A friend of mine, currently hospitalized again, and no longer local to me called today and told me he was informed by the hospital Finance Department that he is 7 days from reaching his Medicare Lifetime Hospital payments. They wanted him to sign some papers, which he declined. I don't know what they wanted him to sign.

He has been in and out of the hospitals a tremendous amount of time in the last couple of years. (Probably more than absolutely necessary.)

I did not know that there was a Lifetime cap on hospital stays from Medicare. Anyway, he is also covered under Tricare For Life.

My advice on the phone today was to call his Regional Tricare office for assistance/advice.

He is not indigent by any means. Although they are a long way from us, our wives call each other almost every day.

Anybody have any ideas that I can pass along? He didn't know if the Hospital Finance guy was trying to sell him an Advantage Plan or a Supplemental Plan. Would that even help him?

Here’s from a Humana website.

quote:

Medicare Part A —hospital insurance—provides coverage for an in-patient hospital stay of up to 90 days. If your hospital stay is longer, lifetime reserve days can offer big savings, but there are some limitations:

Lifetime reserve days can only be used once in a Medicare member’s lifetime.
They are not renewable from year to year.
You’ll pay a deductible for each reserve day you use.
Lifetime reserve days don’t apply to stays at skilled nursing facilities.
Your 60 lifetime reserve days can be split up over more than one hospital stay.

I’m not trying to be funny or insensitive but when I was studying this, the discussion was that this limit is never reached considering how quickly hospitals want to kick patients out and, also, Medicare patients being old, often die before reaching the limit if they need that much hospitalization.

Since he has tricare, I assume he’s military. He could contact the nearest VFW post which has a Veteran Service Officer who helps all veterans navigate the VA system; this service extends to all veterans, not just war veterans. He could try and get transferred to a VA hospital.

I’m sorry your friend is going through this; his health condition must be critical if he’s need hospitalization that much. Good luck.

Thank you for that chart. I took a screenshot of it and s3nt it to him, telling him to call Tricare. It's on him to follow through.

quote:

Originally posted by Rey HRH:
I’m not trying to be funny or insensitive but when I was studying this, the discussion was that this limit is never reached considering how quickly hospitals want to kick patients out and, also, Medicare patients being old, often die before reaching the limit if they need that much hospitalization.

My mother hit her lifetime limit several months before she passed. The worry over the financial impact was a major burden on both her as well as my father, when they should have been focusing on more important things, like recovering, or trying to survive, or trying to come to terms with the fact that they or their spouse is dying.

quote:

Originally posted by Rey HRH:
Since he has tricare, I assume he’s military. He could contact the nearest VFW post which has a Veteran Service Officer who helps all veterans navigate the VA system; this service extends to all veterans, not just war veterans.

Likewise, many state/county/city governments have Veterans Service Officers too. (In Arkansas, all county governments have at least one.) So if there isn't a VFW one available locally, check with his local government.

Aren't the day caps in a given benefit period, rather than over the entire period of coverage?

I understand the lifetime reserve days don't reset each year, but don't the base days?

quote:

Originally posted by RogueJSK:

My mother hit her lifetime limit several months before she passed. The worry over the financial impact was a major burden on both her as well as my father, when they should have been focusing on more important things, like recovering, or trying to survive, or trying to come to terms with the fact that they or their spouse is dying.

Since it was all theoretical for me, the improbability of needing 90 days hospitalization per year plus drawing on a 60 day non-renewable reserve sounded acceptable.

Two incidents from a relatively small group puts it in the realm of probability. I have to come up with a plan to deal with that similar to a family acquaintance who refused a life of having to regularly go for dialysis treatment when faced with the choice. With no treatment, she quickly passed. As far as dealing with dying, my wife and I have been talking about it through the years. It's an inevitability that we're comfortable with whoever which one of us go first.