Medicare covers many medically necessary services for both inpatient and outpatient surgical procedures, but the cost may vary depending on many factors.
For outpatient surgery, the costs of ambulatory surgical center and hospital outpatient surgery may be different. Ambulatory centers usually have lower overhead costs than hospital-based outpatient surgery. For inpatient services, Medicare covers 80% of the Medicare-approved amount for doctors’ services you get while you are in a hospital and you pay the remaining 20% after meeting the deductibles. Currently, the Medicare Part A deductible is $1,676 and Part B is $257.
Other factors that may affect cost include other insurance you may have aside from Medicare (Medicare Advantage or a Medigap plan), how much the provider charges or if the provider accepts Medicare assignment (the provider agrees to accept the Medicare-approved amount as full payment for covered services) and the type of facility.
Outpatient costs can be found by looking up the procedure name, CPT code or Health Care Common Procedure Coding System code at medicare.gov/procedure-price-look-up. Get the code for a specific service from your healthcare provider for more accurate pricing.
COPELAND INSURANCE GROUP
1360 S. Beretania St., Ste. 209, Honolulu, HI 96814
808-591-4877 | josie@copelandgroupusa.com
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