Does Medicare Advantage cover Hysterectomy?

Yes. Medicare Advantage plans must cover the same medically necessary services as Original Medicare. Cost sharing differs - usually a flat copay instead of 20% coinsurance. Medicare Advantage plans may require prior authorization even when Original Medicare does not.

What is the Medicare Part B deductible in 2026?

The 2026 Part B deductible is $257. You pay this amount once per year before Medicare starts covering its 80% share. A Medigap supplement policy (Plan G, Plan N, etc.) can cover this deductible for you.

Does Medigap (Medicare supplement) cover my coinsurance?

Yes. Most Medigap plans (Plan G, Plan F, Plan N) cover the 20% coinsurance you owe after Original Medicare pays its 80% share. Plan G is the most comprehensive supplement currently available to new Medicare enrollees.

Gynecologic Surgery

John Caruso, FSA, MAAA • June 26, 2026 • 7 min read

Medicare Part B covers Hysterectomy at 80% after the Part B deductible. Here's the full cost-sharing breakdown, admission status rules, and Medicare Advantage differences.

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Does Medicare Cover Hysterectomy? (2026)

Q: Does Medicare cover Hysterectomy?

Yes. Medicare Part B covers medically necessary hysterectomy. You pay 20% coinsurance after the $257 Part B deductible (2026). Original Medicare has no annual out-of-pocket cap - Medigap supplements fill this gap.

Yes. Medicare covers medically necessary hysterectomy: Part A if admitted inpatient, or Part B if performed as an outpatient procedure. Prior authorization is not required under Original Medicare but is commonly required under Medicare Advantage.

Quick answer:

Inpatient hysterectomy: Part A - $1,676 hospital deductible (2026), then $0 days 1–60
Outpatient hysterectomy (HOPD or ASC): Part B - 80% after $257 deductible
Prior authorization: Not required under Original Medicare; required under many Medicare Advantage plans

Part A vs. Part B

Part A (inpatient):

Formal inpatient admission order
$1,676 deductible covers days 1–60
Used for complex cases, expected complications, or longer recovery

Part B (outpatient):

Laparoscopic and robotic hysterectomies increasingly done outpatient
20% coinsurance on facility, surgeon, anesthesiologist, and pathology separately

What Medicare Covers

The hysterectomy procedure (various CPT codes depending on approach: vaginal, abdominal, laparoscopic)
Anesthesia (billed separately, 80% under Part B)
Pathology of removed tissue (billed separately by lab)
One pathologist's interpretation (professional component, 80% under Part B)

Medicare Advantage Considerations

MA plans require prior authorization for hysterectomy in most cases. Required documentation typically mirrors commercial plans: indication documentation, prior non-surgical treatment records, and sometimes a second opinion requirement.

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About the Author

John Caruso, FSA, MAAA

Healthcare actuary with 20+ years of experience in insurance pricing, medical billing systems, and healthcare cost analytics.

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