Knee replacement surgery is something that some Americans undergo as they age. According to 2015 statistics from The Journal of Bone and Joint Surgery, around 7 million Americans are living with a hip or knee replacement. Show
If you have Medicare, you may be wondering if knee replacement surgery is covered. Read on to find out details. Does Medicare Cover Knee Replacement?Yes, Medicare covers knee replacement surgery if it's deemed to be medically necessary. Healthcare.gov defines the term medically necessary as "health care services or supplies needed to diagnose or treat an illness, injury, condition, disease or its symptoms and that meet accepted standards of medicine." In other words, your doctor determines whether your knee replacement is medically necessary. Costs for Knee Replacement SurgeryThe costs for knee replacement surgery go beyond just the surgery itself. Also included are the initial diagnosis, referrals and recovery. Knee replacement surgery and associated procedures are covered under different parts of Medicare. Medicare Part AIf you are admitted to the hospital for the knee replacement surgery or after, those costs would be covered under Medicare Part A. During recovery, if a stay at a skilled nursing facility is required, these costs also fall under Part A. Medications, clinical services and testing may be covered under Part A or under Part B depending on the specific service. Medicare Part BInitial screenings, treatment from your primary care doctor, referrals to an orthopedic specialist and other outpatient services are all covered under Medicare Part B. The actual knee replacement surgery itself, if it is medically necessary, is typically performed as an outpatient procedure and would also be covered under Part B. Medicare Part DIf you are prescribed medication to treat pain post-surgery or help ward off infection, those prescriptions would be covered under a Medicare Part D plan. How Much Does a Knee Replacement Cost With Medicare?The total cost of a knee replacement with Medicare is going to vary depending on your coverage. Remember that you have to meet your deductible first for services to be covered under Medicare. Your out-of-pocket costs are going to depend on your specific plan. Check with your Medicare plan representative to find out more information about specific costs related to knee replacement surgery. The Centers for Medicare and Medicaid Services provides coverage for surgeries like knee replacements, as long as they are deemed medically necessary by your doctor. Both parts of Original Medicare — Part A and Part B — may contribute to different aspects of your care related to the procedure. To find out how Medicare Supplement Insurance could help with some your out-of-pocket costs, speak with a licensed agent at 1-800-995-4219. How Much Does Knee Replacement Cost With Medicare?Knee replacements are considered a common surgery in the United States, with more than 660,000 procedures done annually as of 2016 according to The New York Times. Because it's difficult to know exactly what services you'll need to have a successful surgery until it's happening, there is no way of knowing exactly how much it will cost beforehand. Medicare and Knee Replacement Surgery RehabDoes Medicare pay for knee replacement? Medicare Part A covers many inpatient hospital and rehabilitation services you may need after having knee replacement surgery, including a semi-private room, meals and necessary medicine. It can also help with skilled nursing care after the surgery. There is no Medicare knee replacement age limit. However, in order for Medicare to pay for knee replacement surgery, you must be enrolled in Medicare and meet the Medicare Part A deductible. In 2022, the Medicare Part A deductible is $1,556 per benefit period. If your doctor suggests services not covered by Medicare during your recovery, you may be responsible for paying some or all of the additional costs. This cost of the procedure itself may incur additional out-of-pocket costs. Medicare Part B will help pay for outpatient care, like doctor visits. It comes with a $233 annual deductible in 2022. After meeting the deductible, you typically pay 20 percent of the Medicare-approved amount for services. Medicare Supplement Insurance can help cover your out-of-pocket knee replacement surgery costs.Find a plan Or call 1-800-995-4219 to speak with a licensed insurance agent. As we age, our joints naturally begin to break down due to wear, but this process can be exacerbated by excess weight and injury. In particular, the knee joint is one of the most susceptible to damage over time, and when severe wear or injury strikes the knee, mobility can become incredibly limited. Thankfully, knee replacement surgery has come a long way in recent decades, allowing people to undergo
minimally invasive procedures with faster healing times and more permanent replacement parts. This is good news for aging Americans as it means that fewer seniors have to suffer from mobility issues and can enjoy a great quality of life for longer periods of time. Likewise, the materials used in modern knee replacements are engineered more accurately and can be customized to fit each patient, allowing for fewer follow-up appointments and less resources spent by healthcare professionals Medicare
Coverage for Knee Replacement Surgery In order to be considered a good candidate for knee replacement surgery, you first need to receive screenings and treatment from your primary
care physician who participates in Medicare and accepts assignment. Your primary doctor may also refer you to an orthopedic specialist. These doctors’ services are covered under Medicare Part B as they are performed on an outpatient basis. If surgery is the medically necessary option, then the surgery itself will be performed at a surgical center and should also be covered under Medicare Part B as an outpatient service. If you are admitted into a hospital for the surgery, Part A will help cover
the costs of your stay. Medicare Coverage During Recovery After you return home after your surgery, you will likely need follow-up care and monitoring to determine if the surgery was a success or if further corrective action is required. These visits will once again be a part of Medicare Part B coverage. If any medications are prescribed to treat things like pain, to ward off infection or to strengthen tissue, these drugs will likely be covered under the prescription drug benefits outlined in Medicare Part D. Understanding Your Plan’s Deductible Keep in mind that knee replacement surgery, like all other major surgeries, can be expensive on your own, so make sure you understand your plan’s benefits prior to undergoing surgery. If surgery is not within your budget at the moment, you and your doctor may be able to find temporary alternative treatments through orthopedic support systems until the time is right to have the procedure. Related articles: Medicare Part A New to Medicare Does Medicare cover a knee joint replacement?Yes, but the surgery must be medically necessary
Original Medicare only helps pay for surgical procedures that are medically necessary. Your doctor would need to determine that your knee surgery is medically necessary.
Does Medicare Part B cover knee surgery?Original Medicare, which is Medicare parts A and B, will cover the cost of knee replacement surgery — including parts of your recovery process — if your doctor properly indicates that the surgery is medically necessary.
What is Medicare criteria for knee replacement?How does Medicare cover knee replacements? Getting a knee replaced requires surgery. And since Medicare only covers surgical procedures that are deemed medically necessary, your knee replacement surgery must be deemed medically necessary by your doctor for Medicare to cover it.
Does Medicare pay for rehab after knee surgery?Medicare covers inpatient rehab in a skilled nursing facility – also known as an SNF – for up to 100 days. Rehab in an SNF may be needed after an injury or procedure, like a hip or knee replacement.
|
Does medicare pay for knee replacement surgery
Related Posts
Copyright © 2024 mempelajari Inc.
