Does Medicare Cover Bunion Surgery?

Having bunions (or hallux abducto valgus to use the fancy medical term) on your foot can be annoying and painful. Bunions are a progressive condition that gets worse over time.

Most of the time, it starts growing at the big toe. As time goes on, more bulging bumps form that cause discomfort. But they can cause more issues than just pain. If they get bad enough, they can affect your mobility.

The good news is that bunions can be removed through surgery. But one of the disadvantages of having bunion surgery is that it is expensive.

So a common question many people have is, “Does Medicare cover Bunion Surgery?” In this article, we answer that question in clear, plain English. You will also find the average costs of bunion removal surgery, as well as other helpful info.

Does Medicare Cover Bunion Surgery?

The short answer is yes; Medicare will cover the cost of bunion removal surgery. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your bunion removal 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 bunion removal surgery. Coverage for falls under Medicare Part B.

Medicare Part B provides coverage for many podiatry services, including bunion removal surgery. It will cover these things so long as they are medically necessary.

So Medicare Part B will cover bunion removal surgery if your healthcare provider deems it medically necessary and prescribes treatment for it. This surgery is often performed in an outpatient setting.

Bunion removal surgery is not the first, and only treatment for bunions. A doctor may prescribe other means of treating bunions (which we’ll get to in a minute). Medicare Part B covers 80% of the costs of your bunion surgery.

Medicare Advantage plans (Medicare Part C) also provide coverage for bunion removal surgery. They cover everything Original Medicare covers as well as some additional benefits. However, out-of-pocket costs will vary depending on the specifics of your plan.

How Much Does It Cost To Have Bunion Removal Surgery?

Bunion surgery may cost anywhere from $3,500 to over $12,000. However, cost of bunion surgery is about $5,560 on average.

What Are The Other Ways To Treat A Bunion?

There are other ways to treat bunions besides surgery. Your healthcare provider can prescribe bunion inserts, pads, or toe spacers to provide relief. If things get worse, however, then your healthcare provider may decide it’s time for surgery.

What Are The Common Types Of Bunion Surgery?

There are over 40 types of bunion surgery, but here are the three most common bunion surgeries:

Osteotomy – The surgeon will cut the affected big toe joint and will realign the bone into its normal position.
Exostectomy – The surgeon will remove the bunion. However, he/she will not realign the bone.
Arthrodesis – The surgeon will remove the affected joint and will replace it with a screw or metal plate to correct the deformity.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. 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.