Preparing for a Planned Hospital Stay: A Practical Checklist

A planned hospital stay, such as a joint replacement, a scheduled C-section or another surgery, gives you something an emergency does not: time to prepare. A little organizing in the weeks before can prevent billing surprises, medication mix-ups and a stressful trip home.

Use this checklist as a starting point, and follow any specific instructions from your surgeon or hospital. They come first.

Two to four weeks before: insurance and paperwork

Money problems after a hospital stay often start with steps that were skipped beforehand.

• Confirm prior authorization. Many plans require approval before a planned surgery or admission. Your doctor’s office usually submits the request, but call your insurer to confirm it was approved and get a reference number.
• Check the network. Ask whether the hospital, your surgeon and the anesthesia group are all in your plan’s network. Ask about any other doctors likely to be involved, such as a surgical assistant.
• Ask for a cost estimate. Hospitals can tell you what you are likely to owe out of pocket based on your deductible and coinsurance.
• Get pre-admission tests done. Bloodwork, imaging or a pre-surgery checkup may be required. Find out where and when.
• Handle time off. Talk to your employer about leave and short-term disability, and arrange coverage for children, pets or anyone you care for.

Make a complete medication list

A written list is one of the best safety tools you can bring. Include:

• Every prescription, with the dose and how often you take it
• Over-the-counter medicines, vitamins and supplements
• Inhalers, eye drops, creams and injections
• Allergies to medicines, foods or latex, and what reaction you had

Ask your surgeon or primary care doctor, well before the date, which medicines to stop or change before the procedure and when. Blood thinners, diabetes medicines and some supplements often need special instructions. Do not stop or adjust anything on your own.

Also ask whether you should bring your medicines from home or leave them. Hospitals usually supply medications during a stay.

Documents to bring

Put these in one folder or envelope:

• Photo ID and insurance cards, including Medicare and any supplemental or drug plan cards
• Your medication and allergy list
• A list of your doctors with phone numbers
• Names and phone numbers of emergency contacts
• Copies of your advance directive, such as a health care proxy or living will, if you have one
• Any paperwork the hospital sent you, including pre-registration forms

If you do not have an advance directive, this is a good time to make one. It lets you name the person who can speak for you if you cannot speak for yourself.

What to pack (and what to leave home)

Pack light. Hospital rooms are small, and things go missing.

Bring:

• Comfortable, loose clothes for going home, plus socks or slippers with non-slip soles
• Glasses, hearing aids, dentures and their cases, labeled with your name
• CPAP machine or other medical equipment you use at night, if the hospital asks you to bring it
• Phone and a long charging cable
• Basic toiletries and lip balm
• Something to pass the time, such as a book or headphones
• A notebook and pen for questions and instructions

Leave at home: jewelry, large amounts of cash, valuables and anything you would be upset to lose.

Have an advocate

Hospital days are full of medicines, tests, shift changes and decisions, often when you are tired or in pain. A trusted family member or friend can:

• Listen during rounds and write down what the doctors say
• Ask questions when something seems off
• Make sure staff know about allergies and your medication list
• Keep family updated so you can rest
• Help with discharge instructions and the trip home

Tell the care team who your advocate is. If you want them to be able to get information about your care, let the staff know or fill out any forms the hospital uses for this.

Questions worth asking during your stay:

• What is the plan for today, and what are we waiting for?
• What is this medicine for, and what side effects should I watch for?
• Who should I talk to if I have a concern about my care?
• When do you expect I will be able to go home, and what needs to happen first?

Know your status: inpatient or observation (Medicare)

If you have Medicare, it matters whether the hospital lists you as an inpatient or as an outpatient receiving observation services. Staying overnight in a regular hospital bed does not by itself make you an inpatient. According to Medicare.gov:

• You are an inpatient only when you are formally admitted with a doctor’s order.
• Inpatient admission is generally appropriate when your doctor expects you to need medically necessary hospital care spanning two or more midnights.
• Inpatient stays are covered under Part A. Observation is outpatient care covered under Part B, so what you pay can be different.
• If you are under observation for more than 24 hours, the hospital must give you a Medicare Outpatient Observation Notice (MOON) explaining why you are an outpatient and how it affects what you pay.

Status matters most if you might need a skilled nursing facility for rehab afterward. Original Medicare generally covers it only after a qualifying inpatient stay of at least three days in a row, not counting the day you leave. Time under observation, or in the emergency room before you are admitted, does not count (Medicare.gov). Medicare Advantage plans may have different rules.

Ask every day whether you are an inpatient or an outpatient. If you were admitted as an inpatient and the hospital changes you to observation during the stay, you should get a Medicare Change of Status Notice, and for stays on or after February 14, 2025, you may be able to file a fast appeal.

Plan for discharge from day one

Going home goes more smoothly when it is planned early. Before you leave, make sure you know:

• Your medications: which are new, which have changed and which to stop. Compare the discharge list with your home list.
• Warning signs: what symptoms mean you should call the doctor or go back to the hospital.
• Follow-up: dates for appointments, tests or physical therapy, and who to call with questions.
• Equipment and help at home: whether you need a walker, shower chair or home health visits, and who is arranging them.
• Activity limits: when you can shower, drive, lift, climb stairs and return to work.

Ask for written instructions, and have your advocate there to hear them too. Arrange a ride ahead of time, since you usually will not be allowed to drive yourself home after anesthesia.

If you feel you are being discharged too soon, say so. Ask to speak with a case manager or discharge planner. Medicare inpatients should receive a notice called "An Important Message from Medicare about Your Rights," which explains how to ask for a fast appeal of a discharge you disagree with. Follow its directions no later than your scheduled discharge day.

The bottom line

The work you do before a planned hospital stay pays off: confirm prior authorization and network status, bring an up-to-date medication list and your advance directive, pack light and choose an advocate. If you have Medicare, ask daily whether you are an inpatient or under observation, because it can affect your costs and rehab coverage. Start discharge planning early, and do not leave without clear written instructions.

This article is general information, not medical or legal advice. Follow your care team’s instructions, and call 911 in an emergency.