Your chances of visiting the emergency room considerably increase as you get older. According to the CDC, people at the age of 65 and over have a 51 percent chance of using emergency care. Any trip to the emergency room can be nerve-wracking, but when you experience a sudden illness, medical event, or injury, you should not have to be overwhelmed with the cost of emergency room visits. Luckily, Medicare generally covers emergency care.
Here are some of the ways Medicare covers emergency room visits.
Medicare Part B
While Medicare Part A offers hospital and inpatient coverage, Medicare Part B provides medical and outpatient coverage, especially for emergency room visits.
Medicare Part B will generally cover your emergency care costs if you have a sudden illness, injury, or a disease that becomes much worse. Your emergency room cost may include:
- A copayment for each hospital service and a copayment for each emergency room visit
- 20 percent of the Medicare-approved cost for doctor visits
- Your Medicare Part B deductible applies
If you get admitted to the same hospital that you had been receiving treatment within three days of your first visit, you won’t need to pay the copayment costs because Medicare Part A will cover it as part of your inpatient stay.
Medicare Advantage
A Medicare Advantage policy includes Medicare Part A, Part B, and Part D prescription drug coverage. It also includes some extra benefits depending on the Medicare Advantage plan you choose. How Medicare Advantage plans cover the costs of an emergency room visit is close to how Original Medicare covers these items.
However, these plans may structure the costs and billings of emergency care differently from Original Medicare. For instance, a Medicare Advantage plan may ask you to pay a copayment per visit that is responsible for both doctor service and emergency room.
Medicare Supplement
Medicare Supplement policies can offer emergency health coverage for Medicare beneficiaries that are traveling out of the United States. Original Medicare doesn’t provide coverage for the emergency care you receive outside of the country. However, only certain types of Medicare Supplement plans provide coverage for the emergency care you receive outside of the country, so you may want to consider your options.
Do you have more questions about Medicare covering emergency room visits? Don’t hesitate to contact Cornerstone Senior Advisors. Our experienced Medicare experts can help you find the right Medicare plan that is suitable for your needs.