If you have Medicare, you may have to worry about whether or not it will cover surgery. Part A covers most of a person’s Medicare hospital related expenses. Getting Medicare to pay for surgery requires a nightmarish amount of paperwork. Anyone who needs surgery goes through the dance between their hospital and the insurance company. The government sponsored program works in much the same way, except that the government will pay a little more quickly than a private contractor will. Getting the government-sponsored program to pay for a person’s medically necessary expenses can be difficult. As with anything else, it is simply a matter of completing the paperwork.
The doctor will probably start by filling out the necessary paperwork. He, after all, is the one who will make out the final bill. A doctor who works for a hospital rather than having his own practice will have the hospital’s billing staff bill Medicare for him. Filling out the paperwork after the surgery sets up the insurance dance referred to earlier. Even Medicare will wait to see if a consumer pays the bill before sending any money to the doctor. Wait until the next few mailings come through before making any payment arrangement.
If Medicare does not pay for an individual’s surgery, he can appeal the decision. If the appeal does not get approved, he must pay for the surgery from his own pocket. Medicare guidelines make it clear what they will and will not pay for. A patient with a Medigap plan may find that the Medigap plan will cover some things that Medicare does not, but a person is simply out of luck. Hospitals will work it out with a patient if a patient needs extra time to pay.