Does Medicare Cover a Hysterectomy?

• by Christian Worstell
• November 9, 2023
• Reviewed by John Krahnert

Medicare typically does cover hysterectomies that are deemed medically necessary by a doctor. The part of Medicare (Part A or Part B) that covers your hysterectomy will depend on the type of facility in which you undergo surgery.

Medicare Advantage (Part C) plans can also cover a hysterectomy that is deemed medically necessary by your doctor, and they also include an annual out-of-pocket spending limit. This can potentially save you money in Medicare costs for your hysterectomy.

Original Medicare does not include an out-of-pocket spending limit.

How does Medicare cover hysterectomy surgery?

A hysterectomy is a surgical operation that removes all or part of the uterus and can help treat several medical conditions related to a woman’s health.

Depending on where you undergo hysterectomy surgery, Medicare Part A or Part B may cover some of your costs:

• The hospital and inpatient care costs related to the hysterectomy are typically covered by Medicare Part A (Hospital Insurance).
  
  
• Any doctor’s services related to the hysterectomy are typically covered by Medicare Part B (Medical Insurance).

How much does a hysterectomy cost with Medicare?

Even if Medicare covers your hysterectomy, there are some out-of-pocket costs you should expect to pay, which may include:

• Part A deductible
• Part A coinsurance
• Part B deductible
• Part B coinsurance or copayment

Medicare Part A deductible

The Medicare Part A deductible is $1,632 per benefit period in 2024.

The Part A deductible is not annual, and you could experience more than one benefit period in a given calendar year.

Medicare Part A coinsurance

After you meet your Part A deductible in a benefit period, you could face Part A coinsurance costs:

• Days 1-60 spent in the hospital: $0 coinsurance for each benefit period
• Days 61-90: $408 coinsurance per day of each benefit period in 2024
• Days 91 and beyond: $816 coinsurance per each “lifetime reserve day” after day 90 for each benefit period in 2024
• Beyond lifetime reserve days: you pay all costs

Once you use your lifetime reserve days, they are gone. You cannot accrue any additional reserve days.

Medicare Part B deductible

The Medicare Part B deductible is $240 per year in 2024.

Medicare Part B coinsurance or copayment

After your Part B deductible is met, you typically pay 20 percent of the Medicare-approved amount for most doctor’s services.

There is no annual limit on how much you could pay for the Part B coinsurance in a given year.

We recommend speaking with your doctor directly for specific cost and coverage information.

Medicare Advantage plans can cover some surgery costs

Medicare Advantage plans are sold by private insurance companies as an alternative to Original Medicare (Medicare Part A and Part B).

Every Medicare Advantage plan must cover everything that Part A and Part B covers and some Medicare Advantage plans also offer benefits not found in Original Medicare. 

If your hysterectomy is covered by Original Medicare, it will also be covered by a Medicare Advantage plan.

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

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 24/7 to speak with a licensed insurance agent.

About the author

Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.

 

 

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