ARE YOU A HOSPITAL INPATIENT OR OUTPATIENT?

If You Have Medicare—Ask !

Did you know that even if you stay in the hospital overnight, you might still be considered an “outpatient”? Your hospital status (whether the hospital considers you an “inpatient” or outpatient”) affects how much you pay for hospital status may also affect whether Medicare will cover care you get in a skilled nursing
Facility (SNF).

An inpatient admission begins the day you’re formally admitted to the hospital with a doctor’s order. The day before you’re discharged is your last inpatient day. You’re an outpatient if you’re getting emergency department services, observation services, lab tests, or X-rays, and the doctor hasn’t written an order to admit you as an impatient even if you spend the night at the hospital.

If you’re in the hospital more than a few hours,
always ask your doctor or the hospital staff if you’re an inpatient or an outpatient.

Medicare Part A (Hospital Insurance) covers inpatient hospital services. Generally, this means you pay a one-time deductible for all of your hospital services for the first 60 days you’re in the hospital.

Medicare Part B (Medical Insurance) covers most of your doctor services when you’re an inpatient. You pay 20% of the Medicare-approved amount for doctor services after paying the Part B deductible.

Medicare Part B covers outpatient hospital and doctor services. Generally, this means you pay a co-payment For each outpatient hospital service. This amount may vary by service.

For more detailed information on how Medicare covers hospital services, including premiums, deductibles and co-payments, call 1-800-MEDICARE (1-800-633-4227).