time the event is listed in the local newspaper. People call and register, and concerned citizens from all situations attend. Attendees come with questions, share their experiences, and generally leave having learned something new.

This past seminar was no different. Someone who attended shared this information. I thought it would be a great thing to impart upon those who don’t know about this rule for Medicare.

The Rule

If you review Medicare Part A, you see that there are benefits related to skilled nursing care. On that page, you will see, among other things) that there are a certain amount of days and time frames that you need to follow in order to get skilled nursing facility care paid for by Medicare. In a nutshell, you have to have been admitted to the hospital for at least three days, and you have to enter into skilled nursing facility care within 30 days. All of this, of course, has to be approved by Medicare.

After explaining this rule to the attendees of the seminar, a woman in the group chimed in. She showed how hard and fast those days really are. I hope that this is a help to you reading this.

The Story

My mother fell and hurt her knee pretty badly and had to go into the hospital. Everything was fine in the hospital. The staff was very good about making sure she was in there at least 3 days so she could do therapy. We left the hospital and she started recovering at home.

Mom really didn’t want to go into the skilled nursing facility, though. She fought and fought us! Eventually, she gave in, and we took her into the facility. She discovered that she needed could not make a full recovery on her own.

She did really well in the facility and wasn’t in there for very long. When I got the bill, I thought it was a mistake. I couldn’t believe what my responsibility to pay was! Then, I found out why: Mom went into the facility at 35 days, not 30. So Medicare didn’t pay for any of it! Right now, we’re still trying to find a way to pay for everything.

My Take Away

This is a real-life example of how timing is everything with Medicare. Had she gone in just 6 days earlier, Medicare would have paid for 100% of her time (for days 1-20), instead of 0%? Just to put this into perspective, days 21-100, her responsibility, with the help of Medicare, would have been $161 per day. If her benefits started at just THIS level, 20 days would have cost $3,220. However, without the help of Medicare, the total is much, much higher.

We get insurance to make sure that we don’t have to pay out a ton of money when we need medical care. However, when we don’t know what the guidelines are or what our rights are, we can miss very costly opportunities. I’m glad that she attended my seminar. She was able to share and learn in the same place.

Seminar

The Next Seminar

The very next seminar will be held in Elwood, Indiana on November 16, 2016. They are usually held at the Elwood Public Library at 1600 Main St, Elwood, IN 46036. If you or someone you love are needing information on Medicare or Medicare supplements, you can call me at 765-618-6645 to register for this seminar or to set up a personal appointment (Indiana only). If you like to know the dates and times of future seminars, please email me at raphael@simpleseniorhealth.com.

Comments

I’d love to hear comments from you. Have you found any nuggets of information at a seminar you have attended? Would you like a seminar closer to your hometown? Let me know below!

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