I was told by my doctor that I might be considered a hospital outpatient, as opposed to a hospital inpatient. What’s the difference, and what does this have to do with Medicare?
August 1, 2012
Dear Marci, I was told by my doctor that I might be considered a hospital outpatient, as opposed to a hospital inpatient. What’s the difference, and what does this have to do with Medicare? —Norman
Dear Norman,
Generally, an outpatient hospital service is any type of medical care you receive at a hospital that your doctor does not expect will require an overnight stay. However, in some cases, you might stay overnight at a hospital and still be considered an outpatient. To be considered a hospital inpatient, you need to be formally admitted to the hospital.
The difference in your hospital status can affect your Medicare coverage for other services. For example, Medicare will only cover your stay in a skilled nursing facility (SNF) if you have spent at least three consecutive days as a hospital inpatient. Inpatient hospital services, like SNF stays, are generally covered under Medicare Part A, while outpatient services are usually covered under Medicare Part B.
Emergency room services or outpatient clinic services, such as same-day surgery, are generally considered outpatient services. Check with your doctor to see if you are an outpatient or inpatient, since this difference can affect the way Medicare covers the health care services you receive.
—Marci
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