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An aortic aneurysm is a scary condition. It can strike anytime without showing any signs or symptoms. And an aortic aneurysm attack can either be debilitating or deadly.
Males aged 65 and over who have smoked cigarettes have a higher risk of aortic aneurysms. The same could be said for people with a family history of them.
For larger aneurysms, surgery is required to try and repair the condition. If you or a loved one needs this type of surgery, you may wonder, “Does Medicare cover aortic aneurysm surgery?”
In this article, we answer the question in clear, plain English. You will also find the average out-of-pocket costs of an aortic aneurysm surgery for those who don’t have insurance.
Does Medicare Cover Aortic Aneurysm Surgery?
The short answer is yes; Medicare will cover the cost of aortic aneurysm surgery. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met for Medicare to pay for your aortic aneurysm surgery. Below we look at what these are so you know what to expect.
Original Medicare (Medicare Part A and Part B) provides coverage for aortic aneurysm surgery. If your healthcare provider considers the aortic aneurysm surgery to be medically necessary, Original Medicare will cover it. Your healthcare provider must first order the operation for Original Medicare to provide coverage.
Coverage for aortic aneurysm surgery is provided by Medicare Part A if your aortic aneurysm surgery takes place in an inpatient setting. It often takes place in an inpatient setting. Medicare Part A will cover 100 percent of the costs of hospital stays for up to 60 days.
Starting from the 61st day and up to 90 days, Medicare Part A will still provide coverage. However, you will have a copayment each day you stay in the hospital. After 90 days, Medicare Part A will no longer provide coverage.
However, Medicare Part A provides 60 lifetime reserve days. If you have them, they will still provide coverage for your hospital stay after 90 days, but you will have a larger copayment each day.
Medicare Part C and D
Medicare Advantage plans (Medicare Part C) also provide coverage for aortic aneurysm surgery. They have to because it’s the law. Part C plans have to cover everything Original Medicare covers.
Medicare Part D plans provide coverage for needed medications after aortic aneurysm surgery. Part D plans also provide coverage for prescription medications for aortic aneurysms.
Medicare Part D is a prescription drug plan, and just like Medicare Part C, Medicare Part D plans are provided by private insurance companies.
How Much Does Aortic Aneurysm Surgery Costs?
Aortic aneurysm surgery costs somewhere from $20,000 to $30,000. Exactly how much it costs will differ depending on where the surgery is performed.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage. Always be sure to double-check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series, including: Does Medicare cover Forteo?