Medicare Part B covers medically necessary outpatient hospital care, which is care you receive when you have not been formally admitted to the hospital as an inpatient.

Covered services include but are not limited to:

  • Observation services
  • Emergency room and outpatient clinic services, including same-day surgery
  • Mental health care
  • Hospital-billed laboratory tests
  • Blood transfusions
  • Certain drugs
  • Medical supplies, such as splints and casts
  • X-rays and other radiation services

In some cases, you may stay overnight in the hospital without being formally admitted as an inpatient by your doctor. For example, you may be in the hospital receiving emergency room services or be under observation status. While you may receive services similar to those you would receive as an inpatient, keep in mind that you are covered by Part B when you are an outpatient, not Part A.

Costs

After meeting your Part B deductible ($183 in 2018), you pay a copayment for care received in outpatient hospital settings. You may have multiple copays. Each individual copay must be lower than the Part A deductible ($1,340 in 2018), but your total copay costs may be higher than the Part A deductible.

Part B also covers any outpatient provider services you receive while in the hospital. You usually owe a separate 20% coinsurance for these services.