Defibrillators
Medicare may cover an implantable cardioverter defibrillator
Coverage details
Medicare Part A (Hospital Insurance) covers the surgery to implant a defibrillator in a hospital inpatient setting. Medicare Part B (Medical Insurance) covers the surgery if you get it in a hospital outpatient setting.
Who's eligible
Medicare may cover an implantable cardioverter defibrillator if you’ve been diagnosed with heart failure.
Costs
- After you meet the Part B deductible , you pay 20% of the Medicare-approved amount for your doctor’s services. The Part B deductible also applies to the surgery, if you get it in a hospital outpatient setting.
- If you get the surgery in a hospital outpatient setting, you’ll also pay the hospital a copayment. But in most cases, the copayment can’t be more than the Part A hospital stay deductible.
Ask your doctor or healthcare provider how much your test, item, or service will cost.
Your doctor may recommend services that Medicare does not cover or offers too frequently. This could end up in additional costs for you. Make sure to ask your doctor about the reasons for these recommendations and what Medicare will actually cover.
Specific amounts you could owe depend on:
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