Medicare Patients Pay "Under Observation" Expenses-Truth!

Medicare Patients Pay “Under Observation” Expenses-Truth!

Summary of eRumor:

This is a forwarded email that alleges that a change in policy for Medicare patients could end up costing them lots of money.  It warns that if they are admitted into a hospital to insist on “In-Patient” designation.   If the Medicare patients are designated as “Under Observation” they will not be covered by Medicare and end up having to pay the hospital expenses.

The Truth:

The article linked in the eRumor is a real news story by NBC.  

The Wall Street Journal also wrote about this on October 19, 2013 in an article that said, “Observation status can expose Medicare patients to unexpected expenses. As outpatients, their visits aren’t covered under Medicare Part A, which pays for hospital charges above a $1,184 deductible. Instead, outpatient services are billed under Medicare Part B, which requires patients to pay 20% of the cost and imposes no cap on their total expenditures.”

The Wall Street Journal included a link for Medicare recipients prepared by an advocacy group:

For “Self Help Packet for Medicare Observation Status” go to

Later versions of this eRumor have gone viral on the Internet, which cast blame for this new policy on the Affordable Care Act.   We have not yet determined that the Affordable Care Act is the reason for the Medicare coverage policy change.   We will post findings here when they develop.

posted 01/23/14   Updated 4/30/14