How Do I Get Hospital Medicare Reimbursement?

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  • Written By: Helen Akers
  • Edited By: Jessica Seminara
  • Last Modified Date: 11 September 2019
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The procedure for obtaining hospital Medicare reimbursement depends on the type of care received, the individual's Medicare coverage, and the location where treatment was received. Medicare is a type of government subsidized insurance plan in the United States that gives certain income and age groups access to health care services. There are two types of medicare coverage, known as "Part A" and "Part B," that reimburse patients for inpatient hospital treatment and regular, outpatient medical procedures. It is best to contact Medicare plan administrators in order to get detailed information on what costs each type of coverage will reimburse and how that reimbursement will be distributed.

In the majority of cases, most U.S. hospitals that accept Medicare coverage will automatically bill the plan for reimbursement on behalf of the insured. The patient may be responsible for co-payments and the costs of treatments that exceed coverage limits or the scope of Medicare coverage. Medicare plan administrators routinely update a list of potential injuries, illnesses, surgeries and treatments that are eligible for reimbursement under both types of coverage.


"Part A" covers inpatient treatments, which are also eligible for hospital Medicare reimbursement if they are administered outside of the United States in certain circumstances. For example, in the case of a medical emergency that occurs in the U.S., if the nearest hospital is located in a foreign country, Medicare will often reimburse the patient for his treatment costs. U.S. residents may also receive hospital Medicare reimbursement if the nearest hospital to the patient's residence is located in a foreign country. Inpatient treatments require overnight admission to the hospital's main unit and are usually requested by a doctor.

Unlike U.S. hospitals, some foreign hospitals may not bill Medicare directly for reimbursement. If a hospital stay occurs at a foreign location, it is important to keep copies of all bills and invoices received from the doctor as well as the hospital. Proof of treatment and its associated costs typically must be sent in to receive hospital Medicare reimbursement from care administered at a foreign hospital. "Part A" coverage usually only covers treatment received while the patient stayed at the hospital and does not include emergency transportation.

"Part B" coverage provides hospital Medicare reimbursement for outpatient services that do not require overnight admission. In some cases, emergency surgery, medical care, and ambulance or helicopter transportation to a treatment facility may be eligible for reimbursement. "Part B" is also known as regular medical insurance under Medicare's reimbursement terms.


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