Does Medicare Cover Linx Surgery?

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By Daniel Petkevich

Dec 6, 2022

Don't let acid reflux get in your way

If you suffer from severe acid reflux, you could be a candidate for Linx surgery to remedy the pain and discomfort. Luckily, Medicare offers coverage as long as you meet certain conditions. What do you need in order to qualify? Let's find out.

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What is Linx surgery?

Linx surgery is a minimally invasive procedure that can help to reduce and manage severe acid reflux. It involves the placement of a small, flexible ring of magnetic beads around the lower esophageal sphincter (LES). This helps keep the valve closed, preventing stomach acid from flowing up into the esophagus.

How does Medicare cover the surgery?

Medicare will typically cover the cost of Linx surgery if your doctor can provide evidence that you meet certain conditions. To be eligible, you must suffer from severe and frequent acid reflux symptoms that persist despite lifestyle changes or treatment with medication. You must also have already had an endoscopy to rule out other causes for your condition, such as a hiatal hernia or Barrett's esophagus.

In addition, Medicare will only pay for the surgery if it's performed by an approved provider at an approved facility. Your doctor or hospital should be able to tell you if they meet the criteria and can submit claims to Medicare.

What are the prerequisites for coverage?

In order to qualify for coverage, you must have Medicare Part B and be a United States citizen or permanent resident. Your doctor must submit documentation proving that your acid reflux is severe, chronic, and has been present despite lifestyle changes or treatment with medications.

How much will the surgery cost you?

If you qualify and the surgery is covered by Medicare, then most of your costs should be taken care of. However, you may still need to pay a Part B deductible and up to 20% coinsurance of the Medicare-approved amount. Your doctor's office or Medicare plan provider can tell you what fees and expenses may apply in your particular case. To minimize out-of-pocket costs, we typically recommend Medicare Supplement Plan G.

What are the risks associated with Linx surgery?

All surgeries carry some risks, but Linx surgery is generally considered to be low-risk. Possible complications include infection, bleeding, or a reaction to the anesthesia used during the procedure. Your doctor can discuss your individual risk factors with you and help you make an informed decision about whether it's right for you.

If your doctor has determined that you are a good candidate for Linx surgery, Medicare may be able to help cover the cost. Be sure to talk to your doctor and your Medicare plan provider about what is covered and if you meet the criteria for coverage.

How to know if you're a good candidate for the surgery

The best way to determine if you are a good candidate for Linx surgery is to talk to your doctor. They will be able to evaluate your specific condition and lifestyle habits, assess the severity of your symptoms, and discuss any possible risks or benefits associated with the procedure. Ultimately, they’ll be able to advise whether Linx surgery is an appropriate solution for you.

Conclusion

Linx surgery is a minimally-invasive way to treat GERD. If your doctor has determined that you're a good candidate, Medicare may be able to help cover the cost. Be sure to talk to your doctor and your Medicare plan provider about what is covered and if you meet the criteria for coverage. With the right information, you can make an informed decision about whether this procedure is right for you. This content is for informational purposes only. For all your Medicare-related questions, talk with an expert at Fair Square Medicare today.

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