Knee replacement and all of the care you will need before and after surgery is costly. Most insurance plans cover many of these costs. However, finding out the total cost weeks before your surgery can save you trouble and money afterward.
The cost of knee replacement may vary in different parts of the United States and between different hospitals and surgeons. It can cost anywhere between $16,000 and $70,000 without any insurance in the United States. But it may cost more or less in your area.
This amount includes the cost of:
Serious complications during or after surgery may add extra costs -- up to $20,000 or more.
Most health insurance plans and Medicare pay for most of the costs of knee-replacement surgery. Your surgeon's office and your hospital may call your insurance company directly to discuss your coverage for knee replacement.
Even if your insurance covers your knee-replacement surgery, you may still need to pay part of your bill. Most insurance plans have copays, coinsurance, deductibles, or out-of-pocket expenses. These are the costs that you pay.
Often, your surgeon and the hospital can tell you what part of the costs are covered and what you will need to pay yourself.
Check to see whether your insurance will also cover:
Sometimes, your insurance will not pay for care unless they approve it before the care occurs. This is called "preauthorization." Find out exactly what your insurance company will cover before you have surgery. Be sure to ask:
If your insurance company denies or refuses to cover your surgery, you can appeal this decision. Find out why your coverage was denied and submit an appeal. Do all of this long before you go to the hospital for your surgery.
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