Will a major surgery be covered by a supplement to medicare?

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Asked September 6, 2016

2 Answers

If you are referring to a Medigap (Medicare Supplement) plan the answer simply depends on whether or not Medicare approves the surgery.

Since Medicare Supplement insurance supplements" Original Medicare this means that the supplemental insurance company doesn't have any say whether a particular service is covered or not. Once Medicare approves the service, the supplement plan does its job based on the benefits of the policy. Most Medicare Supplement plans do pay 100% for Part A hospital costs and many cover nearly all of the Part B costs as well.""

Answered March 20, 2017 by medicareeasystreet

This is a question that unfortunately doesn't have a truly cut and dried answer. The first thing that you should know is that Part A usually covers services like visits to doctors offices and surgeries. However, there are exceptions to the rule so it is always a good idea to make sure that you have covered all of your bases before you automatically assume that Part A is going to cover the procedure. If you go into it thinking that it will cover the cost of services and you won't be out of pocket, you could get a very unpleasant surprise at the worst possible time.

Typically, Part A will cover most surgeries but it is important to note that more often than not, they do not cover the entire cost of the procedure. In addition, there are often costs associated with the surgery that may not be covered. These types of things might include an extended stay in a rehabilitation hospital, additional medications that are necessary during the recovery phase, so on and so forth. Furthermore, there are those rare occasions where a certain procedure will not be covered in any capacity. Even when they are, you can typically expect Medicare to pick up about 80 percent of the bill. The other 20 percent is up to you to pay for. This might not sound like much, but when you are talking about tens of thousands of dollars, it can add up very quickly.

What is the best way for you to ensure that your procedure is covered so you know exactly how much you will be personally responsible for paying? The first thing you need to do is speak with your doctor and speak with the hospital where the procedure will be handled. This will give you a head start so you know what to expect. If you still have doubts, questions or concerns, do not hesitate to contact a Medicare representative so that you can have those concerns addressed before you have the procedure done as opposed to waiting until after it has been completed.

Answered September 9, 2016 by LifeHealth

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