Proper wound care and healing can be a concern for patients recovering from an injury, surgery, or illness. Even with the smallest of wounds, improper cleaning and recovery care can lead to health complications.
Wounds heal through regeneration or by forming a scar. In regeneration, damaged tissue is replaced by new tissue of the same type to repair the damage and return function to the injured part of the body. When a scar forms on a wound, the damaged tissue is replaced by scar tissue that is fibrous and has different properties than the original tissue.
Proper wound care after surgery is essential for the healing process. How fast you heal depends on the type of surgery you have as well as your general health. In most cases, a large or deep incision takes from six to eight weeks to heal. During recovery it is necessary to get care for the wound and have the right type of dressings applied.
For seniors, individuals who are bedridden, or people living with diabetes, proper wound care is necessary to avoid serious complications. These groups of people are especially vulnerable to chronic wounds such as pressure ulcers, leg ulcers, or a diabetic foot.
Regardless of the type of healing involved, it is imperative to apply proper care to the wound to prevent infection or other complications, and to assist the healing process so there is less scaring.
If you are scheduled for surgery, you’ll want to know if your Medicare benefits will cover wound care during your recovery.
Do Your Medicare Benefits Cover Wound Care?
Medicare categorizes wound care under the heading of surgical dressing services. Through Medicare Part B (medical insurance), you may have coverage for medically necessary treatment of surgical or surgically treated wounds.
A surgical wound occurs when the skin is cut by a scalpel during surgery. The size of the wound depends on the type of surgery or extenuating circumstances. These incisions are commonly closed with sutures or left open to heal in some cases.
Through your Medicare Part B benefits, Medicare covers 80 percent of Medicare approved costs for the services provided by your health care provider for wound care. You are responsible for the remaining 20 percent. You also pay a fixed copayment if the wound care services are provided in a hospital on an outpatient basis. You are also responsible for the Part B deductible which is $185.00 (as of 2019).
With Medicare Part B coverage, you do not have to pay anything for the materials and supplies that are used for your wound care. According to Medicare, wound care supplies include protective covers or fillers, adhesive tapes, gauzes, and bandages used for wounds due to surgical procedures, ulcers, or burns. They are covered by your Medicare Part B benefits if they are medically necessary for the treatment of wounds from surgery.
If you have a Medicare Advantage (Part C) plan through a private insurance company, they are required to offer the same coverage that is provided by Original Medicare Parts A and B. You can get more information about the coverage of wound care from a representative at your insurance provider’s office.
What Are The Health Benefits of Proper Wound Care?
Proper wound care aids in preventing infection, minimizing scarring, and in accelerating the healing process. When your health care provider changes your dressings, he or she can check how well the wound is healing, check for complications such as bleeding, unusual warmth, or discharge. It is important to clean a wound daily with a special disinfectant and apply new dressings.
During the healing process, it is best for a wound to remain soft so hard scabs do not form and later cause excessive scarring. Your health care provider may apply an antibiotic ointment to the wound to keep it, and the surrounding skin, soft and supple.
For more information about coverage for wound care through Medicare benefits, discuss your concerns with your physician and check with your plan directly for more details.