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Medicare Coverage for Wound Care and Supplies


Medicare will cover wound care for all beneficiaries, regardless if it’s done in an inpatient or outpatient setting. Wound care can end up being extremely expensive. As we age, we’re more susceptible to injuries or wounds. Some people suffer from post-surgical lesions. Others may suffer from chronic fungal or viral wounds. Because of the prevalence of wounds with age, it’s easy to see why Medicare would cover this treatment. Below, we’ll go over what you need to know about Medicare coverage for wound care.

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Medicare Guidelines for Wound Care

Medicare will cover treatment for surgical wounds. Also, Medicare covers chronic wounds; you may end up getting. Medicare covers wound care supplies for many different types of wounds. Some of the lesions may be from surgeries, ulcers, burns, or flesh wounds. Depending on if you receive wound care as an inpatient or outpatient will determine which part of Medicare will cover the cost.

Inpatient Wound Care Coverage Under Medicare

If you receive wound care in inpatient settings like a hospital, rehab facility, or Skilled Nursing Facility, coverage would fall under Part A. There is a deductible under Part A. Most Medicare Supplement plans will cover this deductible.

Outpatient Wound Care Coverage Under Medicare

If you receive wound care in an outpatient setting, such as at your doctor’s office, coverage would fall under Part B. Part B also covers Durable Medical Equipment. This includes any supplies that are medically necessary to treat your wound. Just like Part A, Part B also comes with a deductible. However, if you have a supplemental plan, it could be covered.

Wound Care Supplies Covered by Medicare

Medicare will cover primary and secondary wound dressings for your injuries. Primary dressings apply directly to your injury, and secondary forms of dressings are like aids to the primary dressings. Secondary dressings are bandages, gauze, and adhesive tape.

  • Hydrogel Dressings
  • Hydrocolloid Dressings
  • Gauze
  • Foam Dressings
  • Alginate Dressings

Medicare Documentation Requirements for Wound Care

Your doctor will need to provide documentation that your wound is still present. Medicare only covers wound treatment if you have the necessary documents.

  • Evidence of your wound
  • Size of your wound
  • The extent of damage your injury is causing
  • Any necessary drainage needs

Medicare Advantage Coverage for Wound Care

With Medicare Advantage, our cost-sharing is dependent on the carrier. It’s extremely difficult to predict how much you’ll pay out of pocket with a Medicare Advantage plan. You would want to contact the carrier directly to find out how much they will cover and what your cost-sharing will be.

Medicare Supplement Coverage for Wound Care

Cost-sharing is predictable when it comes to Medicare Supplements. As long as Part A & Part B pays, your Medigap plan will pay all or most of the remaining costs. If you have Plan F, you will pay zero out of pocket. If you have Plan G, you’ll only pay the Part B deductible.

FAQs

Does Medicare pay for wound care in a skilled nursing facility?
You can receive necessary wound care in a skilled nursing facility if you qualify. When you stay in a nursing facility, the treatment falls under your Part A benefits.
Will wound care supplies be considered Durable Medical Equipment?
Yes, you’ll be able to get wound care supplies form a Durable Medical Equipment supplier.
Which wound care supplies does Part B cover?
Part B will cover several different forms of wound dressings. For example, Medicare will cover hydrogel dressings, hydrocolloid dressings, gauze, foam dressings, and alginate dressings.
Does Medicare cover InterDry?
InterDry is a protectant for your skin. It helps manage your skin folds and can help keep your skin dry. Since InterDry is a single-use wound care item, Medicare won’t cover it.
Does Medicare cover in-home wound care?
Yes, but Medicare will only cover intermittent nursing services. Skilled nursing care could include in-home wound dressings.
Does Medicare cover a wound vac?
Yes, a wound vac wound falls under Part B.
Does Medicare cover negative pressure wound therapy?
NPWT is when sub-atmospheric pressure is applied to your wound. This application removed exudate and debris. It can be done through a suction pump, dressing sets, or a separate exudate collection chamber. As long as your doctor has a record of other treatments tried, Medicare will cover NPWT.

How to Get Help with Your Wound Care Costs Under Medicare

Medicare may cover many of the wound care services you need, but certainly not all. Medigap can help cover the deductibles and coinsurances you’d otherwise pay. To find the best supplement plan for you, call our team of agents at the number above today. We can identify the most affordable policy in your area. If you can’t call now, fill out an online rate form and compare plans in your area!

Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

31 thoughts on “Medicare Coverage for Wound Care and Supplies

  1. Yes it is helpful, but how many days will Medicare pay for an in home nursing care for a wound. I have been told that the dressing needs to be changed 2x a day.

    1. As long as the care given is through a Medicare-certified home health agency, Medicare will pay the full cost for up to 60 days. After 60 days, Medicare will review your plan of care with your doctor to determine if care should be continued or not.

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