What's the difference between inpatient and outpatient care?

Who is this for?

Learn more about how Medicare helps you get care.

If you're a Medicare member trying to understand your benefits, this information defines inpatient and outpatient care and why it's important to know the difference.

Generally, the care you receive from your doctor is either inpatient or outpatient care. So how do you know which one you're getting? Sometimes, it's easy because the facility will have "outpatient" right in the name. But other times, it's not as clear. 

Inpatient vs. outpatient

It really comes down to one question: were you admitted? If so, then you're an inpatient. If your doctor doesn’t write an order to admit you, you're an outpatient, even if you stay overnight.

If you're unsure about your status, ask your doctor or the hospital staff. They can tell you whether you're an inpatient or an outpatient.

Why it matters

It's important to know what kind of care you're getting because it affects how much you'll pay. For members with Original Medicare, it can also affect whether your stay at a skilled nursing facility is covered.

If you're a member, check your Evidence of Coverage to learn more.

If you're shopping for insurance, learn more about our Medicare Advantage plans.