When looking for health insurance, you may hear about inpatient vs. outpatient care about what is or isn’t covered by your policy.

These two terms refer to care that is either in the hospital or outside of it. Inpatient care refers to medical care that concerns a hospital stay while outpatient care includes essentially all medical care that does not require hospitalization. If you are admitted to the hospital and must stay overnight, for example, this is considered inpatient care.

Covered Under Inpatient Care

• Baby delivery
• Rehabilitation
• Surgery
• Medical issues that require constant monitoring

Covered Under Outpatient Care

• Consultations
• Physical exams
• Chemotherapy and radiation
• X-rays and MRIs
• Minor surgeries (that allow you to leave same day)
• Mammograms and colonoscopies
• Stitches

Essentially if you can receive your care within one day without staying overnight, this is generally considered as outpatient care.

What Health Insurance Covers Emergency Care?

Both inpatient and outpatient care can cover emergency medical care. Inpatient care can cover emergency surgeries, exams and procedures that occur in the hospital while outpatient care may cover ambulance care (hence why outpatient care is also known as ambulatory care) and same day procedures. For example, if you visit a hospital or care facility, receive stitches and are released, this is outpatient care. However, if you are involved in an accident and the hospital keeps you overnight to monitor your vitals, this will be covered under inpatient care.

What Health Insurance Covers Inpatient and Outpatient Care?

Most health insurance policies should cover both inpatient and outpatient care. It is important to check with your insurer to discuss what your policy will and won’t cover.

Unfortunately, many health insurance policies may not cover the entire cost of an inpatient hospital visit. If you or a family member under your policy must receive inpatient hospital care, you should ask the hospital about payment plans and other ways to save money. Most hospitals offer payment relief for individuals and families.

Can a Hospital Turn You Away Without Insurance?

The good news is that you cannot be denied medical care if you do not have health insurance. However, you will still be expected to pay for your medical bills as applicable. Even if you don’t have insurance, you can ask the hospital for assistance and look for help with your medical bills. Be sure to speak with an insurance agent about getting a health insurance policy to cover both your inpatient and outpatient medical care.

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