Defibrillators

Medicare may cover an implantable automatic defibrillator if you’ve been 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.

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 Part A-covered 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
  • If your doctor accepts assignment
  • The type of facility
  • Where you get your test, item, or service