What are the differences between inpatient, outpatient and under observation?
When you receive medical care, you’re typically classified as either inpatient, outpatient or under observation. These are classifications that describe the length of stay and type of care you receive when being treated in a medical setting. Knowing whether you’re being treated as inpatient, outpatient or under observation helps you understand what will and won’t be covered by your Medicare plan. Your coverage will also vary depending on whether you have Parts A and B (also known as Original Medicare), Medicare Advantage or supplemental Medicare. In this article, we’ll talk about the different care statuses and walk you through what Medicare covers for each.
What is inpatient care?
Inpatient care means you have been admitted on a doctor’s order. For example, if you seek medical treatment at an ER, urgent care or doctor’s office and the healthcare provider decides you need to be admitted to the hospital, you become classified as inpatient when your hospital admission begins. You remain inpatient until the day you’re discharged. Medicare Part A typically covers hospital care if you’re admitted as an inpatient after a doctor’s order and if the hospital accepts Medicare.
What is outpatient care?
Outpatient care is care that you receive in a hospital or medical facility without being admitted, or for a stay of less than 24 hours. Medicare Part B typically covers many outpatient diagnostic and treatment services from Medicare-participating hospitals and facilities. These include, but aren’t limited to, emergency room visits, medical supplies (such as splints or casts), lab tests, x-rays and preventive and screening services.
What does under observation mean?
Under observation means a doctor must monitor you for a certain amount of time to determine whether or not you need to be admitted to the hospital. When you’re under observation, you’re usually considered in outpatient care unless the observation extends beyond 24 hours. If that happens, the hospital must provide you with a Medicare Outpatient Observation Notice (MOON). Medicare Part B typically pays for care received at the hospital by an outpatient under observation status.
Need help with Medicare coverage? Let SelectQuote answer your questions and find the coverage that is right for you.
Knowing whether you’re receiving inpatient, outpatient or under observation care can help you make more sense of your Medicare coverage. SelectQuote’s experienced licensed insurance agents are here to help answer any questions about your care status and Medicare coverage, so you can get the treatment you need with less hassle.
