Yes, Medicare may cover hip replacement surgery if your doctor says it is medically necessary.
Medicare Part A and Medicare Part B both may help pay for a variety of medically necessary surgeries and procedures, including joint replacements.
Medicare Advantage plans (Medicare Part C) can also cover hip replacement. Many Medicare Advantage plans also offer prescription drug coverage and benefits such as bathroom grab bars in your home, both of which are not covered by Medicare Part A or Part B.
A damaged hip joint can be replaced with an artificial prosthesis in order to alleviate pain and help patients enjoy a better quality of life.
The Centers for Disease Control and Prevention state that more than 325,000 hip replacements were completed in 2010.1 More than half of those were for patients 65 or older — people who are eligible for Medicare due to age.
The average cost of a hip replacement surgery can be more than $40,000.2
The significant cost of a hip replacement procedure is one reason to make sure you understand your Medicare coverage.
If you undergo hip replacement surgery and are admitted as a hospital inpatient, you can expect both Medicare Part A and Medicare Part B to contribute to your care.
You could be responsible for meeting both Medicare Part A and Part B deductibles, as well as any applicable copayments or coinsurance. If you are an outpatient, your bill may look different.
If you have a Medicare Advantage plan (Medicare Part C), you may have to pay deductibles, copayments and coinsurance in accordance with your particular plan. Because Medicare Advantage plans cover the same benefits that are offered by Medicare Part A and Part B, a Medicare Advantage plan may also cover hip replacement surgery if it is medically necessary.
The price of hip replacement surgery can vary by provider, and your out-of-pocket responsibilities can differ based on how you receive your Medicare benefits. Talk to you doctor to ensure you understand how your coverage works before you schedule your surgery.
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1 Centers for Disease Control and Prevention. Hospitalization for Total Hip Replacement Among Inpatients Aged 45 and Over: United States, 2000-2010. (Feb. 2015). Retrieved from https://www.cdc.gov/nchs/products/databriefs/db186.htm.
2 Charles, Shamard, MD. In and Out: Hip surgery in the morning, home by night. (Dec. 22, 2017). NBC News. Retrieved from https://www.nbcnews.com/health/health-news/out-hip-surgery-morning-home-night-n823021.
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