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. You will only need to submit a request to Medicare, along with your doctor’s orders. As soon as the request is processed, you can schedule an appointment with the surgeon and undergo the procedure.

Remember, you will need to prove the procedure is medically necessary to get Medicare coverage for bunion surgery. Usually, Medicare Part B pays up to 80% of the total cost of bunion surgery for eligible individuals.

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 also 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.

According to studies, around 1/3rd of adults in America suffer from bunions. 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. In most instances, bunion surgery does not even require administering general anesthesia. The surgery can be effectively performed with only a local anesthetic to numb the ankle and foot.

There are several types of surgical techniques 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 then the patient gets 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?

According to reports, over 35% of people over 65 years old have a bunion. 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 to more than US$ 12,000. On average, you can expect to undergo bunion removal surgery for around US$ 5,560. Original Medicare will pay 80% of the cost of bunion surgery under Part B, after the deductible.

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

Hence, the cost of the surgery before insurance varies significantly. If you want to avoid paying out-of-pocket expenses, then you should 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 know 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/.

See Also

Does Medicare Cover Shingles Shots?

Does Medicare Cover Chiropractic?

Does Medicare Cover Hearing Aids?

Does Medicare Cover Cataract Surgery?

Does Medicare Cover Bone Density Test?

Current Version
August 17, 2023
Updated By
Andrea Morales G.
October 16, 2023
Updated By
Andrea Morales G.

https://www.medicare.org/articles/does-medicare-cover-bunion-surgery/

Follow us