Your Medicare Coverage

Is my test, item, or service covered?

Defibrillator (implantable automatic)

How often is it covered?

Medicare covers implantable defibrillators for certain people diagnosed with heart failure.

Medicare Part A (Hospital Insurance) pays if the surgery takes place in a hospital inpatient setting. Medicare Part B (Medical Insurance) pays if the surgery takes place in a hospital 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 your doctor’s services. If you get the device as a hospital outpatient, you also pay the hospital a copayment. But, the copayment won't be 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 Part B covers the device, the Part B deductible applies.

Note

To find out how much your test, item, or service will cost, talk to your doctor or 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
  • Where you get your test, item, or service

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