Fair Square Medicare Wordmark

Does Medicare Cover an FMT?

Fecal microbiota transplant from healthy in unhealthy intestine, FMT. Improvement intestinal microflora and normalization stool by introducing beneficial bacteria in bowel colon tract. Vector stock illustration
By Daniel Petkevich
Dec 2, 2022

Usually not, but you might qualify

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.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

What is an FMT and what are its benefits?

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.

What is the process of getting an FMT?

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.

Medicare coverage of an FMT

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.

How much will it cost you to get an FMT done?

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.

Risks associated with getting FMT done

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.

How long will the results of the procedure last?

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.

Will I need to take any special precautions after getting the treatment done?

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.

Conclusion

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.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

Recommended Articles

Cover image
Can I Choose Marketplace Coverage Instead of Medicare?
May 2, 2023
An elderly couple discusses their healthcare and insurance needs with another woman stock image
Medicare Guaranteed Issue Rights by State
Feb 10, 2023
Closeup of a male Doctor or physiotherapist doing stretching for a patient in the clinic for examining treating injured of back stock photo
Does Medicare Cover Chiropractic Visits?
Dec 22, 2022
cartoon hospital and male doctor stock image
Can I Have Two Primary Care Physicians?
Oct 3, 2022
Heart on Heart Rhythm Background Concept stock photo
Does Medicare Cover the WATCHMAN Procedure?
Dec 1, 2022
wart on the sole of a white man's foot stock photo
Does Medicare Cover Wart Removal?
Jan 17, 2023
Union Station in Denver stock image
15 Best Ways for Seniors to Stay Active in Denver
Mar 9, 2023
Cover image
How Much Does a Medicare Coach Cost?
Mar 20, 2023
Emergency section of a hospital exterior stock photo
How Does Medicare Pay for Emergency Room Visits?
Nov 21, 2022
Senior couple going over their finances stock photo
Explaining IRMAA on Medicare
Dec 21, 2022
Senior couple going over their finances in front of a computer stock image
How Much Does Medicare Part B Cost in 2023?
Dec 27, 2022
a chart explaining different enrollment periods on medicare
How Do I Sign up for Medicare? A Simple How-To Guide For You
Apr 8, 2022
Close up top view of a woman showing a round-shaped Lipoma fatty tumor on an open palm stock photo
Does Medicare Cover Lipoma Removal?
Dec 8, 2022
Washington DC stock image
14 Best Ways for Seniors to Stay Active in Washington, D.C.
Mar 11, 2023
Cover image
Saving Money with Alternative Pharmacies & Discount Programs
Feb 1, 2024
Caucasian nurse holding spine model against the patients backs. Clinic interior. stock photo
Does Medicare Cover Kyphoplasty?
Dec 9, 2022
Cover image
The Fair Square Bulletin: June 2023
Jun 30, 2023
elderly woman with glasses having difficulty reading her phone stock image
Is Vitrectomy Surgery Covered by Medicare?
Dec 2, 2022

More of our articles

13 Best Ways for Seniors to Stay Active in Philadelphia

14 Best Ways to Stay Active in Charlotte

Can I Change My Primary Care Provider with an Advantage Plan?

Can I Laminate My Medicare Card?

Can I switch From Medicare Advantage to Medigap?

Can Medicare Advantage Plans be Used Out of State?

Can Medicare Help with the Cost of Tyrvaya?

Comparing All Medigap Plans | Chart Updated for 2023

Do All Hospitals Accept Medicare Advantage Plans?

Do Medicare Supplement Plans Cover Dental and Vision?

Does Medicare Cover an FMT?

Does Medicare Cover Bariatric Surgery?

Does Medicare Cover Breast Implant Removal?

Does Medicare Cover Cardiac Ablation?

Does Medicare Cover Cervical Disc Replacement?

Does Medicare Cover Compounded Medications?

Does Medicare Cover Diabetic Eye Exams?

Does Medicare Cover Driving Evaluations?

Does Medicare Cover Exercise Physiology?

Does Medicare Cover Hypnotherapy?

Does Medicare Cover Ilumya?

Does Medicare Cover Kidney Stone Removal?

Does Medicare Cover Krystexxa?

Does Medicare Cover Linx Surgery?

Does Medicare Cover Mouth Guards for Sleep Apnea?

Does Medicare Cover Robotic Surgery?

Does Medicare Cover RSV Vaccines?

Does Medicare Cover Service Animals?

Does Medicare Cover Shock Wave Therapy for Plantar Fasciitis?

Does Medicare Cover SIBO Testing?

Does Medicare Cover TENS Units?

Does Medicare Cover the Urolift Procedure?

Does Medicare Cover Vitamins?

Does Medicare Pay for Antivenom?

Does Medicare Pay for Bunion Surgery?

Does Medicare Pay for Funeral Expenses?

Does Medicare Pay for Varicose Vein Treatment?

Does Retiring at Age 62 Make Me Eligible for Medicare?

Everything About Your Medicare Card + Medicare Number

Fair Square Bulletin: We're Revolutionizing Medicare

How Can I Get a Replacement Medicare Card?

How Do Medicare Agents Get Paid?

How Do Medigap Premiums Vary?

How is Medicare Changing in 2023?

How Much Does Medicare Cost?

How Much Does Medicare Part A Cost in 2023?

How Much Does Rexulti Cost with Medicare?

How Much Does Trelegy Cost with Medicare?

How Much Does Xeljanz Cost with Medicare?

How Often Can I Change Medicare Plans?

How to Choose a Medigap Plan

How to Deduct Medicare Expenses from Your Taxes

How Your Employer Insurance and Medicare Work Together

Is Balloon Sinuplasty Covered by Medicare?

Is Botox Covered by Medicare?

Is PAE Covered by Medicare?

Medicare Explained

Plan G vs. Plan N

Should You Work With A Remote Medicare Agent?

The Fair Square Bulletin: August 2023

The Fair Square Bulletin: January 2024

The Fair Square Bulletin: July 2023

The Fair Square Bulletin: November 2023

The Fair Square Bulletin: September 2023

What If I Don't Like My Plan?

What is the Medicare ICEP?

What People Don't Realize About Medicare

What to Do When Your Doctor Doesn't Take Medicare

What You Need to Know About Creditable Coverage

When Can You Change Medicare Supplement Plans?

When to Choose Medicare Advantage over Medicare Supplement

Which Medigap Policies Provide Coverage for Long-Term Care?

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.
Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2023

Terms of Use
Notice of Privacy Practices

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