Does Medicare Cover Cervical Artificial Disc Replacement?

Does Medicare cover cervical artificial disc replacement? Currently, there is no national coverage. The Centers for Medicare and Medicaid (CMS) do not consider it to be a reasonable and necessary medical procedure for the Medicare population over 60 years of age.

While there is no national coverage for Medicare disc replacement procedures, determinations for coverage are instead left up to local areas. In some places it is indeed covered, so you will need to check with a surgeon in your area to see if it applies.

If disc replacement surgery is not covered in your area, there are still other medical coverage options for cervical artificial disc replacement. In addition, for those who do not qualify for Medicare and are looking for the best ways on how to buy health insurance, we can help.

Looking for other types of health insurance? Enter your ZIP code into our helpful tool above to find a medical plan that works for you, as well as auto insurance, life insurance, and anything else you may need in terms of insurance.

Case Studies: Medicare Coverage for Cervical Artificial Disc Replacement

Case Study 1: John’s Experience With Medicare Coverage

John, a 65-year-old Medicare beneficiary, sought cervical artificial disc replacement to treat his degenerated disc condition. However, he discovered that Medicare does not provide national coverage for this procedure for individuals over the age of 60. John was disappointed and decided to explore other insurance options to cover the cost of the surgery.

Case Study 2: Sarah’s Local Coverage

Sarah, a 57-year-old Medicare beneficiary, researched local coverage options for cervical artificial disc replacement. Fortunately, in her area, some insurance companies provided coverage for the procedure. She consulted with a surgeon in her locality and found that she met the necessary criteria for coverage. Sarah proceeded with the surgery, confident that her insurance would cover the costs.

Case Study 3: Alternatives for David

David, a 50-year-old who did not qualify for Medicare, was interested in cervical artificial disc replacement. Although Medicare did not cover the procedure, David discovered that other medical coverage options were available. He decided to explore alternative health insurance plans to find coverage for his specific needs.

What Insurance Companies Cover Cervical Artificial Disc Replacement?

While Medicare does not cover disc replacement procedures, several insurance companies do. They include:

• Aetna
• AmeriHealth
• Anthem
• Blue Cross Blue Shield of North Carolina (some states do not cover cervical artificial disc replacement, so be sure to check first)
• Cigna
• Himark Blue Cross Blue Shield
• Humana
• Molina Healthcare Inc.
• United Healthcare

Although these companies offer coverage for disc replacements, there are restrictions and qualifications. For example, in most cases, patients must be skeletally mature to have the procedure done. This generally occurs once a person has reached 25 years of age.

There may also be out-of-pocket costs for the procedure. This is why understanding health insurance deductibles are so important. You can also take a look at the best insurance companies.

The above companies can also offer coverage for other disc replacement procedures (elsewhere on the spinal column). If you are someone with damage to more than one disc, check to see coverage options for multi-level cervical disc replacement.

While it may not cover cervical artificial disc replacement, Medicare is still useful for those who qualify. It does cover all sorts of other situations, including other types of back surgery. It’s worth taking the time to research to find what works best for you.

After all, everyone is different and has different needs. It makes sense that people will have different insurance needs, and a little research can save you a lot of money along the way.

If you are looking for other insurance types, enter your ZIP code into our tool below to compare health insurance, auto insurance, or any other insurance you may need to find the plan that fits your needs the best.