Your Medicare Coverage

Is my test, item, or service covered?

Defibrillator (implantable automatic)

How often is it covered?

Medicare Part A (Hospital Insurance) or Medicare Part B (Medical Insurance) covers implantable defibrillators for certain people diagnosed with heart failure, depending on whether the surgery takes place in a hospital inpatient or outpatient setting.

Who's eligible?

Certain people with Medicare, who are diagnosed with heart failure, are covered.

Your costs in Original Medicare

You pay 20% of the Medicare-approved amount for the doctor’s services. If you get the device as a hospital outpatient, you also pay the hospital a copayment, but no more than the Part A hospital stay deductible. For surgeries to implant defibrillators in the hospital inpatient setting covered under Part A, see Inpatient hospital care. If covered by Part B, the Part B deductible applies.

Note

To find out how much your specific test, item, or service will cost, talk to your doctor or other health care provider. The specific amount you’ll owe may depend on several things, like other insurance you may have, how much your doctor charges, whether your doctor accepts assignment, the type of facility, and the location where you get your test, item, or service.

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