Inpatient vs Outpatient

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Inpatient vs Outpatient
Health Insurance

Whenever one of our advisors at Tenzing is having a consultation, one of the first topics we discuss is which health insurance benefits you would like to have included in your policy.   If you’re new to private health insurance, you may be unfamiliar with your two most common benefits; Inpatient vs Outpatient. 

Learn more about the key differences between these health insurance benefits.

Inpatient vs Outpatient Health Insurance

Definition of Inpatient

Inpatient health insurance is your most basic form of health insurance, it’s a required benefit which requires admission to a hospital bed, usually overnight. Some providers have a time requirement before they consider inpatient reached, for example 18 or 24 hours. 

Most plans include daypatient as part of their inpatient benefits, which is admission to a hospital bed without an overnight stay. While the name may make you think you’re purely covered for things that require an overnight stay, like a surgery and related hospitalization expenses, you actually do get some outpatient benefits included with your inpatient plans. These typically, but not always, include:

  • Pre/Post hospitalization outpatient visits
  • Outpatient surgery
  • Outpatient cancer treatments
  • Emergency Room which doesn’t require admission

Pre/Post hospitalizaiton for example, are outpatient benefits that are directly related to a covered hospitalization that happen prior to and following the hospitlization. If an MRI revealed a tear that required surgery, that would be pre hospitalization. Any follow-up visits after discharge would be post-hospitalizaiton. So while the name suggests purely inpatient is covered, more outpatient benefits are being added to standard inpatinet plans. 

Synonyms for Inpatient


Major Medical

Catasptrophic Coverage

Inpatient vs Outpatient Health Insurance

Definition of Outpatient

Outpatient visits are going to be, by far, your most common type of visit. It makes sense if you think about it, you very infrequently actually need to stay overnight in a hosptial. You’re much more likely to go for minor visits to a doctor or specialist, have a consultation, gets some tests and medicaiton and go on your way home.  This is what outpatient health insurance covers. 

In addition to your standard outaptient benefits, many modern providers are starting to add a variety of other complimentary visits with their outpatient packages, including:

  • Physiotherapy
  • Chriopractor and alternative medicine
  • Annual health checks
  • Mental wellbeing
  • Vaccinations

Where people can rack up large outpatient medical bills comes with repeated visits for things like chronic conditions, ongoing therapy or treatment, changing bandages and check-ups and routine monitoring. 

What’s the difference between Outpatient & Annual Health Checks?

Annual health check is for when you’re not feeling symptoms, not hurt and simply want to get your health check. This is often done as part of special male or female health check package. If you aren’t feeling well or are hurt, then you’d use normal outpatient benefits. 

Synonyms for Outpatient

Routine Doctor Visits

General Practitioner (GP) Visits

008 checklist


Treatments done in hospital
Treatments done in hospital OR a clinic
Requires admission, usually overnight
See a doctor and go home in same day
Mandatory with all health insurance
Optional add-on
Infrequent, but large expense
Most common type of vist

002 nurse

Types of Treatments

Routine Doctor Fees
Theatre & Surgeon's Fees
Specialist Doctor Fees
Room & Board
Emergency Room
Nursing Fees
Diagnostic & Lab Tests
Hospitalization Expenses
MRI, PET, CT Scans
Intensive Care Unit
Emergency Evacuation
Minor Surgery
Annual Health Checks
Inpatient Psychiatric
Outpatient Mental Health
Organ Transplant
Alternative Medicine

030 money

What's the difference in price?

A broad rule of thumb is if you want to add outpatient benefits, you can expect to pay about double the cost of taking an inpatient only plan. Ultimately, this will depend on many things like the exact benefits, limitations, your age, coverage area and more. 

For example, a plan that limits Outpatient to $100/visit will cost less to add outpatient than a plan where outpatient is fully covered to $6,000.

What does it cost so much to add Outpatient?

Outpatient visits are without a doubt your most common type of visit.  While the cost for outpatient is much lower than inpatient, it’s much more likely to occur.  Furthermore, when someone takes outpatient benefits, they tend to go to the doctor more than they normally would. Insurers know this & put a premium on taking outpatient.


Inpatient vs Outpatient Conclusion

Whether you opt for inpatient only plan or want the comfort of having more comprehensive plan, that ultimately is up to each individual and their personal risk profile.  This may also matter if you’re only taking out a health insurance plan or if you’re also bundling with a savings plan or life insurance.  If so, you may want to consider inpatient only to optimize your premium.  

At the end of the day, it’s up to you and we’re happy to run you through the options and help you reach that conclusion yourself. You can look at the price difference for your age through our partner, Docosan. 

Leave your details below and one of our insurance experts will reach out to you for a short consultation and custom quotes. 

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    Patrik Shore Tenzing Pacific Services

    Patrik Shore

    Senior Advisor
    From Sweden & New Zealand
    7 years' insurance experience
    Joined Tenzing in 2019
    Crim Science
    Speaks English and Swedish

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