Yes, Medicare covers knee replacement surgery if it is considered to be medically necessary by your doctor. Both Medicare Part A and Medicare Part B (Original Medicare) may contribute to different aspects of the procedure.
If you have a Medicare Advantage plan (Medicare Part C), it may provide the same coverage for your knee replacement.
Knee replacement surgeries are common in the United States. According to Forbes, more than one million knee replacement procedures were completed between 2005 and 2015. Many of the people who received these surgeries were Medicare beneficiaries.1
Medicare typically covers a number of surgeries that are considered medically necessary, including knee and other joint replacement surgeries. How much Medicare will pay for your knee replacement surgery depends on where you receive the procedure.
If you get your surgery in a hospital and are admitted as an inpatient, you can expect both Medicare Part A and Part B to contribute. Part A will help pay your hospital costs, and Part B will cover medical costs associated with the procedure.
If you have a Medicare Advantage plan, your plan will offer the same benefits as Original Medicare. Some Medicare Advantage plans may also offer cost-savings benefits that could help you pay less out of pocket for your knee replacement surgery.
For both Original Medicare and Medicare Advantage plans, deductibles, coinsurance and copayments may apply.
If you receive the surgery in an ambulatory surgery center or outpatient setting, you may pay a different amount.
Because Medicare Advantage plans must offer the same benefits as Medicare Part A and Medicare Part B, your Medicare Advantage plan should cover your knee replacement surgery if a doctor says it is medically necessary.
If you’re eligible for Medicare enrollment or are interested in changing to a Medicare Advantage plan, call a licensed insurance agent today to see what Medicare Advantage plans are available in your area.
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1 Ubel, Peter. Medicare Is Reducing The Cost Of Knee Replacements (Here’s How That Could Backfire). (Feb. 10, 2017). Forbes. Retrieved from www.forbes.com/sites/peterubel/2017/02/10/medicare-is-reducing-the-cost-of-knee-replacements-heres-how-that-could-backfire/#279a55416392.
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