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Medicare Coverage for Hysterectomies

Medicare covers a hysterectomy depending on the medical reasoning. At least 500,000 women get some form of hysterectomy every year. For women, it’s the 2nd most common procedure within the United States. Certain factors, such as condition severity, may determine the type of hysterectomy.

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Is a Hysterectomy Covered by Medicare?

Medicare coverage for a hysterectomy is available when a doctor determines the procedure is necessary to treat a condition. Both Medicare Part A and Medicare Part B benefits will cover hysterectomies.

Benefits may also pay for lab work, office visits, and diagnostic testing. Beneficiaries must meet Medicare Part A and Part B deductibles before coverage begins. After deductibles, Medicare pays 80% of the allowable costs. Recipients must pay for the remaining 20% of the costs if they don’t have any supplemental insurance.

How Much Does a Hysterectomy Cost with Medicare?

The cost of a hysterectomy for beneficiaries may differ. Generally, both Parts A and B have deductible expenses. Once met, either Medicare Part A or B pays 80% of the costs of service. Beneficiaries are responsible for 20% of the cost of services.

Aftercare services include office visits, diagnostic testing, and lab work. Medicare Part B benefits include most aftercare services, excluding post-op meds.

Will Medicare Pay for a Partial Hysterectomy?

A partial hysterectomy is when the uterus is taken out, but the cervix is not. Medicare will pay for a partial hysterectomy if your doctor finds it medically necessary.

Will Medicare Supplements Cover Hysterectomies?

Medicare Supplement plans (Medigap) work alongside Medicare Part A and Part B to cover gaps in coverage. As long as Medicare pays for your hysterectomy, your Medicare Supplement plan will cover the cost-sharing.

Will Medicare Part D Cover Prescriptions for Hysterectomies?

Yes, most medications prescribed pre or post-op will be covered by Medicare Part D. If you don’t already, consider buying a Medicare Part D plan to help with drug expenses.

Common Reasons for a Hysterectomy?

There are many common reasons a woman may have a hysterectomy. Medical conditions may vary from moderate to severe. Uterine fibroids are very common and non-cancerous. They’re so common that this is the number 1 reason for a hysterectomy. These tumors grow in the uterus muscle, often causing pain or heavy bleeding. Uterine prolapse often leads to urinary issues such as incontinence. Typically, this is due to weak, stretched ligaments and tissues in the pelvis. Contributing factors may include obesity, menopause, or childbirth.

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Number 2 on the list is a common, non-cancerous condition, endometriosis. Notorious for causing painful periods, infertility, and abnormal bleeding. Hyperplasia is a condition when too much estrogen is present. Too much estrogen may cause the lining of the uterus to become too thick, causing abnormal bleeding. Only about 10% of all hysterectomies are due to cancer. Also, of this 10%, are women with ovarian, fallopian tube, or cervical cancer. Women suffering from heavy bleeding, chronic pelvic pain, and chronic inflammatory disease may also consider the procedure.

Will Medicare Cover a Hysterectomy due to Adenomyosis?

Yes, Adenomyosis causes significant pain and extremely heavy bleeding. If your doctor says a hysterectomy is medically necessary to fix Adenomyosis, Medicare will cover it.

How to Get Help with Out of Pocket Costs for Hysterectomies with Medicare

Understanding different plans and your best option may be difficult. Not to worry, we’re here to help! Give one of our agents a call today at the number above. Can’t call today? We understand. Fill out the online rate form and begin the process. Our agents are happy to help answer any of your questions. Find out how you can save money before having a hysterectomy or any other surgery.

Kayla Hopkins

Kayla Hopkins

Content Editor
Kayla Hopkins is an accomplished writer and Medicare educator serving as the Editor of MedicareFAQ.com. Upon completing her Communications degree from Ohio University, Kayla dedicated her time to understanding the ever-evolving landscape of healthcare. With her extensive background as a Licensed Insurance Agent, she brings a wealth of knowledge and expertise to her writing.

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