Emergency Room Services Detailed
Coverage: Conditions that must be met before Medicare will provide coverage, and limits to coverage.
A medical emergency is when you believe that your health is in serious danger. You may have a bad injury, sudden illness, or an illness quickly getting much worse.
Medicare covers emergency room services. Emergency services are not covered in foreign countries, except in some instances in Canada and Mexico. For more information, please refer to the Travel coverage information.
Emergency room visits usually include both facility charges and doctor’s charges.
Note: If you are admitted to the hospital within 1-3 days of the emergency room visit for the same condition, the emergency room visit is included in the inpatient hospital care charges, not charged separately.
CoPayment: The amount you need to pay.
You pay 20% of the facility charge or applicable copayment for each emergency room visit; you do NOT pay this amount if you are admitted to the hospital for the same condition within 1-3 days of the emergency room visit.
You pay 20% of doctor charges.
Medicare Part: The part of Medicare that pays for this service or supply.
Organization Name: The organization name that this coverage topic is associated with.
Important Notes: Details regarding important notes about the coverage.
You must pay an annual $147 deductible for Part B services and supplies before Medicare begins to pay its share.