Tuesday, July 14, 2015

Medicare & Surgery

It's worth paying extra for Medicare Part B if you think you're going to have outpatient surgery.


Medicare provides health care coverage to many elderly people as well as some younger people with disabilities. Most people, though not all, receive Medicare Part A at no cost, but Medicare recipients must pay monthly premiums for Medicare Part B or Part C. Medicare covers many types of surgeries, both on an inpatient and on an outpatient basis.


Medicare Part A


Medicare Part A covers inpatient hospitalization, including hospitalization for operations that require inpatient admission. While Medicare Part A covers your room and board in the hospital and some other fees, doctors' services, including the services of surgeons and anesthesiologists, are typically covered by Medicare Part B even while you're an inpatient in a hospital. In most cases, Medicare recipients must pay 20 percent of the Medicare-approved fees for doctors' services. That's in addition to the co-pay required for inpatient hospital stays.


Medicare Part B


Medicare Part B covers outpatient medical care, including outpatient surgeries performed in a hospital, ambulatory surgery center or doctor's office. In most cases, Medicare recipients must pay 20 percent of the Medicare-approved fees.


Surgical Dressings and Supplies


Medicare Part B pays for some surgical dressings and other supplies needed on an inpatient or outpatient basis, though some medical supplies are not covered on an outpatient basis. Topical medications needed to treat surgical wounds or incisions on an outpatient basis will be covered by Medicare Part D.


Second Opinions


In many non-emergency cases, Medicare Part B will pay for a second opinion from a qualified surgeon if you need more information or another opinion before deciding whether or not to go ahead with an operation. In some situations, it will even pay for a third opinion, but call 800-633-4227 to make sure before seeking a third opinion so you don't find yourself with an unexpected bill.


Medicare Part C


Some Medicare recipients elect to sign up for a Medicare Advantage plan, otherwise known as Medicare Part C, instead of the traditional parts A, B and D. Recipients who opt for Medicare Part C can choose from several different plans. All cover surgery, but the exact coverage varies from plan to plan. Check your benefits handbook or call the telephone number on your insurance card for specific information about your plan.


Warning


Check with Medicare or your Medicare Advantage plan before having any non-emergency surgery to make sure your policy covers the care you need. That way you can avoid getting stuck with a large, unexpected bill after you recover.