Medicare's Guide to Choosing a Hospital: What Every Medicare Beneficiary Needs to Know

Who Should Read This

This publication is helpful for anyone who has Medicare and may need hospital care, whether planned or unexpected. It is especially useful for people aged 65 and older, those under 65 with certain disabilities, and people with End-Stage Renal Disease (ESRD). If you are a caregiver or family member helping a loved one make decisions about hospital care, this guide is also a valuable resource. Anyone currently enrolled in Original Medicare or a Medicare Advantage Plan will find this information directly relevant to their healthcare decisions.

Quick Overview

This Medicare publication helps beneficiaries understand how to compare and select a hospital that best meets their needs. It covers key tools available to research hospital quality, what rights patients have during a hospital stay, and how Medicare pays for hospital services. The original publication is a concise, easy-to-read guide designed to empower Medicare beneficiaries to make informed choices about their hospital care.

Key Takeaways

• Medicare's Hospital Compare tool at Medicare.gov allows you to compare hospitals in your area based on quality and safety ratings.
• Not all hospitals are the same — quality, safety records, and the services they offer can vary widely from one hospital to another.
• You have the right to choose which hospital you go to for planned procedures, as long as the hospital accepts Medicare.
• Hospitals are rated on factors including infection rates, patient experience, readmission rates, and timely care.
• If you are in a Medicare Advantage Plan, you should check which hospitals are in your plan's network before receiving care.
• You have important rights as a hospital patient, including the right to receive a written notice called the Important Message from Medicare about your rights during your stay.
• After leaving the hospital, Medicare may cover follow-up care such as skilled nursing facility services, home health care, or rehabilitation, depending on your situation.

Publication Summary

Why Choosing the Right Hospital Matters

Not every hospital delivers the same level of care. Research shows that the quality of care, patient safety records, and available services can be very different depending on which hospital you choose. Medicare wants beneficiaries to know they have options and that taking time to compare hospitals can make a real difference in health outcomes. This is true whether you are planning a surgery in advance or preparing for the possibility of an unexpected hospital visit.

How to Compare Hospitals Using Medicare's Tools

Medicare provides a free online tool called Hospital Compare, available at Medicare.gov. This tool gives you side-by-side comparisons of hospitals based on a wide range of quality measures. You can search for hospitals by location and review ratings that cover areas such as how quickly patients receive care in the emergency room, how well hospital staff communicate with patients, rates of hospital-acquired infections, and how often patients need to be readmitted after being discharged. These ratings are based on real data collected from hospitals across the country, making it a reliable resource for making informed decisions.

Key Quality Measures to Look For

When comparing hospitals, there are several important quality measures to consider. These include patient safety ratings, which reflect how well a hospital prevents injuries and infections. Patient experience scores tell you how satisfied past patients were with the care and communication they received. Timely and effective care measures show whether the hospital follows recommended treatments for common conditions. Readmission and death rates are also important indicators of the overall quality of care provided.

Understanding Hospital Types

There are different types of hospitals that Medicare covers. General acute care hospitals handle a wide range of medical and surgical needs. Critical access hospitals serve rural areas and are designed to provide essential care close to home. Specialty hospitals focus on specific conditions such as heart disease or orthopedic issues. Long-term care hospitals treat patients who need extended medical care after a serious illness or surgery. Knowing the type of hospital that best fits your needs can help you make a better choice.

Your Rights as a Medicare Patient in the Hospital

Medicare gives you important rights when you are admitted to a hospital. You have the right to receive a written document called the Important Message from Medicare About Your Rights. This notice explains your right to receive all medically necessary hospital services, your right to appeal a discharge decision if you feel you are being sent home too soon, and information about what you may owe if you choose to stay. You should receive this notice within two days of being admitted and again before you are discharged.

Medicare Advantage and Hospital Networks

If you have a Medicare Advantage Plan instead of Original Medicare, it is important to understand that your plan may have a network of hospitals it works with. Using a hospital outside of your plan's network can result in higher costs or no coverage at all, except in emergencies. Before scheduling any planned hospital care, always check with your Medicare Advantage Plan to confirm that the hospital you are considering is in your network.

After the Hospital: What Medicare May Cover

Once you leave the hospital, Medicare may help cover additional care you need to recover. This can include a short-term stay in a skilled nursing facility, home health services, or outpatient rehabilitation. Coverage for these services depends on specific conditions being met, such as the length of your hospital stay and the type of care your doctor orders. Understanding these options before you are discharged can help you plan for a smoother recovery.

Frequently Asked Questions

How do I find and compare hospitals that accept Medicare?

You can use the Hospital Compare tool at Medicare.gov to search for hospitals near you. The tool lets you compare hospitals on quality measures, safety ratings, and patient satisfaction scores. Any hospital in the search results that accepts Medicare is eligible to provide covered services to Medicare beneficiaries.

Do I have to go to a specific hospital if I have Medicare?

If you have Original Medicare, you can generally go to any hospital in the United States that accepts Medicare. If you are enrolled in a Medicare Advantage Plan, you may be required to use hospitals within your plan's network to receive full coverage. Always check your plan's details before choosing a hospital for planned care.

What is the Important Message from Medicare About Your Rights?

This is a written notice that all Medicare patients admitted to a hospital must receive. It explains your right to get all necessary hospital services, your right to appeal if you think you are being discharged too soon, and what financial responsibility you might have if you decide to stay longer. You should receive this notice within two days of admission and again closer to your discharge date.

What happens if a hospital wants to discharge me before I feel ready to leave?

You have the right to appeal a discharge decision if you believe you are being sent home too soon. The Important Message from Medicare will explain how to file that appeal. If you request an appeal before you leave the hospital, you generally will not have to pay for the additional days you stay while the appeal is being reviewed.

Does Medicare cover care after I leave the hospital?

Medicare may cover follow-up care after a hospital stay, depending on your medical needs and how long you were hospitalized. This can include skilled nursing facility care, home health services, and outpatient rehabilitation. Your doctor and hospital discharge planner can help you understand what follow-up care Medicare may cover based on your specific situation.

Access the Full Publication

Publication Number: 10181
Publication Date: November 2025
Length: 16 pages