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Does Medicare Cover Pacemakers?

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Perhaps you’re one of many people who need pacemakers, according to their doctors. But does Medicare cover pacemakers?

What is a pacemaker?

A pacemaker is a small device placed in your chest to help your heart maintain its proper rhythm, or pace, according to the National Institutes of Health. A pacemaker can sense when your heart rhythm is too fast or too slow, and send electrical pulses to your heart to help correct the heart’s pace.

Why would I need a pacemaker?

A doctor might prescribe a pacemaker if she or he determines that you have a heart arrhythmia, says the National Institutes of Health (NIH). That means your heart may beat too slowly or too quickly. In some cases, this could lead to shortness of breath, tiredness, fainting, or other symptoms. That’s because an arrhythmia may prevent your heart from pumping enough blood through all your blood vessels.

A pacemaker may be able to stabilize the heartbeat at an appropriate pace, and relieve some of these symptoms, adds the NIH.

Does Medicare cover pacemakers?

Medicare considers pacemakers to be “prosthetic” equipment – that is, devices needed to replace a body function or part. If your doctor determines that a pacemaker is medically necessary, and he or she accepts Medicare assignment, in most cases you’ll pay 20% of the Medicare-approved costs for the pacemaker, and a copayment or coinsurance amount for the surgery to implant it. Your Medicare Part A and/or Part B deductible typically applies, so you generally need to pay the deductible amount before Medicare covers any part of the pacemaker costs. You can read more about Medicare coverage of prosthetic devices.

Would a Medicare Supplement plan help with the costs of a pacemaker?

As we said above, Original Medicare (Part A and Part B) might cover up to 80% of your costs related to a pacemaker, although you might need to pay a deductible amount first. Did you know that Medicare Supplement plans are designed to help cover your out-of-pocket Part A and Part B costs? Each of the ten Medicare Supplement standardized plans available in most states may cover at least some portion of the 20% Part B coinsurance amounts mentioned above. Some Medicare Supplement plans may even pay Part A and/or Part B deductible amounts.

Medicare Supplement plans are available from private insurance companies for eligible beneficiaries who have both Medicare Part A and Part B. Read more about Medicare Supplement insurance.

Would you like to know more about Medicare plan options and how they may cover pacemakers? I’d be happy to help explain them to you. You can set up a phone call with me, or have me email you customized information about Medicare plan options – just click on the Get Quotes button on this page to get started.

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