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Medicare covers most knee replacement surgery options. Depending on the type of surgery and the facility, Original Medicare or Medicare Advantage may pay a portion.
Medicare covers various surgical procedures, including knee replacement. Learn about some options for this surgery and how the coverage works out.
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A study of United States community hospitals showed that in 2012, among hospitalizations that involved an OR procedure, knee arthroplasty was the OR procedure performed most frequently during hospital stays paid by Medicare (10.8 percent of stays) and by private insurance (9.1 percent).
Many purchase private Medicare Supplement Plans [10]) to cover co-pays, co-insurance and/or deductibles. They may enroll separately in a Part D Prescription Drug Plan for coverage of prescription drugs. [7]: 8 Other plan types, such as 1876 Cost plans, are available in some areas. Cost plans are not Medicare Advantage plans and are not capitated.
With an aggregate cost of $14.8 billion ($15,400 per stay), it was the second-most expensive condition seen in US hospital stays in 2011. By payer, it was the second-most costly condition billed to Medicare and private insurance. [194] [195]
Simply put, Medicare provides U.S. federal health insurance for people aged 65 and over. You can see any doctor or seek care in any U.S. hospital that accepts Medicare patients.
The coverage of a patient's plan, deductibles, and insurance company will determine how much the patient will pay in copays. [43] Despite the complexity of the procedure and numerous doctor's visits involved, 80–90% of patients who have had the surgery said they had favorable results. [44]