This article was updated on March 17, 2021.
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 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)
Will Medicare pay for a partial hysterectomy?
A partial hysterectomy is when the uterus is taken out, but the cervix is not. Medicare will pay for a partial hysterectomy if your doctor finds it medically necessary.
Will Medicare supplements cover hysterectomies?
Medicare Supplements work alongside Part A and B to cover gaps in coverage. As long as Medicare pays for your hysterectomy, your Medicare Supplement plan will cover the cost-sharing.
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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.
Medicare coverage for a hysterectomy is available when a doctor determines the procedure is necessary to treat a condition. Both Part A & Part B benefits will cover hysterectomies. Benefits may also pay for lab work, office visits, and diagnostic testing. Beneficiaries must meet Part A and B deductibles before coverage begins. After deductibles, Medicare pays 80 percent of the allowable costs. Recipients must pay for the remaining 20 percent of the costs if they don’t have any supplemental insurance.
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.
