Does Medicare Cover a Hysterectomy?
Last Updated : 09/12/20183 min read
The uterus, also called womb, is where a baby grows when a woman is pregnant. A hysterectomy is a surgery to remove a woman’s uterus, according to the U.S. Department of Health & Human Services. The fallopian tubes and ovaries may also be removed.
A hysterectomy is a common surgery. According to the National Women’s Health Network, 1 in 3 women in the United States will have a hysterectomy by the age of 60.
There are several ways to perform a hysterectomy according to the U.S. Department of Health & Human Services.
- In an abdominal hysterectomy the doctor makes a small cut in the lower abdomen to remove the uterus.
- In a vaginal hysterectomy, the doctor makes a small cut in the vagina to remove the uterus.
- In a laparoscopic hysterectomy, the uterus is removed through small cuts in either the abdomen or vagina with the help of a small camera and a thin lighted tube.
- In a robotic hysterectomy, a doctor uses a robotic arm to remove the uterus through small cuts in the lower abdomen.
Why would I need a hysterectomy?
A hysterectomy ends a woman’s menstrual periods if she has not already entered menopause. A hysterectomy also ends a woman’s ability to become pregnant. There are several medical reasons for a hysterectomy, according to the U.S. Department of Health & Human Services.
- Cancer of the uterus, ovaries, cervix or lining of the uterus (endometrium)
- Endometriosis which can cause severe pain and bleeding between periods
- Uterine fibroids or noncancerous growths on the walls of the uterus
- Uterine prolapse where the uterus slips down into the vagina
- Adenomyosis which causes severe pain and heavy bleeding
Does Medicare cover a hysterectomy?
Medicare covers many medically necessary surgical procedures. Medicare Part A generally covers hospital stays and Medicare Part B generally covers doctor services and outpatient care. Whether your hysterectomy is an inpatient or outpatient procedure may depend on the type of hysterectomy performed. According to hysterectomy.org, as high as 80% of all laparoscopic and vaginal hysterectomies are considered outpatient surgeries, but you should clarify with your doctor. If you’re an outpatient, what you pay may be different than if you’re an inpatient. For Medicare inpatient care (Part A), you generally pay a $1,340 deductible for each benefit period. For Medicare outpatient care (Part B) you generally pay 20% of the Medicare-approved amount for most doctor services as well as a $183 deductible per year.
Medicare Part A covers anesthesia if you’re an inpatient. Medicare Part B covers anesthesia if you’re an outpatient. For prescription painkillers or other medications you may take at home, you will probably need Medicare Part D coverage. You can get Medicare Part D through a stand-alone Prescription Drug Plan or a Medicare Advantage plan with prescription drug coverage.
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