What do I pay as an outpatient?
- Medicare Part B covers outpatient hospital services. Generally, this means you pay a co-payment for each individual outpatient hospital service. This amount may vary by service.
- Note: The co-payment for a single outpatient hospital service can’t be more than the inpatient hospital deductible. However, your total co-payment for all outpatient services may be more than the inpatient hospital deductible.
- Part B also covers most of your doctor services when you’re a hospital outpatient. You pay 20% of the medicare-approved amount after you pay the Part B deductible.
- Generally, the prescription and over-the-counter drugs you get in an outpatient setting (like an emergency department), sometimes called “self-administered drugs,” aren’t covered by Part B. Also, for safety reasons, many hospitals have policies that don’t allow patients to bring prescription or other drugs from home. You you have Medicare prescription drug coverage (Part D), these drugs may be covered under certain circumstances. You likely will need to pay out-of-pocket for these drugs and submit a claim to your drug plan for a refund. Call your plan for more info.
