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Does Medicare Cover Hemorrhoid Treatment?

Does Medicare cover hemorrhoid treatment?

If you’re affected by hemorrhoids, Medicare will cover necessary hemorrhoid treatment. If you’d like to learn more about Medicare Advantage coverage options for hemorrhoid treatment, give us a call today at (800) 950-0608.

Just the Essentials:

  • Hemorrhoids are a common affliction, with well over 3 million cases diagnosed each year.

  • Seniors are vulnerable to developing hemorrhoids for a variety of reasons.

  • Treatment for hemorrhoids is available for all levels of the disorder.

  • Medicare plans offer coverage for hemorrhoid treatment.

  • Call us today to learn more about Medicare Advantage plans near you that offer coverage for hemorrhoid treatment.

Medicare and treatment for hemorrhoids.

A Taboo Disorder That Should Be Discussed More

If you have this one particular condition, you’re probably extremely reluctant to talk about it. You’re also probably dealing with a lot of pain each and every day, especially if you’re choosing not to have it treated.

So, what is this very taboo disorder that few, including you, are willing to discuss?

We’re talking today about the condition known as hemorrhoids.

You’re probably one of millions of Americans who deal with hemorrhoids each and every day. However, you may be afraid to do anything about it for a number of reasons. For one, in our culture, the condition is rarely taken seriously.

Truth is, hemorrhoids are no joking matter. The condition starts rather benign, with some discomfort, swelling, or pain. Without treatment, it can get a lot worse.

Are you a senior in need of treatment for hemorrhoids? If so, you may be wondering if Medicare covers medical intervention for the condition. The answer is “yes”, Medicare coverage is available in some aspect for hemorrhoid treatment. This includes colonoscopies, noscopies, and proctoscopies during which hemorrhoids may be discovered.

What will Medicare cover in regards to hemorrhoid treatment? Let’s find out!

Symptoms of Hemorrhoids: What to Look For

Hemorrhoids come with a number of tell-tale signs and symptoms. The symptoms you experience will depend on what type of hemorrhoids you have. There are three different types:

  • External hemorrhoids
  • Internal hemorrhoids
  • Thrombosed hemorrhoids

External hemorrhoids are swollen veins that lie under the skin outside of your anal region. The key symptoms to look for if you suspect that you may have external hemorrhoids include:

  • Itching or irritation around the anal region
  • Pain or a feeling of discomfort
  • Swelling around the anal region
  • Bleeding

Internal hemorrhoids are veins that are swollen within the rectum. In many cases, you won’t feel discomfort with these. However, if you try to strain, or you feel irritation, during a bowel movement, you may notice:

  • Painless bleeding (seen in small amounts of bright red blood on toilet paper or in the toilet)
  • A hemorrhoid prolapses (pops) through the anal opening, causing pain and irritation

Thrombosed hemorrhoids are external hemorrhoids where blood has pooled and thrown a clot. These can be extremely serious and harmful if not treated immediately. Symptoms and signs of thrombosed hemorrhoids include:

  • Severe pain and swelling
  • Inflammation around the anal region
  • A hard lump near the anus

All three require different forms of intervention. Starting with external hemorrhoids, let’s take a look at available treatments for hemorrhoids.

What kinds of hemorrhoid treatment will Medicare cover?

External Hemorrhoid Treatment

In most cases, your doctor’s course of external hemorrhoid treatment may rely on home remedies and Over-the-Counter (OTC) medications. This is especially true if your case of hemorrhoids is relatively mild.

If you’re not feeling serious pain or discomfort, or experiencing serious swelling in external hemorrhoids, your care provider will likely suggest the following:

  • Eating high-fiber foods to soften stool, helping you avoid straining during bowel movements
  • Soaking in a warm bath for 10 to 15 minutes, two to three times a day*
  • Taking oral pain relievers, such as Tylenol, Advil, or aspirin

Your care provider may also suggest the use of OTC topical treatments designed to help manage the symptoms of hemorrhoids. These typically come in the form of creams and ointments, though pads are available as well.

*It is suggested that you add no external elements, such as epsom salts or scented soaking liquid, to the water before your bath. Doing so can result in additional and unnecessary pain and swelling.

Will Medicare pay for treatment for hemorrhoids?

Internal Hemorrhoid Treatment

The course of treatment for mild to moderate internal hemorrhoids will likely follow the same course as the treatment for external hemorrhoids. Your care provider will likely suggest the same course of home remedies and OTC treatments. However, instead of creams, pads, or ointments, they may suggest the use of suppositories designed to curb symptoms that come with internal hemorrhoids.

Surgical Intervention for Severe Internal, External, and Thrombosed Hemorrhoids

If your hemorrhoids are severe enough to impact your daily life, surgical intervention may be required. This is especially true for thrombosed hemorrhoids, which can be life-threatening if they aren’t treated.

The severity of hemorrhoids is determined by a grading system, which is laid out as follows:

  • G1: Bleeding, no prolapse
  • G2: Prolapse with spontaneous reduction
  • G3: Prolapse, manual reduction required
  • G4: Prolapse, incarcerated and irreducible

Surgical intervention is saved for patients with G3 or G4 hemorrhoids. 

If you’re a patient with G1, G2, or mild G3 hemorrhoids, the following minimally invasive procedures are available to you to help you get rid of them:

  • Rubber band ligation – two small rubber bands are placed around the base of an internal hemorrhoid to cut off its circulation; the hemorrhoid withers and falls off within a week
  • Sclerotherapy – a chemical solution is injected into an internal or external hemorrhoid to shrink it down
  • Coagulation – Laser or infrared lights are used to coagulate the blood inside of an internal hemorrhoid, causing it to harden and shrivel

If you suffer from G3 or G4 hemorrhoids, your care provider may suggest the following operative procedures:

  • Hemorrhoid stapling – staples are used to block blood flow to hemorrhoidal tissue (this procedure is typically reserved for internal hemorrhoids)
  • Hemorrhoidectomy (hemorrhoid removal surgery) – a surgical procedure in which hemorrhoidal tissue that causes bleeding is removed

As surgical intervention can be expensive, you may be wondering if a Medicare plan will cover it. This is especially true for those of you who may be living on low fixed incomes. Let’s take a look into what Medicare plans may or may not cover in relation to hemorrhoid surgery.

Does Medicare Pay for Hemorrhoid Surgery?

If you’ve gotten this far, and you’ve been told that hemorrhoid removal surgery is needed to resolve your condition, you may be thinking one thing:

“Does Medicare pay for hemorrhoid surgery?”

Yes, Medicare will pay for hemorrhoid surgery. However, in most cases, you must meet certain conditions before it will do so.

Original Medicare, Medicare Parts A and B, will cover 80 percent of the costs of a hemorrhoid removal surgery. You’ll be responsible for the other 20 percent Out-of-Pocket. Before Original Medicare will cover surgical intervention for hemorrhoids, you’ll need to meet the following criteria:

  • You have anal fissures
  • You’ve tried other treatment methods with no success

Medicare Advantage plans also provide coverage for hemorrhoid removal surgery, but they may also provide coverage and benefits for aftercare and other internal or external hemorrhoid treatment. Before you start planning for your surgery or other hemorrhoid treatment, it’s important to look at your plan first. What’s covered and what isn’t will depend solely on the specifics of your plan.

If you have Original Medicare, and you know you’ll have trouble covering the 20 percent you’ll need to pay, Medigap supplemental insurance may be able to help. This insurance is meant to “fill in the gaps” by providing coverage for items like coinsurance and copays.

Don’t Delay - Get the Treatment You Need

While Original Medicare may cover only surgical intervention and exams, a Medicare Advantage plan may offer extra coverage for other types of hemorrhoid treatment. For example, some Medicare Advantage plans offer allowances for the types of OTC treatments that are often advised by medical professionals.

If you’re interested in Medicare Advantage plans, our licensed insurance agents are here to answer any questions you may have. Give us a call to connect with someone who can walk you through the ins and outs of Medicare Advantage plans in your area.

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