Does Medicare Cover Surgery? [February, 2025 ]

Many health risks are associated with surgery and having a tight budget can only make the situation more stressful. Fortunately, Medicare can help you reduce some significant expenses and release your financial burden. So, does Medicare cover surgery? Read below to find out.

Does Medicare Cover Surgery?

The answer is yes – depending on your package. Medicare might cover different parts of the surgery expenses and medical bills.

Medicare Part A will cover the hospital expenses, including the services of nurses, physicians, health providers, and daily services or room cost.
Medicare Part B will cover any medical treatments which are involved in your surgery.
Medicare Part D will cover the prescriptions for your surgery.

To get the coverage for your surgery from the Medicare Part A and Part B, you should meet 2 basic requirements:

The care should be medically necessary. This means that an authorized healthcare provider must authorize the surgery and Medicare should agree that it’s necessary.
A health care provider participating in Medicare should deliver or perform the surgery.

Which Type of Surgery isn’t Covered by Medicare?

Keep in mind that Medicare doesn’t cover any kind of elective surgery. For example, plastic surgery will not be covered if it doesn’t correct an existing medical issue. Also, Medicare won’t cover any treatment which isn’t associated with follow-up care or deemed as medically necessary. Vertex Insurance says that any additional treatments, therapy, or prescriptions which are required as a result of an elective surgery won’t be compensated as well.

How About the Medicare Supplement?

In most cases, if your Medicare covers your surgery cost, your Medicare supplement will cover the remaining part which you’ll typically be responsible for. The coverage amount often depends on your plan letter; for instance, with a Medicare supplement Plan F, you might undergo your surgery without spending any money from your pocket.After you have met your deductible and paid the co-payments, your Medicare would cover 80 percent of the medical bills. With the Medicare supplement, you will be covered for the remaining 20 percent, co-payments, coinsurance, and deductibles from Part A and B.

Estimate the Surgery Costs

It can be a challenging task to estimate the costs for your surgery because a doctor doesn’t know exactly what services you will need. Below are a few things that you can try to have a rough estimation of your surgery expenses:

Ask the employees of the hospital or doctor how much you will need to pay for your surgery and follow-up care.
Find out if you are an outpatient or inpatient because the hospital status can play an important part in your total cost.
Check with your insurance, such as Medicare supplement, to find out what it’ll pay. The covered amount will mostly depend on your plan letters, such as Plan G or Plan F.

Overall, does Medicare cover surgery? It depends on the current Medicare plan you have. Surgery can be an uneasy experience, especially when tackling on all of the expenses associated with surgery. If you currently have Medicare, this information above will help you decipher whether or not Medicare covers surgery expenses.

Does Medicare Cover Surgery?

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