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woman holding stomach; what medicare covers for hysterectomy

What Does Medicare Cover for a Hysterectomy

Did you know that one in three women have a hysterectomy by the age of 60? But what if you’re over 65? Medicare covers most hysterectomies and related expenses, but there are a few important things you should know so you’re not hit with any unexpected expenses.  

What is a hysterectomy?

A hysterectomy is the surgical removal of a woman’s uterus, although some hysterectomies may also remove the ovaries, cervix, endometrium, and the fallopian tubes. This procedure ends a woman’s menstrual cycle if she has not already entered menopause.

Your doctor may recommend a hysterectomy if you have:

  • Cancer of the uterus, ovaries, cervix, or endometrial layer
  • Abnormal bleeding after menopause
  • Uterine prolapse
  • Persistent pelvic pain
  • Endometriosis, which can cause severe pain and bleeding
  • Recurring uterine fibroids (noncancerous growths)

Your doctor will consider your medical needs and choose between one of four types of hysterectomies:

  1. Abdominal hysterectomy (small cuts in the abdomen)
  2. Vaginal hysterectomy (small cuts in the vagina)
  3. Laparoscopic hysterectomy (small cuts in the abdomen or vagina with the help of a small camera and thin lighted tubes)
  4. Robotic hysterectomy (doctor uses a robotic arm to remove the uterus through small cuts in the abdomen)

What does Medicare cover?

Some hysterectomies are inpatient surgeries while others can be done in an outpatient setting. The cost of your procedure will depend on if you are an inpatient or outpatient, so it’s important that you ask your doctor if you will be formally admitted to the hospital as an inpatient.

Part A: If you are admitted to the hospital for your hysterectomy, you will be responsible for the $1,340 deductible. You will not be charged an additional coinsurance for your stay as long as it does not exceed 60 days. Part A also covers:

  • A semi-private room
  • Hospital meals
  • General nursing
  • Prescribed drugs as part of your treatment

Part B: If your procedure is performed in an outpatient setting like an ambulatory center or surgery center, you will pay 20 percent of all Medicare-approved amounts for items and services rendered. You will also be responsible for the $185 deductible as well as any items or services Medicare does not cover. Part B does not typically cover oral prescription medication. If your doctor prescribes anything to you, it will be covered by Part D.

For more information on what Medicare will cover for your hysterectomy, talk to your doctor or hospital beforehand and call Medicare directly at 1-800-MEDICARE (1-800-63-4227). TTY users call 1-877-486-2048.

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