In patient or outpatient? Know your hospital status
Understanding your benefits and knowing your hospital status (whether you are an “inpatient” or “outpatient”) can help determine what you pay out-of-pocket or if your services will be covered by Medicare.
Medicare Part A (hospital) provides coverage for services as an inpatient when a doctor formally orders your admission to the hospital. Medicare Part B (medical) covers outpatient services such as emergency room services, outpatient surgery, lab tests, x-rays and observation services, and the doctor has not admitted you as an inpatient.
It is especially important to ask about your hospital status if you are under “observation.” Observation services are outpatient services when a doctor decides if you will be admitted to the hospital as an inpatient or if you will be discharged. Medicare can limit the number of days covered for medically necessary observation services, sometimes leaving you with a large bill to pay. Just because you stay overnight doesn’t mean you have been formally admitted by your doctor as an inpatient.
If you are not sure about your inpatient or outpatient status, ask your doctor or the hospital staff. Also, know your Medicare benefits and rights by contacting Alaska’s Medicare Information Office in Anchorage at (907) 269-3680 or statewide 1-800-478-6065. Or e-mail us the office at firstname.lastname@example.org.
Jeanne Larson is a Health Program Associate at the State of Alaska Medicare Information Office.