By Daniel Petkevich
Jan 20, 2023
Searching for the right solution to your back problems can bring its own pain. If you are seeking Medicare coverage for a cervical disc replacement, Medicare is unlikely to cover it for most beneficiaries. No coverage could mean tens of thousands of dollars spent out-of-pocket for this procedure. Read on to see if you might qualify as one of the few eligible beneficiaries.
Unfortunately, Medicare has a national noncoverage notice for cervical disc replacement for beneficiaries over the age of 60. However, if you are under 60 and meet certain criteria, Medicare may help pay for cervical disc replacement surgery. The CMS has a local coverage notice for those under 60, which means you need to meet certain stipulations to get coverage. In order to qualify for coverage, you must have undergone a series of non-surgical treatments that did not improve your condition, and a Medicare-enrolled doctor or facility must perform the surgery. Additionally, the procedure must fall within certain guidelines established by Medicare, and your doctor must provide documentation of your medical condition to support the need for cervical disc replacement.
The age limit does affect eligibility for cervical disc replacement surgery. Medicare does not cover this procedure for beneficiaries over the age of 60, regardless of any other requirements they may meet. However, those under 60 may be eligible to receive coverage depending on their individual circumstances.
Many people opt for cervical disc replacement as a cheaper alternative to more intense back surgery. The cost of a cervical disc replacement procedure varies depending on factors such as the type of disc being replaced, the hospital or medical facility performing the surgery, and any other associated costs. You will see many estimates out there for the cost, but according to Spine.MD, you can expect to pay between $30,000 to $50,000 for a cervical disc replacement.
If you are over the age of 60 and ineligible for cervical disc replacement surgery, there may be other options available to you. Your doctor can discuss alternative treatments that may provide relief from your condition. These could include physical therapy, steroid injections, nerve blocks or non-surgical spinal decompression.
Even if Medicare does not cover the procedure you need, there are still ways to access quality care. Requesting a referral from your primary care physician is one option; they may be able to recommend a specialist who is able to provide appropriate treatment for your condition. Additionally, you can look for programs or services that offer discounts on treatments or procedures that are not covered by Medicare.
Navigating Medicare coverage and understanding your options can be confusing. Fortunately, there are resources available to help seniors make informed decisions about their health care. The Centers for Medicare & Medicaid Services (CMS) provides information on coverage options and financial assistance programs. Additionally, the National Institute on Aging offers resources and support for those aged 60 and older.
It is important to ask your doctor questions about your specific situation and the coverage options available to you. For instance, what criteria do I need to meet in order to be eligible for cervical disc replacement surgery? Are there any alternative treatments that may provide relief from my condition? What resources are available to help me access quality care? Knowing the answers to these questions can help you make an informed decision about your health care.
In conclusion, Medicare does not cover cervical disc replacement for beneficiaries over the age of 60. However, seniors may still be able to access quality care through referrals, discount programs and resources available. It is important to have a conversation with your doctor about the right treatment for you. This content is for informational purposes only. If you have questions about Medicare coverage or your plan, call an expert at Fair Square Medicare.
What Is the Medicare Birthday Rule in Nevada?
Mar 28, 2023
Does Medicare Cover Ozempic?
Mar 28, 2023
Can Medicare Advantage Plans Deny Coverage for Pre-Existing Conditions?
Mar 28, 2023
What People Don't Realize About Medicare
Mar 27, 2023
Medicare Advantage Plans for Disabled People Under 65
Mar 24, 2023
Medicare Supplement Plans for Low-Income Seniors
Mar 23, 2023
Medicare Savings Programs in Kansas
Mar 22, 2023
How Much Does a Medicare Coach Cost?
Mar 20, 2023
20 Questions to Ask Your Medicare Agent
Mar 17, 2023
14 Best Ways for Seniors to Stay Active in Washington, D.C.
Mar 11, 2023
14 Best Ways for Seniors to Stay Active in Nashville
Mar 10, 2023
14 Best Ways for Seniors to Stay Active in Seattle
Mar 10, 2023
15 Best Ways for Seniors to Stay Active in Denver
Mar 9, 2023
13 Best Ways for Seniors to Stay Active in Indianapolis
Mar 9, 2023
14 Best Ways to Stay Active in Charlotte
Mar 9, 2023
13 Best Ways for Seniors to Stay Active in Columbus
Mar 8, 2023
13 Best Ways for Seniors to Stay Active in Philadelphia
Mar 7, 2023
13 Best Ways for Seniors to Stay Active in Phoenix
Mar 6, 2023
Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2022 Help Button Inc
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
MULTIPLAN_FairSquareMedicare_01062022_M