What surgeries does Medicare cover?

Medicare covers many medically necessary services, including surgeries. However, there are certain services – like dental and cosmetics – that Medicare does not cover. To understand what surgeries Medicare covers, read on.

Parts of Medicare

There are 4 parts of Medicare: Parts A, B, C, and D. Parts A and B are traditionally thought of as Original Medicare, so we’ll focus on them here. Part A covers inpatient and hospital services while Part B covers outpatient services like doctor office visits, tests, and equipment. 

Almost all surgeries will fall under Parts A and B. These parts of Medicare do not cover vision, hearing, or dental needs. They also do not cover cosmetic needs.

Surgeries Covered by Medicare

It is difficult to list all of the surgeries covered by Medicare because there are so many. The main criteria in order to be covered by Medicare is that the surgery must be medically necessary. Most surgeries are medically necessary. While vision is not covered, cataract surgery is covered because it is seen as medically necessary. Because there is no way to list all of the surgeries covered by Medicare, the best way to keep costs low is to avoid hidden costs and to estimate your expenses.

Hidden Costs

There are certain things that may cause your surgery costs to go up unexpectedly. If your surgery stay does not count as an inpatient stay, you may pay more. If you have not met your deductible for that year, you will likely be responsible for paying the remainder of the deductible before insurance coverage kicks in.

How to Estimate Your Costs

The best way to know how much your surgery will be is to use Medicare’s tools to estimate your surgery costs. You can contact Medicare.gov, talk to an insurance agent, or use the hospitals’ calculator tool to estimate your costs. You should also check your other insurance policies, such as supplement insurance, Medicaid, or an employer plan. 

To learn more about Medicare coverage, contact us today.

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