How Much Does a Heart Surgery Cost on Medicare?
How much does heart surgery cost? It is one of the first things Medicare recipients ask when they need a big medical treatment, like heart surgery. A report from 2021 by the Kaiser Family Foundation found that a one-day hospital stay in the U.S. costs about $2,883. But people who have heart surgery often have to stay in the hospital for a few days. This means that the costs can add up quickly.
Luckily, Medicare helps pay for the cost of open heart surgery. How much you have to pay out of pocket will depend on the type of Medicare benefits you have. There are three main ways this could go, which will help you understand how much heart surgery might cost you on Medicare.
Heart Surgery Cost with Original Medicare (No Supplement)
If you have Original Medicare Parts A and Part B without any Medigap supplement plan, you will pay the Part A deductible for inpatient hospital care.
In 2025, the Part A deductible is $1,676. No matter how long you stay in the hospital, this deductible covers the first 60 days of care. That means the open heart surgery cost will be the same, $1,676, whether you stay for three days or fifty days.
That means if you are admitted for heart surgery, your out-of-pocket cost under Original Medicare will be this deductible amount. After that, Medicare pays for your hospital stay for the first 60 days in full.
Important: Fewer than one in ten Medicare beneficiaries have Original Medicare alone, with no supplemental coverage. Most choose to add a Medigap plan or Medicare Advantage plan to help lower their out-of-pocket costs.
Open Heart Surgery Cost with Original Medicare + Medigap Plan
If you have a Medigap plan such as Plan G or Plan N, your out-of-pocket costs for heart surgery can be dramatically reduced.
Medigap plans are designed to cover most of the costs that Original Medicare leaves behind. Plans G and N will pay your Part A hospital deductible, which means your cost for a 3-day hospital stay for heart surgery would be $0 out of pocket.
Keep in mind, though, that you do pay a monthly premium for your Medigap plan. So while you may not receive a bill after your heart surgery, you have been paying to keep that supplemental coverage active.
Important: Plans for Medigap are regulated, which means that Plan G from one insurance company covers the same things as Plan G from another. What is different is the amount of money you pay each month.
Heart Surgery Cost with Medicare Advantage (Part C)
Many beneficiaries choose a Medicare Advantage plan (Part C) instead of Original Medicare. These plans often have little to no monthly premiums, but they usually charge daily copays for hospital stays.
On average, in states like Ohio, Medicare Advantage plans charge about $300 per day for inpatient hospital care. For example, if you are in the hospital for three days following heart surgery, you could expect to pay around $900 total out of pocket.
The good news is that you won’t have to pay extra for the actual surgery, tests, or medications during your stay. Your per-day copay covers it all. It makes Medicare Advantage a popular choice for people who want lower monthly costs and are comfortable with some cost-sharing when they need care.
Comparing the Three Options
When comparing the three main ways Medicare covers a 3-day hospital stay for heart surgery, the costs can look very different. With Original Medicare (no supplement), you are responsible for the Part A deductible, which in 2025 is $1,676. It covers up to 60 days of inpatient care. If you have Original Medicare with a Medigap plan, such as Plan G or Plan N, your out-of-pocket cost for the hospital stay would be $0, since the plan covers your Part A deductible. However, you still pay monthly premiums for that extra protection. People who choose a Medicare Advantage plan (Part C) will usually have to pay a daily copay for their stay. This is usually around $300 per day, or $900 for three days in the hospital.
It’s also important to consider network participation, especially if you have a Medicare Advantage plan. Using an in-network hospital ensures you receive the contracted rates and avoid unexpected bills. Another factor to review is your plan’s annual out-of-pocket maximum. You should also look at your plan’s annual out-of-pocket limit. Medicare Advantage limits how much you can spend each year, which can help protect your finances if you need more hospital stays or treatments after surgery.
By looking at these costs side by side, you can see that Medigap plans provide the lowest out-of-pocket costs at the time of surgery, while Medicare Advantage offers predictable per-day copays and an annual spending limit. Original Medicare alone leaves you responsible for the full Part A deductible, which can be costly if you’re admitted multiple times in a year.
Other Things to Consider Before Heart Surgery
When planning for a major procedure like heart surgery, it’s important to ask these questions:
Is your hospital in-network?
If you have Medicare Advantage, confirm your hospital is in-network to avoid higher costs.
Do you have a spending limit?
Medigap plans cover nearly all hospital costs, but Medicare Advantage plans have annual out-of-pocket maximums you should know about.
Do you have other health needs coming up this year?
If you expect multiple hospital visits, your total out-of-pocket costs could be higher with Medicare Advantage.
Bottom Line: Understanding Heart Surgery Cost on Medicare
Heart surgery is one of the most expensive procedures in healthcare, but the heart surgery cost on Medicare provides strong financial protection, as long as you know how your plan works.
- Original Medicare alone leaves you with the Part A deductible.
- Medigap plans can lower your cost to $0, but come with monthly premiums.
- Medicare Advantage plans spread the cost over daily copays but often have no monthly premium.
Need Help Choosing the Right Medicare Coverage?
We help people understand Medicare and choose the best plan for their needs at LMS Insurance Group. We can help you understand your choices, with no cost to you, whether you want the security of a Medigap plan or the low cost of Medicare Advantage.
Forget about having to pay a huge medical bill; call LMS Insurance Group right now, and we will help you find a Medicare plan that works for you.
