
Does Medicare Cover Back Surgery?
Key Takeaways
Original Medicare (Part A and Part B) will typically cover back surgery if deemed medically necessary by a doctor, with Part A covering inpatient hospital care and Part B covering doctor's services during hospital stays and outpatient services post-release.
Medicare coverage includes common types of back surgeries like discectomy, laminectomy, and spinal fusion, but patients should confirm with their doctor that their specific procedure is covered.
Costs for back surgery with Medicare vary and are difficult to determine upfront due to unknown medical specifics, but could be between around $1,500 and $2,000.
If your back surgery is deemed medically necessary by a doctor, Original Medicare (Part A and Part B) will typically cover it.
Your doctor can explain what type of surgery is recommended and if this procedure is covered by Medicare.
This article reviews Medicare coverage for back surgery, including which types of surgery are covered and costs.
Medicare coverage for back surgery
Medicare coverage for back surgery typically mirrors coverage for other medically necessary surgeries, hospital stays, and follow-ups.
Medicare Part A (hospital insurance)
Medicare Part A covers inpatient hospital care, providing that:
the hospital accepts Medicare
you're admitted per an official doctor's order indicating that you need inpatient hospital care
You may need approval for your hospital stay from the hospital's Utilization Review Committee.
Medicare inpatient hospital care coverage includes:
semi-private rooms (a private room only when medically necessary)
general nursing (not private duty nursing)
meals
drugs (as part of inpatient treatment)
general hospital services and supplies (not personal care items like slipper socks or razors)
Medicare Part B (medical insurance)
Medicare Part B covers your doctor's services during your hospital stay and outpatient services following your release from the hospital.
Other insurance, such as Medicare Supplement plans (Medigap), Medicare Part D (prescription drug), or Medicare Advantage plans are available to you when you qualify for Medicare.
If you have this type of additional insurance along with Medicare, it will affect the price you pay for your back surgery and recovery.
How much does back surgery cost with Medicare?
It's difficult to determine exact costs prior to back surgery because the medical specifics of the services you may need are unknown. For example, you might need an extra day in the hospital beyond what was predicted.
To estimate your costs:
Ask your doctor and hospital how much they think you'll have to pay for your surgery and follow-up care. Check to see if there are recommended services that Medicare doesn't cover.
If you have other insurance, such as a Medigap policy, contact them to see what part of the costs they will cover and what they think you'll have to pay.
Check your Medicare account (MyMedicare.gov) to see if you have met your Part A and Part B deductibles.
This table provides an example of potential costs:
Medicare Part A coinsurance is $0 for days 1 to 60 for each benefit (after you pay your Part A deductible).
Examples of back surgery costs
Medicare.gov makes the prices of certain procedures available. These prices don't include physician fees and are based on national Medicare averages from 2024.
This table can give you an indication of what you might have to pay for some of the services involved in back surgery.
Procedure Average cost
Diskectomy The average cost of a diskectomy (aspiration of lower spine disc, accessed through the skin) in a hospital outpatient department is $14,225, with Medicare paying $12,256 and the patient paying $1,969.
Laminectomy The average cost of a laminectomy (partial removal of bone with release of the spinal cord or spinal nerves of one interspace in the lower spine) in a hospital outpatient department is $7,727, with Medicare paying $6,182 and the patient paying $1,545.
Takeaway
If your doctor indicates that back surgery is medically necessary for you, Original Medicare (Part A and Part B) will typically cover it.
Determining how much back surgery will cost after Medicare payments is difficult because the exact services you will need are unknown. Your doctor and hospital should be able to offer some educated estimates.
Hashtags

Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Yahoo
43 minutes ago
- Yahoo
UHC Medicare Advantage patients will lose coverage at Brown Health hospitals on July 1
PROVIDENCE, R.I. (WPRI) — A spokesperson for Brown University Health confirmed to 12 News on Wednesday that negotiations with UnitedHealthcare have ended, and UHC's Medicare Advantage plans will not be accepted at Brown Health's four Rhode Island hospitals starting July 1. Target 12 initially reported back in May that UHC had notified affected patients about the ongoing negotiations via a letter. According to a spokesperson for Brown Health, the hospital system had asked UHC to increase its reimbursement rate, as well as 'eliminate their administrative policies that deviate from traditional Medicare, such as unnecessary prior approval and utilization management, that cause frustration for patients and result in extra cost to our health care system.' 'Since both parties held firm in their positions, we mutually decided to end our Medicare Advantage hospital contract,' the Brown Health spokesperson said. 'We proposed extending our contract through the end of the year to provide Medicare Advantage members continued access to Brown University Health's hospitals while we negotiate,' a UHC spokesperson said in a statement on Wednesday. 'Unfortunately, the health system refused.' Both Brown Health and UHC emphasized that this change only applies to Hasbro Children's Hospital, The Miriam Hospital, Newport Hospital, and Rhode Island Hospital. Physicians associated with Brown Health and the group's urgent care clinics will continue to accept UHC's Medicare Advantage plans through Dec. 31, 2025, as will St. Anne's Hospital and Morton Hospital in Massachusetts. Medicare Advantage is a type of health plan offered by Medicare-approved private companies as an alternative to original Medicare. Like Medicare, it is available for Americans 65 and older, as well as those with certain severe disabilities or illnesses. Federal data shows that about 60% of Rhode Island Medicare recipients utilize Medicare Advantage plans. In Rhode Island, they're offered by Aetna, Blue Cross & Blue Shield, and UHC. (UHC has not answered repeated requests for comment on the number of patients who will be affected by the change.) Brown Health hospitals will continue accepting UHC's Medicaid and commercial health insurance plans, as well as Medicare Advantage plans from other providers. Starting July 1, treatments at Brown Health hospitals will be billed to UHC Medicare Advantage patients as 'out-of-network' care. However, a UHC spokesperson stressed that in an emergency, members should go to the nearest hospital even if it's not 'in-network,' as the company covers emergency visits at its in-network benefit level. Dr. Johnny Luo, a health insurance expert from Doctor's Choice, told 12 News there are ways to get a new insurance plan if needed. Outside of Medicare's open enrollment period, which lasts from Oct. 15 to Dec. 17, Luo said, the Centers for Medicare and Medicaid Services have been known to offer special election periods throughout the year on a case-by-case basis. Brown Health also encouraged UHC Medicare Advantage members to find out if they're eligible for 'continuity of care' protections by calling UHC Customer Service at 1-800-711-0646. Download the and apps to get breaking news and weather alerts. Watch or with the new . Follow us on social media: Close Thanks for signing up! Watch for us in your inbox. Subscribe Now Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

Miami Herald
an hour ago
- Miami Herald
24 million Americans hit by harsh health insurance reality
The Affordable Care Act's (ACA) Marketplace has quietly become one of the federal government's biggest success stories, providing health insurance to more than 24 million Americans in 2025 – a doubling since 2021. But that success now stands on a knife's edge. Don't miss the move: Subscribe to TheStreet's free daily newsletter Unless Congress acts, enhanced premium tax credits that helped fuel this growth will expire at year-end. The result? Higher premiums, fewer enrollees, and more uninsured Americans, especially among older, near-retirement millions, expanding advanced premium tax credits (APTCs) in 2021 was a game-changer. By lowering out-of-pocket premiums through subsidies tied to income, the ACA became accessible to people who previously found it unaffordable. The Inflation Reduction Act extended these credits, but only temporarily. Related: Social Security income tax cuts may include a huge new deduction for retirees Under current rules, these credits are available to individuals and families earning up to 400% of the Federal Poverty Level (roughly $58,320 for an individual or $120,000 for a family of four in 2025). However, absent Congressional reauthorization, the clock runs out this December. The numbers are stark. A new analysis from the Commonwealth Fund projects that 4 million people will lose coverage outright if the enhanced tax credits vanish. Other proposed changes to marketplaces could further harm enrollment: an additional 4 million people could lose coverage by 2034 if the House-passed budget bill (H.R. 1) is enacted. In Texas, over 1 million could become uninsured, with premiums up by $400+ California, 174,000 could lose coverage, facing $700+ West Virginia, nearly every Marketplace enrollee -- 98% -- would see increases, with 16,000 losing coverage. Older adults not yet eligible for Medicare are particularly vulnerable. Consider these examples from KFF: A 40-year-old individual could see $1,000 more per year for the same coverage.A 60-year-old married couple could be looking at $20,000+ increases, depending on the state. As Jae Oh, CFP, author of Maximize Your Medicare, explains: "Twenty thousand dollars does not matter what your net worth is. That's a heck of a lot of money." Oh emphasizes that individuals must now start budgeting for higher premiums, even if policy outcomes remain uncertain. "Some people just stick with the same plan out of habit," he notes, "but not at every price point. That needs to change." Related: Medicare recipients face a growing problem Among his key recommendations: Re-evaluate plan tiering: "If you're in a gold plan, look at their silver plan. If you're in a silver, look at a bronze plan." Review COBRA carefully: While often seen as too costly, COBRA could become a better value if premium tax credits disappear. It offers continuity of care, retention of deductibles already met, and coverage for dependents, including adult children. "If your cost advantage dissipates, maybe COBRA was best all along." Control income to manage subsidy eligibility: Strategies like Roth conversions, Roth contributions, and deferring income could help lower modified adjusted gross income (MAGI) and retain eligibility for reduced premiums. "Anything to defray or to try to limit your modified adjust gross income next year may be very valuable." Plan around uncertainty: "We do not know at all what 2026 individual health insurance plans under the ACA look like. We will not know that until the very, very late fall this year." On the broader economic context, Oh adds: "That white-collar recession -- anything that looks or sounds or feels like it -- is real. People are on the bench, if you will, looking for employment." And for those relying on the ACA to maintain coverage between jobs: "This is that instance when the headlines will affect every aspect for those types of people… meaning that people who have accessed the APTC can be affected going into next year." Michael Gusmano, professor of health policy at Lehigh University, puts the risk into stark terms: "The Commonwealth Fund's analysis is depressing, but accurate and important. The temporary increase in subsidies that were adopted after the 2020 election had no chance of surviving if President Trump won re-election-and may have been difficult to extend even with Biden or Harris in the White House. Getting an extension of these subsidies through Congress would have been a challenge regardless of who is president." More personal finance: Social Security student loan garnishment sparks alarmThe most tax-friendly states for your retirement incomeSALT income tax deduction takes critical step forward He continues: "Beyond the expiration of the subsidies and loss of insurance through the ACA -- and the millions who lost insurance coverage during Medicaid's 'great unwinding' following the end of the public health emergency -- the budget bill that was adopted by the U.S. House and is currently being debated in the U.S. Senate would increase the number of uninsured by several million more. Together, these policy changes would substantially erode health insurance coverage in the U.S. and move us in the direction of the situation in the U.S. before the full implementation of the ACA in 2014." The likely fallout? "This will increase premature death, deteriorate public health, increase avoidable hospitalizations, and place enormous strain on the health care safety-net-including many rural hospitals that are already on the brink of disaster." Anne Montgomery, a health systems researcher focused on older adults, underscores the policy's real-world harm: "Not surprising to see the largest states would get hammered by these provisions. They are very harmful to individuals who won't find it possible to buy private health insurance and who might, but for the massive Medicaid reductions in funding, wind up in Medicaid." "Millions will be stranded," she said. "Dual eligibles will struggle to access Medicare if they fall through the cracks and don't get Medicaid supplemental coverage help." "Then there is the fact that the health care system doesn't operate for free -- there are operations, services and wages to be paid," Montgomery noted." And there is no magic way that states have to replace the lost revenue, so many providers will stagger and increasingly fail." Related: Medicare Advantage plans come under fire from DOGE The Arena Media Brands, LLC THESTREET is a registered trademark of TheStreet, Inc.


CBS News
an hour ago
- CBS News
Frisco mom survives stroke thanks to quick action and advanced care
Time is the number one commodity in the Reid-Keen household. Life can be hectic, as you might expect for a family of five. "I worried about getting the kids to their activities on time and making sure everyone had dinner—and making sure I wasn't late to pick the kids up," said Catherine Keen. "We're running around taking kids every which way—soccer, baseball, dance," said Ryan Reid, Catherine's husband. "We were both working full time." Flu slows family down Reid-Keen household But the family was forced to slow down when everyone came down with the flu during Christmas break at the end of last year. "It just hit us all hard, and it took us a while to recover," said Keen. "It took me longer to recover." Stroke strikes without warning By early January, the 43-year-old mom of three was finally starting to feel like herself again. She decided to take a little time for herself and sneak in an early morning workout while the house was still quiet. "My daughter was down the street at Grandma's, and Catherine was going to work out," said Reid. "I was going to take the boys and go have some dude time." But that plan quickly changed. Before her workout even began, Keen knew something was wrong. "I immediately felt dizzy, and I laid down on the floor," she said. Son finds mom unresponsive Just minutes later, her sons came downstairs and found her. "I said, 'Mom, are you OK?' and 'What are you doing down there?'" said Nicholas Reid, Catherine's son. "She didn't respond to either question, so I'm like, 'This isn't funny. Stop.'" Keen couldn't respond. She had just suffered a massive stroke. The clock was ticking. Fast response saves life When Reid got downstairs and saw that she still couldn't respond, he called 911. The Frisco Fire Department arrived within 10 minutes. "They recognized it immediately," said Reid. "They said, 'We think she's having a stroke, and Plano Presby is the best place to go.' I said, 'I'll race you there.'" Top stroke center in Texas Texas Health Presbyterian Hospital Plano is one of fewer than 50 comprehensive stroke centers in the state. "She had a devastating stroke," said Dr. James Tatum, an interventional neuroradiologist at Texas Health Plano. "She had no speech. She couldn't talk. She was completely paralyzed on the right side of her body." Advanced stroke treatment used Tatum specializes in treating stroke patients using advanced techniques. "We're able to advance a catheter through the blood vessels to the region of the clot and extract it with suction, essentially reestablishing blood flow," he said. Recovery begins within days That life-saving technology, combined with the fast actions of everyone involved, is why Keen was discharged from the hospital after just a few days—and has since made a nearly full recovery. "If it had been 30 minutes sooner, we would have been asleep. If it had been 30 minutes later, the boys and I would have been gone," said Reid. "With a stroke, every minute counts." Stroke warning for others That's what Keen wants others to know: if you see signs of a stroke, don't wait—call 911. "I was so fortunate because my son found me in less than 15 minutes from when I went down," said Keen. "So I'm definitely a survivor. I'm so lucky." Family grateful for recovery "Lucky" doesn't begin to describe how her family feels. "I'm just grateful—grateful that I can get back to worrying about silly stuff like the grocery list or cleaning the pool, and not when her next appointment is," said Reid.