Medicare Part A (Mock Up)

Whether you’re an inpatient or an outpatient affects how much you pay for hospital services and if you qualify for Part A SNF coverage.

Inpatient: You’re an inpatient when the hospital formally admits you with a doctor’s order.

Outpatient: If you’re getting emergency or observation services, lab tests, or X-rays, without a formal inpatient admission (even if you spend the night in the hospital).

If you’re under observation more than 24 hours, you must get a Medicare Outpatient Observation Notice (MOON). This tells you why you’re an outpatient and how it affects what you pay for your care in the hospital and after you leave.

Skilled Nursing Facility Benefits
Medicare covers semi-private rooms, meals, skilled nursing and therapy services, and other medically necessary services and supplies in a SNF

You must meet all the following conditions:

Covered only after hospitalized for 3 consecutive inpatient overnights
Admitted to SNF within 30 days after leaving hospital
Receive care in the SNF for the condition treated in the hospital.
Require daily skilled services
Must be a Medicare participating SNF
Home Health Care Benefits
Must meet the following four conditions:

Must be under the care of a doctor
Must need skilled services
Must be homebound
Must use a Medicare approved agency
Prior hospitalization is not required to receive home health services under Medicare.

Hospice Care Benefits
Hospice care is special care for people who are terminally ill and for family respite care. Medicare pays for a maximum of 210 days of care in a Medicare approved hospice program, through two 90-day periods and one 30-day period.