80 2024 Evidence of Coverage for WA PEBB Kaiser Permanente Senior Advantage Chapter 7: What to do if you have a problem or complaint (coverage decisions, appeals, complaints) Section 6 — How to ask us to cover a longer inpatient hospital stay if you think you are being discharged too soon When you are admitted to a hospital, you have the right to get all of your covered hospital services that are necessary to diagnose and treat your illness or injury. During your covered hospital stay, your doctor and the hospital staff will be working with you to prepare for the day when you will leave the hospital. They will help arrange for care you may need after you leave. • The day you leave the hospital is called your discharge date. • When your discharge date is decided, your doctor or the hospital staff will tell you. • If you think you are being asked to leave the hospital too soon, you can ask for a longer hospital stay, and your request will be considered. Section 6.1 – During your inpatient hospital stay, you will get a written notice from Medicare that tells about your rights Within two days of being admitted to the hospital, you will be given a written notice called An Important Message from Medicare About Your Rights. Everyone with Medicare gets a copy of this notice. If you do not get the notice from someone at the hospital (for example, a caseworker or nurse), ask any hospital employee for it. If you need help, please call Member Services or 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week (TTY 1-877-486-2048). • Read this notice carefully and ask questions if you don't understand it. It tells you: ♦ Your right to receive Medicare-covered services during and after your hospital stay, as ordered by your doctor. This includes the right to know what these services are, who will pay for them, and where you can get them. ♦ Your right to be involved in any decisions about your hospital stay. ♦ Where to report any concerns you have about the quality of your hospital care. ♦ Your right to request an immediate review of the decision to discharge you if you think you are being discharged from the hospital too soon. This is a formal, legal way to ask for a delay in your discharge date so that we will cover your hospital care for a longer time. • You will be asked to sign the written notice to show that you received it and understand your rights. ♦ You or someone who is acting on your behalf will be asked to sign the notice. ♦ Signing the notice shows only that you have received the information about your rights. The notice does not give your discharge date. Signing the notice does not mean you are agreeing on a discharge date. • Keep your copy of the notice handy so you will have the information about making an appeal (or reporting a concern about quality of care) if you need it. kp.org