Medical Services


“Inpatient” or an “Outpatient” - It


Find Out if It Aff ects


Find Out if You’re an or an


ects What ouhat You Pay an Y


edical Services


69


our hospital status - whether you're an


inpatient or an outpatient - affects how much you pay for hospital services (like X-rays, medications, and lab tests) and may also affect whether Medicare will cover


care you get in a skilled nursing facility (SNF) following your hospital stay. You're an inpatient starting when 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, outpatient surgery, lab tests, or X-rays, or any other hospital services, and the doctor hasn't written an order to admit you to a hospital as an inpatient. In these cases, you're an outpatient even if you spend the night in the hospital. The decision for inpatient hospital admission is a complex medical decision based on your doctor’s judgment and your need for medically necessary hospital care. An inpatient admission is generally appropriate when you’re expected to need two or more overnight stays of medically necessary hospital care, but your doctor must order such admission and the hospital must formally admit you in order for you to become an inpatient.


Note:


The copayment for a single outpatient


hospital service can’t be more than the inpatient hospital deductible. However, your total copayment for all outpatient services may be more than the inpatient hospital deductible.


Note:


Remember, even if you stay overnight in a


regular hospital bed, you might be an outpatient. Ask the doctor or hospital.


Note:


Observation services are hospital outpatient


services you get while your doctor decides whether to admit you as an inpatient or discharge you. You can get observation services in the emergency department or another area of the hospital.


Source: www.medicare.gov


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