If your back surgery is deemed medically necessary by a doctor,original Medicare(Part A and Part B) will typically cover it.

If you experienceback pain, talk to your doctor about recommended treatment that may include:

  • diagnostics
  • 药物
  • physical therapy
  • surgery

他们可以让您知道为什么他们认为这些程序是必要的以及是否被Medicare覆盖。

Medicare coverage for back surgery typically mirrors coverage for other medically necessary surgeries, hospital stays, and follow-ups.

Medicare A部分（医院保险）

Medicare Part Acoversinpatient hospital care, providing that:

  • 医院接受医疗保险
  • 您根据官方医生的命令承认您需要住院医院护理

You may need approval for your hospital stayfrom the hospital’s Utilization Review Committee.

Medicare inpatient hospital care coverageincludes:

  • semi-private rooms (a private roomonly when medically necessary)
  • general nursing (not private-dutynursing)
  • 餐
  • drugs (as part of inpatienttreatment)
  • general hospital services andsupplies (not personal care items like slipper socks or razors)

Medicare B部分（医疗保险）

Medicare Part Bcovers您的医生在医院住院期间的服务和门诊服务在您从医院释放后。其他保险, such asMedicare补充计划（medigap），Medicare Part D（处方药）或Medicare Advantage计划当您有资格获得Medicare时，您可以使用。

If you have this type of additional insurance along with Medicare, it will impact the price you pay for your back surgery and recovery.

It’s difficult to determine exact costs prior to back surgery, because the specifics of the services you may need are unknown. For example, you might need an extra day in the hospital beyond what was predicted.

To estimate your costs:

  • Ask your doctor and hospital howmuch they think you’ll have to pay for your surgery and follow-up care. Checkto see if there are services being recommended that Medicare doesn’t cover.
  • 如果您有其他保险，例如Medigap政策，请与他们联系，以查看他们将支付的费用的哪一部分，他们认为您必须支付的费用。
  • Check your Medicare account(MyMedicare.gov) to see if you have met your Part A and Part B deductibles.

该表提供了潜在成本的示例：

Coverage Potential costs
Medicare部分可扣除 2020年$ 1,408
Medicare B部分可扣除 $ 198在2020年
Medicare Part B coinsurance typically 20% of Medicare-approved amounts

Medicare Part A共同保险为第1至60天的每次收益为0美元。

背部手术费用的例子

TheMedicare.gov website使某些程序的价格可用。这些价格不包括医师费，并且基于2019年的国家医疗保险平均值。

这个表可以给你一个indication of what you might have to pay for some of the services involved in a surgical procedure on your back.

Procedure Average cost
Diskectomy The average cost of a diskectomy (aspiration of lower spine disc, accessed through the skin) in a hospital outpatient department is $4,566 with Medicare paying $3,652 and the patient paying $913.
Laminectomy The average cost of a laminectomy (partial removal of bone with release of spinal cord or spinal nerves of 1 interspace in lower spine) in a hospital outpatient department is $5,699 with Medicare paying $4,559 and the patient paying $1,139.
Spinal fusion 医院门诊部的平均脊柱融合成本（将两个或多个椎骨融合在一起，使它们愈合成一个固体骨骼）为764美元，Medicare支付了611美元，患者支付了152美元。

尽管Medicare通常涵盖医学上必要的手术，但请与您的医生联系，以确保Medicare涵盖他们推荐的手术类型。

Common types of back surgery include:

如果您的医生表明对您的背部手术对您来说是必需的，则通常将由原始Medicare（A部分和B部分）涵盖。

很难在Medicare付款之后确定您的背部手术会花费多少，因为您将获得的确切服务尚不清楚。

您的医生和医院应该能够提供一些有根据的估计。