A:

These include pacemakers, defibrillators, joint replacements and other devices that are surgically implanted during a stay in hospital. There are often a number of different choices available with any particular prosthesis, which can vary in cost and benefits.

The Department of Health and Aging has set a Prosthesis List with the majority as ‘No Gap’ which means you do not need to pay any out-of-pocket expenses. You and your surgeon will be able to choose a prosthesis for every Medicare procedure from the prosthesis list that will be fully covered by ACA Health.

In the situation where a more expensive prostheses is available for your surgery, and you elect to use one of these, you will have to pay the gap amount.

Before you have any surgery, check with ACA Health that you will be covered under your current policy.