Q: I am a senior with Medicare as my health care insurance. I am wondering if I have any say in what hospital I would use if I have need for that type of care. Some friends have indicated that I must go to the local hospital but others have said that I can go elsewhere. Are there any rules about where I must or could go?
A: Whether you have a choice of hospital depends on how you receive your Medicare benefits.
Those seniors who receive care through the original Medicare plan may go to any doctor or hospital that accepts Medicare for payment. You are in the original Medicare plan if you use your red, white and blue Medicare card to receive your health care.
In the original Medicare plan your choice could be restricted to the hospital or hospitals where your doctor has his or her privileges.
If a senior has assigned his or her Medicare benefits to a managed care plan (joined a Senior Advantage Plan) then in most cases choice of providers and facilities will be limited to those providers and facilities that have a contract with that managed care plan.
Before joining such a plan it would be wise to check out which providers, specialists, hospitals and skilled nursing facilities are available to plan members.
Another consideration that could affect your choice of hospitals depends on the type of illness or injury that needs to be treated. Sometimes a particular hospital or clinic is known for expertise in the treatment of specific illnesses or injuries. If you have a rare or serious health problem you may want to select a doctor and hospital with reputations for treating that type of condition.
Keep in mind that no matter how you receive your Medicare benefits, original Medicare or managed care or what hospital you use, as a Medicare patient you have certain rights while you are a patient in the hospital.
You have the right to get all the care you need while in the hospital and after you leave. If you feel you have been asked to leave the hospital too soon you have the right to ask for a review of that decision.
If you have a life-threatening medical emergency you should go to the nearest hospital for treatment. After you are stabilized and able to be transported your doctor and/or medical plan may make arrangements for you to be transferred to an appropriate hospital.
Q: In the past you have provided information about a service that helps obtain information about senior services in other areas. Could you provide that information again?
A: Yes. You are looking for information about the Eldercare Locator, which is a nationwide directory assistance service designed to help seniors and their caregivers locate local support resources. The service links the caller with the information and referral networks of state and local Area Agencies on Aging.
The Eldercare Locator is available from 6 a.m. to 5 p.m. Pacific time Monday through Friday. The toll free number is 800-677-1116. Be prepared to provide the county and city name or the ZIP code for the senior you are assisting. Also give a brief description of the problem you are trying to resolve.
HAPPENINGS:
Sunday: 2 p.m. History Comes Alive Presentation “Victorian Clothing from the Outside In,” a brief talk on the Victorian clothing of the late 1800s and a skit on the removal and revealing of the layers of clothing worn at that time. Goebel Adult Community Center, 1385 E. Janss Road in Thousand Oaks. $5 admission. Tickets are available at the center.
May 14: 1:30-3 p.m. “Where Does Your Money Really Go” seminar at Westlake Village Civic Center, 31200 E. Oak Crest Drive, Westlake Village. For information call the Advocate’s office at 495-6250.
