When 83-year-old Maybell Prewette spent one night in an Eden, N.C., hospital a few years ago because she felt dizzy, she was stunned to find out that a couple puffs of allergy nasal spray cost her more than $600.
Medicare didn’t cover the prescription because Prewette was never admitted as a patient at the hospital.
Instead, she was kept overnight for observation. The federal Medicare program doesn’t cover the cost of drugs self-administered by “observation status” patients.
Prewette called her local pharmacy after she was discharged and discovered it charges $30 for the same nasal spray. The hospital marked the medicine up 2,000 percent.
This makes it seem like its a problem with Medicare. Medicare would be crazy to pay this. There was an article in the NYTimes a couple months ago detailing all kinds of examples of this — a couple sutures running $1,000 etc. etc. and the reason why private insurance doesn’t bother to challenge these off-the-wall charges. The fact that private insurance pays them is why hospitals charge them.