The Iowa Insurance Division’s Senior Health Insurance Information Program (SHIIP) has a new Medicare Outpatient Observation Notice (MOON) which informs patients before they leave the hospital if they are outpatient or inpatient.
“Over the past several years Iowans on Medicare were often surprised to receive information that their overnight stay at a hospital was considered to be outpatient, not inpatient,” Kris Gross, director of SHIIP, stated in a press release.
Iowans are considered outpatient if they receive emergency department services, observation services, outpatient surgery, lab tests, X-rays or any other hospital services, and the doctor has not written an order to admit them to a hospital as an inpatient. Observation services are hospital outpatient services given to help the doctor decide if the patient needs to be admitted as an inpatient or can be discharged. In these cases, Iowans are considered an outpatient even if they spend the night at the hospital.
When Iowans with Medicare Part B receive services as an outpatient, Medicare Part B covers the hospital services. This means the patient pays a copayment or coinsurance for each outpatient service, including doctor services and only inpatient stays count towards qualifying for Medicare covered skilled nursing care after leaving the hospital.
Iowans with questions about the MOON, outpatient observation services or filing for Part D outpatient claims may call Mercy Iowa City SHIIP at (319) 339-3658, SHIIP Headquarters at (800) 351-4664 or visit www.therightcalliowa.gov
SHIIP counselors are available to help answer questions and assist with Medicare concerns and related health insurance. SHIIP is a service of the state of Iowa Insurance Division. All services are free, confidential and objective.