Does Medicare Cover Wound Care

Does Medicare Cover Wound Care? 

Proper healing and wound care can be a concern for people recovering from illness, injury, or surgery. No matter the size of the wound, improper recovery care and cleaning can lead to infections and other adverse health problems. 

Wounds form a scar and regenerate in order to heal. During regeneration, new tissue replaces damaged tissue to return function to that part of the body and repair the damage. If a scar forms, your previously damaged tissue gets replaced by a fibrous scar tissue that has different properties. 

For bedridden individuals, seniors, or people who live with diabetes, wound care is necessary to help avoid serious health complications. People who are especially vulnerable to chronic wounds like leg ulcers, pressure ulcers, and diabetic foot need proper care to help prevent infections and help minimize scarring. Medicare recipients may wonder if their Medicare coverage will take care of the cost. 

Do Medicare benefits extend to wound care?

Medicare Part B includes coverage for wound care and surgical dressing services if it’s deemed medically-necessary by a Medicare-approved physician. Depending on the surgery or illness causing the wound, some wounds may be closed with sutures while others may be left open to heal under some circumstances. 

Under Part B benefits, Medicare recipients can get up to 80% coverage for any Medicare-approved services. The provider has to accept Medicare assignment. You are responsible for paying the remaining 20% of the Medicare-approved costs. If you have wound care services in a hospital as an outpatient, you may have a fixed copayment. The Part B deductible will also apply. 

Part B will help pay for the supplies and materials that they use during wound care appointments. Medicare defines these supplies as protective fillers or covers, gauze, adhesive tape, and bandages that doctors use on wounds due to burns, ulcers, or surgical procedures. The Medicare Part B benefits cover the cost if they are considered to be medically necessary to help treat and heal your surgical wounds. 

For Medicare recipients who have a Medicare Advantage plan through a private company, you’ll get the same amount of coverage that you would get under Original Medicare. You may want to call your individual provider’s office and get more information regarding any additional benefits you may have for wound care services. All Medicare Advantage plans vary slightly in costs and benefits.

Wound care benefits

There are several benefits that come with having proper wound care after a surgical procedure. It can help to minimize the scarring, prevent infection, and speed up your healing process. When you go in, and your wound care doctor changes your dressing, they get a chance to see how well the wound is healing. They can also check for complications like discharge, unusual warmth, or bleeding. You want to clean the wound once a day at the very least, and you should apply a special disinfectant with new bandages to keep the area clean and healing. Your doctor will give you instructions to follow. If you have any questions, contact your medical providers immediately.

When the wound is healing, the area should stay soft to prevent hard scabs from forming. This can reduce scarring at the end of the healing process. Your wound care doctor can apply an antibiotic ointment to the wound to help keep the entire area supple and soft. 

Wound care cost

The average cost for wound care services per wound is around $4,000. Jeopardized grafts or flaps are more expensive, and it can cost around $9,400 to heal per wound. A diabetic foot ulcer is one of the most expensive types of chronic ulcers, and they can cost twice as much for wound care services at $5,400 per wound if you had to pay out of pocket.