Does Medicare Cover Laser Spine Surgery?

Medicare Part B does cover laser spine surgery if the procedure is considered medically necessary and is ordered by your doctor.

Medicare Advantage plans (Part C) also cover laser spine surgery if your doctor orders the procedure, and Medicare Advantage plans include an annual out-of-pocket spending limit, which Original Medicare (Part A and Part B) does not have.

Doctor and patient smiling while talking in doctors office

Do Medicare Advantage plans cover laser spine surgery?

Medicare Advantage plans must cover the same minimum benefits as Medicare Part A and Part B. Therefore, if laser spine surgery is ordered by your doctor and is considered medically necessary, it may be covered by your Medicare Advantage plan.

Some Medicare Advantage plans have $0 monthly premiums, meaning you do not have to pay a Part C monthly premium in addition to your Part B premium.

As mentioned above, Medicare Advantage plans come with an annual out-of-pocket spending limit, which can help protect you from potentially high costs associated with back surgery.

Original Medicare does not include such a spending limit. Some of what you could expect to pay out-of-pocket for laser spine surgery without a Medicare Advantage plan is outlined below.

How much does laser spine surgery cost?

Medicare Part B (medical insurance) helps cover a variety of outpatient medical services and preventive care, including:

  • Doctor’s visits
  • Lab testing
  • Certain vaccinations
  • Procedures that are deemed medically necessary

Even if your laser spine surgery is covered by Medicare Part B, there are some costs that you may have to pay out of pocket, including:

  • Medicare Part B deductible: $185 per year in 2019
  • Medicare Part B coinsurance: typically 20 percent of the Medicare-approved amount of service

There are also out-of-pocket costs associated with Medicare Part A (hospital insurance), including:

  • Medicare Part A deductible: $1,364 per benefit period in 2019
  • Medicare Part A coinsurance in 2019:
    • Days 1-60 of hospitalization: $0 coinsurance
    • Days 61-90: $341 coinsurance per day of each benefit period
    • Days 91 and beyond: $682 coinsurance per lifetime reserve day after day 90 for each benefit period
    • Beyond lifetime reserve days: you are responsible for all costs

Note: most people do not have to pay a Medicare Part A monthly premium as long as they paid sufficient Medicare taxes while working.

If you have Medicare Advantage, deductibles, copays and coinsurance amounts may vary based on your specific plan.

Compare Medicare Advantage plans in your area

A licensed insurance agent can help you find $0 premium Medicare Advantage plans in your area.

Even better, most Medicare Advantage plans include coverage for prescription drugs and many provide additional benefits such as vision, dental, and wellness benefits — none of which are included with Original Medicare.  

Find a Medicare Advantage plan that covers laser spine surgery

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Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.