To help with tremors, a surgeon may place electrodes in particular parts of your brain during a technique called deep brain stimulation. For those who are eligible, deep brain stimulation is covered by Medicare.

Does Medicare cover deep brain stimulation?

Deep brain stimulation for Parkinson’s disease, Parkinson’s tremor, and essential tremor are covered by Medicare. Medicare Part A (hospital insurance) will pay for the Medicare-approved expenses because this operation is done in a hospital.

Presurgery testing conducted in an outpatient clinic or institution, authorized lab work, neurology visits, and follow-up care will all be covered by Medicare Part B.

If you require prescription medicine after your deep brain stimulation procedure, Medicare Part D will pay for it. The prescriptions you require and your particular plan will determine your out-of-pocket expenses.

The fees associated with Medicare Part C (Medicare Advantage) will vary depending on your plan and place of residence.

Who qualifies for Medicare coverage for deep brain stimulation?

Deep brain stimulation is covered by Medicare if you:

• have received a diagnosis of essential tremors
• have received a diagnosis of idiopathic Parkinson’s disease
• are severely restricted in your capacity to carry out everyday tasks because of tremor
• since you will be cognizant throughout the process, you can follow the doctor’s directions.
• are allowed to participate in and attend postoperative evaluations

Who may not qualify for deep brain stimulation?

Deep brain stimulation might not be a useful option for certain tremor-prone Parkinson’s disease patients. For some individuals, deep brain stimulation might not be covered by Medicare.

Deep brain stimulation may not be covered by Medicare if you:

• have non-idiopathic Parkinson’s disease
• have Parkinson’s plus syndrome
• possess dementia or another form of cognitive impairment that deep brain stimulation may exacerbate.
• have depression, psychosis, or a substance use disorder
• possess alterations in the brain, such as vascular malformations, tumors, basal ganglionic stroke, or other structural brain abnormalities.
• having undergone prior operations in the same brain region
• possess other ailments that deep brain stimulation surgery would exacerbate

What can you expect to pay for deep brain stimulation?

Your $1,676 Part A deductible will be included in your 2025 out-of-pocket expenses. You will be charged $419 per day for inpatient days 61 through 90 and $816 per day for inpatient days 91 through 150 if you stay in the hospital for more than 60 days.

Your Part B monthly premium of $185, your Part B deductible of $257, and your Part B 20% coinsurance payments will also be considered out-of-pocket expenses in 2025.

For Medicare Part D-covered prescription drugs, the deductible is $2,000 in 2025.

The plan you select will determine your fee if you have Medicare Part C (Medicare Advantage).

Takeaway

If you are eligible for deep brain stimulation, Medicare will pay for it. However, Medicare will not pay for certain individuals who are not appropriate candidates for this operation.

Your medical team can assist you in determining whether deep brain stimulation is beneficial to you and whether the costs will be covered by your Medicare benefits.

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