Does Medicare Cover Robotic Surgery

Does Medicare Cover Robotic Surgery

Robotic surgeries are usually less invasive than traditional surgical methods, but what does Medicare cover?

In the last few decades, robotic technology has come a long way, allowing the medical industry today to use robotics for a multitude of procedures and services that require extreme accuracy. There has been a rise in robotics used for surgery, as they offer a high degree of precision for delicate procedures.

What is robotic surgery?

Robotic surgery, or robotic-assisted surgery, is a surgery method where the surgeon operates precision-guided robot arms that hold and use miniature surgical instruments. These surgeries are minimally invasive, with incisions typically only being around 8 to 13 millimeters.

A small camera gives the surgeon magnified 3D images of the area, allowing them to operate precisely and avoid any surrounding muscles and nerves. And the robotic arms have a 360-degree range of motion, which enables tools to be moved with greater flexibility and precision. In comparison, laparoscopic surgery is done by hand with only a 2D camera.

Some robotic surgeries do not even require the surgeon to be in the same room, or even the same city or state. In some cases, a surgeon may be able to do the work remotely via the internet, so you could get care from a doctor that is several states away.

Medicare coverage for robotic surgery

When it comes to Medicare, surgery is surgery, so as long as the procedure is deemed medically necessary and conducted by a facility or practitioner who accepts Medicare, robotic surgery will be covered. There are no current stipulations that would prevent Medicare from covering your robotic surgery, outside of medical necessity.

Any inpatient surgeries (i.e., you've been admitted to the hospital as an inpatient) would be covered by Medicare Part A. Medicare Part B applies when you have an outpatient procedure – even if it's performed in a hospital setting. Either way, Original Medicare has you covered.

If you have a Medicare Advantage plan (Medicare Part C), it would be covered much the same way, since Advantage plans legally have to cover all the same things as Original Medicare. The good news with Advantage is that there is an annual cap on what you'll spend on healthcare. Original Medicare has no such yearly max.

Of course, you can protect yourself with a Medicare Supplement plan (more commonly known as Medigap), which helps cover your out-of-pocket costs when you have Original Medicare. Assuming Medicare covers the procedure, your Medigap plan will pay your Part A coinsurance and at least half of what you owe under Part B.

As stated above, the person performing the surgery must accept Medicare for it to be covered, so if you do have a robotic procedure done with a surgeon remotely, make sure that physician accepts Medicare.

Common robotic surgery procedures

There are multiple procedures that can be done with robotic surgery, with some common ones including:

  • Bone grafting
  • Cancer surgery
  • Coronary artery bypass
  • Herniated disc repair
  • Hip replacement
  • Hysterectomy
  • Kidney removal
  • Kidney transplant
  • Knee replacement
  • Removal of bone spurs

Around 90% of hysterectomies are performed via robotic surgery, and 20% of prostate removals.

It should be noted that robotic surgeries do tend to cost more than traditional laparoscopic or other surgeries due to the equipment being used. However, this does not change whether Medicare covers the surgery, and your overall surgical costs depend on several factors, including the surgery you get, where you get it, and whether the surgery is inpatient or outpatient.

If you have a Medicare Advantage plan, you might have additional benefits or coverage that help lower the cost of the procedure or cover aspects that Original Medicare does not. You can compare the costs and benefits of Medicare plans in your area with our Find a Plan tool. Just enter your zip code to get started.

Recovering from robotic surgery

Regardless of the type of surgery you have, there will likely be some recovery and recuperation time. This could mean taking it easy for a few days, or it could mean physical therapy, it all depends on the type of surgery you have.

Generally, since robotic surgery is minimally invasive, you have shorter, less intense recovery periods. Refraining from stressing the area, keeping weight off of it, and anything else your doctor recommends is important, but you'll likely have fewer restrictions than you would for an invasive surgery.

That being said, always follow your doctor's orders when it comes to healing from any medical procedure to ensure you heal properly. If you do require a stay in the hospital or a nursing care facility to recover after a robotic surgery, that is covered through Part A (assuming you meet other qualifications).

If you had an outpatient procedure that requires some rehabilitation, that is covered through Part B. Medications administered during surgery or given to you in the hospital would fall under coverage from Part A or Part B, but any prescriptions you need to pick up after the fact are covered by Medicare Part D, which provides prescription drug coverage.

Advantages and disadvantages of robotic surgery

As with any other method of care, there can be both advantages and disadvantages to robotic surgery. Robotic surgery does usually take more time, due to the precision required and the fact that a separate instrument is being used to control several others.

If complications occur during a robotic surgery, it is possible the surgeon may have to start over as a traditional surgery. And, though it is uncommon, there is the possibility that the robot malfunctions during the procedure and causes delays or other issues.

However, most of the time, robotic surgery is a highly efficient process that improves patient care. Advantages to robotic surgery include:

  • Faster recovery and return to normal activity
  • Lower blood loss
  • Reduced pain and discomfort
  • Reduced pain medication use post-surgery
  • Reduced scarring
  • Shorter hospital stay

Any type of medical procedure you go through can come with pros and cons; the best thing to do is talk with your doctor about your options to see what the best choice is for you.

Additional resources

Florida native Eric Ruge lives by one rule: Do the right thing. His goal as a Medicare agent is helping people find the right Medicare coverage for their unique medical needs and budget. He believes everyone deserves the peace of mind they get knowing they made the right decision about their Medicare coverage. When he's not working, Eric enjoys spending time with family and friends, watching Tampa sports, and playing the occasional round of golf.


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