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.
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.
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.
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.
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.
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.
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.
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.
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.
Medicare Guaranteed Issue Rights by State
Feb 10, 2023
When to Choose Medicare Advantage over Medicare Supplement
Jun 7, 2023
2025 Medicare Price Changes
Oct 30, 2023
Does Medicare Pay for Funeral Expenses?
Dec 6, 2022
Gap Health Insurance: The Secret Sidekick to Your High-Deductible Plan
Jul 14, 2025
What is the 8-Minute Rule on Medicare?
Dec 21, 2022
Medicare Deductibles Resetting in 2025
Jan 18, 2024
Does Medicare Cover Urodynamic Testing?
Dec 2, 2022
Does Medicare Cover Bladder Sling Surgery?
Jan 11, 2023
Does Medicare Cover Abortion Services?
Dec 13, 2022
How Do Medicare Agents Get Paid?
Apr 12, 2023
Will Medicare Cover it?
Oct 3, 2023
Welcome to Fair Square's First Newsletter
Feb 28, 2023
Why Is Medicare So Confusing?
Apr 19, 2023
What to Do When Your Doctor Leaves Your Network
Jul 15, 2025
What Happens to Unused Medicare Set-Aside Funds?
Jan 20, 2023
Does Medicare Cover Inqovi?
Jan 11, 2023
Does Medicare Cover Cervical Disc Replacement?
Jan 20, 2023
13 Best Ways for Seniors to Stay Active in Columbus
13 Best Ways for Seniors to Stay Active in Jacksonville
14 Best Ways to Stay Active in Charlotte
Can Doctors Choose Not to Accept Medicare?
Can I Choose Marketplace Coverage Instead of Medicare?
Can I switch From Medicare Advantage to Medigap?
Comparing All Medigap Plans | Chart Updated for 2025
Costco Pharmacy Partners with Fair Square
Do I Need to Renew My Medicare?
Do Medicare Supplement Plans Cover Dental and Vision?
Does Medicare Cover Air Purifiers?
Does Medicare Cover Breast Implant Removal?
Does Medicare Cover Cataract Surgery?
Does Medicare Cover Cold Laser Therapy (CLT)?
Does Medicare cover Deviated Septum Surgery?
Does Medicare Cover Diabetic Eye Exams?
Does Medicare Cover Flu Shots?
Does Medicare Cover Fosamax?
Does Medicare Cover Hearing Aids?
Does Medicare Cover Hepatitis C Treatment?
Does Medicare cover Hyoscyamine?
Does Medicare Cover Ilumya?
Does Medicare Cover Inspire for Sleep Apnea?
Does Medicare Cover Iovera Treatment?
Does Medicare Cover Jakafi?
Does Medicare Cover Ketamine Infusion for Depression?
Does Medicare Cover Krystexxa?
Does Medicare Cover Kyphoplasty?
Does Medicare Cover Light Therapy for Psoriasis?
Does Medicare Cover LVAD Surgery?
Does Medicare Cover Ofev?
Does Medicare Cover Oxybutynin?
Does Medicare Cover Penile Implant Surgery?
Does Medicare Cover RSV Vaccines?
Does Medicare Cover Shock Wave Therapy for Plantar Fasciitis?
Does Medicare Cover the Urolift Procedure?
Does Medicare Cover Tymlos?
Does Medicare Cover Wart Removal?
Does Medicare Cover Xiafaxan?
Does Medicare Require a Referral for Audiology Exams?
Does Your Plan Include A Free Gym Membership?
Everything About Your Medicare Card + Medicare Number
Fair Square Bulletin: We're Revolutionizing Medicare
Fair Square Client Newsletter: AEP Edition
Finding the Best Vision Plans for Seniors
Health Savings Accounts (HSAs) and Medicare
How Does Medicare Cover Colonoscopies?
How Does the End of the COVID-19 Public Health Emergency Affect Your Medicare?
How Much Does a Medicare Coach Cost?
How Much Does Medicare Part B Cost in 2025?
How Much Does Rexulti Cost with Medicare?
How to Compare Medigap Plans in 2025
Is Botox Covered by Medicare?
Is HIFU Covered by Medicare?
Is PAE Covered by Medicare?
Is the Shingles Vaccine Covered by Medicare?
Medicare 101
Medicare Advantage Plans for Disabled People Under 65
Medigap Plan N vs. Plan G — Which One Fits You in 2025?
Seeing the Value in Fair Square
Should You Work With A Remote Medicare Agent?
The Fair Square Bulletin: October 2023
Top 10 Physical Therapy Clinics in San Diego
What Are Medicare Part B Excess Charges?
What is a Medicare Beneficiary Ombudsman?
What is Plan J?
What is the Medicare ICEP?
What People Don't Realize About Medicare
What To Do If Your Medicare Advantage Plan Is Discontinued
What You Need to Know About Creditable Coverage
What's the Difference Between HMO and PPO Plans?
Which Medigap Policies Provide Coverage for Long-Term Care?
Get the Fair Square Bulletin
Medicare savings tips, helpful guides, and more.
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. © 2025 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
Fair Square Medicare