Are You a Hospital Inpatient or on Observation Status? If you have Medicare -Ask!
Did you know that even if you stay in the hospital overnight, you might still be
considered an “outpatient”? More and more often, patients are staying overnight in the
hospital without admission. This is referred to as observation status. Your hospital status
(whether the hospital considers you an “inpatient” or “outpatient”) affects how much you pay for hospital
services (like X-rays, drugs, and lab tests) and may also affect whether Medicare
will cover care you get in a skilled nursing facility (SNF).
You’re an inpatient starting 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, outpatient surgery, lab tests, or X-rays, and the doctor hasn’t written an
order to admit you to the hospital as an inpatient. In these cases, you’re an
outpatient even if you spend the night at the hospital.
Note:Observation services are hospital outpatient services given to help the
doctor decide if the patient needs to be admitted as an inpatient or can be
discharged. Observation services may be given in the Emergency Department
(ED) or another area of 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. If you have questions or for more information please contact Surrey's Home Services department at 610-647-9840.
Read the attached document, published by the U.S. Department of Health and Human Services, to understand the differences in Original Medicare coverage for hospital inpatients and outpatients, and how these rules apply to some common situations. If you have a Medicare Advantage Plan (like an HMO or PPO), costs
and coverage may be different. Check with your plan.