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Home > Hospital Care

Hospital Care

Doctor checking on a woman in the hospital

 

For some care, you need to stay in a hospital. Overnight care in a hospital is called inpatient care.

 

 

 

Topics on this page:

 

How to get hospital care

Your doctor must refer you for hospital care in most cases (unless it’s an emergency).

Use the OPA worksheet to prepare for your hospital stay.

 

Choose the best hospital

If you can choose which hospital you go to, select the one that has the most experience treating medical problems similar to yours. If you and your doctor think you cannot get the care you need at a hospital in your plan’s network, ask your plan to approve care at another hospital.

You can compare hospitals near you at CalQualityCare.org.

 

Learn your plan’s costs and benefits for hospital care

The co-pay or co-insurance for a hospital stay can be high. Ask your plan what is covered and what you will pay.

  • If you have a co-pay, call your health plan and ask what the co-pay will be. Or look in your plan's Evidence of Coverage.
  • If you pay a percent of the cost (co-insurance), call the hospital billing department. Ask what the charges are likely to be and what you will have to pay.

Learn more about hospital costs.

 

Plan for a safe hospital discharge

Many people recover better at home. However, problems can happen if you go home before you are ready.

  • Meet with a discharge planner at the hospital. Ask how to make sure that you and your family are prepared for you to come home.
  • Ask for written discharge instructions that you can understand.
  • You may be given new medicines in the hospital. It is usually good to review these with your primary care doctor as soon as possible. Ask if you should continue to take your new medicines. Ask if they are safe to take with your other medicines.
  • If a hospital is sending you home before you think you are ready, tell your doctor. You, a family member, or your doctor can request a delay.  If you have Medicare, call Livanta(Medicare's Quality Improvement Organization in California) at 1-877-588-1123 for help appealing a hospital discharge.

A discharge plan (or care plan) can help prevent you from having to return to the hospital. Learn more about preventing hospital readmissions...

Resources

OPA materials: How to Use Your Health Plan Guide

OPA worksheet: Prepare for a Hospital Stay

CalQualityCare.org - Compare California hospitals at CalQualityCare.org

Livanta- Call if your Medicare hospital care is ending too soon
1-877-588-1123    https://bfccqioarea5.com/states/ca.html

Joint Commission - File a complaint by phone about the quality of care received at a hospital
1-800-994-6610    www.jcaho.org

American College of Surgeons - Information on common operations and choosing a surgeon
www.facs.org

 

Related Topics

Working with your doctor

Using plan services

Referrals and pre-approvals

Problems and complaints

Preventing hospital readmissions

Health Plan Problems?

Call 1-888-466-2219

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