Does Medicare Cover Bunion Surgery

Does Medicare Cover Bunion Surgery? – Overview

Yes, Medicare does cover Bunion surgery. Medicare Part B covers the cost of bunion surgery when the procedure is done as an outpatient treatment. Medicare coverage for bunion surgery requires that the surgery be deemed medically necessary by a healthcare provider. The healthcare provider must document the medical necessity for the surgery, and this documentation is used to determine Medicare coverage.

Remember, you will need to prove the procedure is medically necessary to get Medicare coverage for bunion surgery. Medicare Part B covers 80% of the Medicare-approved amount for outpatient medical procedures, including bunion surgery if deemed medically necessary, after the Part B deductible is met.

Bunion affects millions of Americans every year. It causes painful symptoms, such as redness, abnormal bulge in the joint, and swelling on the big toe. Besides this, the constant rubbing of the big toe with the second toe also gives rise to calluses and corns, which are discomforting at the least.

Bunions grow when the metatarsal bone of the big toe shifts closer to the inside of the foot. This causes the phalanx bone to tilt towards the second toe. With movement, the soft tissue of the foot rubs against the shoe and causes pain.

The reason for most cases is ill-fitting shoes or genetics. Initially, doctors recommend applying padding and trying wide-toe shoes or arch supports to ease the pressure. However, these aids don’t always work and the doctor will then recommend undergoing bunion surgery to correct the deformed toe.

What is Bunion Surgery and how does it help?

If you experience constant pain or notice swelling in the toes, and find it difficult to walk normally, the doctor will usually recommend you to get bunion surgery. Besides this, bunion surgery is also recommended if the bunion can worsen existing medical conditions, such as joint instability or arthritis.

Bunion surgery can remove bunions, which cause the big toe to get deformed. It is usually done as an outpatient procedure, while some patients may need to be hospitalized, depending on the individual cases.

The type of anesthesia used for bunion surgery depends on the procedure and the patient’s health, with options ranging from local anesthesia to sedation or general anesthesia based on the surgeon’s and anesthesiologist’s recommendation. The surgery can be effectively performed with only a local anesthetic to numb the ankle and foot.

Several types of surgical techniques are used, and the most effective one is determined by the size of the bunion and its reason for growth.

Once the surgical procedure is completed, the patient is sent to recover under observation for a couple of hours. If there are no noticeable side effects of the surgery, the patient is discharged to go home.

After undergoing bunion surgery, doctors usually recommend patients wear a cast or boot to protect the foot. Patients are also advised to use crutches to walk till the surgery site gets healed completely.

What is the cost of Bunion Surgery without Insurance?

The total cost of bunion surgery without insurance will depend on different factors, such as your location, insurance coverage, type of surgery chosen, and health status.

In the US, bunion surgery costs between US$3,500 and more than US$12,000. On average, you can expect to undergo bunion removal surgery for around US$5,560. Original Medicare Part B covers 80% of the Medicare-approved amount for outpatient medical procedures, including bunion surgery deemed medically necessary, after the Part B deductible has been met. Coverage is not based on the total cost but on the Medicare-approved amount.

In the same way, if you need to be hospitalized after the surgery, Medicare Part A will provide coverage for hospitalization expenses. More than 40 different types of bunion surgeries are performed.

Hence, the cost of the surgery before insurance varies significantly. If you want to avoid paying out-of-pocket expenses, apply for a Medicare Supplement plan. This plan helps to ease the pressure of out-of-pocket expenses by paying deductibles and coinsurance.

Besides this, Medicare Advantage plans can also cover the cost of bunion surgery in some states.

Conclusion

Bunion surgery is covered by Medicare Part B when the doctor classifies it as medically necessary in your case. However, if the bunion is not severe enough, there are alternate treatments for it. For instance, anti-inflammatory medications, special shoe inserts, and corticosteroid injections are often recommended in cases with mild bunion growth. To learn more about Medicare coverage for bunion surgery, we recommend you visit the official Medicare website here https://www.medicare.org/articles/does-medicare-cover-bunion-surgery/.

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Does Medicare Cover Bunion Surgery