Frustrating Medicare Catch could put you or a loved one in Heavy Debt

Ruth Felton, of Tiburon, California is a real fireball, even in her 90s. 

Her daughter, Sherry Brier, interviewed her while she was working out on a rowing machine at a gym where she had been going for several years When Brier asked if she felt it helped, her mother replied with a twinkle “I hope so,” as she continued to row.

But when she was 95, Felton fell late one night at home and was taken by ambulance to the emergency room, where doctors found she'd broken her pelvis in three places. 

Brier said the doctors told her that after leaving the hospital, her mother "would have to go to rehab and learn to walk again and learn to function again."

But Brier and her sisters were told that would mean a skilled nursing facility, which is expensive. But, if she "stayed three full nights, we were told that was the criteria for having Medicare pay for the rehab," Brier said. 

There's a nasty catch, however-- many people in the hospital are not officially considered "in-patients" but rather "under observation" although the difference is not obvious.

Says Toby Edelman of the Center for Medicare Advocacy, “Once they are in the hospital and in a bed for several days, getting care and treatment and medicine and food, (a) wristband, they think they're in-patients. People have no idea that they're out-patients." 

Felton’s daughters learned just ten minutes before her discharge that she was only under "observation" -- meaning Medicare would pay nothing for nursing care and rehab -- leaving them to pay a $17,000 bill. 

Many others pay tens of thousands more. Rep. Joe Courtney, D-Conn., says "the inspector general calculated that there were 600,000 cases across the country just last year alone."

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