Does Medicare Cover Open Heart Surgery?

After paying your deductible, Medicare Part A covers heart surgery expenses during inpatient hospital stays, up to 60 days. Open heart surgery, like coronary artery bypass, is included. Medicare also supports post-surgery cardiac rehabilitation. Consider a Medicare Part D drug plan for prescription drug costs post-surgery.

Terry Turner, writer and researcher for RetireGuide
  • Written by
    Terry Turner

    Terry Turner

    Senior Financial Writer and Financial Wellness Facilitator

    Terry Turner has more than 35 years of journalism experience, including covering benefits, spending and congressional action on federal programs such as Social Security and Medicare. He is a Certified Financial Wellness Facilitator through the National Wellness Institute and the Foundation for Financial Wellness and a member of the Association for Financial Counseling & Planning Education (AFCPE®).

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  • Edited By
    Lee Williams
    Lee Williams, senior editor for

    Lee Williams

    Senior Financial Editor

    Lee Williams is a professional writer, editor and content strategist with 10 years of professional experience working for global and nationally recognized brands. He has contributed to Forbes, The Huffington Post, SUCCESS Magazine,, Electric Literature and The Wall Street Journal. His career also includes ghostwriting for Fortune 500 CEOs and published authors.

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  • Published: May 18, 2021
  • Updated: October 23, 2023
  • 6 min read time
  • This page features 6 Cited Research Articles
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APA Turner, T. (2023, October 23). Does Medicare Cover Open Heart Surgery? Retrieved July 24, 2024, from

MLA Turner, Terry. "Does Medicare Cover Open Heart Surgery?", 23 Oct 2023,

Chicago Turner, Terry. "Does Medicare Cover Open Heart Surgery?" Last modified October 23, 2023.

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Open Heart Surgery Coverage at a Glance

Medicare PlanOpen Heart Surgery Coverage
Part A (Inpatient)Covers surgery and Medicare-approved costs of your hospitalization after you have reached your Part A deductible. You are responsible for coinsurance costs for stays beyond 60 days.
Part B (Outpatient)Covers 80% of non-hospital preoperative care costs and doctors visits, plus up to 36 cardiac rehab sessions over a period of up to 36 weeks, after you have reached your Part B deductible.
Part C (Medicare Advantage)Covers everything covered by Medicare Part A and Part B. Select plans may offer additional benefits.
Part D (Prescription Drugs)Covers related prescriptions including blood thinners, blood pressure medications and cholesterol-controlling drugs.
Supplemental InsuranceCan help cover out-of-pocket costs related to open heart surgery. Coverage varies by plan.

Coverage for Open Heart Surgery

Original Medicare — Medicare Part A and Part B — covers most of the cost of open heart surgery. The procedure is often called bypass surgery, and it routes blood flow around blocked arteries in your heart.

How Different Parts of Medicare Cover Open Heart Surgery
Medicare Part A hospital insurance
Medicare Part A applies if you are admitted as an inpatient in a hospital setting. It covers the cost of your surgery and Medicare-approved costs of your hospitalization after you have paid your Part A deductible. You are responsible for coinsurance costs if you are hospitalized beyond 60 days. Covered services include a semi-private room, meals and medications you receive while in the hospital.
Medicare Part B medical insurance
Medicare Part B covers 80% of your non-hospital pre-operative care and tests, doctor visits and cardiac rehab after you have paid your Part B deductible. You are responsible for 20% of the Medicare-approved costs for medical services in addition to your deductible.
Medicare Advantage plans
Medicare Advantage plans are sold by private insurers and are required by law to cover everything Medicare Part A and Part B cover. But your policy may provide additional benefits. Most Medicare Advantage plans also include Medicare Part D prescription drug coverage. Check with your plan’s administrator about what your particular plan covers.
Medicare Part D prescription drug plans
Medicare Part D plans can help with the cost of prescription drugs you will need after open heart surgery. Each plan has its own Part D formulary — a list of prescription drugs it covers. Check with your plan’s administrator and your doctor to determine whether your prescriptions are covered. If they’re not, there may be an alternative drug that is covered.
Medigap (Medicare Supplement) insurance
Medigap policies are sold by private insurers and can help you cover your out-of-pocket costs if you have Original Medicare. Medigap policies cover all or part of your deductibles, copayments and coinsurance. Your plan’s administrator can tell you which costs you will still be responsible for.

Your Medicare plan may not specifically mention open heart or bypass surgery coverage. But Medicare covers procedures that a doctor or other medical specialist deems medically necessary. Open heart surgery generally meets the standard of being reasonable and necessary to protect a patient’s health and wellness.

Coverage for Cardiac Catheterization

Medicare also covers minimally invasive heart disease treatments that may be a viable alternative to open heart surgery. These laparoscopic surgeries use small incisions and with the surgeon using tubes and small instruments to repair the blockages.

These procedures are collectively called cardiac catheterization because they involve catheters inserted into the affected heart arteries.

Cardiac Catheterization Alternatives to Open Heart Surgery
Balloon angioplasty uses a catheter to place a medical balloon into the blocked artery. The balloon is inflated, it opens the narrowed artery and improves blood flow. This procedure does not always result in long-term improvement.
Similar to an angioplasty, a metal stent is inserted into the blocked artery. It is expanded, opening the blockage and holding the artery open for years or decades. This procedure can cause blood clots, which are often treated with prescription blood thinners.

Typically, cardiac catheterization is covered by Medicare Part B medical insurance. You are responsible for your Part B deductible. After that, Medicare pays 80%, and you pay 20% of the costs.

Medicare Part A hospital insurance covers the procedure if you’re admitted to a hospital and remain an inpatient through at least two midnights in a row during which the procedure is performed.

Doctors often prefer cardiac catheterization procedures over open heart surgery when possible. They tend to be less risky. But open heart surgery may be necessary in a cardiac emergency.

Medicare and Cardiac Rehab

Medicare Part B helps pay for cardiac rehabilitation after you have open heart surgery or other heart procedures. You are responsible for your Part B deductible, then Medicare will pay 80% of the cost and you will pay the remaining 20%.

Kaiser Health News reported in 2016 that the average out-of-pocket cost for people with Original Medicare was $20 per session, but that having a Medigap plan reduced that to zero. Copayments for people with Medicare Advantage plans ranged from zero to $60 per session. You should check with your plan’s administrator to see how much you may have to pay.

Medicare will pay for up to 36 cardiac rehab sessions over a period of up to 36 weeks. You can participate in up to two, one-hour sessions per day until you’ve completed the covered sessions. In certain cases, Medicare may cover an additional 36 sessions.

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Open Heart Surgery Costs

Open heart surgery can be extremely expensive without Medicare or other insurance.

The Kaiser Family Foundation estimated that the average inpatient cost ranged from $75,688 to $117,000 in 2018 depending on complexity of the surgery and whether there were complications.

Original Medicare does not cover prescription drugs. But you can buy a Medicare Part D prescription drug plan. Most Medicare Advantage plans also include their own Part D plan.

These plans can help with the cost of prescription drugs you will have to take after your surgery, such as blood thinners, blood pressure medications and cholesterol-controlling drugs.

Select Blood Thinner Retail Prices without Medicare or Other Insurance (2022)
Prescription MedicationRetail Price
Brilinta (ticagrelor)$421–$515 per month
Plavix (clopidogrel)$5.45–$114 per month
Coumadin, Jantoven (warfarin)$4–$23 per month
Source: GoodRx

The monthly cost of statins — the go-to drugs for controlling cholesterol — can range from $29 for a generic to $430 for a brand name drug.

If you have a Medicare Advantage or Medicare Part D prescription drug plan, your choices may be limited by the plan’s formulary. Ask your plan administrator which drugs are covered, whether there are safe alternatives to a drug that isn’t covered under your formulary, and what your out-of-pocket costs will be.

Common Questions About Using Medicare for Open Heart Surgery

Does Medicare pay for inpatient rehab after open heart surgery?
Medicare covers both inpatient and outpatient cardiac rehabilitation following open heart surgery. However, you may have to pay both Medicare Part A and Part B deductibles and coinsurance.
Does Medicare cover heart bypass or heart valve surgery?
Medicare covers most of the costs for heart bypass, heart valve surgery and other cardiovascular treatments. But you may have to pay a portion of the cost in deductibles and coinsurance.
Can you be denied open heart surgery if Medicare deems you in poor health?
Medicare will cover your open heart surgery if it is medically necessary and meets FDA guidelines. It may not pay for the surgery if the doctor or other health care provider does not take Medicare.
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Last Modified: October 23, 2023

6 Cited Research Articles

  1. McDermott, D. et al. (2020, November 4). How Costly Are Common Health Services in the United States? Retrieved from
  2. Appleby, J. (2016, August 31). Cardiac Rehab Improves Health, But Cost and Access Issues Complicate Success. Retrieved from
  3. Roger, V.L. et al. (2011, February 1). Heart Disease and Stroke Statistics – 2011 Update; A Report from the American Heart Association. Retrieved from
  4. U.S. Centers for Medicare & Medicaid Services. (2019, July). Learning What Medicare Covers & How Much You Pay. Retrieved from
  5. U.S. Centers for Medicare & Medicaid Services. (n.d.). Cardiac Rehabilitation. Retrieved from
  6. U.S. Centers for Medicare & Medicaid Services. (n.d.). Surgery. Retrieved from