Q: My mother has been in and out of hospitals for the past two years. She used her 100 days in a skilled nursing facility and now my father is paying the bill. She went back into the hospital for four days. I thought that if you were hospitalized and returned to a skilled nursing facility the 100 days started over. The financial representative at the facility told me there were more stipulations than that. Is this true?
A: The financial person at your mother’s facility was correct. The non-coverage at the facility has to do with the benefit period not the return to the hospital.
A benefit period begins on the day you enter the hospital or skilled nursing facility and ends 60 days after you have not received inpatient care at the hospital or skilled nursing facility.
Your mother has never ended her initial benefit period as she has not had 60 days without inpatient care. Therefore, she has used up her 100 days for the benefit period and is not entitled to another 100 days in this same benefit period.
If she were to be released from the skilled nursing facility and go without the need for inpatient care in a hospital or skilled nursing facility for 60 days then the benefit period would close.
Then if she again needed care and went to the hospital for at least three days she would open a new benefit period and be entitled to up to another 100 days of skilled care or therapy at the skilled nursing facility.
If a patient is covered by a Medicare Senior Advantage plan (an HMO or PPO) instead of traditional or original Medicare the process is different. If this is the case you should check with your particular plan to be sure of its rules and cost for such coverage.
Q: In the past you have provided information about the “OLLI” program at CSU Channel Islands. Do you have any information about the upcoming spring classes?
A: As a matter of fact just yesterday I was given the catalog for the spring session.
The OSHER Lifelong Learning Institute, better known as OLLI, at CSU Channel Islands serves those who believe that “curiosity never retires.” It offers an adventure in academia to adults over 50 with classes in lecture and discussion format with no grades, no tests and no homework for those who are still in love with learning.
Spring classes will start the week of March 21 at all five class locations: CSU Channel Islands Broome Library in Camarillo, CSU Channel Islands Extended University Satellite Campus in Thousand Oaks, Little House in Ojai, Ventura Adult Continuing Education in Ventura and Leisure Village in Camarillo.
Class subjects are varied and include “Identity Crisis: American Heroism, Innovation and Popular Culture from 1945 to Present, “The Instruments of Jazz — a Comparative Study” and “The Early History of Television.” For more information and spring course information, do an online search for “OLLI at CI” or call 437-2748 for information or to register.
HAPPENINGS:
Sunday:
Gilbert and Sullivan Repertoire Company will present “Broadway Music Scores,” including music from Les Miserables and Phantom of the Opera. 2 p.m. at Goebel Adult Community Center, 1385 E. Janss Road in Thousand Oaks. Tickets are $5 and available at the Goebel Center.
Monday:
Individual Economic Check Up appointments from 9 a.m. to 2:30 p.m. at Goebel Adult Community Center, 1325 E. Janss Road in Thousand Oaks. For information and appointment times call the Advocate’s office at 495-6250.
“Savvy Saving Seniors — It’s in the Cards” seminar. Learn the ins and outs of various credit cards, debit cards, prepaid cards and gift cards, and discover tips and tricks for protecting your money. 3:30-4:30 p.m. at Goebel Adult Community Centers. For reservations call the Goebel Center at 381-2744.
Tuesday:
The Empowered Caregiver Series seminar “A Healthier Year: Enjoy Better Hearing & Protect Your Pearly Whites.” 5:30-7 p.m. at Senior Concerns Day Care Center, 401 Hodencamp Road in Thousand Oaks. For reservations call 497-0189.
