Does Medicare Cover LVAD Surgery?
Fair Square Medicare

Does Medicare Cover LVAD Surgery?

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By Daniel Petkevich

Nov 30, 2022

Guidance has been updated recently, you're covered

In the last couple of years, Medicare has added more guidance for coverage of new procedures and treatments. A left ventricular assist device (LVAD) is one of those new devices that has qualified for Medicare coverage. Part A will cover your inpatient hospital stay, and Part B will cover your implant as a prosthetic. But how much would this cost you? Let's find out.

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What is LVAD?

A left ventricular assist device (LVAD) is a mechanical pump that helps the heart pump blood throughout the body. It's implanted in patients to help improve patients with end-stage heart failure with their cardiac output. The LVAD will reduce symptoms of congestive heart failure and improve quality of life.

Benefits and Risks

The most significant benefit of LVADs is that they can improve the quality of life for those with end-stage heart failure. It can reduce symptoms, improve oxygenation in the body, and provide better control over blood pressure and fluid levels. It also helps to reduce hospitalizations due to heart failure.

LVAD surgery carries some risks, including infection, bleeding and stroke. LVADs can also cause a decrease in blood pressure, arrhythmias (irregular heart rhythms), and damage to the surrounding organs. However, the majority of these risks are manageable with proper care and follow-up.

How much does LVAD surgery cost on Medicare?

As mentioned earlier, guidance has changed in recent years, and Medicare covers your LVAD surgery and implant through Medicare Part A and Part B, respectively. You will be responsible for paying the Part A deductible of $1,556 ($1,600 in 2023) for the surgery. For Part B, you will be responsible for 20% of the Medicare-approved amount. For such a significant surgery, the costs can pile up, that's why we recommend Medicare Supplement Plan G to limit your out-of-pocket costs to the Part B deductible.

How to prepare for LVAD surgery?

Prior to undergoing LVAD surgery, you should discuss all your medical conditions, medications, and allergies with your doctor. You may also need to limit any strenuous activity or heavy lifting for a period of time before the procedure. Additionally, it's important to understand what type of lifestyle changes may be necessary after the surgery is complete.

What to expect after LVAD surgery?

After LVAD surgery, you'll likely need to stay in the hospital for several days. During this time, your doctor will monitor your heart and make any necessary adjustments to the device. Following the procedure, it's important that you follow up with your medical team regularly, as well as adhere to any lifestyle modifications recommended by them.

Conclusion

LVAD surgery is a life-saving procedure for those suffering from end-stage heart failure. Medicare covers the majority of the costs associated with the device. However, you will still incur out-of-pocket costs, so confirm with your plan provider. Additionally, check with your doctor before you undergo LVAD surgery. This content is for informational purposes only. Call Fair Square Medicare today to talk with an expert for any questions about your Medicare plan. We're here to help.


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