How Does Medicare Cover Surgical Procedures? – Get the Most Out of Your Coverage
Many people are still unsure of exactly what Medicare covers, since there are different types of Medicare and how they cover different things. So, how does Medicare cover surgical procedures? The simple answer is yes, Medicare does cover surgical operations. However, different plans offer different coverage options. This article will go further in depth about what Medicare covers and how it could apply to you.
Different Types of Medicare Coverage
Original Medicare Part A
Part A covers all of your medical expenses, including daily room services. All expenses pertaining to your stay in the hospital such as physicians and nurses are catered for.
Medicare Part B
Medicare part B only covers treatments associated with the surgery.
Medicare Part D
Medicare part D covers all of the prescriptions associated with your surgery.
Terms of Coverage
For Medicare Part A and B, the coverage is only provided under given circumstances. For you to qualify for the coverage, the care must meet two conditions:
- Must be a medically necessary procedure
- Authorized medical provider must authorize the care
It is a must that the condition necessitates surgery as the only means of treatment. In this case, you must get the authorization from a Medicare authorized healthcare provider. The care must also be provided by an authorized Medicare healthcare institution.
Medicare does not cover elective surgery. This may include procedures such as plastic surgery and minor surgeries that are not necessary. Further, any prescriptions or care that is not associated with mandatory surgery will not be covered.
Although Medicare does not cover elective surgery, cataract surgery is covered. During cataract surgery, you may also enjoy other benefits such as receiving a pair of glasses. Otherwise, glasses are not covered by Medicare.
Does Medicare Supplement Cover Surgery?
To know if you qualify for a Medicare supplement, you only need to find out if your surgery is covered by Medicare. If your Medicare plan covers the surgery, then Medicare supplement covers the rest of the cost. After you settle your deductible and pay the copayments, the cover will cater for 80% of your bills. You will be responsible for the remaining 20%, Medicare ParA and B deductibles, copayments, and coinsurance — unless you have a supplement plan.
Medicare supplements can cover the rest of the expenses. The amount provided depends on the type of plan you have. For instance, with Medicare Plan F, you would walk away from any approved Medicare institution without spending a single cent from your pocket.
The Cost Of Surgery
It is almost impossible to estimate the cost of surgery since doctors cannot tell the type of services you may need. There are a few things you can do to try and find an estimate of your surgery cost. First, ask the doctors how much you will be required to pay for the surgery and aftercare. The value will vary depending on whether you are an inpatient or outpatient. If you will be staying within the facility, confirm whether the cost includes the room service and nursing. Check with the insurance plan such as Medicare supplement to see how much you will be required to pay.
So, how does Medicare cover surgical procedures? Different plans of Medicare can help you pay for your surgery bills. However, it is important to be prepared for any extra costs if your surgery is not covered. Only compulsory surgeries will be catered for by Medicare Plan A and B. You should also have Medicare supplement plans to cater for other costs that may not be provided by your plan.