Self-administered drugs, observation
DOVER-FOXCROFT — Mayo Regional Hospital values education in our community. Here are some helpful hints on two healthcare topics related to Medicare. We want to ensure that you understand your healthcare bill and make the best of your healthcare dollars.
Did you know there are two levels of care in a hospital setting where you may stay overnight in a bed? Sometimes people come to the hospital and tests need to be run in order to find the reason or diagnosis of why a patient is not feeling well. Your doctor may order you to stay overnight under an “observation” level of care. “Observation” falls under the outpatient or “Part B” benefit of Medicare. A 20 percent co-insurance is due from the patient after Medicare pays your bill to the hospital.
Another level of care, called an” inpatient admission,” is ordered when the doctor knows your diagnosis and they know you need to be cared for in the hospital for more than 48 hours. This benefit falls under Medicare A. Patient’s will be billed a deductible for this level of care. The 2015 Medicare A deductible is $1,260.
Did you know Medicare calls “over the counter” medication or medicine prescribed by your doctor that you take at home as a “self-administered drug.” Medicines included in this list might be inhalers for COPD, insulin, Tylenol, Milk of Magnesia, and antacids. Medicare B, or outpatient Medicare, does not pay the cost of these drugs. Only Medicare D may cover the cost of these medicines. You may receive medications like this at the hospital if you are in the emergency room, an observation stay, outpatient surgery, or infusion. The hospital will bill Medicare for these services and the charges for the medicine will not covered by Medicare. The bill will go to the patient as a balance due. You may see a bill from Mayo Regional Hospital, or any other hospital, for these medications come to you in the mail. You can always call the phone number on your statement to ask about the details of your bill. It is important for
you to provide an updated list of medication you take to your doctor and to the hospital so they can best help coordinate your care as well as keep healthcare costs low for all patients.
If you have any healthcare billing or coverage questions, please call your insurance company or Medicare 1-800-Medicare or TTY 1-877-486-2048 or a Mayo Regional Patient Financial Counselor at 564-1615.