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I saw this on NBC News last night…a Fair warning about Medicare

By February 7, 2014December 20th, 2022No Comments

There is a video making the rounds through an email with the subject header being titled “Fair Warning… I saw this on NBC News last night”.

This email  and the video is quickly becoming somewhat of instant phenomenon within the financial planning industry as it touches on how hospitals use the terms “Under Observation” and “In-Patient” and the impact that it may have on finances.

The actual body of the email states:

I saw this on NiBC News last night and thought I should send it to all my friends on Medicare as fair warning.  I’ve included the segment for you to view.  Basically, if I understand it correctly, do not let the hospital admit you with the words, “Under Observation.”  Insist on “In-Patient” designation.   Otherwise, you will be responsible for the hospital expenses.  It might be wise to inform family members too”.

Now, please note that there is nothing wrong with the email or even the video. The information that is provided in it is truthful, factual and spot on. Brian Williams and NBC did a great job on reporting this information and they should be commended for it.

The video can be found here

The video does a fantastic job at explaining the two, very distinct, options hospitals have when admitting a patient, which are:

– “In-Patient”, which by definition is “a patient who is admitted to a hospital or clinic for treatment that requires at least one overnight stay” (keep in mind that this has changed). This status is used when there is a clear medical necessary issue with the patient, i.e. bleeding wound, apparent heart attack.

– “Observation”, which is used by hospitals as a way to determine if the patient is sick enough to need inpatient treatment. Ultimately, if the hospital can not immediately see that there is a medically necessary reason for the patient to be at the hospital they have to admit the patient as being in the “Observation” category to run tests to finally determine what the patient needs.

The video also, correctly, reported on how these two very different options will impact patients and they are:

-“In-patient” will ensure that the costs of care will be covered by Medicare.

-“Observation” will, if the hospital can NOT find a medical reason to admit the patient while being “Under Observation, lead to all of the costs being the responsibility of said patient.

Now, should this information alone make the financial industry sit up and take notice? Is this information, especially for those in the financial industry, in any way shape or form considered to be a “Fair Warning”?

HOPEFULLY NOT and here is why:

This is nothing new!

Inpatient verse Observation has been the standard process for admitting patients under Medicare coverage since the dawn of Medicare. Even more frightening,is that this “Fair Warning” is on page 32 of Medicare’s fantastic handbook, aptly titled “Medicare and You”, where it states very clearly, after a big blue highlighted arrow, that:

“Staying overnight in a hospital doesn’t always mean you’re an inpatient. You only become an inpatient when a hospital formally admits you as an inpatient, after a doctor orders it. You’re still an outpatient if you’ve not been formally admitted as an inpatient, even if you’re getting emergency department services, observation services, outpatient surgery, lab tests, or X-rays. You or a family member should always ask if you’re an inpatient or an outpatient each day during your stay, since it affects what you pay and whether you’ll qualify for Part A coverage in a skilled nursing facility”.

Ultimately, Medicare is and has been screaming at its beneficiaries for years about this so called internet phenomenon and the one other industry, the financial one, which happens to help people plan for retirement and claims to be experts on the subject, find this rule to be “far worse and less known” than even the Medicare “means testing rules” which were just implemented in 2007.

Again, this email is a real “Fair Warning”, but not for the reasons many would think. It is a “Grave Warning” simply because it is highlighting the fact that many people, including those financial professionals AND those financial firms that hold themselves out to be “Retirement Specialists” or Certified Financial Planners may not completely understand the one basic need people will have in retirement – their health.

Eventually, there will come a time when those that sought financial advice will reach the age of needing care and they will feel the brunt of today’s planning or lack thereof. Their savings will have been depleted, their options of generating any more income or cash will have all but dried up and they will be left the very hard decision of what to do when it comes to either their health or their lifestyle (eating).

The only thing that we have yet to see is what will the reaction be of the children, whose parents received this “Retirement Advice” from financial professionals when they quickly realize that their parents are not only broke, but that they are also in pain, simply because the financial industry just didn’t understand the simple rules of actual retirement.

Even scarier, as Mike Padawer of Inertia/Advisor’s Service Group likes to point out, “The financial industry is always looking for niche to market too and this issue of planning for healthcare costs is probably the greatest one ever. It impacts every single person while happening to be the biggest expense anyone will face in retirement and who is actually in this niche?”

Mr. Padawer is actually spot on, with the exception of Nationwide, Jester Financial and Fidelity, who is really marketing to this cost?

From experience not many and what is even more surprising than who is or isn’t marketing to this issue, is the solution to it. When the smoke clears and the information is gathered the real solutions for clients tend to be the current ones advisors already have access to which are: Roth Investments, certain Life Insurance policies, specific Annuities and other less know investment vehicles like Health Savings Accounts and 401(h) plans.

The fact of the matter is the general public will now need financial planning more than ever as there is an obvious need, but who is really there for them to not only help them plan, but also provide the solution?