Medicare ER Visit Costs: What Seniors Need to Know
Emergency room (ER) visits for seniors aged 65 and above averaged $1,110 in 2021. Understanding Medicare coverage for these visits is crucial for seniors and their families.
Medicare Part B covers 80% of ER costs, leaving the patient to pay the remaining 20%. For instance, a $1,110 ER visit would result in a $222 out-of-pocket expense for the patient. Medigap plans can help cover this share.
Medicare Part A does not cover ER visits unless the patient is admitted as an inpatient for at least two consecutive midnights. Part B, however, covers ER visits regardless of inpatient status. This includes ambulance rides to the ER if the patient's health is endangered by traveling another way.
Part D covers medications administered in the ER by a healthcare professional. Part C (Medicare Advantage) plans offer the same benefits as Original Medicare, including ER and urgent care expenses.
For those with other insurance types, health insurance or car insurance policies with emergency medical coverage typically cover ER visits without hospital admission. For example, an Auslandskrankenversicherung (foreign health insurance) might cover emergency medical expenses while abroad.
Signs of a stroke or heart attack necessitate immediate ER care. Understanding Medicare's coverage for ER visits can help seniors plan for these expenses. Part B covers most ER costs, while Medigap plans can help with the remaining 20%. Part A only covers ER visits with inpatient admission. Other insurance types, including car insurance, may also cover ER visits depending on the policy terms.
