Things You Sould Know before going to Hospital
Medicare will not pay for self-administered drugs for hospital outpatients. This includes outpatients, including some outpatient surgery, emergency room and observation patients (ask your doctor how you are being admitted).
What is a self-administered drugs - is a drug or biological furnished to a hospital outpatient or ER outpatient for therapeutic purposes, which is cajpable of being self-administered. These are drugs that you would typically take at home on a routine basis. Examples are, but not limited to pills, syrups, ointments and suppositories.
Since Medicare does not pay for these drugs, how are they billed?
Self-administered drugs are billed to Medicare as non-covered. So me secondary or supplemental insurance companies may cover these drugs, but many insurance companies only pay deductiblies and/or co pays and do not pay for items that are considered "non-covered" by Medicare. The patient will be billed for the self-administered drugs if your secondary insurance does not pay or your do not have a secondary policy.
What alternatives do I have?
1. You can ask the physician to write an order that you may take your home mediciation.
2. Bring your medication that you take everyday, in their orginal containers, when you come to the hospital.
A. The medication will be sent to the hospital pharmacy for identification and bar coding.B. Your medication will be kept in a secure area.C. Patient's narcotic/controlled medications, by law, can not be included.Medicare patients, whose hospital stays would normally be covered under the program, are being hit with surprise bills once they return home, bills that can reach into the tens of thousands of dollars. The loophole stems from the manner in which the patients are being classified during their hospital stays.
If a patient is formally admitted to the hospital, the hospital submits the bill to Medicare for reimbursement. However, if a patient is given the “observation” classification, used in cases lacking an immediate diagnosis, the patient may be billed for services without even realizing that his or her care is not covered. Under Medicare rules, patients under observation face a 20 percent copayment. Furthermore, the burden of paying for rehabilitation following an observational hospital stay would fall entirely on the patient.
