Defibrillators

Medicare may cover an implantable automatic defibrillator if you’ve been diagnosed with heart failure.  Medicare Part A (Hospital Insurance)  pays if the surgery takes place in a hospital inpatient setting. Medicare Part B (Medical Insurance)  pays if the surgery takes place in a hospital outpatient setting.

Your costs in Original Medicare

You pay 20% of the  Medicare-Approved Amount  for your doctor’s services. If you get the device as a hospital outpatient, you also pay the hospital a  copayment . But, the copayment won't be more than the Part A hospital stay  deductible .

For Part A-covered surgeries to implant defibrillators in the hospital inpatient setting covered under Part A, see Inpatient hospital care. If Part B covers the device, the Part B deductible applies. 

Note

To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you’ll owe may depend on several things, like:

  • Other insurance you may have
  • How much your doctor charges
  • If your doctor accepts assignment
  • The type of facility
  • Where you get your test, item, or service

Is my test, item, or service covered?