Does Medicare Part A cover outpatient surgery, or is that strictly under Part B?

Question

Don Hudson · Accepted Answer

Medicare Part A does not cover Outpatient surgery. Medicare Part B covers outpatient surgery with 20% coinsurance you are responsible for.

Norman Smith · Answer

Part A is strictly for your Hospital issues. Your Outpatient surgery and care are covered by your Part B only.

Charise Karjala · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/does-medicare-part-a-cover-outpatient-surgery-or-is-that-strictly-under-part-b#charise-karjala

Jonathan Potter · Answer

Part A covers hospital and Part B covers medical. Think of part A as the physical side of coverage and part B is the human side. Part B will cover the doctors fees and Part A will cover the facilities and other such fees.

Answered by Jonathan Potter on April 14, 2025

Broker Licensed in UT, AZ, CA & 14 other states

Answered by Jonathan Potter Medicare Insurance Agent

Joel Hill · Answer

Medicare Part A does not cover outpatient surgery — that falls under Medicare Part B.

Here’s a quick breakdown:
	•	Medicare Part A covers:
	•	Inpatient hospital care (when you’re formally admitted)
	•	Skilled nursing facility care (post-hospital stay)
	•	Hospice care
	•	Some home health care (under certain conditions)
	•	Medicare Part B covers:
	•	Outpatient surgery
	•	Doctor visits
	•	Preventive services
	•	Durable medical equipment (like walkers or wheelchairs)
	•	Outpatient diagnostic tests and lab work
	•	Emergency room services (unless admitted)

So if someone has outpatient surgery (not admitted as an inpatient), Part B is the part that pays — and it usually covers 80% after the deductible is met.

Steven Bleicher · Answer

If there is one main regulation to memorize it is that: an 80/20 ratio is the main rule of Medicare. Thus, if you are operated on in a hospital, Part A will pay the 80% and your alternate plan will pick up all or most of the remaining 20%. However, if that same operation takes place in a free-standing surgical center outside of a hospital, yes, only Part B will pay the 80% and the same 20% exists as above-mentioned. Just recall that anything of an experimental nature will NOT be paid for until the CDC & CMS combine to approve that treatment.

Answered by Steven Bleicher on May 30, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Timothy Brown · Answer

Medicare Part A covers inpatient services only which are the following:

1) Hospitalization (Surgery performed in the hospital)
2) Home Healthcare 
3) Skilled Nursing Facilities (For rehabilitation, not for long term care)
4) Hospice

Fred Manas · Answer

No, Medicare Part A does not cover outpatient surgery; it's typically covered by Medicare Part B. Part A primarily covers inpatient hospital stays and services, while Part B covers outpatient care, including doctor's visits, lab tests, and outpatient surgeries. 
Elaboration:
Medicare Part A:
This part of Medicare focuses on hospital coverage, including inpatient stays, skilled nursing facility care, and some home health services. It's essentially the hospital insurance component of Medicare. 
Medicare Part B:
This part covers a wide range of outpatient services, including doctor's visits, diagnostic tests like X-rays, and outpatient surgeries. It also covers services received in the hospital as an outpatient, such as surgery performed in a hospital's outpatient department. 
Outpatient Surgery:
When you receive surgery in a hospital or outpatient clinic, but don't stay overnight, it's considered outpatient surgery and is covered under Medicare Part B. 
Cost-Sharing:
Under Part B, after you meet your annual deductible, Medicare generally pays 80% of the approved amount for covered outpatient services, including surgery. You are responsible for the remaining 20% coinsurance. Additionally, you may incur extra costs for anesthesia, lab tests, or other related services.

Vachik Chakhbazian · Answer

Medicare Part A primarily covers inpatient hospital stays, while Part B covers outpatient services, including outpatient surgery. Outpatient surgery is generally covered under Medicare Part B, not Part A

Answered by Vachik Chakhbazian on July 24, 2025

Agent Licensed in CA, AL, AR & 22 other states

Answered by Vachik Chakhbazian Medicare Insurance Agent

Steve Brauer · Answer

Typically, the "outpatient surgeries" are covered under Part B of Medicare. There may be some situations where you are actually in the hospital and go home that same day, which may be covered under Part A of Medicare

Answered by Steve Brauer on April 8, 2025

Broker Licensed in AZ & CA

Answered by Steve Brauer Medicare Insurance Agent

Marcie Barnes · Answer

Medicare Part A is only for inpatient services.  Medicare Part B is for anything outpatient, including outpatient surgery and doctor visits.

Natalee Nimmo · Answer

That would be Medicare Part B. Part A is going to be hospitalization, (if you admitted into the hospital), skilled nursing, also known as rehab, hospice, home healthcare, and your first 3 pints of blood. Everything else is going to be under part B and if it’s a prescription, it would be under part D.

Answered by Natalee Nimmo on April 8, 2025

Broker Licensed in SC, FL, GA & KY, MO, NC & TX

Answered by Natalee Nimmo Medicare Insurance Agent

Sandy Hammond · Answer

So sorry for the delay in getting to this question!  Outpatient surgery is only covered under Medicare Part B, even if the outpatient surgery is performed at the hospital.   Hospital coverage Part A covers some of the costs associated with an in-patient hospital stay-key word being "in-patient" overnight hospital stay.
I hope I have answered your question.

George Francis · Answer

No, Medicare Part A does not cover outpatient surgery. Part A does cover surgery performed during an overnight hospital stay. Medicare Part B does cover minor outpatient surgery.

Lyle Affleck · Answer

To put it simply, no. Medicare Part A will only cover in-patient services offered through hospitals. Outpatient services (including those performed at surgical centers) are covered under Medicare Part B. But remember that a Part B plan, in and of itself, will only cover 80% of the total bill. That is why having a Medicare Supplement or a Medicare Advantage plan is so vitally important.

Answered by Lyle Affleck on July 28, 2025

Agent Licensed in UT, CO, FL & 8 other states

Answered by Lyle Affleck Medicare Insurance Agent

Jessica Breland · Answer

No, Medicare Part A is Inpatient coverage. Part A covers things like being an inpatient in a hospital, Hospice, Home Health & Skilled Nursing. Outpatient surgery would be covered by Part B.

Mike Sosso · Answer

Medicare Part A:  does not pay for outpatient surgery.  Part A covers inpatient services to include inpatient hospital care up to 150 days and inpatient skilled nursing care for up to but no more than 100 days per stay.  Part A has a modest deductible of $1676 for 2025, and is subject to per day coinsurance begining after day 60 of inpatient hospital care and day 20 of in-patient skilled nursing care. Medicare Part A does not pay for Long Term Care services. 

Medicare Part B: pays for outpatient surgery and all other Medicare appoved outpatient services like like Doctor Visits, Lab Work, Outpatient Surgery, Physical Therapy, etc. Part B has a monthly cost to obtain coverage. The cost in 2025 for most Americans is $185 per month. If your Adjustable Gross Income (AGI) is higher than most, the premium for Part B is higher.

Susan Winters · Answer

Medicare Part A generally does NOT cover outpatient surgery because it primarily covers inpatient hospital care, skilled nursing facility care, hospice, and some home health care.

Johnnie Jeter · Answer

Medicare part A may cover outpatient surgery, but part B typically covers the cost. For example if you need a more complex procedure part A may cover the cost.