What’s the difference between inpatient and outpatient hospital care?

Knowing the difference between inpatient and outpatient hospital care can help you plan ahead — and manage your health care expenses.

When you get medical care at a hospital, it often falls into one of two groups: inpatient or outpatient. The difference might sound simple. But it can have a big effect on your costs and coverage.

Knowing what each type of care means can help you make smart choices and avoid surprises on your hospital bills. Learn how inpatient and outpatient hospital care work, and how having coverage can help you feel better about your next visit.

What is inpatient care?

Inpatient care is when you’re admitted to a hospital or care center and stay at least one night.¹

Inpatient care includes testing, treatment and monitoring. It can involve planned care, like childbirth or surgery. It can also happen after sudden events, such as a serious fall or a stroke.

Common inpatient examples

• Major surgeries
  Heart surgery, joint replacement or organ transplants often require at least one night in the hospital.
• Complex medical conditions
  Some illnesses, like severe infections or problems with chronic diseases, may need 24-hour care in a hospital.
• Childbirth
  Labor and delivery are usually inpatient stays.
• Post-injury rehabilitation
  After a major accident, you may need inpatient rehab to regain strength or mobility before going home.

In general, inpatient care includes more involved treatment. Because of that, it usually costs more than outpatient care.

See how hospital indemnity insurance can help cover medical costs. Explore plans online today.

What is outpatient care

Outpatient care is when you get medical services or procedures but don’t need to stay overnight.² It usually means you visit a hospital for testing or treatment.

When your visit ends, you go home the same day. Outpatient services can include  screenings, same-day surgeries and some emergency visits.

Common outpatient examples

• Diagnostic and lab services
  Tests like blood work, X-rays, MRIs and CT scans are usually outpatient services.
• Emergency room visits
  Some ER visits count as outpatient. For example, if you’re treated for a minor injury and released the same day.
• Minor surgeries
  Procedures like mole removals, cataract removal or hernia repair are often done as outpatient care.
• Screenings
  Procedures like colonoscopies and mammograms are frequently done in outpatient settings.

Outpatient care is usually more convenient and costs less than inpatient treatment. Costs and coverage depend on your health plan. But many preventive outpatient services are covered at no cost to you.³

Key differences and what to keep in mind

The main difference between inpatient and outpatient care is whether you stay overnight. But that difference affects more than just your schedule. It can also impact your out-of-pocket costs, coverage and billing.

Find inpatient and outpatient coverage that fits your family and your budget. Call (800) 827-9990 to speak with a licensed insurance agent today.

How costs and coverage compare

• Inpatient costs
  Inpatient stays are more expensive because you’re paying for a hospital room, medical staff and 24-hour care. A three-day hospital stay, for example, can cost about $30,000.⁴
• Outpatient costs
  Outpatient care usually costs less since you’re only billed for the service itself. Many health plans cover preventive outpatient care — like annual screenings — at no cost to you.³

Why patient status matters

Your admission status affects how your insurance covers the visit. Even if you stay overnight for observation, you might still be billed as an outpatient. That’s why it’s smart to confirm your status with your care team or health plan before or during your stay.

How hospital indemnity insurance can help

Even with good health coverage, a hospital stay can bring surprise costs. Hospital indemnity insurance can help with some of those expenses.

These plans, sometimes called hospital and doctor insurance, pay you a set benefit amount when you’re admitted for covered inpatient care.⁵ You can use that money however you need. Common examples include:

• Medical bills
• Daily expenses
• Travel costs

Hospital insurance plans aren’t a replacement for your main health insurance. But they can offer extra coverage when you need hospital care. This can help give you manage medical expenses if you or your family faces an unexpected stay.

It’s important to understand how inpatient and outpatient hospital care differ. And how each affects your costs. Both can help you make informed decisions about your health coverage.

Need help finding coverage that fits your family’s needs? Call (800) 827-9990 to talk with a licensed insurance agent.

For informational purposes only. This information is compiled by HealthMarkets Insurance Agency and does not diagnose problems or recommend specific treatment. Services and medical technologies referenced herein may not be covered under your plan. Please consult directly with your primary care physician if you need medical advice.