Does Your Medicare Part A Cover Emergency Room Visits?

By: Agnus Smith
Published: Thursday, October 18 2018
Last Updated: 3 days ago

Inevitably, emergencies happen outside of regular doctor's hours, which is why you may end up taking yourself or a loved one to the emergency room (ER) for immediate attention. While nobody expects or wants to visit the ER, serious symptoms just simply cannot wait until the primary doctor is available. Many seniors worry about whether their Medicare, or more specifically their Part A, includes emergency room coverage, and here is the answer simply explained.

Medicare Part A Won’t Cover Emergency Room

If you were wondering whether or not your Medicare Part A will cover emergency room services, chances are it won’t. Your Part A coverage will only pay for your emergency room visit if you are admitted for inpatient care. Even if that was the case, you may still have to pay out of your own pocket in deductibles and coinsurance costs.

The fact that Part A, also known as hospital insurance, doesn’t provide ER benefits is confusing to many. However, don’t worry about it too much, because the second part of your Original Medicare will help pick up the tab.

Medicare Part B Emergency Room Coverage

Most Medicare beneficiaries will be enrolled in both Medicare Parts A and B. Part A is used to cover inpatient services, and Part B is used to cover outpatient services. So, even though the emergency room may be located in your local hospital, it would still be viewed as an outpatient service, meaning you're it will be your Medicare Part B that will offer benefits.

Under Part B, the following emergency room services will be covered:

  • Observation services
  • Overnight stays in hospital
  • X-ray and radiology
  • Preventive screening services
  • Supplies and equipment
  • Limited medically necessary surgical procedures

Although most expenses will fall under your benefits, you will still be liable for paying accompanying out-of-pocket expenses. Out-of-pocket costs can include a deductible, copay, and coinsurance. So be aware, even though you may be covered, without supplemental insurance policies, you can end up thousands in medical bills.

Avoiding Out-Of-Pocket Emergency Room Costs

As mentioned above, if you enroll in a Medicare Supplement (Medigap) plan, then your out-of-pocket emergency room costs may be covered. Currently, there are 10 policies to choose from, each with different levels of coverage, so you want to make sure to find one that fits your needs.

FirstQuote Medicare specializes in helping Medicare eligible individuals compare affordable supplemental plans in their area. All you need to do to get started is enter your zip code, and you’ll be able to easily shop for and view options near you. If you’re still confused with where to start, you can also talk to one of our experienced agents at no cost to you. See what Medicare Supplement quotes are available and get enrolled today.

Medicare Advantage Emergency Room Benefits

Medicare Advantage plans include all the benefits covered under Original Medicare. That means if you’re enrolled in and Advantage plans, then your emergency room services will be covered. You may also get added benefits that Original Medicare may not cover, so it’s definitely worth exploring Medicare Advantage as an option for coverage in your senior years.