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does Medicare cover hemorrhoid surgery

Does Medicare Cover Hemorrhoid Surgery?

Hemorrhoids are swollen veins found in the lowest parts of a person’s rectum and anus. They are one of the most common causes of rectal bleeding. Hemorrhoid surgery may be necessary to treat them, especially for large hemorrhoids. Also for it you tried other ways to treat them that did not work.

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

Does Medicare Cover Hemorrhoid Surgery?

The short answer is yes. Medicare will cover the cost of hemorrhoid removal 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 hemorrhoid removal surgery. Below we look at what these are so you know what to expect.

Original Medicare

Original Medicare (Medicare Part A and Part B) provides coverage for hemorrhoid removal surgery. Parts A and B will provide coverage for your hemorrhoid removal surgery if you either have anal fissures or if you have tried other methods of treatment without success.

Once approved, Medicare will cover 80 percent of the costs of your hemorrhoid removal surgery. You will pay for the remaining 20 percent. 

Part C Coverage for Hemorrhoid Surgery

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

How Much Does It Cost To Undergo Hemorrhoid Removal Surgery?

Undergoing hemorrhoid surgery can be expensive. It may cost $5,000 to undergo this procedure. Two main factors that may affect the total cost of your hemorrhoid surgery are the doctor’s fees and the facility fee. 

What Are The Causes Of Hemorrhoids?

You are at risk of having hemorrhoids if you have family members that have/had hemorrhoids. Other causes of hemorrhoids may include:

  • Physical activities that strain your body such as heavy lifting
  • Obesity
  • Not eating enough fiber-rich foods
  • Pregnancy when your uterus presses on your veins
  • Anal sex
  • Diarrhea
  • Standing or sitting for too long

Alternative to Hemorrhoid Removal Surgery

There are a number of alternatives to hemorrhoid removal surgery. In fact, most people seeking treatment for hemorrhoids do not need surgery.

Typically the first line of treatments are things that you can use at home. This will often involve using stool softeners, trying a high fiber diet and giving some topical medications a try.

If none of these treatments work, then there are some non-invasive or minimally invasive treatments your doctor can try.

These non-surgical removal treatments include:

Rubber Band Ligation (Hemorrhoid Banding)

This treatment involves putting a rubber band at the bottom of an inflamed hemorrhoid. The goal of this treatment is to cut off the blood supply to the hemorrhoid. If successful, it will take about a week or two before the hemorrhoid will fall off after getting this procedure.

Hemorrhoidal Sclerotherapy

The sclerotherapy procedure is done by injecting chemicals, usually phenol, into the tissue around the hemorrhoid. It is a painless procedure that has been around for a very long time. It could take several treatments for this to work, but it is a safe and effective way to treat hemorrhoids.

When done for medically necessary reasons, this treatment will be covered by Medicare.

Infrared Coagulation

This is not as common as the first two treatments, but can be very effective for some. This procedure uses a powerful beam of infrared light to destroy the blood vessels feeding the hemorrhoid(s). After this treatment, the hemorrhoid will usually fall off after a week or two.

How Can You Prevent Hemorrhoids?

As a common saying goes, prevention is better than cure. Though there are other treatments, surgery for hemorrhoids can be expensive. It is best to avoid any expenses for treating hemorrhoids, whether it is high or low. Here are some ways you can prevent hemorrhoids:

  • Eating fiber-rich foods
  • Drinking plenty of water
  • Maintaining a healthy weight

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.

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 dementia care?

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