Medicare Coverage Gap?

Critics say a Medicare loophole leaves patients on the hook for tens of thousands of dollars.

It was an injustice Lee Barrows couldn't let stand. Her husband needed nursing home care after a week-long hospital stay. That’s something Medicare usually covers after three or more consecutive days as an admitted hospital patient. But Barrows soon found out she and her husband fell into a loophole.

"Around the fifth day he was there, this neurologist came flanked by a social worker and another doctor and said, ‘I'm sorry Mrs. Barrows, but your husband was never admitted,” said the Canton woman.

Unbeknownst to Lee, her husband had been placed on observation status by hospital officials instead of being considered an in-patient. So all that time in the hospital never counted towards his nursing home care, leaving Lee on the hook for tens of thousands of dollars out-of-pocket for any treatment after he left the hospital. Critics are calling it a coverage gap.

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Source: NBC News