Tuesday, September 1, 2015

Swing Beds and Medicare

Most Americans my age are covered by Medicare. Well, I missed the boat on that one.

In the first place, my first nine years of working were as a teacher in Louisiana public schools. Back in those days of the 1970's, we teachers did not pay into US social security nor into Medicare. Our Teacher's Retirement Plan was considered to be good enough. 

Then I moved to The Netherlands.

When I moved back to the US in 2006, I taught my last two working years in Louisiana public schools so that my Dutch husband could get his US "green card." (For those of you who don't know, immigrants must be able to prove that they will have enough money to live above the US poverty threshold [$13,200 for a 2 person household in 2006] in order to obtain a "green card.") During those two years, money was withheld from my pay check for Medicare. And that was my donation to the Medicare program that I will never be able to use.

Don't feel sorry for me, since I am covered. I lived for over 25 years in a "socialist" country (The Netherlands), paid Dutch social security, and have private health insurance that should take care of me even better than Medicare. 

But do I know very much about US Medicare? Well, I am learning more and more every single day while my mother is ill.

The most recent bit of knowledge popped up yesterday. After a week of antibiotic IV treatments for osteomyelitis, my mom was transferred to a Swing Bed. My SIL had mentioned to my brother and to me that this would probably happen after a few days of treatment in the hospital. When she first said Swing Bed, I envisioned a kind of hammock and wondered how painful this would be for my 90 year old mom's stenosis back. Then my SIL briefly explained that Mom would probably stay in the same room but have a different classification. At that time I was so overwhelmed by the whole hospital situation, that I don't remember if we discussed the financial implications of a Swing Bed.

Last week, my mother and SIL met someone at the hospital that explained the Swing Bed situation to them. Even after my SIL relayed the info to me by phone, I began digging and Googling. It seems that because we live in a rural area, our small local hospital has been designated as a hospital with Swing Beds. From what I can make out, it all has to do with care accessibility, treatment, and Medicare payments.

"Medicare covers swing bed services in certain hospitals and when the hospital or critical access hospital (CAH) has entered into a "swing-bed" agreement with the Department of Health and Human Services (HHS), under which the facility can "swing" its beds and provide either acute hospital or SNF-level care, as needed. When swing beds are used to furnish SNF-level care, the same coverage and cost-sharing rules apply as though the services were furnished in a SNF."

My mom is eligible for a Swing Bed according to the Medicare guidelines/rules. But just as important is what it will cost her.

Her costs in Original Medicare:
Days 0-20: $0 for each benefit period
Days 21-100: $157.50 coinsurance per day of each benefit period
Days 101 and beyond: all costs

For more information about the eligibility and the "ins and outs" of the benefit period, please consult the following:  https://www.medicare.gov/coverage/skilled-nursing-facility-care.html


Janneke said...

I think what concerns social security The Netherlands is one of the best countries to live in. To my opinion they have gone too far, it should be good to take some steps back.

Alie said...

Hoop dat het weer een beetje beter met je moeder gaat. Dat zijn altijd moeilijke tijden. Sterkte!