Monday, November 5, 2012

Do you get to choose the Hospital when you have to be admitted?

By Bob Gregory

The thought of going to the hospital to have a procedure performed is very stressful and confusing.  Most people do not realize they have a choice in the hospital they use for non-emergency procedures.  For seniors, they feel their options are even more limited, especially when they do not fully understand the benefits provided by their primary insurance program. The majority of the population does not realize that hospitals, like doctors, have specialties.  Understanding that hospitals have specialties can be particularly important to seniors as there are hospitals that specialize in geriatric care

There are two major considerations that must be kept in mind when choosing a hospital.

    ARB at Shands at the University of Florida
    ARB at Shands at the University of Florida (Photo credit: Wikipedia)
  • First consideration: does your doctor have hospital privileges in the hospital you choose?  This is where the confusion and stress escalates! The most common choice in which hospital to use is the one in which your physician has hospital privileges.  Most doctors have hospital privileges in only one or two hospitals.  Doctors must apply and be approved to have the “privilege” to practice in a hospital and this is not a quick or easy process.  This can cause conflicts as you choose hospitals that best fit your needs as your doctor may not have hospital privileges.  If this occurs you will be stuck with choosing between your doctor and the hospital!

    English: Centers for Medicare and Medicaid Ser...
    English: Centers for Medicare and Medicaid Services - Medicare & You 2010, official government handbook. (Photo credit: Wikipedia)
  • Second consideration: does your insurance program provide full, limited or no coverage for the hospital you choose.  It is sad but true; we often have to allow cost to dictate the type and quality medical treatment we receive.  This is especially true when faced with hospital care as it can cost tens of thousands of dollars for simple procedures and can easily run into the hundreds of thousands of dollars for complicated procedures.  Understanding the benefits provided under your health insurance policy can ease some of the stress and allow you to make a more informed decision based on benefits you can expect to receive.  Many insurance policies require pre-approval for hospital  procedures/stays and while this seems intrusive, it can help you be assured you will receive the maximum benefit under your policy.  If pre-approval is not required, be sure to contact your insurance company for an explanation of benefits for the hospital(s) you have on your short list.

There are many other very important considerations when choosing a hospital and we will explore those in a future writing.  You should have a very honest and open discussion with your doctor regarding the hospital best suited for your procedure.  Be sure and ask your doctor if the hospital he/she recommends is the best for your procedure or just happens to be a hospital where they have privileges—it’s a fair questions so do not be afraid to ask!  If you take the time to have a discussion with your doctor, do not be surprised if they recommend another doctor that has privileges at a different hospital—the majority of doctors truly want what is best for their patient!  If you would like to obtain a list of hospitals in your area that meet your needs, please consider .

If you would like to contribute your thoughts and ideas, please leave them in our comment section. We want to hear them. Helping people care for themselves or their loved ones is what we care about. 
We look forward to reading yours.

Bob Gregory is an advocate for Seniors and is one of the founders of At, we are dedicated to helping families get the Elder Care help they need without having to provide their personal information! If you find you need a Hospital or other type of senior facility, please consider

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