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Inicio /Qu cubre Medicare /Lo que cubre la Parte A

Averige si es un paciente internado o un paciente ambulatorio (esto determina


lo que tiene que pagar)
Your hospital statuswhether you're an inpatient or an outpatientaffects 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) 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 doctors judgment and your need for medically
necessary hospital care. An inpatient admission is generally appropriate when youre expected to need 2 or more midnights 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.

A continuacin ver algunas situaciones de hospitalizacin comunes y una descripcin de cmo Medicare se encarga de los pagos.
Remember, you pay your deductible, coinsurance, and copayment.

Situacin Paciente Paga la Parte A Paga la Parte B


hospitalizado o
paciente ambulatorio

Usted se encuentra en el Departamento de Outpatient until youre Your inpatient hospital Your doctor services
Emergencias (Emergency Department, ED) formally admitted as an stay
(tambin conocido como Sala de Emergencias inpatient based on your
[Emergency Room, ER]) y, finalmente, lo doctors order. Inpatient
admiten en el hospital con una orden del following such
mdico. admission.

You visit the ED and are sent to the intensive Paciente ambulatorio Nada Your doctor services
care unit (ICU) for close monitoring. Your
doctor expects you to be sent home the next
morning unless your condition worsens. Your
condition resolves and you're sent home the
next day.

You come to the ED with chest pain, and the Outpatient until youre Your inpatient hospital Doctor services and
hospital keeps you for 2 nights. One night is formally admitted as an stay hospital outpatient
spent in observation and the doctor writes an inpatient based on your services (for example,
order for inpatient admission on the second doctors order. Inpatient ED visit, observation
day. following such services, lab tests, or
admission. EKGs)

You go to a hospital for outpatient surgery, but Paciente ambulatorio Nada Doctor services and
they keep you overnight for high blood hospital outpatient
pressure. Su mdico no emite una orden por services (for example,
escrito para admitirlo como paciente surgery, lab tests, or
hospitalizado. Vuelve a su casa al otro da. intravenous medicines)

Your doctor writes an order for you to be Paciente ambulatorio Nada Servicios mdicos y
admitted as an inpatient, and the hospital later servicios del hospital
tells you it's changing your hospital status to para pacientes
outpatient. Your doctor must agree, and the ambulatorios
hospital must tell you in writingwhile you're
still a hospital patient before you're
dischargedthat your hospital status
changed.

Nota

Remember, even if you stay overnight in a regular hospital bed, you might be an outpatient. Ask the doctor or hospital.
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Servicios de Medicare y Medicaid
7500 Security Boulevard, Baltimore, MD 21244

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