Dad's being discharged tomorrow

The call comes: Dad's being discharged tomorrow. Before he leaves, ask the questions that decide what Medicare pays for next. These are Medicare's own rules, for Original Medicare; Advantage plans can differ, so call the plan too.

He's an inpatient only from when he's formally admitted with a doctor's order. Emergency or observation services without that order make him an outpatient, even if he spent the night in a regular hospital bed. If he's been under observation for more than 24 hours, the hospital must give him a Medicare Outpatient Observation Notice (MOON) that says why. Medicare.gov

Medicare covers a skilled nursing facility only after a qualifying inpatient stay of at least 3 days in a row: the admission day counts, the discharge day doesn't. Time under observation or in the ER before admission doesn't count, even overnight. Exceptions: a doctor in an Accountable Care Organization with a 3-day rule waiver, and Medicare Advantage plans may waive it. Without a qualifying stay, ask about home health or other programs.

What rehab costs in 2026 (Original Medicare): days 1 to 20, $0 a day after the $1,736 Part A deductible (not again if he already paid it for this hospital stay); days 21 to 100, $217 a day; after day 100, all costs. Medicare.gov

Within 2 days of admission he should get "An Important Message from Medicare about Your Rights." If he didn't, ask for it. To appeal a discharge, follow its directions no later than the day he's scheduled to leave. An independent reviewer (the BFCC-QIO for California, named with its phone number on the notice) decides. If he was admitted and the hospital switched him to observation, he can ask for a fast appeal while still there. Medicare.gov

• A rehab bed, if he qualifies: nursing homes near you with Medicare stars.
• Home health, if the doctor orders it: agencies, rated.
• Equipment the doctor ordered (walker, commode, hospital bed): suppliers that take Medicare's price.
• The follow-up appointment, the new prescriptions, and who to call if something changes at night.

• Parent Check-In Plan, $25 a month: one check-in visit and one errand a month, and a text to you after each one: how they seemed, what was done, what's coming.
• Errands, $25 a stop: the pharmacy pickup, the walker from the supplier, the grocery fill-in.
• Family Assist, $30 an hour: the calls, the forms, the portals and the waiting on hold.

PJ is based in Solana Beach and covers Solana Beach, Del Mar, Cardiff and Encinitas in person. No rides, no personal care (bathing, dressing, medications: that's licensed agencies), no insurance advice, and no referral fees from anyone. Text PJ

Need a human?

This page is built every morning from public data by SideGuy, run by PJ, a local in Solana Beach. If something looks off, or you want a hand with your plans, text PJ at 858-461-8054. A real person answers.

Local help, free to read: make your fix plan · senior benefits checkup · lower your SDG&E bill · Medicare Extra Help · every 2027 Medicare plan · is my medication recalled? · the next 90 days. Plans start as low as $25. Your parent lives here and you don't? The Parent Check-In Plan, $25 a month.