If you are interested in a Fecal Microbiota Transplantation, your coverage might depend on where you live. There currently is no national coverage position, but you might still get coverage if it's deemed medically necessary and you get approval. Let's learn more about if an FMT is right for you.
Fecal Microbiota Transplantation (FMT) is a medical procedure in which healthy bacteria from one individual's gastrointestinal tract are transplanted into another person's. FMT helps to restore balance in the digestive system, reduce inflammation, and improve overall health. It is particularly beneficial for those suffering from Clostridium difficile (C. difficile) infections, irritable bowel syndrome (IBS), ulcerative colitis, and Crohn's disease, as it has been found to be effective in treating these conditions.
In most cases, an FMT is offered through a physician or clinic in the form of either a colonoscopy or an enema. After determining that you are a suitable candidate for an FMT, your doctor will collect and prepare the healthy donor stool sample needed for the transplantation. This sample is then carefully injected into your gastrointestinal tract with an endoscope or through an enema.
At this time, Medicare does not have a national coverage determination for FMT. This means that Medicare will only cover FMT when it's considered medically necessary. If you are interested in this procedure, you should talk with your doctor to determine if it is a viable option for you. In some cases, your doctor may be able to provide the FMT service and bill Medicare for it or refer you to a specialist who does. You should also contact your local Medicare office to see if they have any coverage policies that include FMT.
The cost of an FMT varies depending on the clinic or doctor performing the procedure and how extensive it is. Generally, you should expect to pay between $2,000 and $5,000 for a full course of treatment. It's important to note that Medicare does not usually cover these costs. Talk with your Medicare plan provider to see what it might cost for your specific situation.
While an FMT is generally considered safe, there are still some potential risks associated with the procedure. These include allergic reactions to donor stool, infection, and even rare cases of intestinal blockages. It's important to talk to your doctor about these risks before undergoing FMT so that you can make an informed decision about whether or not it is the right choice for you.
The effects of an FMT typically last for several months but can sometimes be longer, depending on the individual. Continue to follow up with your doctor after undergoing the procedure to monitor your progress and make sure that any conditions you may have are being appropriately managed.
The best way to ensure that you get the most benefit from your FMT is to follow your doctor's instructions for post-treatment care. This may include taking probiotics and/or other medications to help maintain the balance of bacteria in your digestive system and get regular checkups with your physician. Additionally, it's important to continue to practice good hygiene, such as washing your hands frequently and avoiding raw foods that may contain bacteria or parasites. With careful management and proactive care, it's possible to enjoy the long-term benefits of FMT.
Overall, an FMT can be an effective treatment for a variety of conditions and may help improve your overall health and quality of life. Talk to your doctor about whether or not it is a viable option for you, and make sure to inquire about any coverage policies that might apply to you through Medicare. This content is for informational purposes only. Fair Square Medicare is here for you through each step of your Medicare journey. Give us a call today.
Is Vitrectomy Surgery Covered by Medicare?
Dec 2, 2022
Does Medicare Cover a Spinal Cord Stimulator?
Nov 19, 2022
Does Medicare Cover SI Joint Fusion?
Nov 28, 2022
How Much Does Xeljanz Cost with Medicare?
Jan 25, 2023
Can I Choose Marketplace Coverage Instead of Medicare?
May 2, 2023
Can I Change My Primary Care Provider with an Advantage Plan?
Aug 25, 2023
Does Medicare Cover Iovera Treatment?
Jan 11, 2023
The Fair Square Bulletin: October 2023
Oct 2, 2023
Does Medicare Cover Geri Chairs?
Dec 7, 2022
Welcome to Fair Square's First Newsletter
Feb 28, 2023
Does Medicare Cover Cardiac Ablation?
Dec 9, 2022
Does Medicare Cover Compounded Medications?
Apr 4, 2023
Is Emsella Covered by Medicare?
Nov 21, 2022
Explaining IRMAA on Medicare
Dec 21, 2022
Does Medicare Cover Nexavar?
Nov 30, 2022
Does Medicare Cover Home Heart Monitors?
Dec 1, 2022
Does Medicare Cover Incontinence Supplies?
Dec 22, 2022
Does Medicare Have Limitations on Hospital Stays?
Mar 15, 2024
13 Best Ways for Seniors to Stay Active in Columbus
13 Best Ways for Seniors to Stay Active in Philadelphia
13 Best Ways for Seniors to Stay Active in Phoenix
14 Best Ways for Seniors to Stay Active in Nashville
14 Best Ways for Seniors to Stay Active in Washington, D.C.
20 Questions to Ask Your Medicare Agent
Can I Change Medicare Advantage Plans Any Time? | Medicare Plans
Can I Have Two Primary Care Physicians?
Can Medicare Advantage Plans be Used Out of State?
Can Medicare Advantage Plans Deny Coverage for Pre-Existing Conditions?
Can Medicare Help with the Cost of Tyrvaya?
Do I Need Medicare If My Spouse Has Insurance?
Does Medicare Cover Abortion Services?
Does Medicare Cover Air Purifiers?
Does Medicare Cover Chiropractic Visits?
Does Medicare Cover Driving Evaluations?
Does Medicare Cover Flu Shots?
Does Medicare Cover Hoarding Cleanup?
Does Medicare Cover Krystexxa?
Does Medicare Cover Kyphoplasty?
Does Medicare Cover Light Therapy for Psoriasis?
Does Medicare Cover Linx Surgery?
Does Medicare Cover LVAD Surgery?
Does Medicare Cover Macular Degeneration?
Does Medicare Cover Mouth Guards for Sleep Apnea?
Does Medicare Cover Orthodontic Care?
Does Medicare Cover Ozempic?
Does Medicare Cover Penile Implant Surgery?
Does Medicare Cover Piqray?
Does Medicare Cover Qutenza?
Does Medicare Cover Robotic Surgery?
Does Medicare Cover RSV Vaccines?
Does Medicare Cover Scleral Lenses?
Does Medicare Cover Service Animals?
Does Medicare Cover SIBO Testing?
Does Medicare Cover Tymlos?
Does Medicare Cover Urodynamic Testing?
Does Medicare Pay for Allergy Shots?
Does Medicare pay for Opdivo?
Does Retiring at Age 62 Make Me Eligible for Medicare?
Does Your Medicare Plan Cover B12 Shots?
Everything About Your Medicare Card + Medicare Number
Explaining the Different Enrollment Periods for Medicare
Fair Square Client Newsletter: AEP Edition
How Can I Get a Replacement Medicare Card?
How Do I Sign up for Medicare? A Simple How-To Guide For You
How Do Medigap Premiums Vary?
How is Medicare Changing in 2025?
How to Enroll in Social Security
Is Balloon Sinuplasty Covered by Medicare?
Is Fair Square Medicare Legitimate?
Is PAE Covered by Medicare?
Is the Shingles Vaccine Covered by Medicare?
Medicare & Ozempic
Medicare Explained
Medigap vs. Medicare Advantage
Plan G vs. Plan N
Saving Money with Alternative Pharmacies & Discount Programs
The Easiest Call You'll Ever Make
What Does Medicare Cover for Stroke Patients?
What If I Don't Like My Plan?
What Is a Medicare Advantage POS Plan?
What Is Medical Underwriting for Medigap?
What Is the Medicare Birthday Rule in Nevada?
What is the Medicare ICEP?
What's the Deal with Flex Cards?
What's the Difference Between HMO and PPO Plans?
When Can You Change Medicare Supplement Plans?
When to Choose Medicare Advantage over Medicare Supplement
Which Medigap Policies Provide Coverage for Long-Term Care?
Why Is Medicare So Confusing?
Will Medicare Cover it?
Get the Fair Square Bulletin
Medicare savings tips, helpful guides, and more.
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. © 2025 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