Will a Medicare Supplement Plan Cover My Surgery? | GoMedigap

Will a Medicare Supplement Plan Cover My Surgery?

Home » Medicare Supplement Coverage » Will a Medicare Supplement Plan Cover My Surgery?

When you find out that you need surgery, we know the last thing you want to worry about is whether or not your Medicare Supplement plan will cover it. Fortunately, when it comes to Medicare, your coverage is relatively straightforward. As long as Medicare pays for your treatment, your Medicare Supplement will pay for it as well. So, the real question you need to ask is, will Medicare cover your surgery?

How Do I Know if Medicare Will Cover My Surgery?

Medicare divides your coverage into three categories:

Medicare Part A – These are your inpatient services. If you are having a surgery that requires you to stay overnight, it will be covered by Part A.

Medicare Part B – Your outpatient services are categorized here. Surgery that does not require you to stay overnight, like cataract surgery, will fall under Part B.

Medicare Part D – The prescription medications that you take at home are under your Part D Drug Plan.

There are a few criteria you must meet for Medicare to cover your surgery:

  1. Your doctor must state that your treatment is medically necessary
  2. You must receive treatment from a practitioner that accepts Medicare
  3. Your treatment must be a service that Medicare covers

Medicare will not cover any type of surgery that is not considered medically necessary, nor any associated follow-up care. For example, Medicare won’t pay for elective plastic surgery, but if you need facial reconstruction after an accident, you could receive Medicare-covered treatment. In addition, Medicare doesn’t cover any prescriptions, therapy, or additional treatments that are necessary as a result of the elective surgery. You can search for your treatment on Medicare’s website to see if it is Medicare-eligible.

How Much Will I Pay For My Surgery?

Before your surgery, there are two steps that you can take to help you predict approximately how much you will pay:

  1. Confirm that your treatment aligns with what Medicare will cover by speaking with your doctor and the hospital. Be sure to ask if your surgery is considered inpatient or outpatient.
  2. Review your Medicare Supplement plan coverage. You’ll want to know if you are responsible for expenses like copays, coinsurance, and deductibles. Medicare Supplement plans are all standardized, so you can check your coverage quickly and easily.
  3. Review your Part D Drug Plan coverage. You can find out what your copay on prescriptions that you take at home will be. If you find that you have a high copay, there are several ways that you can spend less on pricey medications, without changing your drug plan.

My Doctor Has Recommended Follow-Up Treatment. Will My Medicare Supplement Cover That?

Many people have follow-up treatment or physical therapy recommended after surgery. If your doctor has recommended this to you, you can rest assured that as long as Medicare approves it, your Medicare Supplement will too. To determine if Medicare covers follow-up treatment, you can follow the same steps as you did to confirm that your surgery was covered. Overall, your Medicare Supplement plan will work seamlessly with your Medicare coverage so that you can focus on healing, rather than bills and paperwork.

Compare Your Medicare Supplement Rates Immediately!

8 Replies to “Will a Medicare Supplement Plan Cover My Surgery?”

  1. I’d like a supplement coverage cost from your top 30 policy holders. I’m 68 currently have Anthem Advantage program. Am in good health.

    1. Hi Mr. Hoke,

      In order for a Medicare supplement plan to cover your hearing aids, Medicare would need to cover them as well. Though Medicare Part B covers diagnostic hearing exams if your doctor or health care provider orders them to see if you need medical treatment, Medicare does not cover hearing exams, hearing aids, or exams for fitting hearing aids.

      However, we do have a Dental, Vision & Hearing plan that covers hearing aids, for as low as $31 per month. If you’d like more information on this plan, please visit the following page: Dental, Vision & Hearing Insurance

    1. Hi,

      Unfortunately, you can’t get a Medicare supplement plan while you are on a Medicare Advantage plan. Your best bet will be to call your current plan to see what expenses you will be responsible for.

      In the future, you can disenroll from Medicare Advantage during an open enrollment period, and enroll in Original Medicare. Once you have Original Medicare, you can add a Medicare supplement plan. Depending on the plan you choose, these may completely cover your surgery.

      Let us know if you have any additional questions!

  2. Does Medicare Cover Knee Replacement. I have the G plan. I also heard the Medicare Part A categorizes this surgery as outpatient. Is that true?
    Thank you

    1. Hi Sharyn,

      Medicare will cover your knee replacement as long as your doctor says that it is medically necessary, and you receive your surgery from a provider that accepts Medicare. Knee replacements are often performed as outpatient surgeries, but you should confirm that with your provider.

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