Leaving the hospital: discharge planning and your rights

Who this guide is for

For patients in the hospital and the family members or friends who help them. Discharge planning starts during your stay: your doctor and the staff (like a discharge planner, social worker or nurse) work with you and your caregiver to plan where you will go and what help you will need.

Notices and words to know

Inpatient or outpatient (observation)

You are an inpatient starting when a doctor formally admits you with an order. If you are getting observation services, you are an outpatient, even if you spend the night. Your status changes what you pay and whether Medicare will cover skilled nursing facility care afterward.

MOON notice

The “Medicare Outpatient Observation Notice”. The hospital must give it to you if you get outpatient observation services for more than 24 hours. It explains that you are an outpatient and how that can affect what you pay.

Important Message from Medicare

The notice “An Important Message from Medicare About Your Rights”. You should get it within 2 days of being admitted and before you are discharged. It explains your right to a fast appeal if you think you are being discharged too soon.

Notice of Medicare Non-Coverage

The “Notice of Medicare Non-Coverage”, given at least 2 days before covered services end in a skilled nursing facility, with home health care or in hospice. It explains the same right to a fast appeal.

BFCC-QIO

The Beneficiary and Family Centered Care Quality Improvement Organization: an independent reviewer under contract with Medicare that decides fast appeals and takes complaints about the quality of care. 1-800-MEDICARE can give you the phone number for your state.

Discharge planning checklist

Medicare’s free checklist, in English and Spanish, to use during your stay. It has room for your medicine list and your appointments.

Questions to ask when you call or visit

• Where will I get care after I leave? Do I have options, like home health care or a skilled nursing facility? Tell the staff what you prefer.
• Which of my medicines should I keep taking, and at what dose? Review your full list, including medicines without a prescription, vitamins and supplements.
• What problems should I watch for, what do I do if they happen, and who do I call with questions?
• Will I need medical equipment, like a walker? Is it covered by Medicare, and who will arrange the delivery?
• Can you show me and my caregiver how to do any special care, like changing a bandage, and let us practice?
• Am I an inpatient or an outpatient under observation? Ask every day you stay.
• Can I have written discharge instructions that I can read and understand, and a summary of my health?

Warning signs

• You are asked to leave before you understand your medicines, your follow-up care or who to call with problems.
• You thought you were admitted, but your papers say outpatient or observation. Ask the staff to explain your status.
• You did not get the Important Message from Medicare, or the MOON when you were under observation for more than 24 hours. Ask for it.

Costs and who pays

Your status matters: as an inpatient, Medicare Part A covers your hospital stay after the deductible; under observation, Part B covers your doctor and hospital outpatient services, and your costs are different.

A skilled nursing facility after the hospital: Original Medicare covers it only after a qualifying inpatient stay of at least 3 days in a row; days under observation do not count. Medicare Advantage plans may waive this rule.

During a fast appeal of a hospital discharge: if you ask by the deadline, you can stay in the hospital while you wait for the decision, and you will not have to pay for that time (except usual coinsurance or deductibles).

If you have a Medicare Advantage plan or other insurance, call the plan first: it may need to approve the care in advance and may only pay for providers in its network.

In general terms only. Deductibles, coinsurance and other amounts change every year, and Medicaid rules differ by state: check Medicare.gov, call 1-800-MEDICARE or your state Medicaid agency, and ask your plan.

How to complain or get help

• Discharged from the hospital too soon: follow the directions on the Important Message from Medicare and contact the BFCC-QIO no later than the day you are scheduled to leave.
• Services ending in a skilled nursing facility, home health or hospice: follow the Notice of Medicare Non-Coverage and contact the BFCC-QIO no later than noon of the day before the end date on the notice.
• Status changed from inpatient to outpatient during your stay: in some cases you can appeal. Medicare explains who qualifies.
• Quality of care: ask for the hospital’s patient advocate. The BFCC-QIO also reviews complaints about the quality of care for Medicare-covered services.
• Medicare: 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, free, with help in Spanish and other languages.

Find care on US Patient Guide

Common questions

Sources

• Your discharge planning checklist (Medicare publication 11376, PDF)
• Fast appeals: if your care is ending too soon (Medicare.gov)
• Inpatient or outpatient hospital status affects your costs (Medicare.gov)
• Appealing a change in status during a hospital stay (Medicare.gov)
• Skilled nursing facility (SNF) care: what Medicare covers (Medicare.gov)
• Quality Improvement Organizations (CMS QIO Program)
• Your discharge planning checklist, in Spanish (Medicare publication 11376-S, PDF)
• Medicare.gov in Spanish

Written in plain language by US Patient Guide from the official sources above, November 11, 2026. The facts on each provider page come from the official data shown on that page, with its date. Not medical advice.