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Medicare Billing

Posted: Mon Jan 31, 2022 1:58 pm
by robertm
I will need an implant in the near future and I'm approaching 65. Does Medicare pay any or all of the cost of an implant: Parts, labor and hospital?

Re: Medicare Billing

Posted: Mon Jan 31, 2022 3:50 pm
by SteveSW
In my case Medicare and my supplemental plan paid 100% of costs. No out of pocket at all. Without a supplemental plan, I think Medicare picks up about 80%...and the out of pocket could be a big bill.

Re: Medicare Billing

Posted: Mon Jan 31, 2022 7:52 pm
by Leebert
Im on the medicare priority edge and pd a $325 co pay and thats all.

Re: Medicare Billing

Posted: Thu Feb 03, 2022 10:46 am
by evank64052
Pretty much the same for me. This is a medicare approved expense. I paid $250 only because of an extended night in the hospital.

Re: Medicare Billing

Posted: Thu Feb 03, 2022 11:27 am
by Old Guy
If you only have straight Medicare I believe it won't cover that surgery. If you have any other insurance and Medicare Part B it should be 100% covered. With Medicare Part B only your co-pay will be 20%. Since the surgery is anywhere from 16K to 25K (or more) that's one big co-pay. Many implants are done on an out-patient basis now, so no hospital stay.

Re: Medicare Billing

Posted: Thu Feb 03, 2022 3:59 pm
by sweaterfan
Just be sure to understand the difference between a Medicare Advantage plan (Part C) and a Medicare Supplement plan. An Advantage plan replaces Part B and may have exclusions while a Supplement plan will supplement Part B, so if Medicare covers the procedure then the supplement plan will take care of the 20%. Advantage plans typically cost less because there are more restrictions while supplement plans cost more but provide greater choice of procedures and providers. Advantage plans can also include dental and vision services while you would have to find your own plans with a supplement plan. Lots to consider :).