ORIGINAL MEDICARE
Medicare covers most procedures that require anesthesia. If the patient’s healthcare provider deems it medically necessary, Medicare should cover the costs of service; including anesthesia. However, the exact cost may differ depending on the patient’s plan, coverage options, and several other factors.
How Does Medicare Cover Anesthesia?
Medical procedures are often paired with anesthesia in both inpatient and outpatient surgical centers. Qualifications include a medically necessary reason from the beneficiary’s healthcare provider. Additionally, the procedure must be by a healthcare provider accepting Medicare assignment. Elective surgeries such as cosmetic procedures are not included in coverage unless for a medical reason. Medicare may cover anesthesia for an eye lift if the patient’s eyelid is impairing their vision.
How Much Will Medicare Pay for Anesthesia?
When a patient undergoes surgery or procedure, anesthesia is typically necessary. While the exact costs may be hard to determine because it’s difficult to know what services a person will need. However, beneficiaries may estimate a total cost amount. Patients should ask their healthcare provider, hospital, or providing facility about out-of-pocket expenses for the surgery and any aftercare, if necessary.
The costs may vary whether at an inpatient or outpatient facility. Patients can better estimate the total cost by knowing what type of facility the service will be administered. Outpatients may be able to choose between ambulatory surgical centers and hospital outpatient facilities.
Review the Part A deductible for hospital admissions or Part B deductibles for doctor’s visits and outpatient care. Many beneficiaries must pay the deductible amounts before Medicare coverage starts. Once coverage starts, there may still be copayments for services.
Beneficiaries can look at the most recent Medicare Summary Notice (MSN) to check if deductibles have been met. The MSN is usually sent via the United States Postal Service, otherwise, the information is available online at MyMedicare.gov.
The next step is to talk to any other insurance providers. Other insurances may include Medigap policies, Medicaid plans, and/or a spouse (or self) employer coverage. Sometimes, other insurances (secondary insurance) may cover the costs Medicare doesn’t.
Does Medicare Advantage Cover Anesthesia?
How to Get Help with Medicare Coverage for Anesthesia
We understand the concern for the cost of your surgical procedures. If you’re wondering what your plan covers relating an upcoming surgery or procedure, give us a call today! One of our licensed Medicare agents will happily answer any questions about coverage.
We can compare different rates and determine if a different plan is best for your budget. Don’t have time to call today? We understand you can fill out an online form instead and get the process going.
About The Author
