Fair Square Medicare Wordmark

Does Medicare Cover an FMT?

Fecal microbiota transplant from healthy in unhealthy intestine, FMT. Improvement intestinal microflora and normalization stool by introducing beneficial bacteria in bowel colon tract. Vector stock illustration
By Daniel Petkevich
Dec 2, 2022

Usually not, but you might qualify

If you are interested in a Fecal Microbiota Transplantation, your coverage might depend on where you live. There currently is no national coverage position, but you might still get coverage if it's deemed medically necessary and you get approval. Let's learn more about if an FMT is right for you.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

What is an FMT and what are its benefits?

Fecal Microbiota Transplantation (FMT) is a medical procedure in which healthy bacteria from one individual's gastrointestinal tract are transplanted into another person's. FMT helps to restore balance in the digestive system, reduce inflammation, and improve overall health. It is particularly beneficial for those suffering from Clostridium difficile (C. difficile) infections, irritable bowel syndrome (IBS), ulcerative colitis, and Crohn's disease, as it has been found to be effective in treating these conditions.

What is the process of getting an FMT?

In most cases, an FMT is offered through a physician or clinic in the form of either a colonoscopy or an enema. After determining that you are a suitable candidate for an FMT, your doctor will collect and prepare the healthy donor stool sample needed for the transplantation. This sample is then carefully injected into your gastrointestinal tract with an endoscope or through an enema.

Medicare coverage of an FMT

At this time, Medicare does not have a national coverage determination for FMT. This means that Medicare will only cover FMT when it's considered medically necessary. If you are interested in this procedure, you should talk with your doctor to determine if it is a viable option for you. In some cases, your doctor may be able to provide the FMT service and bill Medicare for it or refer you to a specialist who does. You should also contact your local Medicare office to see if they have any coverage policies that include FMT.

How much will it cost you to get an FMT done?

The cost of an FMT varies depending on the clinic or doctor performing the procedure and how extensive it is. Generally, you should expect to pay between $2,000 and $5,000 for a full course of treatment. It's important to note that Medicare does not usually cover these costs. Talk with your Medicare plan provider to see what it might cost for your specific situation.

Risks associated with getting FMT done

While an FMT is generally considered safe, there are still some potential risks associated with the procedure. These include allergic reactions to donor stool, infection, and even rare cases of intestinal blockages. It's important to talk to your doctor about these risks before undergoing FMT so that you can make an informed decision about whether or not it is the right choice for you.

How long will the results of the procedure last?

The effects of an FMT typically last for several months but can sometimes be longer, depending on the individual. Continue to follow up with your doctor after undergoing the procedure to monitor your progress and make sure that any conditions you may have are being appropriately managed.

Will I need to take any special precautions after getting the treatment done?

The best way to ensure that you get the most benefit from your FMT is to follow your doctor's instructions for post-treatment care. This may include taking probiotics and/or other medications to help maintain the balance of bacteria in your digestive system and get regular checkups with your physician. Additionally, it's important to continue to practice good hygiene, such as washing your hands frequently and avoiding raw foods that may contain bacteria or parasites. With careful management and proactive care, it's possible to enjoy the long-term benefits of FMT.

Conclusion

Overall, an FMT can be an effective treatment for a variety of conditions and may help improve your overall health and quality of life. Talk to your doctor about whether or not it is a viable option for you, and make sure to inquire about any coverage policies that might apply to you through Medicare. This content is for informational purposes only. Fair Square Medicare is here for you through each step of your Medicare journey. Give us a call today.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

Recommended Articles

Person receiving a vaccine stock photo
Is the Shingles Vaccine Covered by Medicare?
Nov 17, 2022
Cover image
Medicare Advantage MSA Plans
May 17, 2023
20 Q's with Fair Square
20 Questions to Ask Your Medicare Agent
Mar 17, 2023
Senior woman checking blood pressure/heart rate at home stock photo
Does Medicare Cover Home Heart Monitors?
Dec 1, 2022
senior man with his glasses in his hand working in front of his laptop stock photo
Can I Change Medicare Advantage Plans Any Time? | Medicare Plans
Sep 19, 2022
Cover image
Does Your Plan Include A Free Gym Membership?
Jul 12, 2023
a doctor tells her patient she doesn't accept medicare. the patient wonders what to do stock image
What to Do When Your Doctor Doesn't Take Medicare
Feb 24, 2023
Illustrated referential images of a hospital bill, coins, cash in a wallet, a calculator, and a magnifying glass
What Are Medicare Part B Excess Charges?
Jan 6, 2023
Medicare Enrollment Periods stock image
Explaining the Different Enrollment Periods for Medicare
Feb 3, 2023
Doctor demonstrating upper cervical spine anatomy stock photo
Does Medicare Cover Cervical Disc Replacement?
Jan 20, 2023
doctor consulting their patient stock image
Does Medicare Cover the Urolift Procedure?
Dec 6, 2022
Medigap stock image
When Can You Change Medicare Supplement Plans?
Nov 18, 2022
Cover image
Why You Should Keep Your Medigap Plan
Sep 21, 2023
senior couple doing yoga stock image
13 Best Ways for Seniors to Stay Active in Columbus
Mar 8, 2023
Sinusitis. stock illustration
Is Balloon Sinuplasty Covered by Medicare?
Dec 1, 2022
A doctor with a clipboard consults a female patient with cancer
Does Medicare Cover Inqovi?
Jan 11, 2023
Cover image
2024 Medicare Price Changes
Oct 30, 2023
Costco & Fair Square
Costco Pharmacy Partners with Fair Square
Jan 13, 2023

More of our articles

13 Best Ways for Seniors to Stay Active in Phoenix

14 Best Ways for Seniors to Stay Active in Nashville

14 Best Ways for Seniors to Stay Active in Washington, D.C.

Can I Choose Marketplace Coverage Instead of Medicare?

Can I Have Two Primary Care Physicians?

Can I Laminate My Medicare Card?

Do All Hospitals Accept Medicare Advantage Plans?

Do I Need to Renew My Medicare?

Do Medicare Supplement Plans Cover Dental and Vision?

Do You Need Medigap if You're Eligible for Both Medicare and Medicaid?

Does Medicare Cover an FMT?

Does Medicare Cover Boniva?

Does Medicare Cover Breast Implant Removal?

Does Medicare Cover Cala Trio?

Does Medicare Cover Cardiac Ablation?

Does Medicare Cover Cold Laser Therapy (CLT)?

Does Medicare Cover ESRD Treatments?

Does Medicare Cover Geri Chairs?

Does Medicare cover Hyoscyamine?

Does Medicare Cover Hypnotherapy?

Does Medicare Cover Incontinence Supplies?

Does Medicare Cover Jakafi?

Does Medicare Cover Krystexxa?

Does Medicare Cover Light Therapy for Psoriasis?

Does Medicare Cover Linx Surgery?

Does Medicare Cover Lipoma Removal?

Does Medicare Cover Medical Marijuana?

Does Medicare Cover Mental Health?

Does Medicare Cover Ofev?

Does Medicare Cover PTNS?

Does Medicare Cover Scleral Lenses?

Does Medicare Cover Service Animals?

Does Medicare Cover SIBO Testing?

Does Medicare Cover TENS Units?

Does Medicare Cover the WATCHMAN Procedure?

Does Medicare Cover Xiafaxan?

Does Medicare Pay for Antivenom?

Does Retiring at Age 62 Make Me Eligible for Medicare?

Everything About Your Medicare Card + Medicare Number

Fair Square Client Newsletter: AEP Edition

Finding the Best Dental Plans for Seniors

Finding the Best Vision Plans for Seniors

Health Savings Accounts (HSAs) and Medicare

How Are Medicare Star Ratings Determined?

How Can I Get a Replacement Medicare Card?

How Do I Sign up for Medicare? A Simple How-To Guide For You

How Do Medicare Agents Get Paid?

How is Medicare Changing in 2023?

How Medicare Costs Can Pile Up

How Much Does Trelegy Cost with Medicare?

How to Apply for Medicare?

How to Enroll in Social Security

Is Emsella Covered by Medicare?

Is Gainswave Covered by Medicare?

Is PAE Covered by Medicare?

Medicare Advantage Plans for Disabled People Under 65

Medicare Explained

Medicare Savings Programs in Kansas

Medicare Supplement Plans for Low-Income Seniors

Medigap vs. Medicare Advantage

Plan G vs. Plan N

Should You Work With A Remote Medicare Agent?

The Fair Square Bulletin: September 2023

Top 10 Physical Therapy Clinics in San Diego

What Does Medicare Cover for Stroke Patients?

What Is a Medicare Advantage POS Plan?

What Is a Medicare Supplement SELECT Plan?

What Is Medical Underwriting for Medigap?

What People Don't Realize About Medicare

What You Need to Know About Creditable Coverage

What's the Difference Between HMO and PPO Plans?

Will Medicare Cover it?

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.
Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2023

Terms of Use
Notice of Privacy Practices

Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2022 Help Button Inc

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

MULTIPLAN_FairSquareMedicare_01062022_M