•April 6, 2016•

By Trudy Lieberman
Rural Health News Service

Judy Norblade, a retired marketing director, and her husband, Paul, a retired teacher, thought they had all their financial bases covered. They had Medicare, good supplemental coverage from a Medigap policy, a drug plan that paid for most of their prescriptions and long-term-care insurance for a nursing home they hoped they would never need.

“I thought we were pretty well set for healthcare in our retirement years,” she said.

Then the Norblades bumped head on into a notorious Medicare rule that has caught thousands of families off guard over the past eight years and disrupted the sense of healthcare security they thought they had planned for.

They encountered a provision in the Medicare law, one that has been part of the program since it was founded in 1965. The provision says that Medicare will pay for services at a skilled nursing facility only if a patient has had at least a three-day, inpatient, medically necessary hospital stay before being admitted---assuming a few other requirements are also met.

If they are, Medicare pays the bill for the first 20 days. After that, a patient pays coinsurance---this year $161 a day from days 21 through 100. If a stay is longer, the family pays the rest.     Login or Subscribe to read the rest of this story.