Does Medicare Cover Robotic Surgery?

Last Updated : 08/13/20183 min read

Surgeons are using sophisticated new technology more and more. Medicare may cover robotic surgery in some situations. The National Library of Medicine reported in 2013 that when doctors use a minimally invasive surgery called laparoscopic surgery, they used robotic surgery (also called robot-assisted surgery) in approximately:

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  • 15% of colectomies (a kind of colorectal procedure)
  • 90% of hysterectomies
  • 20% of prostate removal procedures (prostatectomies)

The NLM reports that in some cases – for example, in robotic cardiac surgery – the use of robotics (which started, for heart surgery, in 1997) has improved patient outcomes.

According to the Mayo Clinic, robotic surgery can increase precision and even visibility – surgeons can often see the surgical site better than they might with traditional surgery.

Will Medicare cover robotic surgery?

When your doctor decides that surgery is medically necessary for you, Medicare may cover the procedure. Medicare Part A may cover surgery while you’re a hospital inpatient, and Medicare Part B may cover outpatient surgery. Coinsurance or deductibles may apply.

What about robotic surgery? If the procedure is medically necessary, Medicare may cover robotic surgery. You may want to discuss the procedure with your doctor so you’ll understand what type of surgery it is, whether it’s robotic surgery or not, exactly why you need the surgery, and other concerns. You can also call Medicare at the number below this article to ask about Medicare coverage of your surgery.

More about Medicare and robotic surgery

The Bulletin, a news publication based in Bend, Oregon, reported in 2014 that the increasing use of robotic surgery may be driving up Medicare surgery costs for certain procedures. The equipment for robotic surgery may be expensive, and some procedures may require more operating room time. However, the Mayo Clinic reports that robotic surgery often results in less pain, fewer complications, and quicker recovery time for the patient.

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Will Medicare Supplement insurance cover robotic surgery?

Medicare Supplement insurance isn’t designed to cover your surgery – its purpose is to work alongside Original Medicare to help pay Part A and Part B out-of-pocket costs. Each standardized Medicare Supplement plan may cover a different standardized set of basic benefits. Learn more about Medicare Supplement plans.

Will Medicare Advantage plan cover robotic surgery?

If you have a Medicare Advantage plan, coverage for robotic surgery will mainly mirror Original Medicare’s coverage (Part A and Part B). You might pay different cost-sharing amounts, such as deductibles and coinsurance, which vary among plans.

If you’re exploring different Medicare coverage options, or you just have questions about Medicare, feel free to reach out to me. The links below can help you set up a phone call with me, or have me send you an email with information just for you. You can also compare plans in your area – just enter your ZIP code in the box on this page and press the button.

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