Does Medicare Cover Upper Endoscopy?
- 120 POINTSview profileTom PichtIf original Medicare is your primary insurance while on Medicare, any procedure that is deemed to be medical necessary is covered. And any Supplemental/Medigap plan coverage would pay according to the plans coverage once, Medicare pays there portion. If you have an Advantage Plan for your Medicare coverage, I would recommend that you check with your specific insurance provider to determine what your out of pocket expense would be for any procedure.Answered on May 16, 2013flag this answer
521 POINTSview profileEdward CroweOwner, Crowe and Associates, Brookfield, CTOriginal Medicare would cover an upper Endoscopy at 80% of the Medicare allowable amount (meaning you can only be billed based on the amount Medicare allows for the procedure) once the Part B deductible of $166 has been satisfied for the year. If you have a Medicare supplement, it will cover some or all of the deductible and 20% based on which sup you have purchased. A Medicare Advantage plan (Managed Medicare plan) will have a copay associated with the procedure which varies depending on the company and plan you have. It is usually an Outpatient surgery copay.Answered on February 17, 2016flag this answer
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