How to Choose a Hospital When You Have Medicare

As a Medicare beneficiary, you have the right to choose which hospital you receive care at. Understanding how Medicare works with hospital choice helps you make informed decisions while maximizing your benefits.

Your Right to Choose

Medicare gives you the freedom to receive care at any Medicare-certified hospital in the United States. This means:

• You are not limited to hospitals in your immediate area
• You can choose a hospital based on quality ratings, not just proximity
• You can seek care at specialized centers for complex conditions
• Your doctor can refer you to the hospital they believe is best for your needs

Medicare Care Compare: Your Research Tool

Medicare Care Compare was specifically designed for Medicare beneficiaries. Use it to:

• Search for hospitals by location
• Compare quality ratings across multiple hospitals
• View detailed quality measures for specific conditions
• Check patient experience scores
• Compare costs for common procedures

Understanding Medicare Hospital Coverage

Medicare Part A (Hospital Insurance)

• Covers inpatient hospital stays, skilled nursing facility care, and some home health care
• After meeting the deductible, Part A covers most inpatient costs for the first 60 days
• Covers care at any Medicare-certified hospital nationwide

Medicare Advantage (Part C) Considerations

• If you have a Medicare Advantage plan, you may need to use in-network hospitals for the lowest costs
• Some plans require referrals or prior authorization for hospital stays
• Emergency care is covered at any hospital regardless of network
• Check your plan's specific network and rules before choosing a hospital

Cost Considerations

• Medicare Payment data: Medicare Care Compare shows average Medicare payments for common conditions at each hospital
• Observation vs. admission: Ask whether you are being admitted as an inpatient or placed under observation status — this significantly affects your coverage and out-of-pocket costs
• Medigap policies: If you have supplemental insurance, it may cover costs that original Medicare does not

Getting Help With Your Choice

• 1-800-MEDICARE (1-800-633-4227): Free counseling available 24/7
• State Health Insurance Assistance Program (SHIP): Free local counseling for Medicare beneficiaries
• Your physician: Ask your doctor which hospital they recommend based on your specific needs

Data sourced from CMS. Visit Medicare Care Compare or call 1-800-MEDICARE for assistance.

Disclaimer: This article is for informational purposes only and does not substitute for official Medicare guidance.