Medicare can play a major role in helping cover the cost of a hospital stay, but how it works depends on the type of care you receive and the parts of Medicare you have. Knowing the basics can help you avoid unexpected bills and make informed decisions.
Medicare Part A: Inpatient Hospital Coverage
Medicare Part A helps cover inpatient hospital stays when you are formally admitted by a doctor. This includes your room, meals, nursing care, medications given as part of treatment, and necessary hospital services. Part A coverage is organized around benefit periods, not calendar years. You are responsible for a deductible at the start of each benefit period, and longer stays may require daily coinsurance.
Observation Status vs. Inpatient Admission
A hospital stay is not always considered inpatient, even if you stay overnight. If you are under observation status, Medicare treats your care as outpatient. This matters because observation services are covered under Part B, not part A, and can affect both costs and eligibility for follow-up care in a skilled nursing facility.
Medicare Part B: Outpatient and Doctor Services
Medicare Part B covers outpatient hospital services, including observation care, emergency room visits, lab tests, imaging, and doctor fees during a hospital stay. You typically pay a percentage of the cost after meeting your Part B deductible.
Medicare Advantage and Supplemental Coverage
Medicare Advantage plans must cover what original Medicare covers but may have different rules, provider networks, and cost-sharing. Medigap plans can help pay for deductibles, coinsurance, and other out-of-pocket costs left by original Medicare, offering added financial protection during a hospital stay.
McBride Benefit Solutions: Proudly Serving Florence, AL
If you’re looking for more information about Medicare insurance, we’re glad you found us. At McBride Benefit Solutions, we’re proud to serve Florence, AL and surrounding areas, and we’re here to help you with all of your insurance needs. Reach out to our team today to schedule an appointment and learn more.
