Medicare Blog: Moorestown, Cranford NJ

Justin interviews congressman Courtney

2/22/2021

In February 2021, I had the opportunity to interview Congressman Joe Courtney from Connecticut to discuss a key Medicare issue we have been working on for several years, related to "Observation" status in the hospital.

When you are in the hospital in an "Observation" status (before getting "Admitted"),

(1) your medication costs are still covered under your Part D prescription plan rather than your Part A hospital benefits. If you are administered expensive drugs, this could result in high out-of-pocket costs for the patient;

and...

(2) if you need Skilled Nursing Care after the hospitalization, the Medicare Part A benefits will not cover the costs. You will be required to pay out of pocket for the Skilled Nursing Care.

In the video, Congressman Courtney and I discuss these issues and some legislation that is being worked on to fix these problems for the Medicare Beneficiary.

Thank you for watching.

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4 Comments

Rudy DAlessandro

3/28/2021 05:53:01 pm

What is considered to be SKILLED medical care ?
All medical issues after 3 days ?
Example: going into rehabilitation after knee replacement

Justin Lubenow

3/28/2021 06:23:57 pm

Hi Rudy,

Yes, Skilled Nursing Care is generally like rehab after a procedure (e.g. knee/hip replacement) or stroke.

Skilled nursing care is NOT custodial care, assisted living, or long-term care. Those services would be covered under Long-term care insurance but not Medicare.

Melva Romano

4/30/2021 11:24:56 pm

Hi Justin, Would my medigap plan G cover skilled nursing ?
It would be important for me to know this before hand otherwise I would surely not be able to afford such an expense. I do hope our government can help our elderly citizens.

5/3/2021 08:32:32 am

Hi Melva,

Skilled Nursing is covered by Medicare & Medigap Plan G if you are first "Admitted" to a hospital for a 3-day stay, and then transferred to the Skilled Nursing Facility. If you are in an "Observation" status in the hospital, then transferred to Skilled Nursing, then Medicare does not cover the Skilled Nursing Care. This is the issue that Congressman Courtney and I were discussing and hope to have fixed in the near future.

Best,
Justin

Justin interviews congressman Courtney

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Justin Lubenow

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