Making the Most of Medicare
by Noreen Brisson, Volunteer Services Coordinator Senior Health Insurance Benefits Advisors (SHIBA)
Discharge and Advanced Care/ End of Life Planning
W
e are living in a world that bombards us with information – some helpful, much of it aimed at selling something, and too much trying to fool us into allowing criminals to access our money and benefits. This can make it hard to know where to look, and trust resources to make decisions, especially when we are feeling vulnerable due to illness or situation. Fortunately, Medicare offers a number of services and tools to help to ensure we can make the most of our healthcare and have a voice in the decisions made – two of these services are Discharge planning and end-of-life Advance Care planning.
Discharge Planning Effective Discharge planning is one of the easiest ways to support your recovery. Knowing what to ask and what to expect – especially when the hospitalization is for a planned procedure – can help the process. Things to do to prepare for discharge from a hospital or other in-patient facility: 1. Make sure you and your caregiver are part of the discussion regarding discharge and what is expected to support recovery once home. 2. H ave a written list of questions you need answered to feel confident and prepared for discharge. Questions might include, but not be limited to (a) Where will you be getting care next – at home, in a facility as an in-patient, or an out-patient – and who will be providing the care? (b) Will you need to find providers or arrange for medical equipment?
58 Wise Guide | 2021/2022 Edition
3. Share any concerns related to your situation. Your input is important – it is the only way others can know potential barriers and limitations that may affect your ability to remain safe and recover effectively. 4. Try to gain as sound of an understanding as possible of what to expect and what is expected of you. This can be hard when not feeling well, having the person who will help you later (i.e. spouse, adult child or friend, or case manager) present can help. 5. Find more questions you may want to consider asking in the Medicare Publication “Your Discharge Planning Checklist” available on Medicare.gov, Your hospital or care facility may also have this document available. If you feel services are being stopped or you are being discharged too soon, you have a right to file a fast appeal. Within 2 days of your admission and prior to your discharge, you should get a notice called “An Important Message from Medicare about Your Rights.” This notice is sometimes called the Important Message from Medicare or the IM. It explains your rights and includes instructions for submitting a fast appeal. If you don’t get this notice, ask your provider for it. With a fast appeal, an independent reviewer will decide if your covered services should continue. You can contact your Beneficiary and Family Centered Care-Quality Improvement Organization (BFCC-QIO) for help with filing an appeal. You may be able to stay in the hospital (coinsurance and deductible may apply) while the BFCC-QIO reviews your case. The hospital can’t force you to leave before the BFCC-QIO reaches a decision.
