Before you leave a hospital, New York State law requires the facility to give you a written discharge plan.
Medicare has many rules and regulations. While many of these remain consistent from state to state, it's still important to learn the laws for your coverage area. Whether you're currently enrolled in a New York Medicare program, or are considering applying, knowing some basic New York Medicare laws will help you along the way.
Nursing Homes
According to New York state regulation and federal law, nursing homes are required to post a written policy of your rights as a resident in a clear and visible area of the facility. This policy, which protects your civil and legal rights, should also be explained to you by the nursing staff. If you have concerns during your stay, you should contact New York's advocate for residents of nursing homes and assisted living (more commonly referred to as an ombudsmen).
Medigap Open Enrollment
As a resident of New York, you are entitled to apply for Medigap (a separate policy that covers certain expenses when Medicare falls short) at any time throughout the year. The state's open-enrollment and portability provisions offer protection whether you are eligible for Medicare by reason of age or disability. Additionally, no insurance company in New York state can reject a Medigap applicant or make any premium-rate distinctions based on prior claims or medical condition. It is also illegal to deny an applicant because he is already receiving health care services. It can take up to six months before pre-existing conditions are covered by Medigap. However, under New York regulations, this waiting period may be reduced or waived, depending on your situation.
Hospital Discharge
Before you are discharged from a hospital, New York law requires the facility to give you a written discharge plan. You or your representative have the right to be involved in your planning. The discharge plan must detail the arrangements for any future care you may need, but you may not be able to leave the hospital until all of the requested services are secured. The hospital also must give you the state Health Department's contact information so that you may file a formal complaint if you disagree with the discharge plan.
Elderly Pharmaceutical Insurance Coverage Program
As of October 2010, New York's Elderly Pharmaceutical Insurance Coverage Program (EPIC) was affected by the New York State Elder Law. The change resulted in lower program costs and reduced out-of-pocket expense for EPIC members with Medicare Part D. According to the new law, a member who presents prescriptions for drugs not covered by his Part D plan will no longer be covered by EPIC, but will have the option to change his prescription to a drug that is covered under this plan.
Tags: discharge plan, Coverage Program, Elderly Pharmaceutical, Elderly Pharmaceutical Insurance, facility give, facility give written
