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Does Medicare Cover Emergency Room Visits


Emergencies can happen at any time, that’s why it’s important to know what parts of Medicare cover emergency room visits. Let’s take a dive into what Part A, Part B, and Medigap plans cover in the event of an emergency.

Does Medicare Part A Cover Emergency Room Visits?

Part A is your hospital or inpatient coverage. It will help cover a portion of the costs from your emergency room or hospital stay, once your deductible has been met.

Part A coverage includes:

  • Inpatient hospital services
  • Hospice
  • Skilled nursing facility services
  • Limited home health care

How Much Does Medicare Cover for the Emergency Room?

As stated above, Part A doesn’t cover all your costs in the emergency room. You’ll have to pay the deductible before your coverage kicks in. After you met the deductible, Part A will cover 100% of the costs for 60 days. After 60 days, you’ll have coinsurance to pay for each day you stay in the hospital.

Does Medicare Part B Cover Emergency Room Visits?

Part B typically covers emergency services when you have an injury, a sudden illness, or illnesses that get significantly worse in a short period of time. This will also cover your physician follow-up appointments after receiving treatment from the emergency room or urgent care center. You’ll be responsible for some cost-sharing for the emergency room visit and any additional hospital services. Cost-sharing includes the 20% coinsurance and Part B deductible.

What is the Copay for an Emergency Room Visit with Medicare Coverage?

The copay you’ll have to pay out of pocket depends on the type of services you receive, how much your doctor charges for those services, and the type of facility you’re receiving services at. You most likely won’t know the copay until you receive the bill from the hospital.

Tip: If you happen to be admitted into the hospital within three days of your emergency room visit, your visit will be considered as part of your inpatient stay. You won’t have to pay the copayment for the emergency room.

Does Medicare Advantage Cover the Costs of an Emergency Room Visit?

Since Advantage plans are required to cover the same costs as Original Medicare, they also cover emergency room visits. The only difference between Advantage plans and Original Medicare is your out of pocket costs are different and less predictable. While Advantage plans provide more coverage them Medicare alone, they do not provide as much coverage as Medigap plans.

Do Medicare Cover Emergencies Outside the United States?

You may find yourself in need of emergency services when outside of the United States. It’s important to know that this may only be covered in unique circumstances.If you love traveling abroad, this is where the purchase of a Medigap policy would be extremely beneficial. Medigap plans can offer coverage for medical services outside of the United States. Many times, these plans will provide foreign travel coverage in emergency situations.

Do Medigap Plans Cover Emergency Room Visits?

Medigap plans will cover any services that Original Medicare covers. Medigap plans cover the gaps in coverage with Medicare. Depending on the letter plan you choose, your Part A deductible and all cost-sharing could be covered at 100%. This includes coverage for any coinsurance for hospital stays after 60 days.

Our agents are here to help answer all your questions regarding emergency room coverage and Medicare in general. Give us a call today, or feel free to complete an online rate form to compare rates on all your Medicare options in your area now.

Lindsay Malzone

Lindsay Malzone is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

2 thoughts on “Does Medicare Cover Emergency Room Visits

  1. Lindsay If I have a HDG medigap plan and go into the hospital for a procedure or into the ER is the $1,400 deductable covered as it is in the regular Plan G? Thanks, Jim

    1. Hi Jim! Since HDG comes with a deductible of $2,340, you will have to meet that first before it covers the Part A deductible of $1,400. However, that does not mean you have to pay 100% of the $1,400 deductible. You will have to pay a portion of it, how much specifically is dependent on the hospital you go to and how they bill Medicare. If you’ve already met the HDG deductible for the calendar year, then you won’t have to pay any of the Part A deductible.

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