What does Medicare Part A cover for surgery?

Asked by: Dr. Malika Cummerata  |  Last update: January 10, 2026
Score: 4.2/5 (46 votes)

Does Medicare Part A Cover Outpatient Surgery? Medicare Part A does not cover outpatient surgery. Part A only covers inpatient operations. Medicare costs and coverage are different for inpatient versus outpatient care.

Does Medicare Part A pay for surgeries?

Summary: The cost of hospital care can be daunting. Fortunately, if you have Medicare Part A (hospital insurance), it generally covers inpatient surgery. Medicare Part B (medical insurance) may also cover some services while you're an inpatient.

Does Medicare Part A pay 100% of hospital stay?

After you pay the Part A deductible, Medicare pays the full cost of covered hospital services for the first 60 days of each benefit period when you're an inpatient, which means you're admitted to the hospital and not for observational care. Part A also pays a portion of the costs for longer hospital stays.

What Medicare Part A does not cover?

Generally, most vision, dental and hearing services are not covered by Medicare Parts A and B. Other services not covered by Medicare Parts A and B include: Routine physical exams. Cosmetic surgery.

What does the Medicare Part A cover?

In general, Medicare Part A helps pay for inpatient care you get in hospitals, critical access hospitals, and skilled nursing facilities. It also helps cover hospice care and some home health care.

What Does Medicare Part A Cover?

43 related questions found

What are the 6 things Medicare doesn't cover?

Some of the items and services Medicare doesn't cover include:
  • Eye exams (for prescription eyeglasses)
  • Long-term care.
  • Cosmetic surgery.
  • Massage therapy.
  • Routine physical exams.
  • Hearing aids and exams for fitting them.

Does Medicare Part A pay for doctors in the hospital?

Medicare Part A will typically cover the costs of hospital stays, surgeries, and care in a skilled nursing facility, while Part B covers doctor visits, durable medical equipment, and preventative services.

What are 3 services not covered by Medicare?

We don't cover these routine items and services: Routine or annual physical checkups (visit Medicare Wellness Visits to learn about exceptions). exams required by third parties, like insurance companies, businesses, or government agencies. Eye exams for prescribing, fitting, or changing eyeglasses.

Why are people leaving Medicare Advantage plans?

Key takeaways: People leave Medicare Advantage plans because out-of-pocket costs vary between plans, network restrictions can cause frustration, prior authorization requests can delay care, and it can be difficult to use the additional benefits they provide.

How do I know if Medicare will cover a procedure?

2 ways to find out if Medicare covers what you need:
  • Talk to your doctor about why you need certain services or supplies. Ask if Medicare will cover them. What happens if Medicare won't cover a service I need?
  • Check coverage information on your item, service, or supply.

How many days does Medicare Part A cover?

Once you meet your deductible, Part A will pay for days 1–60 that you are in the hospital. For days 61–90, you will pay a coinsurance for each day. If you need to stay in the hospital for longer than 90 days, you can use up to 60 lifetime reserve days.

Does everyone pay $170 for Medicare?

If you don't get premium-free Part A, you pay up to $518 each month. If you don't buy Part A when you're first eligible for Medicare (usually when you turn 65), you might pay a penalty. Most people pay the standard Part B monthly premium amount ($185 in 2025).

Does Medicare pay for an ambulance?

Things to know. If using other transportation could endanger your health, Medicare will only cover ambulance services to the nearest appropriate medical facility that's able to give you the care you need.

Is anesthesia covered under Medicare Part A?

Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care. covers anesthesia services you get as a hospital inpatient.

Is Medicare Part A free at age 65?

Premium-Free Medicare Part A Based on Age

To be eligible for premium-free Part A on the basis of age: A person must be age 65 or older; and. Be eligible for monthly Social Security or Railroad Retirement Board (RRB) cash benefits.

How long does it take Medicare to approve a surgery?

How long does it take for Medicare to approve a procedure? It can take up to 30 days for Medicare to approve a procedure. In some cases, however, approval may be granted sooner. If you have questions about the status of your application, you can contact Medicare directly.

Why are seniors losing Medicare Advantage plans?

Health systems and hospitals are also making the decision to cancel contracts due to excessive prior authorization denial rates and slow payments from insurers. Already 27 health systems have canceled their Medicare Advantage contracts this year.

Why are doctors dropping Medicare Advantage?

Health systems have cited delayed reimbursements, cumbersome prior authorization requirements and high rates of patient claim denials for their decisions to drop Medicare Advantage plans.

Can I drop my Medicare Advantage plan and go back to original Medicare?

Medicare Advantage Open Enrollment Period: Between January 1 and March 31 of each year, if you already have a Medicare Advantage Plan (with or without drug coverage) you can: Switch to another Medicare Advantage Plan (with or without drug coverage). Drop your Medicare Advantage Plan and return to Original Medicare.

Does Medicare Part A cover surgery?

Medicare Part A, which is hospital insurance, applies to inpatient surgery, and Medicare Part B, which is medical insurance, covers outpatient operations. Part B also helps to pay for doctor's services you may receive while you're in the hospital. Original Medicare covers medically necessary surgeries.

Does Medicare cover 100% of hospital bills?

Whether you're new to Original Medicare or have been enrolled for some time, understanding the limitations of your coverage is important as you navigate decisions about your healthcare. One of the main reasons why Original Medicare doesn't cover 100% of your medical bills is because it operates on a cost-sharing model.

Which of the following is not covered by Medicare Part A?

Medicare Part A primarily covers inpatient care services, including hospital stays, skilled nursing facility care, home health care, and hospice care. It does not include coverage for outpatient medical facility services, which are part of Medicare Part B. Thus, the correct option is B. An outpatient medical facility.

Does Medicare Part A cover ER visits?

ER visits are considered outpatient stays, and Medicare Part A does not cover outpatient stays. However, if you're formally admitted to the hospital with a doctor's order, Part A will help pay for your inpatient hospital stay.

What happens if you don't enroll in Medicare Part A at 65?

Part A late enrollment penalty

If you have to buy Part A, and you don't buy it when you're first eligible for Medicare, your monthly premium may go up 10%. You'll have to pay the penalty for twice the number of years you didn't sign up.

Do all hospitals accept Medicare Part A?

Not all hospitals accept Medicare, but luckily, the vast majority of hospitals do. Generally, the hospitals that do not accept Medicare are Veterans Affairs and active military hospitals (they operate with VA and military benefits instead), though there are a few other exceptions nationwide.