Seniors who have chronic medical conditions or severe underlying conditions such as diabetes and immunodeficiency problems are commonly prone to get toenail fungus. If a toenail fungus is left untreated, it can cause serious issues such as pain, discomfort, and even inability to walk. One of the ways to treat this condition is through laser treatment.
If this is a treatment you are considering, one common question you may have is “Does Medicare cover laser treatment for toenail fungus?” In this article, we answer that question in clear, plain English. You will also find the average costs of laser treatment for toenail fungus and other helpful info.
Does Medicare Cover Laser Treatment For Toenail Fungus?
The short answer is yes; Medicare will cover the cost of laser treatment for toenail fungus. 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 laser treatment for toenail fungus. Below we look at what these are so you know what to expect.
Original Medicare (Medicare Part A and Part B) provides coverage for laser treatment for toenail fungus. Parts A and B do not provide coverage for routine foot services and care. However, Original Medicare provides coverage for podiatry services like tests and treatment only if it is considered medically necessary, such as laser treatment for toenail fungus.
Coverage for laser treatment for toenail fungus is provided by Medicare Part B. Medicare Part B provides coverage for laser treatment for toenail fungus as most of the time it takes place in an outpatient setting. For toenail fungus treatment, Medicare Part B provides coverage for doctor’s/podiatrist’s visits, outpatient care, diagnosis, and treatment.
Aside from laser treatment, Medicare Part B also provides coverage for toenail debridement. Toenail debridement is the removal of a dead nail as well as debris of an infected nail.
Medicare Part B covers 80 percent of the costs of laser treatment for toenail fungus. You will pay for the remaining 20 percent.
Part C and Part D Coverage for Laser Treatment for Toenail Fungus
Medicare Advantage plans (Medicare Part C) also provide coverage for laser treatment for toenail fungus. These Part C plans will cover everything that Original Medicare covers (by law they have to). They also offer additional benefits as well.
Medicare Part C plans that include prescription drug plans will also provide coverage for medications that your healthcare provider may prescribe to you to treat your toenail fungus.
Aside from laser treatment and nail debridement, another way of treating toenail fungus is through prescription medication. Medicare Part D plans provide coverage for toenail fungus medications. 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 Laser Treatment For Toenail Fungus Cost?
Laser treatment for toenail fungus can reach up to $1,000 or even more. This price varies depending on the provider.
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 Oncotype DX test?