Hospital Indemnity for Rehab

[DonP]

So if the MAPD kicks you out after 10 days and you have the rider, will it pay? Or does it require insurance coverage as well?

That’s a good question . I’ve never sold the gtl snf rider . I’m pretty sure you have to show insurance bill to get

 

[goillini52]

So if the MAPD kicks you out after 10 days and you have the rider, will it pay? Or does it require insurance coverage as well?

Good question.

I just called and asked and GTL said it's an indemnity plan and as long as the qualifications are met, GTL will pay regardless of what the MA plan does.

 

[straightnochaser]

So if the MAPD kicks you out after 10 days and you have the rider, will it pay? Or does it require insurance coverage as well?

The rider would pay if the member stayed in the facility but typically wont provide enough to foot the entire bill.

 

[Chazm]

So if the MAPD kicks you out after 10 days and you have the rider, will it pay? Or does it require insurance coverage as well?

They pay regardless of other coverage. In your example, if they had option 1, they would get the reimbursement of days 1-10. Option 2, they get nothing.

 

[DonP]

They pay regardless of other coverage. In your example, if they had option 1, they would get the reimbursement of days 1-10. Option 2, they get nothing.

So basically you sent in what you were billed and it’s irrelevant if the ins pays or not . If the ins company tells them they won’t pay anymore you stay in as a cash payer and show them bill . Honestly before I added all these extra riders I’d just do a plan N

 

[somarco]

I think the majority of us assumed SNF. Is there something you need to tell us? You know, the first step to recovery is admitting you have a problem.

I have a problem with the high cost of living. The news tells me everything is great but my bank account does not agree.

 

[Chazm]

So basically you sent in what you were billed and it’s irrelevant if the ins pays or not . If the ins company tells them they won’t pay anymore you stay in as a cash payer and show them bill . Honestly before I added all these extra riders I’d just do a plan N

I sometimes do too. Unless that person gets a $164.90 part B GB PPO and can spend $29 on a GTL HI plan. Add in cancer and SNF for $25 and it’s hard to beat.
I do more plan G $190 than a plan N $160 for T65

 

[MedicareMutt]

They do have that rider. With GTL you can have it pay you from day 1, or from day 20.


OPTION 1: This rider will pay $100-$220 per
day for days 1 through 50 if you are confined to
a skilled nursing facility. This benefit applies if you are admitted to a skilled nursing facility after having been confined to a hospital for three consecutive days. We will pay benefits as long as confinement occurs within 30 days of hospitalization. See certificate for exclusions and limitations.


OPTION 2: This rider will pay $100-$220 per day for days 21 through 100 if you are confined to a skilled nursing facility. This
Skilled Nursing Facility Benefit Rider** Choose from 2 options
OR benefit applies if you are admitted to a skilled nursing facility after having been confined to
a hospital for three consecutive days. We will pay benefits as long as confinement occurs within 30 days of hospitalization.

What is the cost of each ..? Vary by age and zip? Let's say 65 in 44052

 

[Speechman]

Inpatient rehab do tend to be different than SNF. Inpatient rehab usually provide 3+hours/daily rehab services.

 

[rmhaire]

I totally missed this thread back in September and I doubt I would have seen it if @MedicareMutt hadn't bumped it.

There seems to be some misconceptions on here about what an SNF actually is. I know the F stands for Facility but that's misleading. And SNF does not have to be a brick and mortar building. It has everything to do with Medicare certifications.

Most small cities and towns do not have stand alone SNFs. Your local nursing home doubles as the local SNF. It has everything to do with your nurses certification with Medicare.

Here's my most recent example:

I spent 21 days in the hospital back in September. Five separate operations. When I got home I was met by a HHC nurse at my front door. She originally came three days a week and then two. Currently she comes once a week. And yes I'm still on it.

But here's the fun part nobody knows. She's an LPN. And when it comes time for me to be recertified for Medicare another nurse has to come out and do it. She's also an LPN. When I asked why, they told me it had to do with their type of certifications with Medicare.